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Dia AK, Ebrahimpour L, Yolchuyeva S, Tonneau M, Lamaze FC, Orain M, Coulombe F, Malo J, Belkaid W, Routy B, Joubert P, Després P, Manem VSK. The Cross-Scale Association between Pathomics and Radiomics Features in Immunotherapy-Treated NSCLC Patients: A Preliminary Study. Cancers (Basel) 2024; 16:348. [PMID: 38254838 PMCID: PMC10813866 DOI: 10.3390/cancers16020348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Recent advances in cancer biomarker development have led to a surge of distinct data modalities, such as medical imaging and histopathology. To develop predictive immunotherapy biomarkers, these modalities are leveraged independently, despite their orthogonality. This study aims to explore the cross-scale association between radiological scans and digitalized pathology images for immunotherapy-treated non-small cell lung cancer (NSCLC) patients. METHODS This study involves 36 NSCLC patients who were treated with immunotherapy and for whom both radiology and pathology images were available. A total of 851 and 260 features were extracted from CT scans and cell density maps of histology images at different resolutions. We investigated the radiopathomics relationship and their association with clinical and biological endpoints. We used the Kolmogorov-Smirnov (KS) method to test the differences between the distributions of correlation coefficients with the two imaging modality features. Unsupervised clustering was done to identify which imaging modality captures poor and good survival patients. RESULTS Our results demonstrated a significant correlation between cell density pathomics and radiomics features. Furthermore, we also found a varying distribution of correlation values between imaging-derived features and clinical endpoints. The KS test revealed that the two imaging feature distributions were different for PFS and CD8 counts, while similar for OS. In addition, clustering analysis resulted in significant differences in the two clusters generated from the radiomics and pathomics features with respect to patient survival and CD8 counts. CONCLUSION The results of this study suggest a cross-scale association between CT scans and pathology H&E slides among ICI-treated patients. These relationships can be further explored to develop multimodal immunotherapy biomarkers to advance personalized lung cancer care.
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Affiliation(s)
- Abdou Khadir Dia
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
| | - Leyla Ebrahimpour
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (F.C.L.); (M.O.); (P.J.); (P.D.)
- Department of Physics, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Sevinj Yolchuyeva
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Marion Tonneau
- Lille Faculty of Medicine, University of Lille, 59020 Lille, France
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Fabien C. Lamaze
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (F.C.L.); (M.O.); (P.J.); (P.D.)
| | - Michèle Orain
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (F.C.L.); (M.O.); (P.J.); (P.D.)
| | - Francois Coulombe
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (F.C.L.); (M.O.); (P.J.); (P.D.)
| | - Julie Malo
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Wiam Belkaid
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Philippe Joubert
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (F.C.L.); (M.O.); (P.J.); (P.D.)
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Philippe Després
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (F.C.L.); (M.O.); (P.J.); (P.D.)
- Department of Physics, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Venkata S. K. Manem
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Quebec City, QC G1V 0A6, Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, QC G1V 0A6, Canada
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Yolchuyeva S, Ebrahimpour L, Tonneau M, Lamaze F, Orain M, Coulombe F, Malo J, Belkaid W, Routy B, Joubert P, Manem VS. Multi-institutional prognostic modeling of survival outcomes in NSCLC patients treated with first-line immunotherapy using radiomics. J Transl Med 2024; 22:42. [PMID: 38200511 PMCID: PMC10777540 DOI: 10.1186/s12967-024-04854-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have emerged as one of the most promising first-line therapeutics in the management of non-small cell lung cancer (NSCLC). However, only a subset of these patients responds to ICIs, highlighting the clinical need to develop better predictive and prognostic biomarkers. This study will leverage pre-treatment imaging profiles to develop survival risk models for NSCLC patients treated with first-line immunotherapy. METHODS Advanced NSCLC patients (n = 149) were retrospectively identified from two institutions who were treated with first-line ICIs. Radiomics features extracted from pretreatment imaging scans were used to build the predictive models for progression-free survival (PFS) and overall survival (OS). A compendium of five feature selection methods and seven machine learning approaches were utilized to build the survival risk models. The concordance index (C-index) was used to evaluate model performance. RESULTS From our results, we found several combinations of machine learning algorithms and feature selection methods to achieve similar performance. K-nearest neighbourhood (KNN) with ReliefF (RL) feature selection was the best-performing model to predict PFS (C-index = 0.61 and 0.604 in discovery and validation cohorts), while XGBoost with Mutual Information (MI) feature selection was the best-performing model for OS (C-index = 0.7 and 0.655 in discovery and validation cohorts). CONCLUSION The results of this study highlight the importance of implementing an appropriate feature selection method coupled with a machine learning strategy to develop robust survival models. With further validation of these models on external cohorts when available, this can have the potential to improve clinical decisions by systematically analyzing routine medical images.
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Affiliation(s)
- Sevinj Yolchuyeva
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, Canada
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada
| | - Leyla Ebrahimpour
- Quebec Heart & Lung Institute Research Center, Québec , Canada
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada
- Department of Physics, Laval University, Québec, Canada
| | - Marion Tonneau
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montreal, Canada
- Université de médecine de Lille, Lille, France
| | - Fabien Lamaze
- Quebec Heart & Lung Institute Research Center, Québec , Canada
| | - Michele Orain
- Quebec Heart & Lung Institute Research Center, Québec , Canada
| | | | - Julie Malo
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montreal, Canada
| | - Wiam Belkaid
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montreal, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montreal, Canada
| | - Philippe Joubert
- Quebec Heart & Lung Institute Research Center, Québec , Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Québec, Canada
| | - Venkata Sk Manem
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, Canada.
- Quebec Heart & Lung Institute Research Center, Québec , Canada.
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada.
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Yolchuyeva S, Giacomazzi E, Tonneau M, Lamaze F, Orain M, Coulombe F, Malo J, Belkaid W, Routy B, Joubert P, Manem VS. Imaging-Based Biomarkers Predict Programmed Death-Ligand 1 and Survival Outcomes in Advanced NSCLC Treated With Nivolumab and Pembrolizumab: A Multi-Institutional Study. JTO Clin Res Rep 2023; 4:100602. [PMID: 38124790 PMCID: PMC10730368 DOI: 10.1016/j.jtocrr.2023.100602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/18/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
Background Although the immune checkpoint inhibitors, nivolumab and pembrolizumab, were found to be promising in patients with advanced NSCLC, some of them either do not respond or have recurrence after an initial response. It is still unclear who will benefit from these therapies, and, hence, there is an unmet clinical need to build robust biomarkers. Methods Patients with advanced NSCLC (N = 323) who were treated with pembrolizumab or nivolumab were retrospectively identified from two institutions. Radiomics features extracted from baseline pretreatment computed tomography scans along with the clinical variables were used to build the predictive models for overall survival (OS), progression-free survival (PFS), and programmed death-ligand 1 (PD-L1). To develop the imaging and integrative clinical-imaging predictive models, we used the XGBoost learning algorithm with ReliefF feature selection method and validated them in an independent cohort. The concordance index for OS, PFS, and area under the curve for PD-L1 was used to evaluate model performance. Results We developed radiomics and the ensemble radiomics-clinical predictive models for OS, PFS, and PD-L1 expression. The concordance indices of the radiomics model were 0.60 and 0.61 for predicting OS and PFS and area under the curve was 0.61 for predicting PD-L1 in the validation cohort, respectively. The combined radiomics-clinical model resulted in higher performance with 0.65, 0.63, and 0.68 to predict OS, PFS, and PD-L1 in the validation cohort, respectively. Conclusions We found that pretreatment computed tomography imaging along with clinical data can aid as predictive biomarkers for PD-L1 and survival end points. These imaging-driven approaches may prove useful to expand the therapeutic options for nonresponders and improve the selection of patients who would benefit from immune checkpoint inhibitors.
