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Park JH, Fernando K, Park YH, Park EO. Global perspectives on bipolar disorder treatment: in-depth comparative analysis of international guidelines for medication selection. BJPsych Open 2024; 10:e75. [PMID: 38586960 DOI: 10.1192/bjo.2024.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Bipolar disorder, a chronic mental health condition characterised by fluctuations in mood, energy and functionality, affects millions of individuals worldwide. Its management requires a comprehensive approach, and, as such, treatment guidelines have a pivotal role in guiding clinicians to alleviate symptoms, prevent relapse and enhance overall patient well-being. However, the treatment landscape is far from homogenous, with significant variations existing across different countries. AIMS This study aimed to explore and compare treatment guidelines for bipolar disorder in various regions, shedding light on the factors that influence therapeutic approaches and thus offering insights that could contribute to the ongoing refinement of evidence-based practices in management. METHOD The study explores various international treatment guidelines for bipolar disorder that have been updated after 2014. Guidelines from the UK, Canada, Australia/New Zealand, South Korea and the International College of Neuropsychopharmacology are scrutinised to identify factors contributing to the observed differences among them. RESULTS The variations in recommended drugs across guidelines arise from the approaches employed in guideline development - whether relying on expert consensus or meta-analysis results. Timing disparities in conducting these analyses and the selection of studies also exert influence. Moreover, differences in metabolic enzymes among diverse races and the health policies implemented by individual nations play a significant part in shaping these differences. CONCLUSION The primary hindrance to consistent treatment conclusions lies in the scarcity of high-quality research results, leading to variations in guidelines. Enhancing evidence-based recommendations necessitates the undertaking of large-scale studies dedicated to assessing treatments for bipolar disorder.
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Affiliation(s)
- Ji Hyun Park
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea
| | - Kaveesha Fernando
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea
| | - Youngja Hwang Park
- Omics Research Center, Korea University, Sejong, Republic of Korea; and Metabolomics Laboratory, College of Pharmacy, Korea University, Sejong, Republic of Korea
| | - Esther O Park
- School of Nursing, College of Public Health, George Mason University, Fairfax, Virginia, USA
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Saura C, Modi S, Krop I, Park YH, Kim SB, Tamura K, Iwata H, Tsurutani J, Sohn J, Mathias E, Liu Y, Cathcart J, Singh J, Yamashita T. Trastuzumab deruxtecan in previously treated patients with HER2-positive metastatic breast cancer: updated survival results from a phase II trial (DESTINY-Breast01). Ann Oncol 2024; 35:302-307. [PMID: 38092229 DOI: 10.1016/j.annonc.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/02/2023] [Accepted: 12/04/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Primary analysis of the multicenter, open-label, single-arm, phase II DESTINY-Breast01 trial (median follow-up 11.1 months) demonstrated durable antitumor activity with trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC) previously treated with trastuzumab emtansine (T-DM1). We report updated cumulative survival outcomes with a median follow-up of 26.5 months (data cut-off 26 March 2021). PATIENTS AND METHODS Patients with HER2-positive mBC resistant or refractory to T-DM1 received T-DXd 5.4 mg/kg intravenously every 3 weeks until disease progression, unacceptable adverse events, or withdrawal of consent. The primary endpoint was confirmed objective response rate (ORR) by independent central review (ICR). Secondary endpoints included overall survival (OS), duration of response (DoR), progression-free survival (PFS), and safety. RESULTS The ORR by ICR was 62.0% [95% confidence interval (CI) 54.5% to 69.0%] in patients who received T-DXd 5.4 mg/kg every 3 weeks (n = 184). Median OS was 29.1 months (95% CI 24.6-36.1 months). Median PFS and DoR were 19.4 months (95% CI 14.1-25.0 months) and 18.2 months (95% CI 15.0 months-not evaluable), respectively. Drug-related treatment-emergent adverse events (TEAEs) were observed in 183 patients (99.5%), and 99 patients (53.8%) had one or more grade ≥3 TEAEs. Adjudicated drug-related interstitial lung disease/pneumonitis occurred in 15.8% of patients (n = 29), of which 2.7% (n = 5) were grade 5. CONCLUSIONS These updated results provide further evidence of sustained antitumor activity of T-DXd with a consistent safety profile in heavily pretreated patients with HER2-positive mBC.
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Affiliation(s)
- C Saura
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
| | - S Modi
- Memorial Sloan Kettering Cancer Center, New York
| | - I Krop
- Yale Cancer Center, New Haven, USA
| | | | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - K Tamura
- Shimane University Hospital, Izumo
| | - H Iwata
- Aichi Cancer Center Hospital, Nagoya
| | - J Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - J Sohn
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - E Mathias
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - Y Liu
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - J Cathcart
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - J Singh
- Daiichi Sankyo, Inc., Basking Ridge, USA
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Pusztai L, Denkert C, O'Shaughnessy J, Cortes J, Dent R, McArthur H, Kümmel S, Bergh J, Park YH, Hui R, Harbeck N, Takahashi M, Untch M, Fasching PA, Cardoso F, Zhu Y, Pan W, Tryfonidis K, Schmid P. Event-free survival by residual cancer burden with pembrolizumab in early-stage TNBC: exploratory analysis from KEYNOTE-522. Ann Oncol 2024:S0923-7534(24)00046-2. [PMID: 38369015 DOI: 10.1016/j.annonc.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND KEYNOTE-522 demonstrated statistically significant improvements in pathological complete response (pCR) with neoadjuvant pembrolizumab plus chemotherapy and event-free survival (EFS) with neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab in patients with high-risk, early-stage triple-negative breast cancer (TNBC). Prior studies have shown the prognostic value of the residual cancer burden (RCB) index to quantify the extent of residual disease after neoadjuvant chemotherapy. In this preplanned exploratory analysis, we assessed RCB distribution and EFS within RCB categories by treatment group. PATIENTS AND METHODS A total of 1174 patients with stage T1c/N1-2 or T2-4/N0-2 TNBC were randomized 2 : 1 to pembrolizumab 200 mg or placebo every 3 weeks given with four cycles of paclitaxel + carboplatin, followed by four cycles of doxorubicin or epirubicin + cyclophosphamide. After surgery, patients received pembrolizumab or placebo for nine cycles or until recurrence or unacceptable toxicity. Primary endpoints are pCR and EFS. RCB is a prespecified exploratory endpoint. The association between EFS and RCB was assessed using a Cox regression model. RESULTS Pembrolizumab shifted patients into lower RCB categories across the entire spectrum compared with placebo. There were more patients in the pembrolizumab group with RCB-0 (pCR), and fewer patients in the pembrolizumab group with RCB-1, RCB-2, and RCB-3. The corresponding hazard ratios (95% confidence intervals) for EFS were 0.70 (0.38-1.31), 0.92 (0.39-2.20), 0.52 (0.32-0.82), and 1.24 (0.69-2.23). The most common first EFS events were distant recurrences, with fewer in the pembrolizumab group across all RCB categories. Among patients with RCB-0/1, more than half [21/38 (55.3%)] of all events were central nervous system recurrences, with 13/22 (59.1%) in the pembrolizumab group and 8/16 (50.0%) in the placebo group. CONCLUSIONS Addition of pembrolizumab to chemotherapy resulted in fewer EFS events in the RCB-0, RCB-1, and RCB-2 categories, with the greatest benefit in RCB-2. These findings demonstrate that pembrolizumab not only increased pCR rates, but also improved EFS among most patients who do not have a pCR.
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Affiliation(s)
- L Pusztai
- Yale School of Medicine, Yale Cancer Center, New Haven, USA.
| | - C Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg, Marburg, Germany
| | - J O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology Network, Dallas, USA
| | - J Cortes
- International Breast Cancer Center, Quironsalud Group, Barcelona; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | - R Dent
- National Cancer Center Singapore, Duke - National University of Singapore Medical School, Singapore, Singapore
| | - H McArthur
- University of Texas Southwestern Medical Center, Dallas, USA
| | - S Kümmel
- Breast Unit, Kliniken Essen-Mitte, Essen; Charité - Universitätsmedizin Berlin, Department of Gynecology with Breast Center, Berlin, Germany
| | - J Bergh
- Department of Oncology-Pathology, Karolinska Institutet and Breast Cancer Centre, Cancer Theme, Karolinska University Hospital, Karolinska Comprehensive Cancer Center, Solna, Sweden
| | - Y H Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - R Hui
- Westmead Breast Cancer Institute, Westmead Hospital and the University of Sydney, Sydney, Australia
| | - N Harbeck
- Breast Center, Department of Obstetrics and Gynaecology, LMU University Hospital, Munich, Germany
| | - M Takahashi
- Hokkaido University Hospital, Sapporo, Japan
| | - M Untch
- Breast Cancer Center, Helios Klinikum Berlin-Buch, Berlin
| | - P A Fasching
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Y Zhu
- Oncology, Merck & Co., Inc., Rahway, USA
| | - W Pan
- Oncology, Merck & Co., Inc., Rahway, USA
| | | | - P Schmid
- Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London, UK
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Lee H, Yoon S, Park YH, Lee JS, Rhyu DY, Kim KT. Microbiota dysbiosis associated with type 2 diabetes-like effects caused by chronic exposure to a mixture of chlorinated persistent organic pollutants in zebrafish. Environ Pollut 2023; 334:122108. [PMID: 37422083 DOI: 10.1016/j.envpol.2023.122108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/10/2023]
Abstract
Mixtures of chlorinated persistent organic pollutants (C-POPs-Mix) are chemically related risk factors for type 2 diabetes mellitus (T2DM); however, the effects of chronic exposure to C-POPs-Mix on microbial dysbiosis remain poorly understood. Herein, male and female zebrafish were exposed to C-POPs-Mix at a 1:1 ratio of five organochlorine pesticides and Aroclor 1254 at concentrations of 0.02, 0.1, and 0.5 μg/L for 12 weeks. We measured T2DM indicators in blood and profiled microbial abundance and richness in the gut as well as transcriptomic and metabolomic alterations in the liver. Exposure to C-POPs-Mix significantly increased blood glucose levels while decreasing the abundance and alpha diversity of microbial communities only in females at concentrations of 0.02 and 0.1 μg/L. The majorly identified microbial contributors to microbial dysbiosis were Bosea minatitlanensis, Rhizobium tibeticum, Bifidobacterium catenulatum, Bifidobacterium adolescentis, and Collinsella aerofaciens. PICRUSt results suggested that altered pathways were associated with glucose and lipid production and inflammation, which are linked to changes in the transcriptome and metabolome of the zebrafish liver. Metagenomics outcomes revealed close relationships between intestinal and liver disruptions to T2DM-related molecular pathways. Thus, microbial dysbiosis in T2DM-triggered zebrafish occurred as a result of chronic exposure to C-POPs-Mix, indicating strong host-microbiome interactions.
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Affiliation(s)
- Hyojin Lee
- Department of Biology, University of Ottawa, Ontario K1N 6N5, Canada; Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
| | - Sojeong Yoon
- Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
| | - Youngja Hwang Park
- Metabolomics Laboratory, College of Pharmacy, Korea University, Sejong City 30019, Republic of Korea
| | - Jeong-Soo Lee
- Microbiome Convergence Research Center, KRIBB, Daejeon 34141, Republic of Korea
| | - Dong Young Rhyu
- Department of Biomedicine, Health & Life Convergence Sciences, BK21 FOUR, Mokpo National University, Jeonnam 58554, Republic of Korea
| | - Ki-Tae Kim
- Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea.
