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Arends CM, Kopp K, Hablesreiter R, Estrada N, Christen F, Moll UM, Zeillinger R, Schmitt WD, Sehouli J, Kulbe H, Fleischmann M, Ray-Coquard I, Zeimet A, Raspagliesi F, Zamagni C, Vergote I, Lorusso D, Concin N, Bullinger L, Braicu EI, Damm F. Dynamics of clonal hematopoiesis under DNA-damaging treatment in patients with ovarian cancer. Leukemia 2024:10.1038/s41375-024-02253-3. [PMID: 38637689 DOI: 10.1038/s41375-024-02253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
Clonal hematopoiesis (CH) driven by mutations in the DNA damage response (DDR) pathway is frequent in patients with cancer and is associated with a higher risk of therapy-related myeloid neoplasms (t-MNs). Here, we analyzed 423 serial whole blood and plasma samples from 103 patients with relapsed high-grade ovarian cancer receiving carboplatin, poly(ADP-ribose) polymerase inhibitor (PARPi) and heat shock protein 90 inhibitor (HSP90i) treatment within the phase II EUDARIO trial using error-corrected sequencing of 72 genes. DDR-driven CH was detected in 35% of patients and was associated with longer duration of prior PARPi treatment. TP53- and PPM1D-mutated clones exhibited substantially higher clonal expansion rates than DNMT3A- or TET2-mutated clones during treatment. Expansion of DDR clones correlated with HSP90i exposure across the three study arms and was partially abrogated by the presence of germline mutations related to homologous recombination deficiency. Single-cell DNA sequencing of selected samples revealed clonal exclusivity of DDR mutations, and identified DDR-mutated clones as the origin of t-MN in two investigated cases. Together, these results provide unique insights into the architecture and the preferential selection of DDR-mutated hematopoietic clones under intense DNA-damaging treatment. Specifically, PARPi and HSP90i therapies pose an independent risk for the expansion of DDR-CH in a dose-dependent manner.
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Affiliation(s)
- Christopher Maximilian Arends
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Klara Kopp
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Raphael Hablesreiter
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Natalia Estrada
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Christen
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ute Martha Moll
- Department of Pathology, Stony Brook University Cancer Center, Stony Brook, NY, 11794, USA
| | - Robert Zeillinger
- Department of Obstetrics and Gynaecology, Molecular Oncology Group, Comprehensive Cancer Center-Gynaecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Daniel Schmitt
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany
- North Eastern German Society for Gynecological Cancer. Tumor Bank Ovarian Cancer Network, Berlin, Germany
| | - Hagen Kulbe
- Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany
- North Eastern German Society for Gynecological Cancer. Tumor Bank Ovarian Cancer Network, Berlin, Germany
| | - Maximilian Fleischmann
- Klinik für Innere Medizin II, Abteilung Hämatologie und Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Isabelle Ray-Coquard
- Centre Anticancereux Léon Bérard, University Claude Bernard Lyon, GINECO Group, Lyon, France
| | - Alain Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Austrian AGO, Innsbruck, Austria
| | | | - Claudio Zamagni
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Ignace Vergote
- Division of Gynecological Oncology, Department of Gynecology and Obstetrics, Leuven Cancer Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), Leuven, Belgium
| | | | - Nicole Concin
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Austrian AGO, Innsbruck, Austria
| | - Lars Bullinger
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elena Ioana Braicu
- Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany
- North Eastern German Society for Gynecological Cancer. Tumor Bank Ovarian Cancer Network, Berlin, Germany
| | - Frederik Damm
- Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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2
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Ihlow J, Monjé N, Hoffmann I, Bischoff P, Sinn BV, Schmitt WD, Kunze CA, Darb-Esfahani S, Kulbe H, Braicu EI, Sehouli J, Denkert C, Horst D, Taube ET. Low Expression of RGS2 Promotes Poor Prognosis in High-Grade Serous Ovarian Cancer. Cancers (Basel) 2022; 14:cancers14194620. [PMID: 36230542 PMCID: PMC9561967 DOI: 10.3390/cancers14194620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/03/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Recent advances in molecular medicine have indicated G-protein coupled receptors (GPCRs) as possible therapeutic targets in ovarian cancer. The cellular effects of GPCRs are determined by regulator of G protein signaling (RGS) proteins. Especially RGS2 has currently moved into focus of cancer therapy. Therefore, we retrospectively analyzed RGS2 and its association with the prognosis of high-grade serous ovarian cancer (HGSOC). Here, we provide in situ and in silico analyses regarding the expression patterns and prognostic value of RGS2. In silico we found that RGS2 is barely detectable in tumor cells on the mRNA level in bulk and single-cell data. Applying immunohistochemistry in 519 HGSOC patients, we detected moderate to strong protein expression of RGS2 in situ in approximately half of the cohort, suggesting regulation by post translational modification. Furthermore, low protein expression of RGS2 was associated with an inferior overall- and progression-free survival. These results warrant further research of its role and related new therapeutic implications in HGSOC. Abstract RGS2 regulates G-protein signaling by accelerating hydrolysis of GTP and has been identified as a potentially druggable target in carcinomas. Since the prognosis of patients with high-grade serous ovarian carcinoma (HGSOC) remains utterly poor, new therapeutic options are urgently needed. Previous in vitro studies have linked RGS2 suppression to chemoresistance in HGSOC, but in situ data are still missing. In this study, we characterized the expression of RGS2 and its relation to prognosis in HGSOC on the protein level by immunohistochemistry in 519 patients treated at Charité, on the mRNA level in 299 cases from TCGA and on the single-cell level in 19 cases from publicly available datasets. We found that RGS2 is barely detectable on the mRNA level in both bulk tissue (median 8.2. normalized mRNA reads) and single-cell data (median 0 normalized counts), but variably present on the protein level (median 34.5% positive tumor cells, moderate/strong expression in approximately 50% of samples). Interestingly, low expression of RGS2 had a negative impact on overall survival (p = 0.037) and progression-free survival (p = 0.058) on the protein level in lower FIGO stages and in the absence of residual tumor burden. A similar trend was detected on the mRNA level. Our results indicated a significant prognostic impact of RGS2 protein suppression in HGSOC. Due to diverging expression patterns of RGS2 on mRNA and protein levels, posttranslational modification of RGS2 is likely. Our findings warrant further research to unravel the functional role of RGS2 in HGSOC, especially in the light of new drug discovery.