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Affiliation(s)
- Sevinj Yolchuyeva
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Quebec, Canada
| | - Elena Giacomazzi
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Quebec, Canada
| | - Marion Tonneau
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Quebec, Canada
- Université de Médecine de Lille, Lille, France
| | - Fabien Lamaze
- Quebec Heart & Lung Institute Research Center, Quebec, Canada
| | - Michele Orain
- Quebec Heart & Lung Institute Research Center, Quebec, Canada
| | | | - Julie Malo
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Quebec, Canada
| | - Wiam Belkaid
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Quebec, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Quebec, Canada
- Centre Hospitalier Universitaire de Montréal, Hemato-Oncology Service, Quebec, Canada
| | - Philippe Joubert
- Quebec Heart & Lung Institute Research Center, Quebec, Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec, Canada
| | - Venkata S.K. Manem
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Quebec, Canada
- Quebec Heart & Lung Institute Research Center, Quebec, Canada
- Centre de Recherche du CHU de Québec – Université Laval, Quebec, Canada
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Proulx-Rocray F, Routy B, Nassabein R, Belkaid W, Tran-Thanh D, Malo J, Tonneau M, Ouarzadi OE, Florescu M, Tehfe M, Blais N. The prognostic impact of KRAS, TP53, STK11 and KEAP1 mutations and their influence on the NLR in NSCLC patients treated with immunotherapy. Cancer Treat Res Commun 2023; 37:100767. [PMID: 37832364 DOI: 10.1016/j.ctarc.2023.100767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 08/23/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND PD-L1 expression is used to predict NSCLC response to ICIs, but its performance is suboptimal. The impact of KRAS mutations in these patients is unclear. Studies evaluating co-mutations in TP53, STK11 and KEAP1 as well as the NLR showed that they may predict the benefit of ICIs. PATIENTS & METHODS This is a retrospective study of patients with NSCLC treated with ICIs at the CHUM between July 2015 and June 2020. OS and PFS were compared using Kaplan-Meier and logrank methods. Co-mutations in TP53, STK11 and KEAP1 as well as the NLR were accounted for. ORR and safety were compared using Wald method. RESULTS From 100 patients with known KRAS status, 50 were mutated (KRASMut). Mutation in TP53, STK11 and KEAP1 were present, and their status known in, respectively, 19/40 (47.5 %), 8/39 (20.5 %) and 4/38 (10.5 %) patients. STK11Mut and KEAP1Mut were associated with shorter overall survival when compared with wild type tumors (respectively median OS of 3.3 vs 20.4, p = 0.0001 and 10.1 vs 17.7, p = 0.24). When KRAS status was compounded with STK11/KEAP1, KRASMut trended to a better prognosis in STK11+KEAP1WT tumors (median OS 21.1 vs 15.8 for KRASWT, p = 0.15), but not for STK11+/-KEAP1Mut tumors. The NLR was strongly impacted by STK11 (6.0Mutvs 3.6WT, p = 0.014) and TP53 (3.2Mutvs 4.8WT, p = 0.048), but not by KEAP1 or KRAS mutations. CONCLUSION STK11Mut and KEAP1Mut are adverse predictors of ICI therapy benefit. The NLR is strongly impacted by STK11Mut but not by KEAP1Mut, suggesting differences in their resistance mechanism. In STK11-KEAP1WT tumors, KRASMut seem associated with improved survival in NSCLC patients treated with ICIs. MICROABSTRACT Response of NSCLC to immunotherapy is not easily predictable. We conducted a retrospective study in 100 patients with NSCLC and a known KRAS status. By accounting for different co-mutations, KRAS mutation was found to be associated with a better median overall survival in STK11 and KEAP1 wild-type tumors (21.1 vs 15.8, p = 0.15). NLR was impacted by STK11, but not KEAP1 mutation, suggesting a difference in their resistance mechanism.
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Affiliation(s)
- Francis Proulx-Rocray
- Medical Oncology Department, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet Street, Montreal, QC, Canada
| | - Bertrand Routy
- Medical Oncology Department, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet Street, Montreal, QC, Canada; Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Rami Nassabein
- Medical Oncology Department, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet Street, Montreal, QC, Canada
| | - Wiam Belkaid
- Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Danh Tran-Thanh
- Pathology Department, Centre Hospitalier de l'Université de Montréal, 1051 Sanguinet Street, Montreal, QC, Canada
| | - Julie Malo
- Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Marion Tonneau
- Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Omar El Ouarzadi
- Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Marie Florescu
- Medical Oncology Department, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet Street, Montreal, QC, Canada; Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Mustapha Tehfe
- Medical Oncology Department, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet Street, Montreal, QC, Canada; Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada
| | - Normand Blais
- Medical Oncology Department, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet Street, Montreal, QC, Canada; Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, 900 Saint-Denis Street, Montreal, QC, Canada.
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Diop K, Pidgeon R, Diop A, Benlaïfaoui M, Belkaid W, Malo J, Bernet E, Veyrier F, Jacq M, Brun Y, Elkrief A, Castagner B, Routy B, Richard C. Characterization and description of Gabonibacter chumensis sp. nov., isolated from feces of a patient with non-small cell lung cancer treated with immunotherapy. Arch Microbiol 2023; 205:338. [PMID: 37742282 PMCID: PMC10518271 DOI: 10.1007/s00203-023-03671-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023]
Abstract
A polyphasic taxonomic approach, incorporating analysis of phenotypic features, cellular fatty acid profiles, 16S rRNA gene sequences, and determination of average nucleotide identity (ANI) plus digital DNA-DNA hybridization (dDDH), was applied to characterize an anaerobic bacterial strain designated KD22T isolated from human feces. 16S rRNA gene-based phylogenetic analysis showed that strain KD22T was found to be most closely related to species of the genus Gabonibacter. At the 16S rRNA gene level, the closest species from the strain KD22T corresponded with Gabonibacter massiliensis GM7T, with a similarity of 97.58%. Cells of strain KD22T were Gram-negative coccobacillus, positive for indole and negative for catalase, nitrate reduction, oxidase, and urease activities. The fatty acid analysis demonstrated the presence of a high concentration of iso-C15: 0 (51.65%). Next, the complete whole-genome sequence of strain KD22T was 3,368,578 bp long with 42 mol% of DNA G + C contents. The DDH and ANI values between KD22T and type strains of phylogenetically related species were 67.40% and 95.43%, respectively. These phylogenetic, phenotypic, and genomic results supported the affiliation of strain KD22T as a novel bacterial species within the genus Gabonibacter. The proposed name is Gabonibacter chumensis and the type strain is KD22T (= CSUR Q8104T = DSM 115208 T).
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Affiliation(s)
- Khoudia Diop
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada.
| | - Reilly Pidgeon
- Department of Pharmacology & Therapeutics, Faculty of Medicine and Health Sciences, McGill University, 3655 Promenade Sir-William-Osler, Montreal, QC, H3G 1Y6, Canada
| | - Awa Diop
- Department of Biology, University of North Carolina Greensboro, 321 McIver Street, PO Box 26170, Greensboro, NC, 27402, USA
| | - Myriam Benlaïfaoui
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada
| | - Wiam Belkaid
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada
| | - Julie Malo
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada
| | - Eve Bernet
- INRS-Centre Armand-Frappier Santé Biotechnologie, Bacterial Symbionts Evolution, Laval, QC, H7V 1B7, Canada
| | - Frederic Veyrier
- INRS-Centre Armand-Frappier Santé Biotechnologie, Bacterial Symbionts Evolution, Laval, QC, H7V 1B7, Canada
| | - Maxime Jacq
- Faculty of Medicine, Department of Microbiology and Immunology, University of Montreal, Montreal, QC, Canada
| | - Yves Brun
- Faculty of Medicine, Department of Microbiology and Immunology, University of Montreal, Montreal, QC, Canada
| | - Arielle Elkrief
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada
| | - Bastien Castagner
- Department of Pharmacology & Therapeutics, Faculty of Medicine and Health Sciences, McGill University, 3655 Promenade Sir-William-Osler, Montreal, QC, H3G 1Y6, Canada
| | - Bertrand Routy
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada.
- Hematology-Oncology Service, Department of Medicine, University of Montreal Healthcare Centre (CHUM), Montreal, QC, H2X 0A9, Canada.
| | - Corentin Richard
- Laboratory of Immunotherapy and Onco-Microbiome, University of Montreal Healthcare Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada
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Yolchuyeva S, Giacomazzi E, Tonneau M, Ebrahimpour L, Lamaze FC, Orain M, Coulombe F, Malo J, Belkaid W, Routy B, Joubert P, Manem VSK. A Radiomics-Clinical Model Predicts Overall Survival of Non-Small Cell Lung Cancer Patients Treated with Immunotherapy: A Multicenter Study. Cancers (Basel) 2023; 15:3829. [PMID: 37568646 PMCID: PMC10417039 DOI: 10.3390/cancers15153829] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/14/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are a great breakthrough in cancer treatments and provide improved long-term survival in a subset of non-small cell lung cancer (NSCLC) patients. However, prognostic and predictive biomarkers of immunotherapy still remain an unmet clinical need. In this work, we aim to leverage imaging data and clinical variables to develop survival risk models among advanced NSCLC patients treated with immunotherapy. METHODS This retrospective study includes a total of 385 patients from two institutions who were treated with ICIs. Radiomics features extracted from pretreatment CT scans were used to build predictive models. The objectives were to predict overall survival (OS) along with building a classifier for short- and long-term survival groups. We employed the XGBoost learning method to build radiomics and integrated clinical-radiomics predictive models. Feature selection and model building were developed and validated on a multicenter cohort. RESULTS We developed parsimonious models that were associated with OS and a classifier for short- and long-term survivor groups. The concordance indices (C-index) of the radiomics model were 0.61 and 0.57 to predict OS in the discovery and validation cohorts, respectively. While the area under the curve (AUC) values of the radiomic models for short- and long-term groups were found to be 0.65 and 0.58 in the discovery and validation cohorts. The accuracy of the combined radiomics-clinical model resulted in 0.63 and 0.62 to predict OS and in 0.77 and 0.62 to classify the survival groups in the discovery and validation cohorts, respectively. CONCLUSIONS We developed and validated novel radiomics and integrated radiomics-clinical survival models among NSCLC patients treated with ICIs. This model has important translational implications, which can be used to identify a subset of patients who are not likely to benefit from immunotherapy. The developed imaging biomarkers may allow early prediction of low-group survivors, though additional validation of these radiomics models is warranted.