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Im SA, Gennari A, Park YH, Kim JH, Jiang ZF, Gupta S, Fadjari TH, Tamura K, Mastura MY, Abesamis-Tiambeng MLT, Lim EH, Lin CH, Sookprasert A, Parinyanitikul N, Tseng LM, Lee SC, Caguioa P, Singh M, Naito Y, Hukom RA, Smruti BK, Wang SS, Kim SB, Lee KH, Ahn HK, Peters S, Kim TW, Yoshino T, Pentheroudakis G, Curigliano G, Harbeck N. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer. ESMO Open 2023; 8:101541. [PMID: 37178669 PMCID: PMC10186487 DOI: 10.1016/j.esmoop.2023.101541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/27/2023] [Accepted: 04/01/2023] [Indexed: 05/15/2023] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer (MBC) was published in 2021. A special, hybrid guidelines meeting was convened by ESMO and the Korean Society of Medical Oncology (KSMO) in collaboration with nine other Asian national oncology societies in May 2022 in order to adapt the ESMO 2021 guidelines to take into account the differences associated with the treatment of MBC in Asia. These guidelines represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with MBC representing the oncological societies of China (CSCO), India (ISMPO), Indonesia (ISHMO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO). The voting was based on the best available scientific evidence and was independent of drug access or practice restrictions in the different Asian countries. The latter were discussed when appropriate. The aim of these guidelines is to provide guidance for the harmonisation of the management of patients with MBC across the different regions of Asia, drawing from data provided by global and Asian trials whilst at the same time integrating the differences in genetics, demographics and scientific evidence, together with restricted access to certain therapeutic strategies.
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Affiliation(s)
- S-A Im
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea.
| | - A Gennari
- Department of Translational Medicine, University Piemonte Orientale, Novara, Italy
| | - Y H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J H Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Z-F Jiang
- Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - S Gupta
- Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - T H Fadjari
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - K Tamura
- Department of Medical Oncology, Shimane University Hospital, Shimane, Japan
| | - M Y Mastura
- Cancer Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - M L T Abesamis-Tiambeng
- Section of Medical Oncology, Department of Internal Medicine, Cardinal Santos Cancer Center, San Juan, The Philippines
| | - E H Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - C-H Lin
- Department of Medical Oncology, National Taiwan University Hospital, Cancer Center Branch, Taipei, Taiwan
| | - A Sookprasert
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - N Parinyanitikul
- Medical Oncology Unit, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand
| | - L-M Tseng
- Taipei-Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - S-C Lee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore (NCIS), Singapore, Singapore
| | - P Caguioa
- The Cancer Institute of St Luke's Medical Center, National Capital Region, The Philippines; The Cancer Institute of the University of Santo Tomas Hospital, National Capital Region, The Philippines
| | - M Singh
- Department of Radiotherapy, Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; Department of Oncology, Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Y Naito
- Department of General Internal Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - R A Hukom
- Department of Hematology and Medical Oncology, Dharmais Hospital (National Cancer Center), Jakarta, Indonesia
| | - B K Smruti
- Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - S-S Wang
- Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - S B Kim
- Department of Oncology, Asan Medical Centre, Seoul, Republic of Korea
| | - K-H Lee
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - H K Ahn
- Division of Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - T W Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan, Italy; Department of Oncology and Haematology, University of Milano, Milan, Italy
| | - N Harbeck
- Breast Center, Department of Obstetrics and Gynaecology and Comprehensive Cancer Center Munich, LMU University Hospital, Munich, Germany
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Kim H, Bang G, Park YE, Park M, Choi JH, Oh MJ, An HJ, Yoo JS, Park YH, Kim JY, Hwang H. Advanced assessment through intact glycopeptide analysis of Infliximab’s biologics and biosimilar. Front Mol Biosci 2022; 9:1006866. [DOI: 10.3389/fmolb.2022.1006866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022] Open
Abstract
Characterization of therapeutic monoclonal antibodies (mAbs) represents a major challenge for analytical sciences due to their heterogeneity associated with post-translational modifications (PTMs). The protein glycosylation requires comprehensive identification, which could influence on the mAbs’ structure and their function. Here, we demonstrated high-resolution tandem mass spectrometry with an ultra-high-performance liquid chromatography for characterization and comparison between biologics and biosimilar of infliximab at an advanced level. Comparing the N- and O-glycopeptides profiles, a total of 49 and 54 glycopeptides was identified for each product of the biologics and biosimilar, respectively. We also discovered one novel N-glycosylation site at the light chain from both biopharmaceuticals and one novel O-glycopeptide at the heavy chain from only biosimilar. Site-specific glycopeptide analysis process will be a robust and useful technique for evaluating therapeutic mAbs and complex glycoprotein products.
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Bang G, Park JH, Park C, Kim KJ, Kim JK, Lee SY, Kim JY, Park YH. High-resolution metabolomics-based biomarker discovery using exhaled breath condensate from patients with lung cancer. J Anal Sci Technol 2022. [DOI: 10.1186/s40543-022-00347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractEarly diagnosis and treatment are critical for improving the survival of patients with lung cancer, which is the leading cause of cancer-related deaths worldwide. In this study, we investigated whether the metabolomics analysis of exhaled breath condensate (EBC) from patients with lung cancer can provide biomarkers that can be used for noninvasive screening for lung cancer diagnosis. EBC samples obtained from patients with lung cancer (n = 20) and healthy individuals (n = 5) were subjected to high-resolution metabolomics (HRM) using liquid chromatography–mass spectrometry (LC–MS). Univariate analysis, with a false discovery rate (FDR), q = 0.05, and hierarchical clustering analysis were performed to discover significantly different metabolites between the healthy controls and patients with lung cancer. This was followed by the identification of the metabolites using the METLIN database. Pathway analysis based on the identified metabolites revealed that arachidonic acid (AA) metabolism was the most significantly affected pathway. Finally, 5-hydroxyicosatetraenoic acid (HETE) (m/z 343.2233, [M + Na]+), a metabolite involved in AA metabolism, was found to be significantly higher in patients with lung cancer than in healthy counterparts. Our finding suggested that the HRM of EBC samples is a useful approach for identifying biomarkers for noninvasive screening for lung cancer diagnosis.
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Bang G, Lee H, Kim H, Han EH, Park YH, Kim JY. Comparison of protein characterization using In solution and S-Trap digestion methods for proteomics. Biochem Biophys Res Commun 2021; 589:197-203. [PMID: 34922203 DOI: 10.1016/j.bbrc.2021.12.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/02/2022]
Abstract
Protein extraction and digestion are important analytical steps in the study of proteomics. The use of sodium dodecyl sulfate (SDS) buffer makes it possible to effectively analyze various proteins. Its use was evaluated using the S-Trap digestion method and compared to the traditional In solution digestion method. Differences in protein composition were examined for each protein preparation method. S-Trap digestion followed by SDS buffer extraction clearly increased the number of identified proteins, including more mitochondrial and membrane-related proteins. The S-Trap digestion method with 5% SDS buffer was applied to the pellet remaining from the removal of RIPA buffer-soluble proteins, which identified more extracellular space proteins than the conventional S-Trap digestion method. S-Trap digestion of the pellet was particularly advantageous for identifying proteins located inside multilayer membranes.
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Affiliation(s)
- Geul Bang
- Research Center for Bioconvergence Analysis, Korea Basic Science Institute, Chungbuk, 28119, Republic of Korea; Metabolomics Laboratory, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Hayoung Lee
- Research Center for Bioconvergence Analysis, Korea Basic Science Institute, Chungbuk, 28119, Republic of Korea; Department of Bio-Analytical Science, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Hyejin Kim
- Research Center for Bioconvergence Analysis, Korea Basic Science Institute, Chungbuk, 28119, Republic of Korea
| | - Eun Hee Han
- Research Center for Bioconvergence Analysis, Korea Basic Science Institute, Chungbuk, 28119, Republic of Korea
| | - Youngja Hwang Park
- Metabolomics Laboratory, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea.
| | - Jin Young Kim
- Research Center for Bioconvergence Analysis, Korea Basic Science Institute, Chungbuk, 28119, Republic of Korea.
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Na J, Zhang J, Choe YL, Lim CS, Park YH. An in vitro study on the differentiated metabolic mechanism of chloroquine-resistant Plasmodium falciparum using high-resolution metabolomics. J Toxicol Environ Health A 2021; 84:859-874. [PMID: 34338159 DOI: 10.1080/15287394.2021.1944945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Chloroquine (CQ) is an important drug used therapeutically for treatment of malaria. However, due to limited number of studies on metabolic targets of chloroquine (CQ), it is difficult to attribute mechanisms underlying resistance associated with usage of this drug. The present study aimed to investigate the metabolic signatures of CQ-resistant Plasmodium falciparum (PfDd2) compared to CQ-sensitive Plasmodium falciparum (Pf3D7). Both Pf3D7 and PfDd2 were treated with CQ at 200 nM for 48 hr; thereafter, the harvested red blood cells (RBCs) and media were subjected to microscopy and high-resolution metabolomics (HRM). Glutathione, γ-L-glutamyl-L-cysteine, spermidine, inosine monophosphate, alanine, and fructose-1,6-bisphosphate were markedly altered in PfDd2 of RBC. In the media, cysteine, cysteic acid, spermidine, phenylacetaldehyde, and phenylacetic acid were significantly altered in PfDd2. These differential metabolic signatures related signaling pathways of PfDd2, such as oxidative stress pathway and glycolysis may provide evidence for understanding the resistance mechanism and pathogenesis of the CQ-resistant parasite.
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Affiliation(s)
- Jinhyuk Na
- College of Pharmacy, Korea University, Sejong, Republic of Korea
| | - Jian Zhang
- Omics Research Center, Sejong, Republic of Korea
| | - Young Lan Choe
- Department of Laboratory Medicine, Korea University, Seoul, Republic of Korea
| | - Chae Seung Lim
- Department of Laboratory Medicine, Korea University, Seoul, Republic of Korea
| | - Youngja Hwang Park
- College of Pharmacy, Korea University, Sejong, Republic of Korea
- Omics Research Center, Sejong, Republic of Korea
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Kang MG, Kim KH, Park HW, Koh JS, Park JR, Park YH, Hwang SJ, Jeong YH, Kwak CH, Ahn JH, Song HN, Hwang JY. Impact of active and stable cancer on survival in patients undergoing percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2858] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
With advances in treatment of ischemic heart disease and cancer treatment, use of percutaneous coronary intervention (PCI) in cancer survivors and patients with active cancer (AC) is expanding.
Objectives
The purpose of this study was to determine the impact of cancer on survival and major cardiovascular events (MACE) in a long-term, single-center cohort of patients treated with PCI.
Methods
Patients treated with PCI between January 2010 and December 2017 were grouped as follows: controls (patients without cancer), stable cancer (SC), and AC. AC was included patients with cancer diagnosed within the past 6 months, patients who had cancer-related therapy within the past 6 months, active metastatic disease, or active recurrence of the cancer. The primary endpoints were 5-year survival and a secondary endpoint was 5-year MACE.