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Affiliation(s)
- Jana Ihlow
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Nanna Monjé
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Inga Hoffmann
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Philip Bischoff
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Bruno Valentin Sinn
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Wolfgang Daniel Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Catarina Alisa Kunze
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Sylvia Darb-Esfahani
- Institute of Pathology, Berlin-Spandau, Stadtrandstraße 555, 13589 Berlin, Germany
| | - Hagen Kulbe
- Department of Obstetrics and Gynecology with Center of Oncological Surgery, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
- Tumorbank Ovarian Cancer Network, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Elena Ioana Braicu
- Department of Obstetrics and Gynecology with Center of Oncological Surgery, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
- Tumorbank Ovarian Cancer Network, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jalid Sehouli
- Department of Obstetrics and Gynecology with Center of Oncological Surgery, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
- Tumorbank Ovarian Cancer Network, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Carsten Denkert
- Institute of Pathology, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, Germany
| | - David Horst
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Eliane Tabea Taube
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450-536-033; Fax: +49-30-450-536-900
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Marchenko S, Piwonski I, Hoffmann I, Sinn BV, Kunze CA, Monjé N, Pohl J, Kulbe H, Schmitt WD, Darb-Esfahani S, Braicu EI, von Brünneck AC, Sehouli J, Denkert C, Horst D, Jöhrens K, Taube ET. Prognostic value of regulatory T cells and T helper 17 cells in high grade serous ovarian carcinoma. J Cancer Res Clin Oncol 2022; 149:2523-2536. [PMID: 35763108 PMCID: PMC10129928 DOI: 10.1007/s00432-022-04101-2] [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: 05/03/2022] [Accepted: 05/30/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE In recent years the tumor microenvironment and its interaction with the tumor has emerged into research focus with increased attention to the composition of Tumor-infiltrating lymphocytes. We wanted to quantify the composition of Regulatory T cells (Tregs) and T helper 17 cells (Th17 cells) and their prognostic impact in high-grade serous tubo-ovarian carcinoma. METHODS Tregs and Th17 cells were determined by immunohistochemical analysis of CD25 FoxP3 and RORγt, respectively on tissue microarrays of a cohort of 222 patients with reviewed histology and available clinical data. Expression was analyzed with Qupath for quantification and integration with clinical data enabled calculation of prognostic impact. For validation FOXP3 and RORC mRNA expression levels from 502 patients with HGSC in publicly available datasets were evaluated. RESULTS An average percentage of 0.93 Tregs and of 0.06 Th17 cells was detected per cells in overall tissue. Optimal cut-offs were determined and higher Tregs were associated with a better overall survival in stroma (p = 0.006), tumor area (p = 0.0012) and overall tissue (p = 0.02). After accounting for well-known prognostic factors age at diagnosis, residual tumor and FIGO stage, this association remained significant for stromal Tregs with overall survival (p = 0.02). Survival analysis for Th17 cells revealed no significant association with survival rates. Moreover, lower Th17/Treg ratios had a positive impact on patient overall survival (p = 0.025 tumor, p = 0.049 stroma and p = 0.016 overall tissue). CONCLUSION Our results outline a positive prognostic effect for higher Tregs but not for Th17 in high grade serous tubo-ovarian carcinoma.
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Affiliation(s)
- Sofya Marchenko
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Iris Piwonski
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Inga Hoffmann
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Bruno Valentin Sinn
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Catarina Alisa Kunze
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Nanna Monjé
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Jonathan Pohl
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Hagen Kulbe
- Tumorbank Ovarian Cancer Network, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Wolfgang Daniel Schmitt
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | | | - Elena Ioana Braicu
- Tumorbank Ovarian Cancer Network, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Ann-Christin von Brünneck
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Jalid Sehouli
- Tumorbank Ovarian Cancer Network, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Carsten Denkert
- Institute of Pathology, Philipps-University Marburg, Marburg, Germany
| | - David Horst
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany
| | - Korinna Jöhrens
- Institute of Pathology, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Eliane Tabea Taube
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
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4
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Loibl S, Untch M, Burchardi N, Huober J, Sinn BV, Blohmer JU, Grischke EM, Furlanetto J, Tesch H, Hanusch C, Engels K, Rezai M, Jackisch C, Schmitt WD, von Minckwitz G, Thomalla J, Kümmel S, Rautenberg B, Fasching PA, Weber K, Rhiem K, Denkert C, Schneeweiss A. Corrigendum to "A randomised phase II study investigating durvalumab in addition to an anthracycline taxane-based neoadjuvant therapy in early triple-negative breast cancer: clinical results and biomarker analysis of GeparNuevo study": [Annals of Oncology (2019), volume 30:1279-1288]. Ann Oncol 2022; 33:743-744. [PMID: 35595658 DOI: 10.1016/j.annonc.2022.04.003] [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: 11/27/2022] Open
Affiliation(s)
- S Loibl
- German Breast Group, Neu-Isenburg; Oncological Practice Bethanien, Cancer Center Frankfurt Northeast, Frankfurt am Main.
| | - M Untch
- HELIOS Klinikum Berlin-Buch, Berlin
| | | | - J Huober
- Brustzentrum, Universitätsfrauenklinik Ulm, Ulm
| | - B V Sinn
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin; Berlin Institute of Health (BIH), Berlin
| | - J-U Blohmer
- Gynäkologie mit Brustzentrum, Charité-Universitätsmedizin Berlin, Berlin
| | | | | | - H Tesch
- Oncological Practice Bethanien, Cancer Center Frankfurt Northeast, Frankfurt am Main
| | - C Hanusch
- Rotkreuzklinikum München Frauenklinik, München
| | - K Engels
- Zentrum für Pathologie, Zytologie und Molekularpathologie Neuss, Neuss
| | - M Rezai
- Medical Center, Luisenkrankenhaus Düsseldorf, Düsseldorf
| | - C Jackisch
- Brustzentrum, Sana-Klinikum Offenbach, Offenbach
| | - W D Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin
| | | | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie Koblenz, Koblenz
| | - S Kümmel
- Breast Unit, Kliniken Essen-Mitte, Essen
| | - B Rautenberg
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg
| | - P A Fasching
- Brustzentrum, Universitätsklinikum Erlangen, Erlangen
| | - K Weber
- German Breast Group, Neu-Isenburg
| | - K Rhiem
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Cologne
| | - C Denkert
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin
| | - A Schneeweiss
- National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
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5
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Jurmeister P, Wrede N, Hoffmann I, Vollbrecht C, Heim D, Hummel M, Wolkenstein P, Koch I, Heynol V, Schmitt WD, Thieme A, Teichmann D, Sers C, von Deimling A, Thierauf JC, von Laffert M, Klauschen F, Capper D. Mucosal melanomas of different anatomic sites share a common global DNA methylation profile with cutaneous melanoma but show location-dependent patterns of genetic and epigenetic alterations. J Pathol 2022; 256:61-70. [PMID: 34564861 DOI: 10.1002/path.5808] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 06/23/2021] [Revised: 08/30/2021] [Accepted: 09/22/2021] [Indexed: 02/03/2023]
Abstract