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Affiliation(s)
- Sevinj Yolchuyeva
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Elena Giacomazzi
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Marion Tonneau
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
- Université de Médecine de Lille—Université Henri Warembourg, 59020 Lille, France
| | - Leyla Ebrahimpour
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
- Department of Physics, Engineering Physics and Optics, Laval University, Quebec City, QC G1V 4G5, Canada
| | - Fabien C. Lamaze
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Michele Orain
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - François Coulombe
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Julie Malo
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Wiam Belkaid
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Philippe Joubert
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Québec City, QC G1V 0A6, Canada
| | - Venkata S. K. Manem
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
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Yolchuyeva S, Giacomazzi E, Tonneau M, Lamaze F, Orain M, Coulombe F, Malo J, Belkaid W, Routy B, Joubert P, Manem VSK. Radiomics approaches to predict PD-L1 and PFS in advanced non-small cell lung patients treated with immunotherapy: a multi-institutional study. Sci Rep 2023; 13:11065. [PMID: 37422576 PMCID: PMC10329671 DOI: 10.1038/s41598-023-38076-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023] Open
Abstract
With the increasing use of immune checkpoint inhibitors (ICIs), there is an urgent need to identify biomarkers to stratify responders and non-responders using programmed death-ligand (PD-L1) expression, and to predict patient-specific outcomes such as progression free survival (PFS). The current study is aimed to determine the feasibility of building imaging-based predictive biomarkers for PD-L1 and PFS through systematically evaluating a combination of several machine learning algorithms with different feature selection methods. A retrospective, multicenter study of 385 advanced NSCLC patients amenable to ICIs was undertaken in two academic centers. Radiomic features extracted from pretreatment CT scans were used to build predictive models for PD-L1 and PFS (short-term vs. long-term survivors). We first employed the LASSO methodology followed by five feature selection methods and seven machine learning approaches to build the predictors. From our analyses, we found several combinations of feature selection methods and machine learning algorithms to achieve a similar performance. Logistic regression with ReliefF feature selection (AUC = 0.64, 0.59 in discovery and validation cohorts) and SVM with Anova F-test feature selection (AUC = 0.64, 0.63 in discovery and validation datasets) were the best-performing models to predict PD-L1 and PFS. This study elucidates the application of suitable feature selection approaches and machine learning algorithms to predict clinical endpoints using radiomics features. Through this study, we identified a subset of algorithms that should be considered in future investigations for building robust and clinically relevant predictive models.
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Affiliation(s)
- Sevinj Yolchuyeva
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois Rivières, Canada
| | - Elena Giacomazzi
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois Rivières, Canada
| | - Marion Tonneau
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, Canada
- Université de médecine de Lille, Lille, France
| | - Fabien Lamaze
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada
| | - Michele Orain
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada
| | - François Coulombe
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada
| | - Julie Malo
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, Canada
| | - Wiam Belkaid
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, Canada
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec, Canada
| | - Venkata S K Manem
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois Rivières, Canada.
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada.
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Benlaïfaoui M, Richard C, Diop A, Naimi S, Belkaid W, Bernet E, Veyrier F, Elkrief A, Bobay LM, Routy B, Diop K. Tractidigestivibacter montrealensis sp. nov., a new member of human gut microbiota isolated from a healthy volunteer. FEMS Microbiol Lett 2023:fnad058. [PMID: 37348476 PMCID: PMC10396324 DOI: 10.1093/femsle/fnad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Strain KD21T, isolated from the fecal sample of a healthy female volunteer, is a strictly anaerobic, non-motile, Gram-staining-positive, saccharolytic small rod, that does not produce spores. Strain KD21T was able to grow in the range of temperature 28-37°C (optimum, 37 °C), pH 6.0-8.0 (optimum, pH 7.0), and with 0-5.0 g/L NaCl (optimum, 0 g/L NaCl). Bacteria cells reduced nitrates to nitrites. Its major fatty acids were C18:1ω9c, C16:0, C18:0 and summed in feature 8 (C18:1ω7c and/or C18:1ω6c). 16S rRNA gene phylogenetic analysis revealed that KD21T is a member of the genus Tractidigestivibacter and is distinct from any species with validly published names. The sequence showed 98.48% similarity with T. scatoligenes SK9K4T. The DNA G + C content of strain KD21T was 62.6 mol%. The DNA-DNA hybridization and OrthoANI values between strain KD21T and T. scatoligenes SK9K4T were were 40.2% and 90.2%, respectively. Differences in phenotypic, phylogenetic, chemotaxonomic, and genomic characteristics indicated that strain KD21T represents a novel species within the genus Tractidigestivibacter. The name Tractidigestivibacter montrealensis sp. nov. is proposed and the type strain is KD21T ( = CSUR Q8103T = DSM 115111T).
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Affiliation(s)
- Myriam Benlaïfaoui
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Corentin Richard
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Awa Diop
- Departement of Biology, University of North Carolina Greensboro, 321 Mclver Street, PO Box 26170, Greensboro, NC, USA
| | - Sabrine Naimi
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Wiam Belkaid
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Eve Bernet
- INRS-Centre Armand-Frappier Santé Biotechnologie, Bacterial Symbionts Evolution, Laval, QC H7V 1B7, QC, Canada
| | - Frederic Veyrier
- INRS-Centre Armand-Frappier Santé Biotechnologie, Bacterial Symbionts Evolution, Laval, QC H7V 1B7, QC, Canada
| | - Arielle Elkrief
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Louis-Marie Bobay
- Departement of Biology, University of North Carolina Greensboro, 321 Mclver Street, PO Box 26170, Greensboro, NC, USA
| | - Bertrand Routy
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
- Hematology-Oncology Service, Department of Medicine, University of Montreal Healthcare Centre (CHUM), Montreal, QC, Canada
| | - Khoudia Diop
- Laboratory of Immunotherapy and Onco-microbiome, University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
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9
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Tonneau M, Nolin-Lapalme A, Kazandjian S, Auclin E, Panasci J, Benlaifaoui M, Ponce M, Al-Saleh A, Belkaid W, Naimi S, Mihalcioiu C, Watson I, Bouin M, Miller W, Hudson M, Wong MK, Pezo RC, Turcotte S, Bélanger K, Jamal R, Oster P, Velin D, Richard C, Messaoudene M, Elkrief A, Routy B. Helicobacter pylori serology is associated with worse overall survival in patients with melanoma treated with immune checkpoint inhibitors. Oncoimmunology 2022; 11:2096535. [PMID: 35832043 PMCID: PMC9272833 DOI: 10.1080/2162402x.2022.2096535] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The microbiome is now regarded as one of the hallmarks of cancer and several strategies to modify the gut microbiota to improve immune checkpoint inhibitor (ICI) activity are being evaluated in clinical trials. Preliminary data regarding the upper gastro-intestinal microbiota indicated that Helicobacter pylori seropositivity was associated with a negative prognosis in patients amenable to ICI. In 97 patients with advanced melanoma treated with ICI, we assessed the impact of H. pylori on outcomes and microbiome composition. We performed H. pylori serology and profiled the fecal microbiome with metagenomics sequencing. Among the 97 patients, 22% were H. pylori positive (Pos). H. pylori Pos patients had a significantly shorter overall survival (p = .02) compared to H. pylori negative (Neg) patients. In addition, objective response rate and progression-free survival were decreased in H. pylori Pos patients. Metagenomics sequencing did not reveal any difference in diversity indexes between the H. pylori groups. At the taxa level, Eubacterium ventriosum, Mediterraneibacter (Ruminococcus) torques, and Dorea formicigenerans were increased in the H. pylori Pos group, while Alistipes finegoldii, Hungatella hathewayi and Blautia producta were over-represented in the H. pylori Neg group. In a second independent cohort of patients with NSCLC, diversity indexes were similar in both groups and Bacteroides xylanisolvens was increased in H. pylori Neg patients. Our results demonstrated that the negative impact of H. pylori on outcomes seem to be independent from the fecal microbiome composition. These findings warrant further validation and development of therapeutic strategies to eradicate H. pylori in immuno-oncology arena.