Results
A total of 6,743 patients (age 66±12 years, 68.4% men) treated with PCI were included: 6,404 (95.0%) controls, 245 (3.6%) SC, and 94 (1.4%) AC. Predominant malignancies were gastrointestinal (37.4%), lung (22.7%), and genitourinary cancer (14.7%). No differences were observed between patients with AC, SC and controls regarding 5-year MACE (total MACE, 33.2% vs. 28.1% vs. 17.5%, p=0.072; cardiac death, 13.6% vs. 9.1% vs. 6.7%, p=0.066; non-fatal myocardial infarction, 2.9% vs. 7.5% vs. 7.8%, p=0.820; revascularization, 17.9% vs. 17.6% vs. 11.6%, p=0.794, respectively). Patients with AC and SC had reduced 5-year survival compared with controls (62.0% vs. 81.5% vs. 89.8%, p<0.001) (Figure). AC was associated with a 1.76 (95% CI 1.22 to 2.54, p=0.002) fold increased risk of all-cause 5-year mortality in multivariable adjusted models.
Conclusions
Cumulative incidence of 5-year survival was discriminated by concurrent status of cancer following PCI. Individualized decision making is needed in the routine practice of PCI regarding concurrent cancer-specific treatment and prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kang
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Park
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - H N Song
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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Lee H, Gao Y, Ko E, Lee J, Lee HK, Lee S, Choi M, Shin S, Park YH, Moon HB, Uppal K, Kim KT. Nonmonotonic response of type 2 diabetes by low concentration organochlorine pesticide mixture: Findings from multi-omics in zebrafish. J Hazard Mater 2021; 416:125956. [PMID: 34492873 DOI: 10.1016/j.jhazmat.2021.125956] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/03/2021] [Accepted: 04/21/2021] [Indexed: 06/13/2023]
Abstract
Exposure to a single organochlorine pesticide (OCP) at high concentration and over a short period of exposure constrain our understanding of the contribution of chemical exposure to type 2 diabetes (T2D). A total of 450 male and female zebrafish was exposed to mixtures of five OCPs at 0, 0.05, 0.25, 2.5, and 25 μg/L for 12 weeks. T2D-related hematological parameters (i.e., glucose, insulin, free fatty acid, and triglycerides) and mitochondrial complex I to IV activities were assessed. Metabolomics, proteomics, and transcriptomics were analyzed in female livers, and their data-driven integration was performed. High fasting glucose and low insulin levels were observed only at 0.05 μg/L of the OCP mixture in females, indicating a nonlinear and sexually dependent response. We found that exposure to the OCP mixture inhibited the activities of mitochondrial complexes, especially III and IV. Combining individual and integrated omics analysis, T2D-linked metabolic pathways that regulate mitochondrial function, insulin signaling, and energy homeostasis were altered by the OCP mixture, which explains the observed phenotypic hematological effects. We demonstrated the cause-and-effect relationship between exposures to OCP mixture and T2D using zebrafish model. This study gives an insight into mechanistic research of metabolic diseases caused by chemical exposure using zebrafish.
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Affiliation(s)
- Hyojin Lee
- Department of Environmental Energy Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
| | - Yan Gao
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Eun Ko
- Department of Biotechnology and Bioengineering, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Jihye Lee
- Metabolomics Laboratory, College of Pharmacy, Korea University, Sejong City 30019, Republic of Korea
| | - Hyun-Kyung Lee
- Department of Marine Science and Convergent Technology, Hanyang University, Ansan 15588, Republic of Korea
| | - Sangkyu Lee
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Moonsung Choi
- Department of Optometry, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea; Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
| | - Sooim Shin
- Department of Biotechnology and Bioengineering, Chonnam National University, Gwangju 61186, Republic of Korea; Interdisciplinary Program of Bioenergy and Biomaterials Graduate School, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Youngja Hwang Park
- Metabolomics Laboratory, College of Pharmacy, Korea University, Sejong City 30019, Republic of Korea
| | - Hyo-Bang Moon
- Department of Marine Science and Convergent Technology, Hanyang University, Ansan 15588, Republic of Korea
| | - Karan Uppal
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Ki-Tae Kim
- Department of Environmental Energy Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea; Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea.
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12
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Park SJ, Park YH. Simplified technique of in-office secondary tracheoesophageal puncture with immediate voice prosthesis placement under transnasal esophagoscope guidance. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 2:53-54. [PMID: 34116948 DOI: 10.1016/j.anorl.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/17/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Affiliation(s)
- S J Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul, 07345, Korea
| | - Y H Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul, 07345, Korea.
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13
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Park YH, Lee YS, Seo YM, Seo H, Park JS, Bae HS, Park JC. Midkine Promotes Odontoblast-like Differentiation and Tertiary Dentin Formation. J Dent Res 2020; 99:1082-1091. [PMID: 32442055 DOI: 10.1177/0022034520925427] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Autophagy is an intracellular self-degradation process that is essential for tissue development, cell differentiation, and survival. Nevertheless, the role of autophagy in tooth development has not been definitively identified. The goal of this study was to investigate how autophagy is involved in midkine (MK)-mediated odontoblast-like differentiation, mineralization, and tertiary dentin formation in a mouse tooth pulp exposure model. In vitro studies show that MK and LC3 have similar expression patterns during odontoblast-like cell differentiation. Odontoblast-like cell differentiation is promoted through MK-mediated autophagy, which leads to increased mineralized nodule formation. Subcutaneous transplantation of hydroxyapatite/tricalcium phosphate with rMK-treated human dental pulp cells led to dentin pulp-like tissue formation through MK-mediated autophagy. Furthermore, MK-mediated autophagy induces differentiation of dental pulp cells into odontoblast-like cells that form DSP-positive tertiary dentin in vivo. Our findings may provide 1) novel insight into the role of MK in regulating odontoblast-like differentiation and dentin formation in particular via autophagy and 2) potential application of MK in vital pulp therapy.
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Affiliation(s)
- Y H Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Y S Lee
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Y M Seo
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H Seo
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - J S Park
- Department of Dental Hygiene, Seoyeong University, Gwang-ju, Republic of Korea
| | - H S Bae
- Department of Oral Hygiene, Namseoul University, Cheonan, Republic of Korea
| | - J C Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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14
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Park YH, Senkus-Konefka E, Im SA, Pentheroudakis G, Saji S, Gupta S, Iwata H, Mastura MY, Dent R, Lu YS, Yin Y, Smruti BK, Toyama T, Malwinder S, Lee SC, Tseng LM, Kim JH, Kim TY, Suh KJ, Cardoso F, Yoshino T, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with early breast cancer: a KSMO-ESMO initiative endorsed by CSCO, ISMPO, JSMO, MOS, SSO and TOS. Ann Oncol 2020; 31:451-469. [PMID: 32081575 DOI: 10.1016/j.annonc.2020.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/20/2019] [Accepted: 01/04/2020] [Indexed: 12/27/2022] Open
Abstract
In view of the planned new edition of the most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of primary breast cancer published in 2015, it was decided at the ESMO Asia Meeting in November 2018, by both the ESMO and the Korean Society of Medical Oncology (KSMO), to convene a special face-to-face guidelines meeting in 2019 in Seoul. The aim was to adapt the latest ESMO 2019 guidelines to take into account the ethnic and geographical differences associated with the treatment of early breast cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with early breast cancer representing the oncology societies of Korea (KSMO), China (CSCO), India (ISMPO) Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices, and the drug availability and reimbursement situations, in the individual participating Asian countries.
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Affiliation(s)
- Y H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - E Senkus-Konefka
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - S-A Im
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - S Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - S Gupta
- Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Y Mastura
- Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - R Dent
- Medical Oncology, National Cancer Center Singapore, Singapore, Singapore
| | - Y-S Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Y Yin
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - B K Smruti
- Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - T Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - S Malwinder
- Sri Kota Specialist Medical Centre, Selangor, Malaysia
| | - S C Lee
- Department of Haematology-Oncology, National University, Cancer Institute, Singapore, (NCIS) National University Health System, Singapore, Singapore
| | - L-M Tseng
- Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
| | - J H Kim
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - T-Y Kim
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - K J Suh
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Lee SY, Lee SH, Park YH. P799 The echocardiographic and clinical characteristics of Fabry patients without overt left ventricular hypertrophy but progressing despite on enzyme replacement therapy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.455] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Fabry disease (FD) is X-linked genetic disorder caused by the deficiency or absent activity of lysosomal α- galactosidase. When the heart is involved, progressive left ventricular hypertrophy (LVH) is the key feature. Although, LVH is not present in all subjects, some of them progress with LVH despite enzyme replacement therapy (ERT). The present study aimed to evaluate the characteristics of patient of FD without overt LVH, but progresses with their left ventricular mass index (LVMI).
Method : This study includes subjects carrying genetic mutations for FD without LVH (n = 12) in a single tertiary center. ‘Decreasing LVMI group (Group1)’ was defined when pre-ERT LVMI minus last LVMI value obtained by echocardiography was positive, and when negative, defined as ‘Increasing LVMI group (Group 2)’. The baseline characteristics and echocardiographic parameters including global strain was analyzed.
Result : Total 6 patients were classified as Group 1 and 2 each. The median age at diagnosis for male was 21 vs 27 for each group, and 21 vs 31 for female. The median follow-up duration was 4.0 vs 5.7 yr. The antibody formation for replaced enzyme was 3 for Group 2 and any family member who developed overt LVH was much 1 vs 3 for group 1 vs 2. Initial 3 plane GLS was worse and showed trend to drop in Group 2.
Conclusion : In the Fabry patients get worse with their LVMI but still not developed overt LVH despite enzyme replacement therapy, there are some clinical and echo-parameter difference. These findings could suggest insufficient enzyme replacement therapy.
Group 1 (n = 6) Group 2 (n = 6) Female/Male 4/2 3/3 Age of at Dx (Female) (median) 21 28 Age of at Dx (Male) (median) 21 31 F/U duration (median) 4.0 yrs 5.7 yrs Antibody formation 0 3 Any Overt LVH family Genotype c.56T > C c.40-11T > A, 782_delG, c.658C > T Initial LVMI (Median) 98.2g/m2 70.9g/m2 Initial GLS (3P) -19 -17.8 Continuously elevated LysoGb3 2 4 Proteinuria >300mg 1 3 (1 preparing HD)
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Affiliation(s)
- S Y Lee
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| | - S H Lee
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
| | - Y H Park
- Pusan National University Yangsan Hospital, Yangsan-si, Korea (Republic of)
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16
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Na J, Khan A, Kim JK, Wadood A, Choe YL, Walker DI, Jones DP, Lim CS, Park YH. Discovery of metabolic alterations in the serum of patients infected with Plasmodium spp. by high-resolution metabolomics. Metabolomics 2019; 16:9. [PMID: 31872321 DOI: 10.1007/s11306-019-1630-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/18/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Despite the advances in diagnosis and treatment, malaria has still not been eradicated. Metabolic interactions between the host and Plasmodium may present novel targets for malaria control, but such interactions are yet to be deciphered. An exploration of metabolic interactions between humans and two Plasmodium species by high-resolution metabolomics may provide fundamental insights that can aid the development of a new strategy for the control of malaria. OBJECTIVES This study aimed at exploring the metabolic changes in the sera of patients infected with Plasmodium falciparum and Plasmodium vivax. METHODS Uni- and multivariate metabolomic analyses were performed on the sera of four groups of patients, namely normal control (N, n = 100), P. falciparum-infected patients (PF, n = 21), P. vivax-infected patients (PV, n = 74), and non-malarial pyretic patients (Pyr, n = 25). RESULTS Univariate and multivariate analyses of N, PF, and PV groups showed differential metabolic phenotypes and subsequent comparisons in pairs revealed significant features. Pathway enrichment test with significant features showed the affected pathways, namely glycolysis/gluconeogenesis for PF and retinol metabolism for PV. The metabolites belonging to the affected pathways included significantly low 2,3-diphosphoglycerate and glyceraldehyde-3-phosphate in the sera of PF. The sera of PV had significantly low levels of retinol but high levels of retinoic acid. CONCLUSION Our study reveals metabolic alterations induced by Plasmodium spp. in human serum and would serve as a milestone in the development of novel anti-malarial strategies.