Cutaneous, ocular, and mucosal melanomas are histologically indistinguishable tumors that are driven by a different spectrum of genetic alterations. With current methods, identification of the site of origin of a melanoma metastasis is challenging. DNA methylation profiling has shown promise for the identification of the site of tumor origin in various settings. Here we explore the DNA methylation landscape of melanomas from different sites and analyze if different melanoma origins can be distinguished by their epigenetic profile. We performed DNA methylation analysis, next generation DNA panel sequencing, and copy number analysis of 82 non-cutaneous and 25 cutaneous melanoma samples. We further analyzed eight normal melanocyte cell culture preparations. DNA methylation analysis separated uveal melanomas from melanomas of other primary sites. Mucosal, conjunctival, and cutaneous melanomas shared a common global DNA methylation profile. Still, we observed location-dependent DNA methylation differences in cancer-related genes, such as low frequencies of RARB (7/63) and CDKN2A promoter methylation (6/63) in mucosal melanomas, or a high frequency of APC promoter methylation in conjunctival melanomas (6/9). Furthermore, all investigated melanomas of the paranasal sinus showed loss of PTEN expression (9/9), mainly caused by promoter methylation. This was less frequently seen in melanomas of other sites (24/98). Copy number analysis revealed recurrent amplifications in mucosal melanomas, including chromosomes 4q, 5p, 11q and 12q. Most melanomas of the oral cavity showed gains of chromosome 5p with TERT amplification (8/10), while 11q amplifications were enriched in melanomas of the nasal cavity (7/16). In summary, mucosal, conjunctival, and cutaneous melanomas show a surprisingly similar global DNA methylation profile and identification of the site of origin by DNA methylation testing is likely not feasible. Still, our study demonstrates tumor location-dependent differences of promoter methylation frequencies in specific cancer-related genes together with tumor site-specific enrichment for specific chromosomal changes and genetic mutations. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Philipp Jurmeister
- Institute of Pathology, Ludwig Maximilians University Hospital Munich, Munich, Germany
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Niklas Wrede
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Inga Hoffmann
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Vollbrecht
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Daniel Heim
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Hummel
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Peggy Wolkenstein
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany
| | - Ines Koch
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Verena Heynol
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Wolfgang Daniel Schmitt
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anne Thieme
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany
| | - Daniel Teichmann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany
| | - Christine Sers
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas von Deimling
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Julia Cara Thierauf
- Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Maximilian von Laffert
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frederick Klauschen
- Institute of Pathology, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - David Capper
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany
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6
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Jank P, Lindner JL, Lehmann A, Pfitzner BM, Blohmer JU, Horst D, Kronenwett R, Denkert C, Schmitt WD. Comparison of risk assessment in 1652 early ER positive, HER2 negative breast cancer in a real-world data set: classical pathological parameters vs. 12-gene molecular assay (EndoPredict). Breast Cancer Res Treat 2021; 191:327-333. [PMID: 34783927 PMCID: PMC8763835 DOI: 10.1007/s10549-021-06415-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Risk assessment on the molecular level is important in predictive pathology to determine the risk of metastatic disease for ERpos, HER2neg breast cancer. The gene expression test EndoPredict (EP) was trained and validated for prediction of a 10-year risk of distant recurrence to support therapy decisions regarding endocrine therapy alone or in combination with chemotherapy. The EP test provides the 12-gene Molecular Score (MS) and the EPclin-Score (EPclin), which combines the molecular score with tumor size and nodal status. In this project we investigated the correlation of 12-gene MS and EPclin scores with classical pathological markers. METHODS EndoPredict-based gene expression profiling was performed prospectively in a total of 1652 patients between 2017 and 2020. We investigated tumor grading and Ki67 cut-offs of 20% for binary classification as well as 10% and 30% for three classes (low, intermediate, high), based on national and international guidelines. RESULTS 410 (24.8%) of 1652 patients were classified as 12-gene MS low risk and 626 (37.9%) as EPclin low risk. We found significant positive associations between 12-gene MS and grading (p < 0.001), EPclin and grading (p = 0.001), 12-gene MS and Ki67 (p < 0.001), and EPclin and Ki67 (p < 0.001). However, clinically relevant differences between EP test results, Ki67 and tumor grading were observed. For example, 118 (26.3%) of 449 patients with Ki67 > 20% were classified as low risk by EPclin. Same differences were seen comparing EP test results and tumor grading. CONCLUSION In this study we could show that EP risk scores are distributed differentially among Ki67 expression groups, especially in Ki67 low and high tumors with a substantial proportion of patients with EPclin high risk results in Ki67 low tumors and vice versa. This suggests that classical pathological parameters and gene expression parameters are not interchangeable, but should be used in combination for risk assessment.
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Affiliation(s)
- Paul Jank
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM)-Universitätsklinikum Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Judith Lea Lindner
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Charitéplatz 1, 10117, Berlin, Germany
| | - Annika Lehmann
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Charitéplatz 1, 10117, Berlin, Germany
| | | | - Jens-Uwe Blohmer
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Gynecology and Obstetrics, Charitéplatz 1, 10117, Berlin, Germany
| | - David Horst
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Charitéplatz 1, 10117, Berlin, Germany
| | | | - Carsten Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM)-Universitätsklinikum Marburg, Baldingerstraße, 35043, Marburg, Germany.
| | - Wolfgang Daniel Schmitt
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Charitéplatz 1, 10117, Berlin, Germany
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7
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Denkert C, Untch M, Benz S, Schneeweiss A, Weber KE, Schmatloch S, Jackisch C, Sinn HP, Golovato J, Karn T, Marmé F, Link T, Budczies J, Nekljudova V, Schmitt WD, Stickeler E, Müller V, Jank P, Parulkar R, Heinmöller E, Sanborn JZ, Schem C, Sinn BV, Soon-Shiong P, van Mackelenbergh M, Fasching PA, Rabizadeh S, Loibl S. Reconstructing tumor history in breast cancer: signatures of mutational processes and response to neoadjuvant chemotherapy ⋆. Ann Oncol 2021; 32:500-511. [PMID: 33418062 DOI: 10.1016/j.annonc.2020.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/04/2020] [Revised: 11/13/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Different endogenous and exogenous mutational processes act over the evolutionary history of a malignant tumor, driven by abnormal DNA editing, mutagens or age-related DNA alterations, among others, to generate the specific mutational landscape of each individual tumor. The signatures of these mutational processes can be identified in large genomic datasets. We investigated the hypothesis that genomic patterns of mutational signatures are associated with the clinical behavior of breast cancer, in particular chemotherapy response and survival, with a particular focus on therapy-resistant disease. PATIENTS AND METHODS Whole exome sequencing was carried out in 405 pretherapeutic samples from the prospective neoadjuvant multicenter GeparSepto study. We analyzed 11 mutational signatures including biological processes such as APOBEC-mutagenesis, homologous recombination deficiency (HRD), mismatch repair deficiency and also age-related or tobacco-induced alterations. RESULTS Different subgroups of breast carcinomas were defined mainly by differences in HRD-related and APOBEC-related mutational signatures and significant differences between hormone-receptor (HR)-negative and HR-positive tumors as well as correlations with age, Ki-67 and immunological parameters were observed. We could identify mutational processes that were linked to increased pathological complete response rates to neoadjuvant chemotherapy with high significance. In univariate analyses for HR-positive tumors signatures, S3 (HRD, P < 0.001) and S13 (APOBEC, P = 0.001) as well as exonic mutation rate (P = 0.002) were significantly correlated with increased pathological complete response rates. The signatures S3 (HRD, P = 0.006) and S4 (tobacco, P = 0.011) were prognostic for reduced disease-free survival of patients with chemotherapy-resistant tumors. CONCLUSION The results of this investigation suggest that the clinical behavior of a tumor, in particular, response to neoadjuvant chemotherapy and disease-free survival of therapy-resistant tumors, could be predicted by the composition of mutational signatures as an indicator of the individual genomic history of a tumor. After additional validations, mutational signatures might be used to identify tumors with an increased response rate to neoadjuvant chemotherapy and to define therapy-resistant subgroups for future therapeutic interventions.