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Affiliation(s)
- Marion Tonneau
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Université de Médecine, Lille, France
| | - Alexis Nolin-Lapalme
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | | | - Edouard Auclin
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Justin Panasci
- Department of Oncology, McGill University Health Center, QC, Canada
| | - Myriam Benlaifaoui
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Mayra Ponce
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Afnan Al-Saleh
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Wiam Belkaid
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Sabrine Naimi
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | | | - Ian Watson
- Rosalind and Morris Goodman Cancer Institute, Montréal, QC, Canada
| | - Mickael Bouin
- Department of Gastroenterology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Wilson Miller
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Matthew K. Wong
- Division of Medical Oncology, Sunnybrook Health Sciences Center, Odette Cancer Center, QC, Canada
| | - Rossanna C. Pezo
- Division of Medical Oncology, Sunnybrook Health Sciences Center, Odette Cancer Center, QC, Canada
| | - Simon Turcotte
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Department of Surgery, Centre Hospitalier de l’Université de Montréal, QC, Canada
| | - Karl Bélanger
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Division of Hemato-Oncology, Centre Hospitalier de l’Université de Montréal (CHUM)Montreal, QC, Canada
| | - Rahima Jamal
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Division of Hemato-Oncology, Centre Hospitalier de l’Université de Montréal (CHUM)Montreal, QC, Canada
| | - Paul Oster
- Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Dominique Velin
- Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Corentin Richard
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Meriem Messaoudene
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Arielle Elkrief
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Bertrand Routy
- Axe Cancer, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Division of Hemato-Oncology, Centre Hospitalier de l’Université de Montréal (CHUM)Montreal, QC, Canada
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10
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Messaoudene M, Pidgeon R, Richard C, Ponce M, Diop K, Benlaifaoui M, Nolin-Lapalme A, Cauchois F, Malo J, Belkaid W, Isnard S, Fradet Y, Dridi L, Velin D, Oster P, Raoult D, Ghiringhelli F, Boidot R, Chevrier S, Kysela DT, Brun YV, Falcone EL, Pilon G, Oñate FP, Gitton-Quent O, Le Chatelier E, Durand S, Kroemer G, Elkrief A, Marette A, Castagner B, Routy B. A Natural Polyphenol Exerts Antitumor Activity and Circumvents Anti-PD-1 Resistance through Effects on the Gut Microbiota. Cancer Discov 2022; 12:1070-1087. [PMID: 35031549 PMCID: PMC9394387 DOI: 10.1158/2159-8290.cd-21-0808] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/26/2021] [Accepted: 01/11/2022] [Indexed: 01/07/2023]
Abstract
Several approaches to manipulate the gut microbiome for improving the activity of cancer immune-checkpoint inhibitors (ICI) are currently under evaluation. Here, we show that oral supplementation with the polyphenol-rich berry camu-camu (CC; Myrciaria dubia) in mice shifted gut microbial composition, which translated into antitumor activity and a stronger anti-PD-1 response. We identified castalagin, an ellagitannin, as the active compound in CC. Oral administration of castalagin enriched for bacteria associated with efficient immunotherapeutic responses (Ruminococcaceae and Alistipes) and improved the CD8+/FOXP3+CD4+ ratio within the tumor microenvironment. Moreover, castalagin induced metabolic changes, resulting in an increase in taurine-conjugated bile acids. Oral supplementation of castalagin following fecal microbiota transplantation from ICI-refractory patients into mice supported anti-PD-1 activity. Finally, we found that castalagin binds to Ruminococcus bromii and promoted an anticancer response. Altogether, our results identify castalagin as a polyphenol that acts as a prebiotic to circumvent anti-PD-1 resistance. SIGNIFICANCE The polyphenol castalagin isolated from a berry has an antitumor effect through direct interactions with commensal bacteria, thus reprogramming the tumor microenvironment. In addition, in preclinical ICI-resistant models, castalagin reestablishes the efficacy of anti-PD-1. Together, these results provide a strong biological rationale to test castalagin as part of a clinical trial. This article is highlighted in the In This Issue feature, p. 873.
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Affiliation(s)
- Meriem Messaoudene
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Reilly Pidgeon
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Corentin Richard
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Mayra Ponce
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Khoudia Diop
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Myriam Benlaifaoui
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Alexis Nolin-Lapalme
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Florent Cauchois
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Julie Malo
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Wiam Belkaid
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Stephane Isnard
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Yves Fradet
- Centre de recherche du CHU de Québec, Oncology Division, CHU de Québec, Université Laval, Québec City, Quebec, Canada
| | - Lharbi Dridi
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Dominique Velin
- Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Paul Oster
- Service of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Didier Raoult
- Aix Marseille Université, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | | | - Romain Boidot
- Unit of Molecular Biology, Department of Biology and Pathology of Tumors, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, France
- UMR CNRS 6302, Dijon, France
| | - Sandy Chevrier
- Unit of Molecular Biology, Department of Biology and Pathology of Tumors, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, France
| | - David T. Kysela
- Faculté de Médecine, Département de Microbiologie, Infectiologie et Immunologie, University of Montreal, Montreal, Quebec, Canada
| | - Yves V. Brun
- Faculté de Médecine, Département de Microbiologie, Infectiologie et Immunologie, University of Montreal, Montreal, Quebec, Canada
| | - Emilia Liana Falcone
- Department of Immunity and Viral Infections, Montreal Clinical Research Institute (IRCM), Montreal, Quebec, Canada
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Geneviève Pilon
- Department of Medicine, Faculty of Medicine, Cardiology Axis of the Québec Heart and Lung Institute and Institute of Nutrition and Functional Foods, Laval University, Québec City, Quebec, Canada
| | | | | | | | - Sylvere Durand
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Centre de Recherche des Cordeliers, Équipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris, France
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Centre de Recherche des Cordeliers, Équipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris, France
- Pôle de Biologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Arielle Elkrief
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - André Marette
- Department of Medicine, Faculty of Medicine, Cardiology Axis of the Québec Heart and Lung Institute and Institute of Nutrition and Functional Foods, Laval University, Québec City, Quebec, Canada
| | - Bastien Castagner
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Bertrand Routy
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Hematology-Oncology Division, Department of Medicine, University of Montreal Healthcare Centre (CHUM), Montreal, Quebec, Canada
- Corresponding Author: Bertrand Routy, Hemato-Oncology, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec H2X 3H8, Canada. Phone: 514-890-8000; E-mail:
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11
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Nassabein R, Weng X, Alameddine R, Blanc-Durand F, Belkaid W, Tehfe M, Florescu M, Routy B, Blais N. 1213P Clinical utility of liquid biopsy for the early diagnosis of EGFR mutant advanced lung cancer in a real-life setting (CLEAR). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Deschênes-Simard X, Richard C, Galland L, Blais F, Desilets A, Malo J, Cvetkovic L, Belkaid W, Elkrief A, Gagné A, Hamel MA, Orain M, Joubert P, Ghiringhelli F, Routy B, Blais N. Venous thrombotic events in patients treated with immune checkpoint inhibitors for non-small cell lung cancer: A retrospective multicentric cohort study. Thromb Res 2021; 205:29-39. [PMID: 34246011 DOI: 10.1016/j.thromres.2021.06.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Venous thrombotic events (VTEs) are a frequent complication of non-small cell lung cancer (NSCLC) and are associated with increased morbidity. Immune checkpoint inhibitors (ICIs) are revolutionizing the management of NSCLC, but little is known about their impact on thrombosis. This study aims to define the incidence and clinical relevance of VTEs in NSCLC patients receiving these treatments. METHODS A retrospective multicentric cohort study including 593 patients from three centers in Canada and France was performed. The cumulative incidence of VTEs after ICIs was estimated using competing risk analysis, and the association of these events with survival and response to treatment was determined. Finally, univariate and multivariate tests were performed to identify VTE risk factors. RESULTS The cumulative incidence of VTEs in the cohort was 14.8% (95% CI = 7.4-22.2%) for an incidence rate of 76.5 (95% CI = 59.9-97.8) thrombosis per 1000 person-years, with most thromboses occurring rapidly after treatment initiation. VTEs were not correlated with overall survival, progression-free survival, or objective response to ICIs. Age ˂ 65 years old (HR = 2.00; 95% CI = 1.11-3.59) and tumors with PD-L1 1-49% (HR = 3.36; 95% CI = 1.19-9.50) or PD-L1 ≥ 50% (HR = 3.22; 95% CI = 1.21-8.57) were associated with more VTEs after 12 months of ICI initiation. Also, a delay of less than 12 months from diagnosis to the first ICI treatment (HR = 2.06; 95% CI = 1.09-3.89) and active smoking (HR = 2.00; 95% CI = 1.12-3.58) are probable risk factors of VTEs. CONCLUSION This study suggests that the incidence of VTEs in NSCLC patients treated with ICIs is comparable to what is reported in other cohorts of patients treated with chemotherapy. In our cohort, VTEs were not associated with a decreased survival or response to therapy. Patient age < 65 and tumors with PD-L1 ≥ 1% were associated with a higher risk of VTEs under ICIs.
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Affiliation(s)
- Xavier Deschênes-Simard
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Corentin Richard
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Loïck Galland
- Dijon Bourgogne University Hospital, 2 Boul. du Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Florence Blais
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Antoine Desilets
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Julie Malo
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Lena Cvetkovic
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Wiam Belkaid
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Arielle Elkrief
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Andréanne Gagné
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Marc-André Hamel
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Michèle Orain
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Philippe Joubert
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - François Ghiringhelli
- Dijon Bourgogne University Hospital, 2 Boul. du Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Bertrand Routy
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Normand Blais
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada.
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13
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Nassabein R, Gaudreau PO, Belkaid W, Florescu M, Blais N. A phase I/II study of pembrolizumab in combination with nab-paclitaxel in patients with unresectable stage III or stage IV non small-cell lung carcinoma (NSCLC). Cancer Treat Res Commun 2021; 28:100421. [PMID: 34119763 DOI: 10.1016/j.ctarc.2021.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Rami Nassabein
- Hematology and Medical Oncology Service, Department of Medicine, Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, H2 X 3E4, Canada
| | | | - Wiam Belkaid
- Hematology and Oncology, Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis St, Montreal, QC, H2 X 0A9, Canada
| | - Marie Florescu
- Hematology and Medical Oncology Service, Department of Medicine, Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, H2 X 3E4, Canada
| | - Normand Blais
- Hematology and Medical Oncology Service, Department of Medicine, Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, H2 X 3E4, Canada; Hematology and Oncology, Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis St, Montreal, QC, H2 X 0A9, Canada.