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Affiliation(s)
- Jinhyuk Na
- College of Pharmacy, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong, 30019, Republic of Korea
| | - Adnan Khan
- College of Pharmacy, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong, 30019, Republic of Korea
| | - Jae Kwan Kim
- College of Pharmacy, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong, 30019, Republic of Korea
| | - Abdul Wadood
- College of Pharmacy, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong, 30019, Republic of Korea
| | - Young Lan Choe
- Department of Laboratory Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Douglas I Walker
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University, Atlanta, GA, 30308, USA
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University, Atlanta, GA, 30308, USA
| | - Chae Seung Lim
- Department of Laboratory Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
| | - Youngja Hwang Park
- College of Pharmacy, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong, 30019, Republic of Korea.
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Park YH, Lee SJ, Cho EY, La Choi Y, Lee JE, Nam SJ, Yang JH, Shin JH, Ko EY, Han BK, Ahn JS, Im YH. Clinical relevance of TNM staging system according to breast cancer subtypes. Ann Oncol 2019; 30:2011. [PMID: 31408085 DOI: 10.1093/annonc/mdz223] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
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18
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Park M, Lee Y, Khan A, Aleta P, Cho Y, Park H, Park YH, Kim S. Metabolite tracking to elucidate the effects of environmental pollutants. J Hazard Mater 2019; 376:112-124. [PMID: 31128390 DOI: 10.1016/j.jhazmat.2019.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/30/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to determine whether behavioral tests and metabolic profiling of organisms can be promising alternatives for assessing the health of aquatic systems. Water samples from four potential pollution sources in South Korea were collected for toxicity evaluation. First, conventional acute toxicity test in Daphnia magna and behavioral test in zebrafish was conducted to assess water quality. Second, metabolomic analysis was performed on zebrafish exposed to water samples and on environmental fish collected from the same source. Acute toxicity test in D. magna showed that none of the water samples exerted significant adverse effects. However, activity of zebrafish larvae exposed to samples from the zinc smelter (ZS) and industrial complex (IND) sites decreased compared to those exposed to samples from the reference site (RS). Metabolomic analysis using the Manhattan plot and Partial Least Square (PLS)/Orthogonal PLS Discriminant Analysis (OPLS-DA) showed differences in metabolic profiles between RS and ZS, and between IND and abandoned mine site (M). Interestingly, applying the same metabolomic analysis to environmental fish revealed patterns similar to those for zebrafish, despite the uncontrollable variables involved in environmental sampling. This study shows that metabolomics is a promising tool in assessing the health of aquatic environments.
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Affiliation(s)
- Minseung Park
- Bio Monitoring Laboratory, Program in Environmental Technology and Policy, Korea University Sejong Campus, 2511 Sejong-ro, Sejong City, Chungnam 30019, Republic of Korea
| | - Yeseung Lee
- Metabolomics Laboratory, College of Pharmacy, Korea University Sejong Campus, 2511 Sejong-ro, Sejong City, Chungnam 30019, Republic of Korea
| | - Adnan Khan
- Metabolomics Laboratory, College of Pharmacy, Korea University Sejong Campus, 2511 Sejong-ro, Sejong City, Chungnam 30019, Republic of Korea
| | - Prince Aleta
- Bio Monitoring Laboratory, Program in Environmental Technology and Policy, Korea University Sejong Campus, 2511 Sejong-ro, Sejong City, Chungnam 30019, Republic of Korea
| | - Yunchul Cho
- Department of Environmental Engineering, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 300-716, Republic of Korea
| | | | - Youngja Hwang Park
- Metabolomics Laboratory, College of Pharmacy, Korea University Sejong Campus, 2511 Sejong-ro, Sejong City, Chungnam 30019, Republic of Korea.
| | - Sungpyo Kim
- Bio Monitoring Laboratory, Program in Environmental Technology and Policy, Korea University Sejong Campus, 2511 Sejong-ro, Sejong City, Chungnam 30019, Republic of Korea.
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19
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Park JH, Lee KE, Yu YM, Park YH, Choi SA. Incidence and Risk Factors for Venous Thromboembolism After Spine Surgery in Korean Patients. World Neurosurg 2019; 128:e289-e307. [PMID: 31028984 DOI: 10.1016/j.wneu.2019.04.140] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Data regarding the incidence of venous thromboembolism (VTE) after spine surgery are scarce. Identifying ideal candidates for pharmacologic thromboprophylaxis and balancing the risk of thromboembolic complications against the risk of permanent neurologic deficits from a spinal epidural hematoma (SEH) are difficult. Even guidelines cannot suggest the standard of thromboprophylaxis. OBJECTIVES This study aimed to identify the incidence of and risk factors for VTE after spine surgery in the Korean population. In addition, the rate of pharmacoprophylaxis and the incidence of SEH after spine surgery were analyzed. METHODS The study cohort was generated by extracting patients with disease codes of spine surgery and VTE from the Health Insurance Review & Assessment Service National Inpatient Sample in 2014. After analyzing the incidence of VTE after spine surgery, a univariate comparison was performed to examine the possible relationship between the incidence of VTE and the independent variable. Variables found to be significant were included in a multivariable analysis model for further analysis. RESULTS The incidence of VTE was 2.09% among all 21,261 patients who had spine surgery, and prophylaxis was applied to 7.89% of all patients who had spine surgery. Comorbidities and surgery-related risk factors were venous disease, cancer, respiratory disease, prolonged surgery hours, and increased total blood loss. Hospital-related risk factors were the location and hospital size. CONCLUSIONS On the basis of the incidence of VTE and the risk factors, more active prophylaxis is suggested for patients in the Korean population who undergo spine surgery.
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Affiliation(s)
- Ji Hyun Park
- College of Pharmacy, Korea University, Sejong-si, Republic of Korea
| | - Kyung Eun Lee
- College of Pharmacy, Chungbuk National University, Yeonje-ri, Osong-eup, Heungdeok-gu, Cheongju-si, Republic of Korea
| | - Yun Mi Yu
- College of Pharmacy, Yonsei University, Incheon, Yeonsu-gu, Republic of Korea
| | | | - Soo An Choi
- College of Pharmacy, Korea University, Sejong-si, Republic of Korea.
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Khan A, Shin OS, Na J, Kim JK, Seong RK, Park MS, Noh JY, Song JY, Cheong HJ, Park YH, Kim WJ. A Systems Vaccinology Approach Reveals the Mechanisms of Immunogenic Responses to Hantavax Vaccination in Humans. Sci Rep 2019; 9:4760. [PMID: 30886186 PMCID: PMC6423257 DOI: 10.1038/s41598-019-41205-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 07/17/2018] [Accepted: 02/27/2019] [Indexed: 01/08/2023] Open
Abstract
Hantavax is an inactivated vaccine for hemorrhagic fever with renal syndrome (HFRS). The immunogenic responses have not been elucidated yet. Here we conducted a cohort study in which 20 healthy subjects were administered four doses of Hantavax during 13-months period. Pre- and post- vaccinated peripheral blood mononuclear cells (PBMCs) and sera were analysed by transcriptomic and metabolomic profilings, respectively. Based on neutralizing antibody titers, subjects were subsequently classified into three groups; non responders (NRs), low responders (LRs) and high responders (HRs). Post vaccination differentially expressed genes (DEGs) associated with innate immunity and cytokine pathways were highly upregulated. DEG analysis revealed a significant induction of CD69 expression in the HRs. High resolution metabolomics (HRM) analysis showed that correlated to the antibody response, cholesteryl nitrolinoleate, octanoyl-carnitine, tyrosine, ubiquinone-9, and benzoate were significantly elevated in HRs, while chenodeoxycholic acid and methyl palmitate were upregulated in NRs and LRs, compared with HRs. Additionally, gene-metabolite interaction revealed upregulated gene-metabolite couplings in, folate biosynthesis, nicotinate and nicotinamide, arachidonic acid, thiamine and pyrimidine metabolism in a dose dependent manner in HR group. Collectively, our data provide new insight into the underlying mechanisms of the Hantavax-mediated immunogenicity in humans.
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Affiliation(s)
- Adnan Khan
- Metabolomics Laboratory, Korea University College of Pharmacy, Sejeong city, Republic of Korea
| | - Ok Sarah Shin
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jinhyuk Na
- Metabolomics Laboratory, Korea University College of Pharmacy, Sejeong city, Republic of Korea
| | - Jae Kwan Kim
- Metabolomics Laboratory, Korea University College of Pharmacy, Sejeong city, Republic of Korea
| | - Rak-Kyun Seong
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Man-Seong Park
- Department of Microbiology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youngja Hwang Park
- Metabolomics Laboratory, Korea University College of Pharmacy, Sejeong city, Republic of Korea.
| | - Woo Joo Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea. .,Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
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Imoto S, Futamura M, Toi M, Fujiwara Y, Ueno T, Im YH, Im SA, Ahn SG, Lee JE, Park YH, Wang K, Kitagawa Y, Nishiyama M. Abstract OT2-05-02: International retrospective cohort study of locoregional and systemic therapy in oligometastatic breast cancer (OLIGO-BC1). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-05-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer (BC) is so-called “systemic disease”, because disseminated cancer cells in bone marrow and blood are detected even in early BC patients. Despite adjuvant therapy and postoperative radiation therapy, patients with triple negative BC and Luminal B-like BC often relapse early and systemic therapy is the only way to control disease progression. On the other hand, some BC patients relapse several years later. In such patients, oligometastases are occasionally diagnosed, because metastatic cancer cells are slowly growing and indolent. Oligometastatic BC is defined as low volume metastatic disease with limited number and size of metastatic lesions (up to five and not necessarily in the same organ). This definition is proposed in the Advanced Breast Cancer guidelines that are developed as a joint effort from European School of Oncology and European Society of Medical Oncology. Several retrospective studies demonstrated survival benefit of locoregional therapy in addition to systemic therapy. Locoregional therapy consisted of surgical resection, radiation therapy, ablation therapy, etc. However, it remains unclear about survival benefit of combined therapy in oligometastatic BC. To improve the standard of cancer treatment through the cooperate studies on more effective therapeutic strategies based on drugs, surgery and/or radiotherapy, Federation of Asian Clinical Oncology (FACO) was established in 2012 by Chinese Society of Clinical Oncology (CSCO), Korean Society of Medical Oncology (KSMO) and Japan Society of Clinical Oncology (JSCO). Thus, FACO conducted a retrospective cohort study on oligometastatic BC. The primary endpoint is to compare the estimated 5-year overall survival (OS) of oligometastatic BC patients treated with combined therapy and systemic therapy alone. To hypothesize that combined therapy has more advantage of OS in oligometastatic BC, the 5-year OS rates are expected to be 50% and 40%, respectively. The estimated sample size is calculated to be the number of 698 cases (349 cases in each group) needed to prove the superiority of survival with a two-sided type I error rate of 5% and a statistical power of 80%. Case registry opened in February 2018 and will close in January 2019. We planned to register 700 cases, i.e., 234 cases each from investigators of CSCO, KSMO and JSCO. Update information will be discussed.