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Affiliation(s)
- C Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UK-GM), Marburg, Germany; Charité - Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany.
| | - M Untch
- Helios Klinikum Berlin-Buch, Department of Obstetrics and Gynaecology, Berlin, Germany
| | - S Benz
- NantOmics, LLC, Culver City, USA
| | - A Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum und Deutsches Krebsforschungszentrum Heidelberg, Heidelberg, Germany
| | - K E Weber
- German Breast Group (GBG), Neu-Isenburg, Germany
| | - S Schmatloch
- Brustzentrum Kassel, Elisabeth Krankenhaus, Kassel, Germany
| | - C Jackisch
- Department of Obstetrics and Gynecology and Breast Cancer Center, Sana Klinikum Offenbach, Offenbach, Germany
| | - H P Sinn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany; German Cancer consortium (DKTK), Heidelberg, Germany
| | | | - T Karn
- Klinik für Frauenheilkunde und Geburtshilfe, Goethe Universität, Frankfurt, Germany
| | - F Marmé
- Universitätsfrauenklinik Mannheim, Mannheim, Germany
| | - T Link
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - J Budczies
- Charité - Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany; Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany; German Cancer consortium (DKTK), Heidelberg, Germany
| | - V Nekljudova
- German Breast Group (GBG), Neu-Isenburg, Germany
| | - W D Schmitt
- Charité - Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany
| | - E Stickeler
- Department of Gynecology, RWTH Aachen, Aachen, Germany
| | - V Müller
- Department of Gynecology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - P Jank
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UK-GM), Marburg, Germany; Charité - Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany
| | | | | | | | - C Schem
- Mammazentrum Hamburg am Krankenhaus Jerusalem, Hamburg, Germany
| | - B V Sinn
- Charité - Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany
| | | | - M van Mackelenbergh
- Universitätsklinikum Schleswig-Holstein, Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany
| | - P A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | | | - S Loibl
- German Breast Group (GBG), Neu-Isenburg, Germany; University of Frankfurt, Frankfurt am Main, Germany
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8
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Fasching PA, Link T, Hauke J, Seither F, Jackisch C, Klare P, Schmatloch S, Hanusch C, Huober J, Stefek A, Seiler S, Schmitt WD, Uleer C, Doering G, Rhiem K, Schneeweiss A, Engels K, Denkert C, Schmutzler RK, Hahnen E, Untch M, Burchardi N, Blohmer JU, Loibl S. Neoadjuvant paclitaxel/olaparib in comparison to paclitaxel/carboplatinum in patients with HER2-negative breast cancer and homologous recombination deficiency (GeparOLA study). Ann Oncol 2020; 32:49-57. [PMID: 33098995 DOI: 10.1016/j.annonc.2020.10.471] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [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: 07/27/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The efficacy and toxicity of olaparib as combination therapy in early breast cancer (BC) patients with homologous recombinant deficiency (HRD) [score high and/or germline (g) or tumour (t) BRCA1/2 mutation] is not well described. GeparOLA (ClinicalTrials.gov, NCT02789332) investigated olaparib in combination with paclitaxel in HER2-negative early BC with HRD. PATIENTS AND METHODS Patients with untreated primary HER2-negative cT2-cT4a-d or cT1c with either cN+ or pNSLN+ or cT1c and triple-negative breast cancer (TNBC) or cT1c and Ki-67>20% BC with HRD were randomised either to paclitaxel (P) 80 mg/m2 weekly plus olaparib (O) 100 mg twice daily for 12 weeks or P plus carboplatinum (Cb) area under the curve 2 weekly for 12 weeks, both followed by epirubicin/cyclophosphamide (EC). Stratification factors were hormone receptor (HR) status (HR+ versus HR-) and age (<40 versus ≥40 years). The primary endpoint was pathological complete response (pCR; ypT0/is ypN0). A two-sided one-group χ2-test was planned to exclude a pCR rate of ≤55% in the PO-EC arm. Secondary end points were other pCR definitions, breast conservation rate, clinical/imaging response, tolerability and safety. RESULTS A total of 107 patients were randomised between September 2016 and July 2018; 106 (PO N = 69; PCb N = 37) started treatment. Median age was 47.0 years (range 25.0-71.0); 36.2% had cT1, 61.0% cT2, 2.9% cT3, and 31.8% cN-positive tumours; grade 3 tumours: 86.8%; Ki-67>20%: 89.6%; TNBC: 72.6%; confirmed gBRCA1/2 mutation: 56.2%. The pCR rate with PO was 55.1% [90% confidence interval (CI) 44.5% to 65.3%] versus PCb 48.6% (90% CI 34.3% to 63.2%). Analysis for the stratified subgroups showed higher pCR rates with PO in the cohorts of patients <40 years and HR+ patients. CONCLUSION GeparOLA could not exclude a pCR rate of ≤55% in the PO arm. PO was significantly better tolerated and the combination merits further evaluation.
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Affiliation(s)
- P A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-Nuremberg, National Center for Tumor Diseases, Erlangen, Germany
| | - T Link
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Carl Gustav Carus Dresden, Germany
| | - J Hauke
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - F Seither
- German Breast Group, Neu-Isenburg, Germany
| | - C Jackisch
- Sana Klinikum Offenbach, Offenbach, Germany
| | - P Klare
- MediOnko-Institut GbR Berlin, Berlin, Germany
| | | | - C Hanusch
- Rotkreuzklinikum Munich, Munich, Germany
| | - J Huober
- University Hospital Ulm, Ulm, Germany
| | - A Stefek
- Johanniter-Krankenhaus Genthin-Stendal, Stendal, Germany
| | - S Seiler
- German Breast Group, Neu-Isenburg, Germany
| | - W D Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Uleer
- Gemeinschaftspraxis Hildesheim, Hildesheim, Germany
| | - G Doering
- Hämato-Onkologie im Medicum Bremen, Bremen, Germany
| | - K Rhiem
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - A Schneeweiss
- National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Engels
- Center for Pathology, Cytology and Molecular Pathology Neuss, Neuss, Germany
| | - C Denkert
- Institute of Pathology, Philipps-Universität Marburg und University Hospital Marburg (UKGM), Marburg, Germany
| | - R K Schmutzler
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - E Hahnen
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - M Untch
- Helios-Klinikum Berlin-Buch, Berlin, Germany
| | | | - J-U Blohmer
- Brustzentrum Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Loibl
- German Breast Group, Neu-Isenburg, Germany.