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14
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Proulx-Rocray F, Routy B, Nassabein RM, El Ouarzadi O, Belkaid W, Tran-Thanh D, Florescu M, Tehfe M, Blais N. The prognostic impact of KRAS, TP53, STK11 and KEAP1 mutations and the influence of the NLR in NSCLC patients treated with immunotherapy. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21010 Background: ICIs changed the way NSCLC is treated, but not all patients benefit from it. PD-L1 level is used to predict response to therapy, but its performance is sub-optimal. KRAS is important in NSCLC tumorigenesis, but the impact of its mutations in patients treated with ICIs is unclear. Similarly, studies evaluating co-mutations in TP53, STK11 and KEAP1 as well as the NLR showed that they may predict the benefit of ICIs. Methods: We conducted a retrospective study including all consenting patients with NSCLC treated with ICIs at the CHUM between July 2015 and June 2020. OS and PFS were compared in co-mutation subgroups using Kaplan-Meier and logrank methods. Co-mutations in TP53, STK11 and KEAP1 as well as the NLR were accounted for. Overall response rate (ORR) and safety data was also compared in subgroups and will be detailed at the meeting. Results: We included 100 patients with known KRAS status. From these, 50 were wild-type ( KRASWT) and 50 were mutated ( KRASMut). The most frequent mutation was G12C (54%). Co-mutation status for TP53, STK11 and KEAP1 were known for, respectively, 40, 39 and 38 patients. Co-mutations for these genes were present in respectively 19 (47.5%), 8 (20.5%) and 4 (10.5%). Data comparing KRASMut and KRASWT showed non-significant differences in survival (median OS of respectively 21.1 vs. 17.7 months, p = 0.27). The presence of STK11 and/or KEAP1 mutations was associated with a negative impact on survival when compared with wild-type (median OS 7.4 vs 20.4 months, p = 0.001). When the presence of a KRAS mutation was compounded with STK11 and KEAP1, KRASMut (vs KRASWT) trended to a better prognosis in STK11+KEAP1WT tumors (median OS of 21.1 for KRASMut vs 15.8 for KRASWT, p = 0.15), but not in STK11+/-KEAP1Mut tumors (7.4 for KRASMut vs 7.0 for KRASWT). No influence on survival was seen in relationship to the TP53 co-mutation. Interestingly, the NLR was significantly higher with STK11 mutations (6.66Mut vs 3.59WT, p = 00012), slightly lower with TP53 mutations (3.23Mut vs 4.82WT, p = 0.047) but not impacted by KEAP1 (3.72Mut vs 4.20WT, p = 0.72) or KRAS mutations (4.32Mut vs 5.21WT, p = 0.34). Conclusions: The STK11 and KEAP1 mutations are significant adverse predictors of ICI therapy benefit. The NLR is strongly impacted by STK11 mutations but not by KEAP1 mutations suggesting marked differences in the resistance mechanism for both mutations. In STK11-KEAP1WT tumors, KRAS mutations seems to be associated with improved survival in NSCLC patient treated with ICIs.
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Affiliation(s)
| | - Bertrand Routy
- University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | | | | | - Wiam Belkaid
- University of Montreal Research Center (CRCHUM), Montréal, QC, Canada
| | | | - Marie Florescu
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Mustapha Tehfe
- Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Normand Blais
- Hematology-Oncology Division, University of Montreal Health Centre (CHUM), Montréal, QC, Canada
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15
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Deschenes-Simard X, Galland L, Blais F, Desilets A, Malo J, Cvetkovic L, Belkaid W, Elkrief A, Gagné A, Hamel MA, Orain M, Joubert P, Ghiringhelli F, Routy B, Blais N. Thrombotic events in patients treated with immune checkpoint inhibitors for non-small cell lung cancer: A retrospective multicentric cohort study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21198 Background: Venous thromboembolism is a frequent complication of non-small cell lung cancer (NSCLC) and is associated with a worse prognosis, a reduced quality of life, and increased healthcare costs. Immune checkpoint inhibitors (ICI) are revolutionizing the management of NSCLC, but little is known about their impact on thrombosis. This study aims to define the incidence and clinical relevance of thrombosis in NSCLC patients receiving these treatments. Methods: A retrospective multicentric cohort study including 593 patients from three centers in Canada and France was performed. The cumulative incidence of venous thrombotic events after ICIs was calculated, and the impact of these events on survival and response to treatment was determined. Finally, univariate log-rank tests were performed to identify thrombosis risk factors. Results: The incidence of venous thrombosis in the cohort was 9.9% for an incidence rate of 76.5 thrombosis per 1000 person-years, with most thromboses occurring rapidly after treatment initiation. Thrombosis was not correlated with overall survival, progression-free survival, or objective response to ICIs (summarized in the table below). Age ˂ 65 years old (HR = 1.66; 95 % CI = 1.00 – 2.82) and a delay of less than 12 months from diagnosis to the first ICI treatment (HR = 1.74; 95 % CI = 1.03 – 2.87) were associated with an increased risk of thrombosis. Tumors with PD-L1 > 1% were associated with more thrombosis in the first year since the beginning of therapy (HR = 3.06; 95 % CI = 1.19 – 4.76, p=0.015). Conclusions: This study suggests that the time distribution and incidence of thrombotic events in NSCLC patients treated with ICI are comparable to what is reported in other cohorts of patients treated with chemotherapy. In our cohort, thrombosis was not a prognostic factor for survival or response to therapy. Patient age < 65 and tumors with PD-L1 > 1% were associated to a higher risk of thrombotic events.[Table: see text]
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Affiliation(s)
| | - Loik Galland
- Dijon Bourgogne University Hospital, Dijon, France
| | - Florence Blais
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), Quebec, QC, Canada
| | - Antoine Desilets
- University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Julie Malo
- University of Montreal Research Center (CRCHUM), Montréal, QC, Canada
| | - Lena Cvetkovic
- University of Montreal Research Center (CRCHUM), Montréal, QC, Canada
| | - Wiam Belkaid
- University of Montreal Research Center (CRCHUM), Montréal, QC, Canada
| | - Arielle Elkrief
- University of Montreal Research Center (CRCHUM), Montréal, QC, Canada
| | - Andréanne Gagné
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), Quebec, QC, Canada
| | - Marc-Andre Hamel
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), Quebec, QC, Canada
| | - Michèle Orain
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), Quebec, QC, Canada
| | - Philippe Joubert
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), Quebec, QC, Canada
| | | | - Bertrand Routy
- University of Montreal Research Center (CRCHUM), Montreal, QC, Canada
| | - Normand Blais
- Hematology-Oncology Division, University of Montreal Health Centre (CHUM), Montréal, QC, Canada
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16
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Desilets A, Blanc-Durand F, Lau S, Hakozaki T, Kitadai R, Malo J, Belkaid W, Richard C, Messaoudene M, Cvetkovic L, Kazandjian S, Tehfe M, Florescu M, Jao K, Daaboul N, Owen S, Shieh B, Agulnik J, Cohen V, Charbonneau C, Marcoux N, Blais N, Leighl NB, Bradbury PA, Liu G, Shepherd FA, Bahig H, Routy B, Sacher A, Elkrief A. Durvalumab therapy following chemoradiation compared with a historical cohort treated with chemoradiation alone in patients with stage III non-small cell lung cancer: A real-world multicentre study. Eur J Cancer 2020; 142:83-91. [PMID: 33242835 DOI: 10.1016/j.ejca.2020.10.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/30/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The PACIFIC trial demonstrated that durvalumab therapy following chemoradiation (CRT) was associated with improved overall survival (OS) in patients with stage III non-small cell lung cancer (NSCLC). It is unclear whether the results obtained as part of randomised controlled trials are a reflection of real-world (RW) data. Several questions remain unanswered with regard to RW durvalumab use, such as optimal time to durvalumab initiation, incidence of pneumonitis and response in PD-L1 subgroups. METHODS In this multicentre retrospective analysis, 147 patients with stage III NSCLC treated with CRT followed by durvalumab were compared with a historical cohort of 121 patients treated with CRT alone. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test in univariate analysis. Multivariate analysis was performed to evaluate the effect of standard prognostic factors for durvalumab use. RESULTS Median OS was not reached in the durvalumab group, compared with 26.9 months in the historical group (hazard ratio [HR]: 0.56, 95% confidence interval [CI]: 0.37-0.85, p = 0.001). In the durvalumab group, our data suggest improved 12-month OS in patients with PD-L1 expression ≥50% (100% vs 86%, HR: 0.25, 95% CI: 0.11-0.58, p = 0.007). There was no difference in OS between patients with a PD-L1 expression of 1-49% and patients with PD-L1 expression <1%. Delay in durvalumab initiation beyond 42 days did not impact OS. Incidence of pneumonitis was similar in the durvalumab and historical groups. In the durvalumab group, patients who experienced any-grade pneumonitis had a lower 12-month OS than patients without pneumonitis (85% vs 95%, respectively; HR: 3.3, 95% CI: 1.2-9.0, p = 0.006). CONCLUSIONS This multicentre analysis suggests that PD-L1 expression ≥50% was associated with favourable OS in patients with stage III NSCLC treated with durvalumab after CRT, whereas the presence of pneumonitis represented a negative prognostic factor.