Citation Format: Imoto S, Futamura M, Toi M, Fujiwara Y, Ueno T, Im Y-H, Im S-A, Ahn SG, Lee JE, Park YH, Wang K, Kitagawa Y, Nishiyama M. International retrospective cohort study of locoregional and systemic therapy in oligometastatic breast cancer (OLIGO-BC1) [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 OT2-05-02.
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Affiliation(s)
- S Imoto
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - M Futamura
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - M Toi
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Y Fujiwara
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Ueno
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Y-H Im
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - S-A Im
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - SG Ahn
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - JE Lee
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - YH Park
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - K Wang
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Y Kitagawa
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
| | - M Nishiyama
- Kyorin University School of Medicine, Mitaka, Japan; Gifu University School of Medicine, Gifu, Japan; Kyoto University School of Medicine, Kyoto, Japan; National Cancer Center Hospital, Tokyo, Japan; Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Guangdong General Hospital, Guangzhou, China; Keio University School of Medicine, Tokyo, Japan; Gunma University Graduate School of Medicine, Maebashi, Japan
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Ahn HK, Park S, Hyun SH, Park K, Lee E, Kim JY, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im YH, Park YH. Abstract P3-08-12: PIK3CA mutations in breast cancer: Mutational landscape and clinical implications in ER+/HER2- subtype. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: PIK3CA mutation is one of the most frequent genomic alterations in breast cancer. We evaluated PIK3CA mutational status including spatial and temporal heterogeneity, clinical characteristics and prognostic impact focused on ER+/HER2- subtype.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) of breast cancer tissue in a prospective cohort. Burden of disease was assessed by metabolic tumor volume(MTV) in 18F-FDG-PET scan. Association with clinical characteristics or survival were tested in ER+/HER2- subtype, using Chi square test or Kaplan-Meier method.
Results: PIK3CA analyses were performed in 1274 breast cancer specimens from 1091 patients. 957 patients had early breast cancer. PIK3CA alterations were found in 397 patients(36.3%), and frequency of PIK3CA mutation was significantly lower in triple negative breast cancer(19.0%), compared with 40.4% in ER+/HER2-, 40.9% in ER+/HER2+, and 45.2% in ER-/HER2+ subtype(p<0.0001). 158 patients had more than two biopsies. Among 92 patients with second biopsy within one month, 11%(10/92) had spatial heterogeneity of PIK3CA mutation. After neoadjuvant chemotherapy, 10%(3/30) of patients had change of PIK3CA mutational status. Serial biopsy at time of recurrence revealed loss or gain of PIK3CA mutation in 10 out of 59 patients (17%). In ER+/HER2- subtype, PIK3CA had a trend toward longer distant disease free survival without statistical significance. In patients with stage IV ER+/HER2- disease, PIK3CA hotspot mutations were associated with significant longer overall survival(OS) (71.0 vs. 37.8 months, p=0.048) and better progression free survival(PFS) at 1st line palliative treatment (37.7 vs. 9.4 months, p = 0.0004). Frequency of symptomatic recurrence, recurrence as oligometastases, and specific metastatic sites were not associated with PIK3CA mutational status, except that bone metastases at first distant metastases was less prevalent in patients with PIK3CA hotspot mutations(35.6% vs. 53.8% in PIK3CA wt, p=0.048). Metabolic tumor volume(MTV) at time of first distant metastases was not associated with presence of PIK3CA mutation.
Conclusion: We observed variations in PIK3CA mutational status in more than 10% of patients with >1 repeated biopsy. In stage IV ER+/HER2- disease, PIK3CA hotspot mutation seemed to be associated with longer PFS and OS, however metabolic tumor burden was not associated with PIK3CA alterations.
Citation Format: Ahn HK, Park S, Hyun SH, Park K, Lee E, Kim J-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im Y-H, Park YH. PIK3CA mutations in breast cancer: Mutational landscape and clinical implications in ER+/HER2- subtype [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 P3-08-12.
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Affiliation(s)
- HK Ahn
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Park
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SH Hyun
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Park
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E Lee
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J-Y Kim
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SJ Nam
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SW Kim
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JE Lee
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SK Lee
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JH Yu
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JS Ahn
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-H Im
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - YH Park
- Gachon University Gil Medical Center, Incheon, Korea; Samsung Advanced Institute for H Ealth Sciences & Tehnology, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim JY, Park KH, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im YH, Park YH. Abstract P1-09-11: Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Genetic alteration of Estrogen Receptor 1(ESR1) gene have been associated with acquired endocrine resistance and occurred in about 20% of endocrine resistant estrogen receptor(ER)-positive metastatic breast cancer(MBC). Mutations in ligand binding domain of ESR1 lead to constitutive activity of the ER without ligand estrogen and stimulated down stream cell growth signal. Therefore, ESR1 ligand binding domain alteration is known resistant mechanism of aromatase inhibitor. Among these ESR1 mutations, Y537S, one of the ligand binding domain mutations, caused ER antagonist, fulvestrant resistance. Therefore, assessment of ESR1 mutation in ER-positive MBC had significant benefit to further precision medicine for MBCs. In this study, we explored to identify the frequency and type of ESR1 genetic alterations of ER-positive MBC.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 990 BC tissues. Of 990 tissue samples, 341(34.5%) were MBCs. Of MBCs, 112(11.3%) were ER-positive and human epidermal growth factor receptor 2(HER2)-negative BCs. In ER-positive HER2-negative MBCs (N=112), 21 ESR1 genetic alterations were identified in 19 BCs (17.0%). Nineteen were single nucleotide variats (SNVs) and three were copy number (CN) amplification. Most commonly detected single nucleotide variant (SNV) was D538G (6 of 19, 31.6%) followed by Y537N, Y537S, V382I (4, 2 and 2 cases, respectively). Three mutations occurred in non-ligand binding domain (G415V, V392I and P79A). Two BC samples harbored two ESR1 mutations, respectively (Y537S and D538G, L536P and Y537N). In terms of treatment, 11 of 12 patients with ER-positive MBC harboring ESR1 mutation received palliative endocrine therapies. Eight patients received aromatase inhibitor and two patients received tamoxifen. One patient received letrozole plus palbociclib. In 2 MBCs with Y537S mutation, progression free survival (PFS) of endocrine therapy was 1.4 and 5.3 months. MBCs with D538G had 12.3months of PFS (range, 5.3-23.7(months)) and BCs harboring another ligand binding domain mutations (Y537N, L536H and L536P) had 15.7months of PFS of endocrine therapy (range, 8.4-17.3(months)). BC with mutation observed in non-lignand binding domain had short PFS (1.8 (V392I) and 2.7 (P79A) months, respectively). In terms of ESR1 CN amplification, patients could not receive endocrine therapy because their BCs rapidly progressed and extensive distant metastases were occurred within 3 months after curative surgery.
Conclusion: In this exploratory study, ESR1 genetic alterations were detected in about 20% of ER-positive MBC. The type of genetic alterations varied including SNVs, CNAs. Each locus of ESR1 mutation predicted endocrine resistance. In addition, we might suggest that ESR1 CN amplification is prognostic marker of ER-positive BCs.
Citation Format: Kim J-Y, Park KH, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im Y-H, Park YH. Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-09-11.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Sim SH, Park IH, Jung KH, Kim SB, Ahn JH, Lee KH, Im SA, Im YH, Park YH, Sohn JH, Kim YJ, Lee S, Kim HJ, Chae YS, Park KH, Nam BH, Lee KS, Ro J. Abstract P6-17-23: Randomized phase II study of lapatinib plus vinorelbine versus vinorelbine in patients with HER2 positive metastatic breast cancer progressed after lapatinib and trastuzumab treatment. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-23] [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
The continuum of anti-HER2 agents is regarded as a standard strategy for HER2 positive metastatic breast cancer patients who had progressed disease with anti-HER2 agent- containing treatments. However, there has been lack of data on which agents should be continued and how long continuous anti-HER2 therapies would be effective. This study was aimed to evaluate the efficacy of lapatinib plus vinorelbine in HER2 positive metastatic breast cancer patients who had progressed on both trastuzumab and lapatinib treatments.
Methods
A total of 149 patients were randomly assigned to lapatinib with vinorelbine (LV) (n=75; laptinib, 1000mg daily ; vinorelbine 20mg/m2 D1,D8 q3w) or vinorelbine alone (V) (n=74; 30mg/m2 D1,D8 q3w). The stratification factors were followings; 1) visceral metastasis, 2) previous response to lapatinib treatment, CR+PR vs. SD ≥ 12 weeks. The primary endpoint was progression free survival (PFS) rate at 18 weeks. The secondary endpoints were objective response rate (ORR), PFS, and overall survival (OS).
Results :
Both arms were well balanced in various clinical factors. The median number of previous anti-HER2 therapies were 2 (range 2-5). There was no significant difference in PFS rate at 18 weeks between LV and V arms (44.0% vs 36.5%, p=0.44). ORR was 19.7% in LV arm and 16.9% in V arm (p=0.881). PFS and OS did not differ between two arms (LV vs V; median PFS, 16weeks vs 12 weeks, HR= 0.86, 95% CI 0.61-1.22, p=0.41; median OS, 15.0 months vs 18.9 months, HR= 1.07, 95% CI 0.72-1.58, p=0.72). In subgroup analysis, there was no difference in PFS and OS between two arms according to previous response to lapatinib (median PFS, CR+PR vs. SD ≥ 12 weeks, 12.1weeks vs.17.4 weeks; HR= 1.242, 95% CI 0.881-1.751, p=0.215; median OS, 14.9 months vs. 19.4 months; HR= 1.179, 95% CI 0.797-1.744, p=0.41). Most common adverse events in both arms were neutropenia which was more often observed in V arm (55% vs 73%, p=0.03). Overall, the profiles of adverse events were similar in both arms and all were manageable.
Conclusion
Lapatinib plus vinorelbine treatment was tolerable, however, it did not demonstrate the clinical benefits compared to vinorelbine alone in HER2 positive metastatic breast cancer patients after progression on both trastuzumab and lapatinib.
Citation Format: Sim SH, Park IH, Jung KH, Kim S-B, Ahn J-H, Lee K-H, Im S-A, Im Y-H, Park YH, Sohn JH, Kim YJ, Lee S, Kim H-J, Chae YS, Park K-H, Nam B-H, Lee KS, Ro J. Randomized phase II study of lapatinib plus vinorelbine versus vinorelbine in patients with HER2 positive metastatic breast cancer progressed after lapatinib and trastuzumab treatment [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-23.
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Affiliation(s)
- SH Sim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - IH Park
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - KH Jung
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - S-B Kim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - J-H Ahn
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - K-H Lee
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - S-A Im
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - Y-H Im
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - YH Park
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - JH Sohn
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - YJ Kim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - S Lee
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - H-J Kim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - YS Chae
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - K-H Park
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - B-H Nam
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - KS Lee
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - J Ro
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
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Kim JY, Jung HH, Lim JE, Cho EY, Lee SK, Yu JH, Lee JE, Kim SW, Nam SJ, Park YH, Ahn JS, Im YH. Abstract P4-08-30: Prognostication of immune related gene expression in patients with triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-08-30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: To date, the role of immunotherapy with check point inhibitors and/or vaccines in the treatment of breast cancer (BC) is still debating, and the main focus of immunotherapy in BC is on triple negative subtype as a target population in many ongoing clinical trials. Translational research into identifying predictive and prognostic immune biomarkers is of particular clinical relevance, but, there are currently no definite prognostic and predictive immune biomarkers in BC, especially in triple negative breast cancer(TNBC). We investigated the expression profiles of immune genes in patients with TNBC to identify the prognostic value of immune genes in search of clinical implications.