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9
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Loibl S, Untch M, Burchardi N, Huober J, Sinn BV, Blohmer JU, Grischke EM, Furlanetto J, Tesch H, Hanusch C, Engels K, Rezai M, Jackisch C, Schmitt WD, von Minckwitz G, Thomalla J, Kümmel S, Rautenberg B, Fasching PA, Weber K, Rhiem K, Denkert C, Schneeweiss A. A randomised phase II study investigating durvalumab in addition to an anthracycline taxane-based neoadjuvant therapy in early triple-negative breast cancer: clinical results and biomarker analysis of GeparNuevo study. Ann Oncol 2020; 30:1279-1288. [PMID: 31095287 DOI: 10.1093/annonc/mdz158] [Citation(s) in RCA: 387] [Impact Index Per Article: 96.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Combining immune-checkpoint inhibitors with chemotherapy yielded an increased response rates in patients with metastatic triple-negative breast cancer (TNBC). Therefore, we evaluated the addition of durvalumab to standard neoadjuvant chemotherapy (NACT) in primary TNBC. PATIENTS AND METHODS GeparNuevo is a randomised phase II double-blind placebo-controlled study randomising patients with TNBC to durvalumab or placebo given every 4 weeks in addition to nab-paclitaxel followed by standard EC. In the window-phase durvalumab/placebo alone was given 2 weeks before start of nab-paclitaxel. Randomisation was stratified by stromal tumour-infiltrating lymphocyte (sTILs). Patients with primary cT1b-cT4a-d disease, centrally confirmed TNBC and sTILs were included. Primary objective was pathological complete response (pCR) (ypT0 ypN0). RESULTS A total of 174 patients were randomised, 117 participated in the window-phase. Median age was 49.5 years (range 23-76); 47 patients (27%) were younger than 40 years; 113 (65%) had stage ≥IIA disease, 25 (14%) high sTILs, 138 of 158 (87%) were PD-L1-positive. pCR rate with durvalumab was 53.4% (95% CI 42.5% to 61.4%) versus placebo 44.2% (95% CI 33.5% to 55.3%; unadjusted continuity corrected χ2P = 0.287), corresponding to OR = 1.45 (95% CI 0.80-2.63, unadjusted Wald P = 0.224). Durvalumab effect was seen only in the window cohort (pCR 61.0% versus 41.4%, OR = 2.22, 95% CI 1.06-4.64, P = 0.035; interaction P = 0.048). In both arms, significantly increased pCR (P < 0.01) were observed with higher sTILs. There was a trend for increased pCR rates in PD-L1-positive tumours, which was significant for PD-L1-tumour cell in durvalumab (P = 0.045) and for PD-L1-immune cell in placebo arm (P = 0.040). The most common immune-related adverse events were thyroid dysfunction any grade in 47%. CONCLUSIONS Our results suggest that the addition of durvalumab to anthracycline-/taxane-based NACT increases pCR rate particularly in patients treated with durvalumab alone before start of chemotherapy. TRIAL REGISTRATION ClinicalTrials.gov number: NCT02685059.
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Affiliation(s)
- S Loibl
- German Breast Group, Neu-Isenburg; Oncological Practice Bethanien, Cancer Center Frankfurt Northeast, Frankfurt am Main.
| | - M Untch
- HELIOS Klinikum Berlin-Buch, Berlin
| | | | - J Huober
- Brustzentrum, Universitätsfrauenklinik Ulm, Ulm
| | - B V Sinn
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin; Berlin Institute of Health (BIH), Berlin
| | - J-U Blohmer
- Gynäkologie mit Brustzentrum, Charité-Universitätsmedizin Berlin, Berlin
| | | | | | - H Tesch
- Oncological Practice Bethanien, Cancer Center Frankfurt Northeast, Frankfurt am Main
| | - C Hanusch
- Rotkreuzklinikum München Frauenklinik, München
| | - K Engels
- Zentrum für Pathologie, Zytologie und Molekularpathologie Neuss, Neuss
| | - M Rezai
- Medical Center, Luisenkrankenhaus Düsseldorf, Düsseldorf
| | - C Jackisch
- Brustzentrum, Sana-Klinikum Offenbach, Offenbach
| | - W D Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin
| | | | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie Koblenz, Koblenz
| | - S Kümmel
- Breast Unit, Kliniken Essen-Mitte, Essen
| | - B Rautenberg
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg
| | - P A Fasching
- Brustzentrum, Universitätsklinikum Erlangen, Erlangen
| | - K Weber
- German Breast Group, Neu-Isenburg
| | - K Rhiem
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Cologne
| | - C Denkert
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin
| | - A Schneeweiss
- National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
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10
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Sinn BV, Weber KE, Schmitt WD, Fasching PA, Symmans WF, Blohmer JU, Karn T, Taube ET, Klauschen F, Marmé F, Schem C, Stickeler E, Ataseven B, Huober J, von Minckwitz G, Seliger B, Denkert C, Loibl S. Human leucocyte antigen class I in hormone receptor-positive, HER2-negative breast cancer: association with response and survival after neoadjuvant chemotherapy. Breast Cancer Res 2019; 21:142. [PMID: 31829264 PMCID: PMC6907189 DOI: 10.1186/s13058-019-1231-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 04/29/2019] [Accepted: 11/18/2019] [Indexed: 01/27/2023] Open
Abstract
Background Clinical application of cancer immunotherapy requires a better understanding of tumor immunogenicity and the tumor microenvironment. HLA class I molecules present antigens to CD8+ cytotoxic cells. Their loss or downregulation is frequently found in tumors resulting in reduced T cell responses and worse prognosis. Methods We evaluated HLA class I heavy chain expression by immunohistochemistry in 863 biopsies (GeparTrio trial). Patients received neoadjuvant chemotherapy and adjuvant endocrine treatment if tumors were hormone receptor-positive (HR+). In parallel, the expression of HLA-A was analyzed using a microarray cohort of 320 breast cancer patients from the MD Anderson Cancer Center. We evaluated its association with clinical outcome, tumor-infiltrating lymphocytes (TILs), and immune cell metagenes. Results In HR+/HER2− breast cancer, HLA class I heavy chain expression was associated with increased TILs and better response to chemotherapy (7% vs. 14% pCR rate, P = 0.029), but worse disease-free survival (hazard ratio (HR) 1.6 (1.1–2.4); P = 0.024). The effect was significant in a multivariate model adjusted for clinical and pathological variables (HR 1.7 (1.1–2.6); P = 0.016) and was confirmed by analysis of HLA-A in a microarray cohort. HLA-A was correlated to most immune cell metagenes. There was no association with response or survival in triple-negative or HER2+ disease. Conclusions The study confirms the negative prognostic role of lymphocytes in HR+ breast cancer and points at a complex interaction between chemotherapy, endocrine treatment, and tumor immunogenicity. The results point at a subtype-specific and potentially treatment-specific role of tumor-immunological processes in breast cancer with different implications in triple-negative and hormone receptor-positive disease.