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Affiliation(s)
- Antoine Desilets
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada; Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Félix Blanc-Durand
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada; Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Sally Lau
- Princess Margaret Cancer Centre, University Health Network (UNH), 610 University Ave, M5G 2C1, Toronto, Ontario, Canada.
| | - Taiki Hakozaki
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, 113-8677, Bunkyo City, Tokyo, Japan.
| | - Rui Kitadai
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, 113-8677, Bunkyo City, Tokyo, Japan.
| | - Julie Malo
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada.
| | - Wiam Belkaid
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada.
| | - Corentin Richard
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada.
| | - Meriem Messaoudene
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada.
| | - Lena Cvetkovic
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Suzanne Kazandjian
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Mustapha Tehfe
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Marie Florescu
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Kevin Jao
- Department of Hematology and Oncology, Hôpital Du Sacré Coeur de Montréal, 5400, Boulevard Gouin Ouest, H4J 1C5, Montreal, Quebec, Canada.
| | - Nathalie Daaboul
- Integrated Cancer Center, Charles-Le-Moyne Hospital, 3120, Boulevard Taschereau, J4V 2H1, Greenfield Park, Quebec, Canada.
| | - Scott Owen
- Cedars Cancer Center, McGill University Healthcare Center (MUHC), 1001, Boulevard Décarie, H4A 3J1, Montreal, Quebec, Canada.
| | - Benjamin Shieh
- Cedars Cancer Center, McGill University Healthcare Center (MUHC), 1001, Boulevard Décarie, H4A 3J1, Montreal, Quebec, Canada.
| | - Jason Agulnik
- Segal Cancer Center, Jewish General Hospital, 3755, Chemin de La Côte-Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada.
| | - Victor Cohen
- Segal Cancer Center, Jewish General Hospital, 3755, Chemin de La Côte-Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada.
| | - Chloé Charbonneau
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Québec (CHUQ), 11, Côte Du Palais, G1R 2J6, Quebec City, Quebec, Canada.
| | - Nicolas Marcoux
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Québec (CHUQ), 11, Côte Du Palais, G1R 2J6, Quebec City, Quebec, Canada.
| | - Normand Blais
- Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Natasha B Leighl
- Princess Margaret Cancer Centre, University Health Network (UNH), 610 University Ave, M5G 2C1, Toronto, Ontario, Canada.
| | - Penelope A Bradbury
- Princess Margaret Cancer Centre, University Health Network (UNH), 610 University Ave, M5G 2C1, Toronto, Ontario, Canada.
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, University Health Network (UNH), 610 University Ave, M5G 2C1, Toronto, Ontario, Canada.
| | - Frances A Shepherd
- Princess Margaret Cancer Centre, University Health Network (UNH), 610 University Ave, M5G 2C1, Toronto, Ontario, Canada.
| | - Houda Bahig
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada; Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Bertrand Routy
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada; Department of Hematology and Oncology, Centre Hospitalier de L'Université de Montréal (CHUM), 1051, Rue Sanguinet, H2X 3E4, Montreal, Quebec, Canada.
| | - Adrian Sacher
- Princess Margaret Cancer Centre, University Health Network (UNH), 610 University Ave, M5G 2C1, Toronto, Ontario, Canada.
| | - Arielle Elkrief
- Centre de Recherche Du Centre Hospitalier de L'Université de Montréal (CRCHUM), 900, Rue Saint-Denis, Pavillon R, H2X 0A9, Montreal, Quebec, Canada; Cedars Cancer Center, McGill University Healthcare Center (MUHC), 1001, Boulevard Décarie, H4A 3J1, Montreal, Quebec, Canada; Segal Cancer Center, Jewish General Hospital, 3755, Chemin de La Côte-Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada.
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17
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Elkrief A, Desilets A, Papneja N, Cvetkovic L, Groleau C, Lakehal YA, Shbat L, Richard C, Malo J, Belkaid W, Cook E, Doucet S, Tran TH, Savard P, Jao K, Daaboul N, Bhang E, Loree J, Miller W, Vinh D, Bouganim N, Batist G, Letendre C, Routy B. Abstract S12-01: High mortality among hospital-acquired COVID-19 infection in patients with cancer: An observational cohort study from Quebec and British Columbia. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-s12-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Studies suggest that patients with cancer are more likely to experience severe outcomes from COVID-19. Therefore, cancer centers have undertaken efforts to care for patients with cancer in COVID-free zones. Nevertheless, nosocomial transmission of COVID-19 in patients with cancer likely occurs, but the frequency and relevance of these events remain unknown. The goal of this study was to determine the incidence and impact of hospital-acquired COVID-19 in this population and identify prognostic factors for COVID-19 severity in patients with cancer.
Methods: Patients with cancer and a laboratory-confirmed or presumed diagnosis of COVID-19 were prospectively identified using provincial registries and hospital databases between March 3rd and May 23rd, 2020, in the provinces of Quebec and British Columbia. Patients’ baseline characteristics including age, sex, comorbidities, cancer type, and type of anticancer treatment were collected. The primary outcome was incidence of hospital-acquired infection defined by diagnosis of SARS-CoV-2 5 days after hospital admission for COVID-unrelated cause. Co-primary outcomes were death or composite outcomes of severe illness from COVID-19 such as hospitalization, supplemental oxygen, intensive-care unit (ICU) admission, and/or mechanical ventilation.
Results: A total of 253 patients (N=250 adult and N=3 pediatric) with COVID-19 and cancer were identified, and the majority were residents of Quebec (N=236). Ninety patients (35.6%) received active anticancer treatment in the last 3 months prior to COVID-19 diagnosis. During a median follow-up of 23 days, 209 (82.6%) required hospitalization, 38 (15%) required admission to ICU, and 71 (28%) died. Forty-seven (19%) had a diagnosis of hospital-acquired COVID-19. Median overall survival was shorter in those with hospital-acquired infection, compared to a contemporary community-acquired population (27 days vs. 71 days, HR 2.2, 95% CI 1.2-4.0, p=0.002). Multivariate analysis demonstrated that hospital-acquired COVID-19, age, ECOG status, and advanced stage of cancer were independently associated with death.
Conclusion: Our study demonstrates a high rate of nosocomial transmission of COVID-19, associated with increased mortality in both univariate and multivariate analysis in the cancer population, reinforcing the importance of treating patients with cancer in COVID-free zones. We also validated that age, poor ECOG, and advanced cancer were negative prognostic factors for COVID-19 in patients with cancer.
Citation Format: Arielle Elkrief, Antoine Desilets, Neha Papneja, Lena Cvetkovic, Catherine Groleau, Yahia Abdelali Lakehal, Layla Shbat, Corentin Richard, Julie Malo, Wiam Belkaid, Erin Cook, Stephane Doucet, Thai Hoa Tran, Patrice Savard, Kevin Jao, Nathalie Daaboul, Eric Bhang, Jonathan Loree, Wilson Miller, Donald Vinh, Nathaniel Bouganim, Gerald Batist, Caroline Letendre, Bertrand Routy. High mortality among hospital-acquired COVID-19 infection in patients with cancer: An observational cohort study from Quebec and British Columbia [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S12-01.
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Affiliation(s)
- Arielle Elkrief
- 1Centre de recherche de l'Université de Montréal, Montreal, QC, Canada,
| | - Antoine Desilets
- 1Centre de recherche de l'Université de Montréal, Montreal, QC, Canada,
| | | | - Lena Cvetkovic
- 1Centre de recherche de l'Université de Montréal, Montreal, QC, Canada,
| | | | | | | | | | - Julie Malo
- 1Centre de recherche de l'Université de Montréal, Montreal, QC, Canada,
| | - Wiam Belkaid
- 1Centre de recherche de l'Université de Montréal, Montreal, QC, Canada,
| | - Erin Cook
- 2Segal Cancer Centre, Montreal, QC, Canada,
| | - Stephane Doucet
- 3Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada,
| | | | - Patrice Savard
- 3Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada,
| | - Kevin Jao
- 5Sacre Coeur Hospital, Montreal, QC, Canada,
| | | | - Eric Bhang
- 7BC Cancer Centre, Montreal, QC, Canada,
| | | | | | - Donald Vinh
- 8McGill University Healthcare Centre, Montreal, QC, Canada,
| | | | | | | | - Bertrand Routy
- 1Centre de recherche de l'Université de Montréal, Montreal, QC, Canada,
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18
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Elkrief A, Desilets A, Papneja N, Cvetkovic L, Groleau C, Lakehal YA, Shbat L, Richard C, Malo J, Belkaid W, Cook E, Doucet S, Tran TH, Jao K, Daaboul N, Bhang E, Loree JM, Miller WH, Vinh DC, Bouganim N, Batist G, Letendre C, Routy B. High mortality among hospital-acquired COVID-19 infection in patients with cancer: A multicentre observational cohort study. Eur J Cancer 2020; 139:181-187. [PMID: 33035991 PMCID: PMC7470707 DOI: 10.1016/j.ejca.2020.08.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/11/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Studies suggest that patients with cancer are more likely to experience severe outcomes from COVID-19. Therefore, cancer centres have undertaken efforts to care for patients with cancer in COVID-free units. Nevertheless, the frequency and relevance of nosocomial transmission of COVID-19 in patients with cancer remain unknown. The goal of this study was to determine the incidence and impact of hospital-acquired COVID-19 in this population and identify predictive factors for COVID-19 severity in patients with cancer. METHODS Patients with cancer and a laboratory-confirmed diagnosis of COVID-19 were prospectively identified using provincial registries and hospital databases between March 3rd and May 23rd, 2020 in the provinces of Quebec and British Columbia in Canada. Patient's baseline characteristics including age, sex, comorbidities, cancer type and type of anticancer treatment were collected. The exposure of interest was incidence of hospital-acquired infection defined by diagnosis of SARS-CoV-2 ≥ 5 days after hospital admission for COVID-unrelated cause. Co-primary outcomes were death or composite outcomes of severe illness from COVID-19 such as hospitalisation, supplemental oxygen, intensive-care unit (ICU) admission and/or mechanical ventilation. RESULTS A total of 252 patients (N = 249 adult and N = 3 paediatric) with COVID-19 and cancer were identified, and the majority were residents of Quebec (N = 233). One hundred and six patients (42.1%) received active anticancer treatment in the last 3 months before COVID-19 diagnosis. During a median follow-up of 25 days, 33 (13.1%) required admission to the ICU, and 71 (28.2%) died. Forty-seven (19.1%) had a diagnosis of hospital-acquired COVID-19. Median overall survival was shorter in those with hospital-acquired infection than that in a contemporary community-acquired population (27 days versus unreached, hazard ratio (HR) = 2.3, 95% CI: 1.2-4.4, p = 0.0006. Multivariate analysis demonstrated that hospital-acquired COVID-19, age, Eastern Cooperative Oncology Group status and advanced stage of cancer were independently associated with death. INTERPRETATION Our study demonstrates a high rate of nosocomial transmission of COVID-19, associated with increased mortality in both univariate and multivariate analysis in the cancer population, reinforcing the importance of treating patients with cancer in COVID-free units. We also validated that age and advanced cancer were negative predictive factors for COVID-19 severity in patients with cancer.