Methods : We investigated expression profiles of 770 pan-cancer immune related genes using the nCounter mRNA expression assay (NanoString®) from paraffin-embedded tumor tissues in 200 patients diagnosed as TNBC who received curative surgery at Samsung Medical Center from 2000 to 2004. We analyzed the relationship between stage adjusted level of gene expressions and patients' survival outcomes using Cox regression model.
Results: Of 770 genes, 186 genes were selected from univariate analysis with clinical stage adjustment. In multivariate analysis using Cox regression, expressions of CD1B, CD45, CD53, CT45A1, GTF3C1, IL11RA, IL1RN, LRRN3, MAPK1, NEFL, PRKCE, SPACA3 and RANKL were associated with distant recurrence free survival (p<0.05, respectively). Among these 13 genes, expression of MAPK1, NEFL, CD45, SPACA3 and RANKL were correlated with favorable outcome in terms of distant recurrence free survival (p<0.05, respectively). In terms of overall survival, C3, IL1RL1, IL1RN, IL7 and PRKCE were associated with poor prognosis (p<0.05, respectively) and expression of SAA1 CXCL9 and RANKL resulted in favorable outcome (p<0.05, respectively).
Table 1ParameterParameter EstimateStandard Errorp-valueHazard Ratio95% Confidence Interval(a) distant recurrence free survival Stage2.487350.680570.000312.0293.169, 45.661CD1B1.141910.2753<.00013.1331.826, 5.374CD531.531650.34851<.00014.6262.336, 9.159CT45A10.426110.134210.00151.5311.177, 1.992GTF3C11.193110.579720.03963.2971.059, 10.271IL11RA1.671120.461750.00035.3182.151, 13.146IL1RN0.980280.24657<.00012.6651.644, 4.321LRRN31.424170.28742<.00014.1542.365, 7.297MAPK1-0.542740.258240.03560.5810.35, 0.964NEFL-1.12170.335610.00080.3260.169, 0.629PRKCE2.378340.49659<.000110.7874.076, 28.549CD45-2.736780.43154<.00010.0650.028, 0.151SPACA3-0.745930.272270.00610.4740.278, 0.809RANKL-1.288920.2976<.00010.2760.154, 0.494(b) overall survival Stage1.359280.497810.00633.8931.468, 10.329C30.329830.150350.02831.3911.036, 1.867CXCL9-0.379190.100680.00020.6840.562, 0.834IL1RL10.679360.262940.00981.9731.178, 3.303IL1RN0.437130.172370.01121.5481.104, 2.171IL70.507280.206250.01391.6611.109, 2.488PRKCE0.835340.272910.00222.3061.35, 3.936SAA1-0.564250.13449<.00010.5690.437, 0.74RANKL-0.604990.234510.00990.5460.345, 0.865
Conclusion: High expression of IL1RN, PRKCE were associated with short distant recurrence free survival and overall survival in patients with TNBCs who received curative surgery. In contrast, RANKL expression resulted in prolonged distant recurrence free survival and overall survival.
Citation Format: Kim J-Y, Jung HH, Lim JE, Cho EY, Lee SK, Yu JH, Lee JE, Kim SW, Nam SJ, Park YH, Ahn JS, Im Y-H. Prognostication of immune related gene expression in patients with triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-30.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JE Lim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - EY Cho
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
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Kim JY, Lee EJ, Park KH, Im SA, Kim SB, Sohn SH, Lee KS, Chae YS, Lee KH, Kim JH, Im YH, Kim TY, Lee KH, Ahn JH, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH, Park YH. Abstract P3-11-07: Exploratory biomarker analysis from a phase II, multicenter, randomized trial of eribulin plus gemcitabine(EG) versus paclitaxel plus gemcitabine(PG) as first-line chemotherapy for human epidermal growth factor receptor 2 (HER2)- negative metastatic breast cancer(MBC): Korean cancer study group trial (KCSG BR13-11). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-11-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction : A phase II, multicenter, randomized clinical trial of the comparison between eribulin plus gemcitabine (EG) and paclitaxel plus gemcitabine (PG) as first-line chemotherapy for patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) found EG was less neurotoxic, but had similar efficacy of PG. In this study, we performed exploratory biomarker analysis of the impact of genetic alterations on the efficacy according to EG and PG chemotherapy.
Methods : This biomarker study was conducted using tumor samples from 40patients. When tissue collection was possible after disease progression, we performed paired sample analysis. Tumor DNA and RNA were extracted from formalin-fixed, paraffin-embedded tissues. To perform targeted deep sequencing, we used CancerScanTM, a 375 cancer gene panel. And we performed an nCounter expression assay for gene expression analysis using 730 PanCancer panel and 730 Immune panel.
Results: In total, we obtained 44 tissue samples from 40 patients. Twenty two patients were assigned in EG arm and 18 patients were in PG arm. Thirty-eight were at baseline and six after disease progression. Gene expression assay were performed in 44 tissue samples but only 31 samples were possible to be targeted deep sequencing.
We performed differently expressed gene(DEG) analysis for detecting the association between level of gene expression and disease progression. In this analysis, high expression of CCNE1, TGFB4 and BAMBI and low expression of DDB2, CD14 and SHC3 were associated with disease progression among 730 PanCancer panel genes (p<0.05, respectively). In terms of immune panel genes, most of immune related genes were highly expressed in a group without disease progression compared with that with disease progression. Only 2 genes, C8G and CD24 were highly expressed in a group with disease progression. Paired sample analysis showed that expression levels of THBS4 and CD27 decreased after disease progression while those of CCNE2 and FGFR4 increased.
In targeted deep sequencing, FAT3 (42.3%) was most frequently mutated gene followed by PKHD1, PIK3CA and TP53. Among mutated genes, EWSR1 mutation and upstream mutation of ETV1 were associated with disease progression, respectively (p<0.05, respectively). In mutation signature analysis, signature 1 (S, age related), S3(homologous recombination deficiency, HRD), S6 (mismatch repair, MMR), S20(MMR) and S21(microsatellite instability, MSI) were enriched in this population. Mutation signature 3 related to short disease free survival (p=0.0026).
Conclusion: In gene expression analysis, high expression of TGF-B signaling pathway related genes was associated with disease progression while high expression of immune related genes were related to prolonged disease free survival. In mutation analysis, EWSR1 and ETV1 mutations indicated short disease free interval and HRD mutation signature was also related to poor prognosis.
Citation Format: Kim J-Y, Lee EJ, Park KH, Im S-A, Kim S-B, Sohn SH, Lee KS, Chae YS, Lee KH, Kim JH, Im Y-H, Kim T-Y, Lee K-H, Ahn J-H, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH, Park YH. Exploratory biomarker analysis from a phase II, multicenter, randomized trial of eribulin plus gemcitabine(EG) versus paclitaxel plus gemcitabine(PG) as first-line chemotherapy for human epidermal growth factor receptor 2 (HER2)- negative metastatic breast cancer(MBC): Korean cancer study group trial (KCSG BR13-11) [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 P3-11-07.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - EJ Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - S-A Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - S-B Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SH Sohn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KS Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - YS Chae
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - JH Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - T-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - K-H Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - J-H Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - GM Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - IH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SJ Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - HS Han
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SH Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim SB, Sohn J, Im SA, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Abstract P3-10-09: Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract
Background:Increasing quantities of stromal TILs (sTILs) are associated with higher pathologic complete response (pCR) rates with conventional chemo in early-stage TNBC. We evaluated the association between sTILs and PD-L1 expression with response to pembro+chemo as NAT for TNBC in the KEYNOTE-173 trial (NCT02622074).
Methods: sTILs were quantified using light microscopy of H&E-stained slides from pretreatment and on-treatment (during first 3 weeks of pembro monotherapy) tumor biopsies by a pathologist blind to response data. Pretreatment PD-L1 expression was assessed using the PD-L1 IHC 22C3 pharmDx assay and reported as combined positive score (CPS). Endpoints were pCR rate by ypT0 ypN0 and ypT0/Tis ypN0 and objective response rate (ORR; RECIST v1.1) after the first 4 cycles of NAT (taxane±carboplatin+pembro) by MRI. sTILs and PD-L1 CPS were evaluated as continuous variables. Association between sTILs and PD-L1 CPS with response was assessed using logistic regression and area under the reciever operating curve (AUROC) analyses, with a 1-sided alpha level of 0.10. Correlation between PD-L1 and sTILs was assessed by Spearman's rank correlation coefficient. Multivariate analysis included sTILs (pretreatment and on-treatment) and PD-L1 CPS. Likelihood ratio tests were used to evaluate the added value of factors in predicting pCR rate.
Results: Of 60 total pts, 34 had tumors evaluated for pretreatment sTILs, 52 for PD-L1 CPS, and 33 for both sTILs and CPS. On-treatment sTILs were evaluated in 31 pts. Overall pCR rates were 56.7% and 60% by ypT0 ypN0 and ypT0/Tis ypN0, respectively; ORR was 78.3%. In pts evaluated for sTILs and CPS (individually), pCR rates and ORR were comparable with overall pCR rates and ORR. There was a significant correlation between pretreatment sTILs and PD-L1 CPS (ρ=0.65, P<0.001).Higher pretreatment sTILs were significantly associated with response: ypT0 ypN0 P= 0.011; ypT0/Tis ypN0 P=0.006; ORR P=0.061. On-treatment sTILs were also significantly associated with response: ypT0 ypN0 P=0.061; ypT0/Tis ypN0 P=0.041; ORR P=0.031. Pretreatment PD-L1 CPS was significantly associated with response: ypT0 ypN0 P=0.073; ypT0/is ypN0 P=0.030; and ORR P=0.021. AUROC of pretreatment sTIL association with pCR was numerically higher than with on-treatment sTILs and PD-L1 CPS (0.69 vs 0.61 vs 0.56 for ypT0ypN0 and 0.72 vs 0.67 vs 0.62 for ypT0/Tis ypN0). Responders had higher median pretreatment sTIL levels vs nonresponders: 45% [10, 75] vs 10% [5, 20] for pCR rate by ypT0 ypN0 and 52.5% [10, 73.8] vs 10% [5, 20] for pCR rate by ypT0/Tis ypN0; 25% [5, 70] vs 10% [6.3, 27.5] for ORR. In multivariate analysis, only pretreatment sTILs were significant for both pCR endpoints (ypT0 ypN0 P=0.031; ypT0/Tis ypN0 P=0.034). Likelihood ratio tests demonstrated that for both pCR endpoints, PD-L1 CPS (P=0.683/P=0.422) and on-treatment sTILs (P=0.984/P=0.568) did not add significantly more value to pretreatment sTILs when predicting pCR.
Conclusions:Higher quantities of pretreatment sTILs and PD-L1 CPS and on-treatment sTILs were significantly associated with higher pCR rates and ORR in primary TNBC treated with pembro and NAT.
Citation Format: Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim S-B, Sohn J, Im S-A, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial [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 P3-10-09.