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Affiliation(s)
- Bruno Valentin Sinn
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany.
| | | | - Wolfgang Daniel Schmitt
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Peter A Fasching
- Department of Gynecology, University Hospital Erlangen, Erlangen, Germany
| | - William Fraser Symmans
- Department of Translational Molecular Pathology, The University of Texas - MD Anderson Cancer Center, Houston, TX, USA
| | - Jens-Uwe Blohmer
- Department of Gynecology with Breast Cancer, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thomas Karn
- Department of Gynecology and Obstetrics, University Hospital Frankfurt, Frankfurt, Germany
| | - Eliane Tabea Taube
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Frederick Klauschen
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site Berlin, Berlin, Germany
| | - Frederik Marmé
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Schem
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Kiel, Germany.,Mammazentrum Hamburg, Hamburg, Germany
| | - Elmar Stickeler
- Department of Gynecology and Obstetrics, RWTH Aachen, Aachen, Germany
| | - Beyhan Ataseven
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany.,Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Jens Huober
- Department of Gynecology and Breast Medical Oncology, Universitätsklinikum Ulm, Ulm, Germany
| | | | - Barbara Seliger
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Carsten Denkert
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site Berlin, Berlin, Germany.,Department of Pathology, University Hospital Marburg, Marburg, Germany
| | - Sibylle Loibl
- German Breast Group Forschungs GmbH, Neu-Isenburg, Germany
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11
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Villegas SL, Lederer B, Untch M, Holms F, Ulmer HU, Diebold K, Fasching PA, Weber K, Schmitt WD, Tesch H, Rezai M, Marmé F, Sinn B, Hackmann J, Schneeweiss A, Tannapfel A, Nekljudova V, Denkert C, Loibl S. Abstract P2-08-10: Similarities between low hormone receptor positive and hormone receptor negative breast cancer: An analysis of 4366 patients from multicenter clinical trials. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-10] [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:
Currently, patients with breast cancer (BC) with hormone receptor (HR) immunohistochemical expression between 1-9% are eligible to receive endocrine therapy. However, recent data suggest that these tumors express a basal-like molecular phenotype associated with triple negative BC (TNBC) rather than luminal phenotype associated with HR positive BC. Here, we aimed to determine the differences between strong HR positive, low HR positive and negative HR BC, in regard to responsiveness to neoadjuvant chemotherapy (NACT) and disease free survival (DFS) in large cohorts from GBG clinical trials.
Methods:
In this retrospective analysis of data from women with BC treated in the neoadjuvant GeparQuinto (n=2572), GeparSixto (n=588) and GeparSepto (n=1206) clinical trials, we compared patients with three HR phenotypes: low positive (ER and/or PR= 1-9%), strong positive (ER or PR= 10-100%), and negative (ER and PR= <1%), regarding pathological complete response (pCR, ypT0 ypN0) and DFS. A logistic regression model for endpoint pCR was performed on pooled data from all trials. Cox regression was used to model DFS for patients participating in GeparQuinto and GeparSixto trial, including 71 with low HR positive phenotype. The models were adjusted by age, tumor and nodal status, grading, Her2 status, histological type, stromal and tumor infiltrating lymphocytes and clinical trial. The survival model was additionally adjusted by pCR after NACT.
Results:
Patients median age was 49 years, the majority had clinical tumor stage 2 (54.1%), negative nodal status (54.7%), and Her2 negative tumors (72.4%). 85.1% of women had BC classified as no special histological type. The pCR rate across the studies was 26.2%. 145 (3.4%) patients had low HR positive, 2417 (57.3%) strong HR positive and 1658 (39.3%) HR negative tumors. After NACT, 16.3% of patients with strong HR positive BC achieved a pCR, while among those with HR negative and low HR positive tumors, pCR rates were 40.2% and 37.9%, respectively (p<0.001). In the adjusted logistic regression model, there was no statistically significant difference between low HR positive and HR negative tumors (OR: 1.34, 95%-CI: (0.84-2.13), p=0.222). But strong HR positive tumors had a significantly lower chance of achieving a pCR compared to low HR positives (OR 0.48, 95%-CI: 0.30-0.76, p=0.002). Patients with strong HR positive BC had a better DFS than patients with low HR positive tumors (hazard ratio 0.35, 95%-CI: 0.18-0.70, p=0.003). DFS was not significantly different between patients with HR negative and low HR positive tumors (hazard ratio 0.74, 95%-CI: 0.38-1.43, p=0.370).
Conclusions:
Similarly to patients with negative HR tumors, patients with low HR positive tumors have a better responsiveness to NACT and worse survival rates, compared to patients with strongly HR positive BC. We suggest that studies on treatment options for basal-like/TNBC, should also consider including patients with low HR positive tumors.
Citation Format: Villegas SL, Lederer B, Untch M, Holms F, Ulmer H-U, Diebold K, Fasching PA, Weber K, Schmitt WD, Tesch H, Rezai M, Marmé F, Sinn B, Hackmann J, Schneeweiss A, Tannapfel A, Nekljudova V, Denkert C, Loibl S. Similarities between low hormone receptor positive and hormone receptor negative breast cancer: An analysis of 4366 patients from multicenter clinical trials [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-10.
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Affiliation(s)
- SL Villegas
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - B Lederer
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - M Untch
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - F Holms
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - H-U Ulmer
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - K Diebold
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - PA Fasching
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - K Weber
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - WD Schmitt
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - H Tesch
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - M Rezai
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - F Marmé
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - B Sinn
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - J Hackmann
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - A Schneeweiss
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - A Tannapfel
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - V Nekljudova
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - C Denkert
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
| | - S Loibl
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany; German Breast Group (GBG Forschungs GmbH), Neu-Isenburg, Germany; HELIOS Klinikum, Berlin, Germany; Institute of Pathology, St. Barbara Klinik, Hamm-Heessen, Germany; Mittelbaden Hospital, Karlsruhe, Germany; University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany; Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany; Luisenkrankenhaus, Medical Center Düsseldorf, Düsseldorf, Germany; National Center for Tumour Diseases and University Hospital Heidelberg, Heidelberg, Germany; Marien Hospital, Witten, Germany; Institute for Pathology, Ruhr-University, Bochum, Germany
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Loibl S, Untch M, Denkert C, Huober J, Blohmer JU, Grischke EM, Furlanetto J, Tesch H, Hanusch C, Rezai M, Jackisch C, Schmitt WD, von Minckwitz G, Thomalla J, Kümmel S, Rautenberg B, Fasching PA, Rhiem K, Burchardi N, Schneeweiss A. Abstract P6-15-01: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-15-01] [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
This abstract was withdrawn by the authors.
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Affiliation(s)
- S Loibl
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - M Untch
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - C Denkert
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - J Huober
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - JU Blohmer
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - E-M Grischke
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - J Furlanetto
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - H Tesch
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - C Hanusch
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - M Rezai
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - C Jackisch
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - WD Schmitt
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - G von Minckwitz
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - J Thomalla
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - S Kümmel
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - B Rautenberg
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - PA Fasching
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - K Rhiem
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - N Burchardi
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
| | - A Schneeweiss
- German Breast Group; Centrum für Hämatologie und Onkologie Bethanien Frankfurt; HELIOS Klinikum Berlin Buch; Universitätsfrauenklinik Ulm; Brustzentrum Charité; Universitätsfrauenklinik Tübingen; Klinikum zum Roten Kreuz München; Medical Center, Luisenkrankenhaus; Sana-Clinic, Offenbach; Praxisklinik für Hämatologie und Onkologie, Koblenz; Brustzentrum, Kliniken Essen-Mitte; Universitätsklinikum Freiburg; Brustzentrum Universitätsklinikum Erlangen; Uniklinik Köln; Charité University Hospital Berlin; National Center for Tumor Diseases (NCT), Heidelberg
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13
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Sinn BV, Weber K, Denkert C, Fasching PA, Schmitt WD, Thomas K, Ingold-Heppner B, van Mackelenbergh M, Symmans WF, Marmé F, Taube E, Müller V, Kunze CA, Schem C, Pfitzner BM, Stickeler E, von Minckwitz G, Loibl S. Abstract P1-07-01: HLA class I expression is associated with tumor-infiltrating lymphocytes and response and survival after neoadjuvant chemotherapy in hormone receptor-positive, HER2-negative breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-07-01] [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: Interactions between cancer cells and the host immune system influence tumor biology, response to therapy and patient survival and their modulation offers promising new approaches for cancer therapy. The downregulation or loss of HLA class I expression in breast cancer cells might be an effective mechanism to evade the recognition by the immune system facilitating malignant behavior.