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Affiliation(s)
- Arielle Elkrief
- Cedar's Cancer Center, McGill University Healthcare Centre, Montreal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Antoine Desilets
- Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Neha Papneja
- Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Lena Cvetkovic
- Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Catherine Groleau
- Cedar's Cancer Center, McGill University Healthcare Centre, Montreal, QC, Canada; Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Yahia Abdelali Lakehal
- Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Layla Shbat
- Cedar's Cancer Center, McGill University Healthcare Centre, Montreal, QC, Canada; Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Corentin Richard
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Julie Malo
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Wiam Belkaid
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Erin Cook
- Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Stéphane Doucet
- Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Thai Hoa Tran
- Division of Pediatric Hematology-Oncology, Charles-Bruneau Cancer Center, CHU Sainte-Justine, Montreal, QC, Canada
| | - Kevin Jao
- Department of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Nathalie Daaboul
- Department of Hematology and Oncology, Hôpital Charles-Le Moyne, Longueuil, QC, Canada
| | - Eric Bhang
- BC Cancer/University of British Columbia, Vancouver, BC, Canada
| | | | - Wilson H Miller
- Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Donald C Vinh
- Department of Infectious Diseases, McGill University Healthcare Centre, Montreal, QC, Canada
| | - Nathaniel Bouganim
- Cedar's Cancer Center, McGill University Healthcare Centre, Montreal, QC, Canada
| | - Gerald Batist
- Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Caroline Letendre
- Department of Hematology and Oncology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada
| | - Bertrand Routy
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Hematology-Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
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Cvetkovic L, Régis C, Iebba V, Derosa L, Leblond A, Malo J, Messaoudene M, Belkaid W, Elkrief A, Routy B, Juneau D. Physiologic colonic uptake of 18F-FDG on PET/CT predicts immunotherapy response and gut microbiome diversity in patients with advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9600 Background: Immune checkpoint inhibitors (ICI) represent the backbone treatment of advanced non-small cell lung cancer (aNSCLC) patients. Emerging evidence suggests increased gut microbiome (GM) diversity is associated with favorable response. Conversely, antibiotic-induced dysbiosis may be associated with deleterious outcomes in patients receiving ICI in multiple retrospective studies and one prospective study. 18F-FDG physiologic colonic uptake on PET/CT increases following treatment with antibiotics and could be a surrogate marker for GM diversity and therefore clinical response. The aim of this study was to determine if 18F-FDG physiologic colonic uptake prior to ICI initiation correlates with outcomes and GM metagenomics in patients with advanced NSCLC. Methods: 71 patients with aNSCLC who underwent PET/CT prior to ICI were identified. For each patient, the colon was manually contoured, SUVmax was measured in each segment of the colon by a nuclear medicine specialist and average SUVmax was calculated for the whole colon. Patients were stratified in two groups according to median colon SUVmax (low vs high uptake). 18F-FDG physiologic colonic uptake was then compared to overall survival (OS), objective response (ORR), and progression-free survival (PFS). For patients with available stool samples (n = 10), GM composition was defined using metagenomics sequencing. Results: 71 patients (54% men, median age: 68 years) with aNSCLC were included in the study and ICI was the first line of therapy in 38% of those patients. The mean colon SUV for the low and high uptake groups were 1.41 (CI 95% 1.35-1.47) and 2.18 (CI 95% 1.90-2.46) respectively. The high uptake group had a higher proportion of non-responders (p = 0.033) and significant shorter PFS (4.1 months vs 11.3 months, p = 0.005). In the caecum, high uptake also correlated with numerically shorter OS (10.82 vs 27.56 months, p = 0.058) compared to low uptake group. Despite the low number of samples, metagenomics sequencing revealed that PLS-DA (Partial Least Squares Discriminant Analysis) for diversity was lower in the high SUV group (p = 0.008). Conclusions: Higher colon SUVmax on pre-ICI FDG PET/CT is associated with worse clinical outcomes and lower baseline GM diversity in patients with advanced NSCLC. Here, we propose that 18F-FDG physiologic colonic uptake on PET/CT could serve as a surrogate marker of GM diversity and predicts clinical outcomes.
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Affiliation(s)
- Lena Cvetkovic
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Claudine Régis
- Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, QC, Canada
| | | | - Lisa Derosa
- INSERM U1015, Gustave Roussy, Villejuif, France
| | - Antoine Leblond
- Centre Hospitalier Affilié Universitaire Régional (CHAUR), Trois-Rivières, QC, Canada
| | - Julie Malo
- Centre De Recherche Du Centre Hospitalier De L'université De Montréal (CRCHUM), Montréal, QC, Canada
| | - Meriem Messaoudene
- Centre De Recherche Du Centre Hospitalier De L'université De Montréal (CRCHUM), Montréal, QC, Canada
| | - Wiam Belkaid
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Arielle Elkrief
- Centre De Recherche Du Centre Hospitalier De L'université De Montréal (CRCHUM), Montreal, QC, Canada
| | - Bertrand Routy
- Centre De Recherche Du Centre Hospitalier De L'université De Montréal (CRCHUM), Montréal, QC, Canada
| | - Daniel Juneau
- University of Ottawa Heart Institute, Ottawa, ON, Canada
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Malo J, Messaoudene M, Cauchois F, Belkaid W, Frizon-Peresa D, Ikene S, Rousseau L, Lattouf JB, Elkrief A, Mezquita L, Derosa L, Besse B, Blais N, Alameddine R, Tehfe M, Florescu M, Routy B. Cancer patient participation and compliance in microbiome sample collection: An oncology research nurse’s experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz277.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Elkrief A, El Raichani L, Richard C, Messaoudene M, Belkaid W, Malo J, Belanger K, Miller W, Jamal R, Letarte N, Wong P, Routy B. Antibiotics are associated with decreased progression-free survival of advanced melanoma patients treated with immune checkpoint inhibitors. Oncoimmunology 2019; 8:e1568812. [PMID: 30906663 PMCID: PMC6422373 DOI: 10.1080/2162402x.2019.1568812] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/13/2018] [Accepted: 01/03/2019] [Indexed: 01/20/2023] Open
Abstract
Background: The gut microbiota has been shown to be an important determinant of the efficacy of immune checkpoint inhibitions (ICI) in cancer. Several lines of evidence suggest that antibiotic (ATB) usage prior to or within the first month of ICI initiation negatively impacts clinical outcomes. Methods: We examined patients with advanced melanoma treated with an anti-PD-1 monoclonal antibody (mAb) or an anti-CTLA-4 mAb alone or in combination with chemotherapy. Those receiving ATB within 30 days of beginning ICI were compared with those who did not receive ATB. Response rates as determined by RECIST 1.1, progression-free survival (PFS), overall survival (OS) and immune-related toxicities were assessed. Results: Of these 74 patients analyzed, a total of 10 patients received ATB (13.5%) within 30 days of initiation of ICI. Patients who received ATB 30 days prior to the administration of ICI experienced more primary resistance (progressive disease) (0% of the objective response rate compared to 34%), and progression-free survival (PFS) was significantly shorter (2.4 vs 7.3 months, HR 0.28, 95% CI (0.10-0.76) p = 0.01). Overall survival (OS) was also shorter; however, this was not statistically significant (10.7 vs 18.3 months, HR:0.52, 95% CI (0.21-1.32) p = 0.17). The multivariate analysis further supported that ATB administration was associated with worse PFS (HR 0.32 (0.13-0.83) 95% CI, p = 0.02). Conclusion: These findings suggest that ATB use within 30 days prior to ICI initiation in patients with advanced melanoma may adversely affect patient outcomes.