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Affiliation(s)
- S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - P Schmid
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - T Foukakis
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S Kuemmel
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - A Wang
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - V Karantza
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Salgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
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Hwang IC, Kim AJ, Ro H, Jung JY, Chang JH, Lee HH, Chung W, Park YH. Changes in Bone Mineral Density After Kidney Transplantation. Transplant Proc 2018; 50:2506-2508. [PMID: 30316387 DOI: 10.1016/j.transproceed.2018.04.019] [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] [Received: 01/16/2018] [Revised: 03/22/2018] [Accepted: 04/06/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Numerous studies have shown that osteoporosis is common in kidney transplant recipients. However, the change in bone mineral density after kidney transplantation (KT) is not fully understood. METHODS Thirty-nine kidney transplant recipients with bone densitometry at pretransplant and 24 months after KT were reviewed. RESULTS The recipients' median age (44.5 ± 10.7 years) and dialysis duration before KT (4.2 ± 3.4 years) were recorded. The T-scores of the lumbar spine and femur neck at 24 months after KT were positively associated with the respective pretransplant T-score (P < .001 in the lumbar spine and P < .001 in the femur neck). However, the T-score after KT did not show significant change (P = .680 in lumbar spine, P = .093 in femur neck). Changes in the T-scores of the lumbar spine and femur neck over 24 months (delta T-score) were negatively associated with the respective pretransplant T-scores (P = .001 in lumbar spine, P = .026 in femur neck). Changes in the T-scores of the lumbar spine and femur neck over 24 months (delta T-score) were also associated with the pretransplant T-scores after the adjustment of other variables. CONCLUSION The change of bone mineral density was related with pretransplant bone mineral density. Careful follow-up of bone densitometry for KT recipients was needed.
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Affiliation(s)
- I C Hwang
- Department of Medicine, Gachon University College of Medicine, Inchon, Republic of Korea
| | - A J Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea
| | - H Ro
- Department of Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea.
| | - J Y Jung
- Department of Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea
| | - J H Chang
- Department of Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea
| | - H H Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea
| | - W Chung
- Department of Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea
| | - Y H Park
- Department of Surgery, Gachon University Gil Medical Center, Inchon, Republic of Korea
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Hwang KW, Choi JH, Jung SM, Kim YS, Lee SY, Chon MK, Lee SH, Kim JS, Park YH, Kim JH, Chun KJ, Je HG, Lee SK, Choi HO. P1520Defining the blanking period after maze procedure for atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1520] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K W Hwang
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J H Choi
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S M Jung
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - Y S Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S Y Lee
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - M K Chon
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - S H Lee
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J S Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - Y H Park
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - J H Kim
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - K J Chun
- Pusan National University Yangsan Hospital, Division of Cardiology, Department of Internal Medicine, Yansan, Korea Republic of
| | - H G Je
- Pusan National University Yangsan Hospital, Department of Cardiovascular and Thoracic Surgery, Yansan, Korea Republic of
| | - S K Lee
- Pusan National University Yangsan Hospital, Department of Cardiovascular and Thoracic Surgery, Yansan, Korea Republic of
| | - H O Choi
- Soonchunhyang University Hospital, Cardiology, Bucheon, Korea Republic of
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30
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Kim YS, Hwang KW, Choi HO, Jung SM, Choi JH, Lee SY, Chun MK, Lee SH, Kim JS, Je HG, Park YH, Kim JH, Lee SK, Chun KJ. P4815Incidence of incomplete surgical left atrial appendage closure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4815] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y S Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - K W Hwang
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - H O Choi
- Soonchunhyang University Hospital, Department of internal medicine, Bucheon, Korea Republic of
| | - S M Jung
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J H Choi
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S Y Lee
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - M K Chun
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S H Lee
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J S Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - H G Je
- Pusan National University, Department of Cardiovascular and Thoracic Surgery, Yangsan, Korea Republic of
| | - Y H Park
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - J H Kim
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
| | - S K Lee
- Pusan National University, Department of Cardiovascular and Thoracic Surgery, Yangsan, Korea Republic of
| | - K J Chun
- Pusan National University Yangsan Hospital, Department of internal medicine, Yangsan-si, Korea Republic of
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Kim DS, Son E, Lee YS, Lee YM, Park YH, Kim DH, Lee KW. Herbal Complex DKB114 for Hyperuricemia and Gout. Am J Transl Res 2018. [DOI: 10.1055/s-0038-1644979] [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: 10/28/2022]
Affiliation(s)
- DS Kim
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - E Son
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YS Lee
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YM Lee
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YH Park
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
| | - DH Kim
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
| | - KW Lee
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
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Kim AJ, Ro H, Chang JH, Jung JY, Chung WK, Park YH, Lee HH. Suspected Frequent Relapsing IgG4-related Lung Disease in Kidney Transplant Patient: A Case Report. Transplant Proc 2018; 50:2572-2574. [PMID: 30316401 DOI: 10.1016/j.transproceed.2018.02.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/19/2018] [Indexed: 12/21/2022]
Abstract
Besides the initial description of IgG4-related pancreatic disease, other sites are now commonly involved. However, occurrence of IgG4-related disease is rare in organ transplanted patients. A 57-year-old man who received a kidney transplantation presented with recurrent dyspnea on exertion. A computed tomography scan of the chest revealed bilateral interlobular septal thickening and multiple tubular and branching small nodular lesions in the right upper lobe, and mass-like consolidation of the left middle lobe. Despite no elevation of serum IgG4 level, a percutaneous core needle biopsy on consolidative mass showed interstitial fibrosis and infiltration of IgG4-positive plasma cells to be more than > 20 per high power field. After treatment with glucocorticoids and rituximab, the consolidative mass of the left middle lobe disappeared.
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Affiliation(s)
- A J Kim
- Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - H Ro
- Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - J H Chang
- Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - J Y Jung
- Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - W K Chung
- Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - Y H Park
- Department of Surgery, College of Medicine, Gachon University, Incheon, Korea
| | - H H Lee
- Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea.
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Kim JY, Park K, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Jung HH, Yu JH, Ahn JS, Im YH, Park YH. Abstract P6-09-08: Identification of ESR1 mutation in breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Estrogen Receptor 1 (ESR1) gene encodes an estrogen receptor, which regulates cell proliferation and promotes tumor progression in estrogen receptor(ER)-positive breast cancer (BC). Therefore, endocrine therapy that inhibiting ER downstream signal, is the most effective treatment strategy in ER-positive BC. However, about 25% of patients with primary disease and almost all patients with metastases will present with or eventually develop endocrine resistance. And genetic alteration of ESR1 is now identified as the endocrine resistance mechanism. However, a few data from clinical trials or public data base exists and could not reflect real world clinic. Therefore, we aimed to identify the frequency and type of ESR1 genetic alterations in BCs through this large scaled study.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 618 BC tissues. Of 618 tissue samples, 253(40.9%) were MBCs, 362(58.6%) were early BCs (EBCs) and 3 were not identified. In terms of subtypes, 220 ER-positive BCs, 122 ER-positive and HER2-positive BCs, 119 HER2-positive and 153 triple-negative BCs (TNBCs) were included. BCs from patients under 40 year-old were 277(44.8%)(Median: 43.0, range: 23.5 -75.6). ESR1 genetic alterations were identified in 21 BCs (5 EBCs and 16 MBCs). In EBCs, 3 cases were observed in TNBCs and 2 cases were in ER-positive BCs (2.6% and 1.2%, respectively). All five EBC were treatment naïve status. Of 16 cases of ESR1 alterations in MBCs, 10 cases of ESR1 alterations were detected in ER-positive BCs (17.6%), 5cases in ER and HER2-positive BCs(6.7%) and 1 in HER2-positive BCs (1.2%). All ER-positive MBCs were treated with more than one line of endocrine therapy. Most commonly detected genetic alteration was single nucleotide variant (SNV) (15 of 21, 71.4%). Thirteen were in ligand binding domain and two cases occurred in activation function-1 (AF-1) domain (P79A and G145S). D538G and V392I were most frequently mutated loci followed by Y537N (3, 3 and 2 cases, respectively) and only metastatic ER-positive BCs harbored ESR1 activating mutation. Four copy number (CN) amplification in 2 ER-positive and 2 ER and HER2-positive BCs, one CN deletion in TNBC and one ESR1 fusion in ER and HER2-positive BC were also detected (19.0%, 4.8% and 4.8%, respectively). In frame ESR1 fusion was occurred between ESR1 and NPHS1 genes.
Conclusion: In this experimental study, ESR1 genetic alterations were frequently detected in ER-positive MBC but ER-negative or EBC also harbored. The type of genetic alterations varied including SNVs, CN alterations and translocation and ESR1-NPHS1 fusion is the novel genetic alteration that has not been reported. To identify the role of ESR1 genetic alteration in ER-negative BCs and novel translocation, further functional validation would be warranted (Clinical trials.gov Number :NCT02591966).
Citation Format: Kim J-Y, Park K, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Jung HH, Yu JH, Ahn JS, Im Y-H, Park YH. Identification of ESR1 mutation in breast cancers using targeted ultra-deep sequencing data analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-08.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
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Kim JY, Lee E, Park K, Jung HH, Park WY, Lee KH, Sohn JH, Lee KS, Jung KH, Kim JH, Lee KH, Im SA, Park YH. Abstract P2-09-21: Molecular alterations and poziotinib, a pan-HER inhibitor efficacy in human epidermal growth factor receptor 2(HER2) positive breast cancers: Combined exploratory biomarker analysis from phase II clinical trial of poziotinib for refractory HER2 positive breast cancer(BC) patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Poziotinib is a novel, pan-HER kinase inhibitor which showed potent anti-tumor activities through irreversible inhibition of HER family tyrosine kinases in preclinical and early clinical studies. Recent the open-label, multicenter phase II trial of poziotinib monotherapy evaluated that poziotinib is a new promising option for patients with HER2-positive metastatic BC who have failed more than two HER2 targeted therapy (NCT02418689). We evaluated genetic profiles of HER2-positive metastatic BC and investigated potential biomarkers of poziotinib for HER2-positive metastatic BC (MBC). Methods: All participants were diagnosed as HER2-positive BCs according to American Society of Clinical Oncology/College of American Pathologists HER2 guideline and provided tissue specimens that would be possible to extract DNA and RNA for next generation sequencing. We performed targeted deep sequencing with a customized 381 cancer gene panel (CancerSCAN™) and analyzed the relationship among the sequencing data, immunohistochemistry and clinical outcome.
Results: From Apr 2015 to Feb 2016, 106 patients were enrolled in the trial from 7 institutes in Korea. Of 106 patients, biomarker data were available for 79 patients. TP53 was the most frequently mutated gene (70.8%) followed by PIK3CA (45.6%). HER2 single nucleotide variant (SNV) was detected in 13 BCs (16.5%) and HER3 SNV was in 9 (11.4%). The score of HER2 immunohistochemistry (IHC) was 3+ in 68 BCs and 2+ with positive in situ hybridization in 11 BCs. In copy number variant (CNV) analysis, HER2 amplification (86.1%) was most frequently observed and followed by CDK12 amplification (58.2%) and APOBEC3B deletion (30.4%). IHC score of HER2 was positively correlated to copy number (CN) of HER2 (P=0.001) but 11 breast cancer tissue did not have copy number amplification of HER2 (13.9%) (Six of HER2 IHC score 2+ and 5 of 3+). The median progression free survival (PFS) was 4.04 months (95% CI, 2.96 - 4.40) for patients who treated with poziotinib in this study. PIK3CA activating mutations were associated with short PFS compared to wild type (WT) and other SNVs (Median PFS of activating mutations vs. WT and others: 2.66 vs. 4.40 (months), P=0.009). HER2 CN amplification was positively correlated to duration of PFS (Median PFS of no amplification vs. 4 ≤ CN < 16 vs. 16 ≤ CN: 2.56 vs. 3.02 vs. 4.86 (months), P=0.032). HER2 SNVs prolonged duration of PFS without statistical significance (Median PFS of HER2 SNVs vs. WT: 4.24 vs. 3.19 (months), P=0.114), but 10 of 13 BCs with HER2 SNV (76.9%) had clinical benefit from poziotinib and 5 BCs (38.5%) had durable response more than 6 months. Conclusion: In this biomarker analysis, SNV of HER2 was frequently observed in HER2 positive MBCs and HER2 CN amplification was detected not in all. High CN amplification of HER2 derived longer PFS than those with low CN. To contrary to this, activating PIK3CA mutations shorten PFS compared to those with WT. In addition, HER2 SNVs might be a potential biomarker of poziotinib in HER2-positive MBC. Further functional study would be warranted.