Aim: To evaluate the association of tumor-infiltrating lymphocytes (TILs) with HLA class I expression and its theranostic value for therapy response and survival after neoadjuvant chemotherapy.
Methods: HLA class I expression was evaluated by immunohistochemistry in a cohort of 732 pre-therapeutic core biopsies from breast cancer patients treated within the neoadjuvant GeparTrio trial. Patients received anthracycline- and taxane-based neoadjuvant therapy and adjuvant endocrine treatment if hormone receptor-positive (HR+). A publicly available microarray dataset of pre-therapeutic core biopsies from 508 breast cancer patients that received neoadjuvant chemotherapy and endocrine treatment if HR+ was used for validation of the results. The association of HLA class I expression with predefined genomic signatures for immune cell populations was evaluated in publicly available data from the cancer genome atlas.
Results: HLA class I expression was associated with TILs (p < 0.001) and was predictive of better response to neoadjuvant chemotherapy in the subgroup of patients with HR+/HER2- breast cancer (14 % in tumors with high HLA vs. 7 % in tumors with low HLA, p = 0.029). Interestingly, high HLA was also predictive for shorter progression-free survival in univariate analysis (HR 1.590, 95 % CI 1.062—2.380; p = 0.024) and after adjustment to clinical and pathological parameters (HR 1.701, 95 % CI 1.105—2.618; p = 0.016). The results could be validated in the independent microarray-based dataset (HR 1.521, 95% CI 1.088 – 2.129; p = 0.0142). HLA class I was not associated with therapy response or survival in hormone receptor-negative breast cancer. HLA class I was associated with a predefined signature for T-cells and cytotoxic T- cells in the cancer genome atlas dataset (rho = 0.546).
Conclusion: HLA class I expression is associated with better response but shorter progression-free survival in HR+/HER2- breast cancer following neoadjuvant chemotherapy. The underlying mechanisms warrant further investigation.
Citation Format: Sinn BV, Weber K, Denkert C, Fasching PA, Schmitt WD, Thomas K, Ingold-Heppner B, van Mackelenbergh M, Symmans WF, Marmé F, Taube E, Müller V, Kunze CA, Schem C, Pfitzner BM, Stickeler E, von Minckwitz G, Loibl S. HLA class I expression is associated with tumor-infiltrating lymphocytes and response and survival after neoadjuvant chemotherapy in hormone receptor-positive, HER2-negative breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-01.
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Affiliation(s)
- BV Sinn
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - K Weber
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - C Denkert
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - PA Fasching
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - WD Schmitt
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - K Thomas
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - B Ingold-Heppner
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - M van Mackelenbergh
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - WF Symmans
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - F Marmé
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - E Taube
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - V Müller
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - CA Kunze
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - C Schem
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - BM Pfitzner
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - E Stickeler
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - G von Minckwitz
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - S Loibl
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
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Denkert C, Loibl S, Müller BM, Eidtmann H, Schmitt WD, Eiermann W, Gerber B, Tesch H, Hilfrich J, Huober J, Fehm T, Barinoff J, Jackisch C, Prinzler J, Rüdiger T, Erbstösser E, Blohmer JU, Budczies J, Mehta KM, von Minckwitz G. Ki67 levels as predictive and prognostic parameters in pretherapeutic breast cancer core biopsies: a translational investigation in the neoadjuvant GeparTrio trial. Ann Oncol 2013; 24:2786-93. [PMID: 23970015 DOI: 10.1093/annonc/mdt350] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The proliferation marker Ki67 has been suggested as a promising cancer biomarker. As Ki67 needs an exact quantification, this marker is a prototype of a new generation of tissue-based biomarkers. In this study, we have systematically evaluated different cut points for Ki67 using three different clinical end points in a large neoadjuvant study cohort. PATIENTS AND METHODS We have evaluated pretherapeutic Ki67 levels by immunohistochemistry in 1166 breast cancer core biopsies from the neoadjuvant GeparTrio trial. We used the standardized cutoff-finder algorithm for three end points [response to neoadjuvant chemotherapy (pCR), disease-free (DFS) and overall-survival (OS)]. The analyses were stratified for hormone receptor (HR) and HER2 status by molecular subtype radar diagrams (MSRDs). RESULTS A wide range of Ki67 cut points between 3%-94% (for pCR), 6%-46% (for DFS) and 4%-58% (for OS) were significant. The three groups of Ki67 ≤ 15% versus 15.1%-35% versus >35% had pCR-rates of 4.2%, 12.8%, and 29.0% (P < 0.0005), this effect was also present in six of eight molecular subtypes. In MSRD, Ki67 was significantly linked to prognosis in uni- and multivariate analysis in the complete cohort and in HR-positive, but not triple-negative tumors. CONCLUSIONS Ki67 is a significant predictive and prognostic marker over a wide range of cut points suggesting that data-derived cut point optimization might not be possible. Ki67 could be used as a continuous marker; in addition, the scientific community could define standardized cut points for Ki67. Our analysis explains the variability observed for Ki67 cut points in previous studies; however, this should not be seen as weakness, but as strength of this marker. MSRDs are an easy new approach for visualization of biomarker effects on outcome across molecular subtypes in breast cancer. The experience with Ki67 could provide important information regarding the development and implementation of other quantitative biomarkers.
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Affiliation(s)
- C Denkert
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin
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Schmitt WD, Siegert A, Lach SS, Fuhrmann S, Kondla A, Holm PS, Hauptmann S. Ribozyme to TGF-beta1 mRNA abrogates immunosuppressive effects of human colorectal adenocarcinoma HRT-18 cells in vitro and in vivo. Int J Oncol 2009; 35:901-8. [PMID: 19724928 DOI: 10.3892/ijo_00000405] [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: 11/05/2022] Open
Abstract
Transforming growth factor-beta1 (TGF-beta1) is overexpressed in a variety of malignant epithelial tumors and was suggested to be a marker of colorectal cancer. Moreover, there is growing evidence that TGF-beta1 contributes to tumor progression by regulating tumor cell proliferation and differentiation, inducing a favorable tumor microenvironment, promoting migration and invasion, and suppressing macrophage cytotoxicity. Therefore, we stably transfected an anti-TGF-beta1 hammerhead ribozyme into the human colorectal adenocarcinoma cell line HRT-18. Expression of this ribozyme resulted in significant inhibition of TGF-beta1 expression on mRNA and protein level. This was associated with an enhanced tumor cell differentiation and a reduced tumor growth in vivo. The capability of tumor cells to suppress ROI production of co-cultivated human macrophages was abrogated in transfectants. Taken together, inhibition of TGF-beta1 in colorectal carcinoma cells might be an interesting therapeutic tool leading to reduced tumor cell growth and increased macrophage cytotoxicity. Thus, a gene-therapeutic approach using anti-TGF-beta1 ribozyme in combination with established anti-tumor agents is of great promise.