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Affiliation(s)
- Arielle Elkrief
- Hematology and Oncology, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Segal Cancer Center, Jewish General Hospital, Rossy Cancer Network, McGill University, Montreal, QC, Canada
| | - Layal El Raichani
- Department of Pharmacy, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada
| | - Corentin Richard
- Oncology, Research Platform in Biological Oncology, Dijon, France
| | - Meriem Messaoudene
- Hematology and Oncology, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Wiam Belkaid
- Hematology and Oncology, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Julie Malo
- Hematology and Oncology, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Karl Belanger
- Hematology-Oncology Division, Department of Medicine, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada
| | - Wilson Miller
- Segal Cancer Center, Jewish General Hospital, Rossy Cancer Network, McGill University, Montreal, QC, Canada
| | - Rahima Jamal
- Hematology-Oncology Division, Department of Medicine, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada
| | - Nathalie Letarte
- Department of Pharmacy, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada
| | - Philip Wong
- Hematology and Oncology, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Division of radiation oncology, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada
| | - Bertrand Routy
- Hematology and Oncology, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada
- Hematology-Oncology Division, Department of Medicine, Centre hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada
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22
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Messaoudene M, Derosa L, Belkaid W, Routy B. [In bacteria veritas: pronostic role of intestinal microbiote in cancer therapy]. Med Sci (Paris) 2018; 34:657-659. [PMID: 30230457 DOI: 10.1051/medsci/20183408009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Meriem Messaoudene
- Centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), 900 rue Saint-Denis, H2X 3H8 Montréal, Québec, Canada
| | - Lisa Derosa
- Campus cancer Gustave Roussy, Inserm U1015, Villejuif. Équipe labellisée-Ligue nationale contre le cancer, Villejuif, France - Université Paris-sud, université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Wiam Belkaid
- Centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), 900 rue Saint-Denis, H2X 3H8 Montréal, Québec, Canada
| | - Bertrand Routy
- Centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), 900 rue Saint-Denis, H2X 3H8 Montréal, Québec, Canada - Division d'hémato-oncologie, département de médicine, centre hospitalier de l'université de Montréal (CHUM), Montréal, Québec, Canada
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Belkaid W, Thostrup P, Yam PT, Juzwik CA, Ruthazer ES, Dhaunchak AS, Colman DR. Cellular response to micropatterned growth promoting and inhibitory substrates. BMC Biotechnol 2013; 13:86. [PMID: 24119185 PMCID: PMC3819464 DOI: 10.1186/1472-6750-13-86] [Citation(s) in RCA: 12] [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: 02/28/2013] [Accepted: 10/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Normal development and the response to injury both require cell growth, migration and morphological remodeling, guided by a complex local landscape of permissive and inhibitory cues. A standard approach for studying by such cues is to culture cells on uniform substrates containing known concentrations of these molecules, however this method fails to represent the molecular complexity of the natural growth environment. RESULTS To mimic the local complexity of environmental conditions in vitro, we used a contact micropatterning technique to examine cell growth and differentiation on patterned substrates printed with the commonly studied growth permissive and inhibitory substrates, poly-L-lysine (PLL) and myelin, respectively. We show that micropatterning of PLL can be used to direct adherence and axonal outgrowth of hippocampal and cortical neurons as well as other cells with diverse morphologies like Oli-neu oligodendrocyte progenitor cell lines and fibroblast-like COS7 cells in culture. Surprisingly, COS7 cells exhibited a preference for low concentration (1 pg/mL) PLL zones over adjacent zones printed with high concentrations (1 mg/mL). We demonstrate that micropatterning is also useful for studying factors that inhibit growth as it can direct cells to grow along straight lines that are easy to quantify. Furthermore, we provide the first demonstration of microcontact printing of myelin-associated proteins and show that they impair process outgrowth from Oli-neu oligodendrocyte precursor cells. CONCLUSION We conclude that microcontact printing is an efficient and reproducible method for patterning proteins and brain-derived myelin on glass surfaces in order to study the effects of the microenvironment on cell growth and morphogenesis.
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Affiliation(s)
- Wiam Belkaid
- McGill Program in Neuroengineering, McGill University, Montreal, Canada.
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24
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Magdesian MH, Sanchez FS, Lopez M, Thostrup P, Durisic N, Belkaid W, Liazoghli D, Grütter P, Colman DR. Atomic force microscopy reveals important differences in axonal resistance to injury. Biophys J 2013; 103:405-414. [PMID: 22947856 DOI: 10.1016/j.bpj.2012.07.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 06/22/2012] [Accepted: 07/02/2012] [Indexed: 01/06/2023] Open
Abstract
Axonal degeneration after traumatic brain injury and nerve compression is considered a common underlying cause of temporary as well as permanent disability. Because a proper functioning of neural network requires phase coherence of all components, even subtle changes in circuitry may lead to network failure. However, it is still not possible to determine which axons will recover or degenerate after injury. Several groups have studied the pressure threshold for axonal injury within a nerve, but difficulty accessing the injured region; insufficient imaging methods and the extremely small dimensions involved have prevented the evaluation of the response of individual axons to injury. We combined microfluidics with atomic force microscopy and in vivo imaging to estimate the threshold force required to 1), uncouple axonal transport without impairing axonal survival, and 2), compromise axonal survival in both individual and bundled axons. We found that rat hippocampal axons completely recover axonal transport with no detectable axonal loss when compressed with pressures up to 65 ± 30 Pa for 10 min, while dorsal root ganglia axons can resist to pressures up to 540 ± 220 Pa. We investigated the reasons for the differential susceptibility of hippocampal and DRG axons to mechanical injury and estimated the elasticity of live axons. We found that dorsal root ganglia axons have a 20% lower elastic modulus than hippocampal axons. Our results emphasize the importance of the integrity of the axonal cytoskeleton in deciding the axonal fate after damage and open up new avenues to improve injury diagnosis and to identify ways to protect axons.
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Affiliation(s)
- Margaret H Magdesian
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada; Institute of Medical Biochemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Fernando S Sanchez
- Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada; Department of Physics, McGill University, Montreal, Quebec, Canada
| | - Monserratt Lopez
- Department of Physics, McGill University, Montreal, Quebec, Canada
| | - Peter Thostrup
- Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada; Department of Physics, McGill University, Montreal, Quebec, Canada
| | - Nela Durisic
- Department of Physics, McGill University, Montreal, Quebec, Canada
| | - Wiam Belkaid
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada
| | - Dalinda Liazoghli
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada
| | - Peter Grütter
- Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada; Department of Physics, McGill University, Montreal, Quebec, Canada
| | - David R Colman
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Program in NeuroEngineering, McGill University, Montreal, Quebec, Canada
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Gopalakrishnan G, Awasthi A, Belkaid W, De Faria O, Liazoghli D, Colman DR, Dhaunchak AS. Lipidome and proteome map of myelin membranes. J Neurosci Res 2012; 91:321-34. [PMID: 23325434 DOI: 10.1002/jnr.23157] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 09/17/2012] [Accepted: 09/20/2012] [Indexed: 12/18/2022]
Abstract
To understand the molecular anatomy of myelin membranes, we performed a large-scale, liquid chromatography-coupled tandem mass spectrometry (LC-MS/MS)-based lipidome and proteome screen on freshly purified human and murine myelin fractions. We identified more than 700 lipid moieties and above 1,000 proteins in the two species, including 284 common lipids and 257 common proteins. This study establishes the first comprehensive map of myelin membrane components in human and mice. Although this study demonstrates many similarities between human and murine myelin, several components have been identified exclusively in each species. Future quantitative validation studies focused on interspecies differences will authenticate the myelin membrane anatomy. The combined lipidome and proteome map presented here can nevertheless be used as a reference library for myelin health and disease.
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Affiliation(s)
- Gopakumar Gopalakrishnan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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Huang JK, Phillips GR, Roth AD, Pedraza L, Shan W, Belkaid W, Mi S, Fex-Svenningsen A, Florens L, Yates JR, Colman DR. Glial membranes at the node of Ranvier prevent neurite outgrowth. Science 2005; 310:1813-7. [PMID: 16293723 DOI: 10.1126/science.1118313] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Nodes of Ranvier are regularly placed, nonmyelinated axon segments along myelinated nerves. Here we show that nodal membranes isolated from the central nervous system (CNS) of mammals restricted neurite outgrowth of cultured neurons. Proteomic analysis of these membranes revealed several inhibitors of neurite outgrowth, including the oligodendrocyte myelin glycoprotein (OMgp). In rat spinal cord, OMgp was not localized to compact myelin, as previously thought, but to oligodendroglia-like cells, whose processes converge to form a ring that completely encircles the nodes. In OMgp-null mice, CNS nodes were abnormally wide and collateral sprouting was observed. Nodal ensheathment in the CNS may stabilize the node and prevent axonal sprouting.
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Affiliation(s)
- Jeffrey K Huang
- Fishberg Department of Neuroscience, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA
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