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16
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Schmidt H, Taubert H, Lange H, Kriese K, Schmitt WD, Hoffmann S, Bartel F, Hauptmann S. Small polydispersed circular DNA contains strains of mobile genetic elements and occurs more frequently in permanent cell lines of malignant tumors than in normal lymphocytes. Oncol Rep 2009; 22:393-400. [PMID: 19578782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Small polydispersed circular DNA (spcDNA) belongs to the extrachromosomal pool of DNA and is composed of heterogeneous DNA circles. Whether spcDNA has a special function is currently unclear but their occurrence was suggested to be linked to genetic instability. In this study we investigated as to whether human lymphocytes from healthy volunteers also harbour spcDNA and whether spcDNA is present in all permanent cell lines from human normal and malignant tissues. Moreover, we were interested to see whether spcDNA contains sequences of mobile genetic elements. Our results show that spcDNA is present in all samples investigated yet the amount is lower in normal lymphocytes when compared to cancer cell lines (5.4 vs. 17.8%). Alu sequences were present in 12/16 cancer cell lines whereas LINE-1 (L1) sequences were present in 15 of them. Six tumor cell lines also contained telomeric sequences. In contrast to that, spcDNA of normal lymphocytes contains Alu and L1 sequences only in 3/16 cases and no telomeric sequences at all. Our findings suggest a direct dependency of the amount of Alu and L1 sequences on that of spcDNA. Beside these repetitive sequences, sequencing of spcDNA revealed in most cases chromosomal sequences of almost all chromosomes without an increased frequency of single regions. We suggest that the whole spcDNA including retrotranspositional elements and telomeric sequences may play a role for chromosomal rearrangements and genomic instability.
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Affiliation(s)
- Hannelore Schmidt
- Institute of Pathology, University of Halle-Wittenberg, D-06097 Halle/Saale, Germany.
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17
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Bartling B, Rehbein G, Schmitt WD, Hofmann HS, Silber RE, Simm A. S100A2-S100P expression profile and diagnosis of non-small cell lung carcinoma: impairment by advanced tumour stages and neoadjuvant chemotherapy. Eur J Cancer 2007; 43:1935-43. [PMID: 17689067 DOI: 10.1016/j.ejca.2007.06.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Revised: 06/12/2007] [Accepted: 06/20/2007] [Indexed: 01/29/2023]
Abstract
Early and correct diagnosis of non-small cell lung carcinoma (NSCLC) is essential for the choice of an appropriate anti-cancer therapy. Besides the histopathological diagnosis, molecular profiling by detection of the tumour-associated gene expression might play an upcoming role. As proteins of the S100 gene family show a distinct cell type-specific expression profile, our study focused on the relevance of the S100 family for identification and classification of NSCLCs. Among the S100 members, we identified the expression of S100A1, S100A2, S100A4, S100A6, S100A9 and S100P in human lung carcinoma cells (H358(p53-), A549(p53+)) or NSCLC tissues. Distinct S100 members are increased in NSCLCs compared with control lung specimens depending on the histopathological subtype. In particular, S100A2 was upregulated in squamous cell carcinomas, whereas S100P was mainly increased in adenocarcinomas. The upregulation of either S100A2 or S100P was detected in early but less in advanced tumour stages and not at all in NSCLC patients who had received neoadjuvant chemotherapy. In conclusion, our study indicates an important role of the S100A2-S100P expression profile for molecular diagnosis of NSCLCs at early and, therefore, prognostically more favourable tumour stage. As the S100A2-S100P profile also allows the histopathological classification, it might significantly support the conventional tumour diagnostics.
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Affiliation(s)
- Babett Bartling
- Department of Cardio-Thoracic Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, D-61120 Halle/Saale, Germany.
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Köbel M, Weidensdorfer D, Reinke C, Lederer M, Schmitt WD, Zeng K, Thomssen C, Hauptmann S, Hüttelmaier S. Expression of the RNA-binding protein IMP1 correlates with poor prognosis in ovarian carcinoma. Oncogene 2007; 26:7584-9. [PMID: 17546046 DOI: 10.1038/sj.onc.1210563] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The IMP (IGFII mRNA-binding protein) family comprises a group of three RNA-binding proteins involved in the regulation of cytoplasmic mRNA-fate. Recent studies identified IMP proteins as oncofetal factors in various neoplasias, but knowledge of a potential role in ovarian carcinomas is still lacking. The immunohistochemical analysis of 107 ovarian carcinomas, 30 serous borderline tumors of the ovary and five normal ovaries revealed de novo synthesis of IMP1 in 69% of ovarian carcinomas. Elevated IMP1 expression was observed preferentially in high-grade and high-stage cases and was a significant prognostic indicator for reduced recurrence-free and overall survival. Phenotypic studies in ovarian carcinoma-derived ES-2 cells demonstrated that IMP1 knockdown affects proliferation and cell survival. Reduced proliferation was associated with decreased c-myc mRNA half-life, suggesting IMP1 as an oncogenic factor that is involved in promoting elevated proliferation by stabilizing the c-myc mRNA in ovarian carcinoma cells.
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Affiliation(s)
- M Köbel
- Department of Medicine, Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Siegert A, Rosenberg C, Schmitt WD, Denkert C, Hauptmann S. Nitric oxide of human colorectal adenocarcinoma cell lines promotes tumour cell invasion. Br J Cancer 2002; 86:1310-5. [PMID: 11953890 PMCID: PMC2375351 DOI: 10.1038/sj.bjc.6600224] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2001] [Revised: 12/18/2001] [Accepted: 01/31/2002] [Indexed: 12/22/2022] Open
Abstract
The present study investigates the role of nitric oxide and the involvement of nitric oxide synthase II isoform on the invasion of human colorectal adenocarcinoma cell lines HRT-18 and HT-29. HRT-18 cells, which constitutively express nitric oxide synthase II mRNA were three-fold more invasive in a Matrigel invasion assay than nitric oxide synthase II mRNA negative HT-29 cells. Treatment of HT-29 cells with the nitric oxide donor Deta NONOate (50 nM) as well as induction of nitric oxide synthase II mRNA and production of endogenous nitric oxide by inflammatory cytokines (IFN-gamma and IL-1alpha) increased the invasiveness of HT-29 cells by approximately 40% and 75%, respectively. In HT-29 cells nitric oxide synthase II mRNA was also induced in co-culture with human monocytes. The invasiveness of HRT-18 cells and stimulated HT-29 cells was partly inhibited by the nitric oxide synthase II inhibitor 1400 W. These results show that nitric oxide increases the invasion of human colorectal adenocarcinoma cell lines HRT-18 and HT-29, and the involvement of nitric oxide synthase II isoform in tumour cell invasion. Therefore, the production of nitric oxide and secretion of pro-inflammatory cytokines by tumour-associated macrophages, which in turn induce nitric oxide synthase II isoform in tumour cells, promotes tumour cell invasiveness.
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Affiliation(s)
- A Siegert
- Institute of Pathology, Charité Hospital, Humboldt University, Schumannstr 20/21, D-10117 Berlin, Germany.
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