Citation Format: Kim J-Y, Lee E, Park K, Jung HH, Park W-Y, Lee K-H, Sohn JH, Lee KS, Jung KH, Kim J-H, Lee KH, Im S-A, Park YH. Molecular alterations and poziotinib, a pan-HER inhibitor efficacy in human epidermal growth factor receptor 2(HER2) positive breast cancers: Combined exploratory biomarker analysis from phase II clinical trial of poziotinib for refractory HER2 positive breast cancer(BC) patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-21.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - E Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - K-H Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - JH Sohn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KS Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - J-H Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KH Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - S-A Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
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Kan Z, Powell E, Ram S, Ching K, Ding Y, Vizcarra P, Nichols T, Hardwick J, Lee SH, Cho SY, Choi YL, Yu JH, Park YH. Abstract P2-07-01: Integrative analyses of immunophenotypes and multi-omics profiles in breast cancers. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-07-01] [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
The advent of immuno-oncology (IO) therapies has made it an imperative to characterize intratumoral immune microenvironment in addition to oncogenic alterations through molecular profiling of the tumor. To elucidate the baseline profiles of tumor infiltrating leukocytes (TILs) in breast cancer (BC) in the context of molecular subtypes and oncogenic alterations, we performed whole-exome sequencing (WES) and RNA-Seq of an Asian BC cohort (SMC) consisting of 178 treatment naïve primary tumors. A subset of 120 tumors was further analyzed by H&E and IHC using a panel of 8 TIL markers (CD45, CD4, CD8, CD163, PD1, PD-L1, IDO1 and FOXP3). Using expression signatures representing distinct immune cell types, we classified an expression compendium of 2,781 tumor samples, including SMC and multiple cancers from TCGA, into three immune subtypes with high, medium and low levels of TILs. Basal and HER2 subtypes show higher levels of TILs than Luminal subtypes, consistent with observed clinical responses to checkpoint blockade in clinical trials. Moreover, Asian BCs were significantly enriched in TIL-high subtype (35.3%) compared to the primarily Caucasian TCGA BC cohort (20.2%) while 50.6% of the highly immunogenic Lung adenocarcinoma was TIL-high. We then applied machine learning methods to detect and quantify TILs from H&E images of 120 SMC and 349 TCGA BC tumors. The expression signature analysis results were concordant with independently derived histology based TIL data. Taken together, our findings suggest that IO therapies may be more effective in HR negative BC subtypes and Asian BCs.
Leukocyte exclusion (LE), an immunophenotype where TILs concentrate at the tumor periphery, has been linked to worse prognosis and resistance to IO therapies. Visual assessment of whole tumor IHC images identified LE patterns in 25% of SMC cases. We observed differential distribution of LE by molecular subtype and evidence for selective exclusion of immune cell subsets. Covariate analyses with clinical and molecular data while controlling for subtype as a confounder identified significant associations with tumor proliferation index, percent tumor purity and TP53 mutations. LE is also significantly associated with expression signatures of chemokine signaling, macrophages, angiogenesis and hypoxia, indicating that marked distinctions exist in both tumor intrinsic and microenvironment characteristics between TIL excluded and TIL infiltrated tumors. To validate these findings, we independently identified LE for 200 cases of TCGA BCs based on patterns of TILs extracted from H&E images and saw significant concordance of covariate relationships identified between TCGA and SMC. Our study provided a rare comprehensive resource for studying tumor associated immunity in breast cancers by generating the integrated multi-omics and IO profiles for a large cohort of primary tumors. Comparative analyses revealed that TIL activities are highly variable across different intrinsic subtypes and geographic origins of BC, with potential implications for IO therapeutic application. Correlative analyses of immunophenotypes with molecular data further yielded insights into LE's role in immune escape and identified hallmark signatures for LE indicative of causal molecular mechanisms.
Citation Format: Kan Z, Powell E, Ram S, Ching K, Ding Y, Vizcarra P, Nichols T, Hardwick J, Lee S-H, Cho SY, Choi Y-L, Yu J-H, Park YH. Integrative analyses of immunophenotypes and multi-omics profiles in breast cancers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-07-01.
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Affiliation(s)
- Z Kan
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - E Powell
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - S Ram
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - K Ching
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - Y Ding
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - P Vizcarra
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - T Nichols
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - J Hardwick
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - S-H Lee
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - SY Cho
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - Y-L Choi
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - J-H Yu
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
| | - YH Park
- Pfizer Oncology Research, San Diego, CA; Pfizer Korea, Seoul, Korea; Samsung Medical Center, Seoul, Korea
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Schmid P, Dent R, Sohn J, Park YH, Muñoz-Couselo E, Kim SB, Im SA, Holgado E, Chen E, Dang T, Aktan G, Cortés J. Abstract PD6-12: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- P Schmid
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Chen
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - T Dang
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
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Kim YM, Park YH, Lim JM, Jung H, Han JY. Technical note: Induction of pluripotent stem cell-like cells from chicken feather follicle cells. J Anim Sci 2018; 95:3479-3486. [PMID: 28805906 DOI: 10.2527/jas.2017.1418] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Pluripotent stem cells including embryonic stem cells (ESC) and induced pluripotent stem cells (iPSC) are regarded as representative tools for conservation of animal genetic resources. Although ESC have been established from chicken, it is very difficult to obtain enough embryos for isolation of stem cells for avian conservation in most wild birds. Therefore, the high feasibility of obtaining the pluripotent cell is most important in avian conservation studies. In this study, we generated induced pluripotent stem cell-like cells (iPSLC) from avian Feather Follicular cells (FFC). Avian FFC are one of the most easily accessible cell sources in most avian species, and their reprogramming into pluripotent stem cells can be an alternative system for preservation of avian species. Intriguingly, FFC had mesenchymal stromal cells (MSC)-like characteristics with regard to gene expression, protein expression, and adipocyte differentiation. Subsequently, we attempted to generate iPSLC from FFC using retroviral vectors. The FFC-iPSLC can proliferate with the stem pluripotent property and differentiate into several types of cells in vitro. Our results suggest that chicken FFC are an alternative cell source for avian cell reprogramming into pluripotent stem cells. This experimental strategy should be useful for conservation and restoration of endangered or high-value avian species without sacrificing embryos.
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Park I, Kim YS, Sym SJ, Ahn HK, Kim KK, Park YH, Lee JN, Shin DB. Metastasectomy for recurrent or metastatic biliary tract cancers: A single center experience. Indian J Cancer 2017; 54:57-62. [PMID: 29199665 DOI: 10.4103/0019-509x.219581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess efficacy or long-term result of metastasectomy for recurrent or metastatic biliary tract carcinoma (BTC), we conducted a retrospective review of the outcomes of metastasectomy for recurrent or metastatic BTCs, comprising intrahepatic cholangiocellular carcinoma (IHCCC), proximal and distal common bile duct cancer (pCBDC and dCBDC), gallbladder cancer (GBC), and ampulla of Vater cancer (AoVC). PATIENTS AND METHODS The clinicopathological features and outcomes of BTC patients who underwent surgical resection for the primary and metastatic disease at the Gachon University Gil Medical Centre from 2003 to 2013 were reviewed retrospectively. RESULTS We found 19 eligible patients. Primary sites were GBC (seven patients, 37%), IHCCC (five patients, 26%), dCBDC (three patients, 16%), pCBDC (two patients, 11%), and AoVC (two patients, 11%). Eight patients (42%) had synchronous metastasis whereas 11 (58%) had metachronous metastasis. The most common metastatic site was liver (nine patients, 47%), lymph node (nine patients, 47%), and peritoneum (three patients, 16%). Nine patients (47%) achieved R0 resection, whereas four (21%) and six (32%) patients had R1 and R2 resection, respectively. With a median follow-up period of 26.7 months, the estimated median overall survival (OS) was 18.2 months (95% confidence interval, 13.6-22.9 months). Lower Eastern Cooperative Oncology Group performance status (P = 0.023), metachronous metastasis (P = 0.04), absence of lymph node metastasis (P = 0.009), lower numbers of metastatic organs (P < 0.001), normal postoperative CA19-9 level (P = 0.034), and time from diagnosis to metastasectomy more than 1 year (P = 0.019) were identified as prognostic factors for a longer OS after metastasectomy. CONCLUSIONS For recurrent or metastatic BTCs, metastasectomy can be a viable option for selected patients.
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Affiliation(s)
- I Park
- Department of Internal Medicine, Division of Hematology-Oncology, Gachon University Gil Medical Center, Incheon, Korea
| | - Y S Kim
- Department of Internal Medicine, Division of Hematology-Oncology, Gachon University Gil Medical Center, Incheon, Korea
| | - S J Sym
- Department of Internal Medicine, Division of Hematology-Oncology, Gachon University Gil Medical Center, Incheon, Korea
| | - H K Ahn
- Department of Internal Medicine, Division of Hematology-Oncology, Gachon University Gil Medical Center, Incheon, Korea
| | - K K Kim
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Y H Park
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - J N Lee
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - D B Shin
- Department of Internal Medicine, Division of Hematology-Oncology, Gachon University Gil Medical Center, Incheon, Korea
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Abstract
AIMS Morton's neuroma is common condition of the forefoot, but its aetiology remains unclear. Our aim was to evaluate the relationship between the width of the forefoot and the development of a Morton's neuroma. PATIENTS AND METHODS Between January 2013 and May 2016, a total of 84 consecutive patients (17 men, 67 women) with a unilateral Morton's neuroma were enrolled into the study. The involved and uninvolved feet of each patient were compared. A control group of patients with symptoms from the foot, but without a neuroma who were matched for age, gender, affected side, and web space location, were enrolled. The first to fifth intermetatarsal distance, intermetatarsal angle and intermetatarsal distance of involved web space on standing radiographs were assessed. RESULTS The inter- and intra-observer reliability was excellent. The three parameters did not differ significantly between the involved and uninvolved feet. Neither did they differ significantly between the patients and the controls. CONCLUSION We conclude that there is no significant relationship between the width of the forefoot and the development of a Morton's neuroma. Cite this article: Bone Joint J 2017;99-B:365-8.
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Affiliation(s)
- Y H Park
- Korea University Guro Hospital, Department of Orthopaedic Surgery, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Korea
| | - S M Jeong
- Korea University Guro Hospital, Department of Orthopaedic Surgery, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Korea
| | - G W Choi
- Korea University Ansan Hospital, Department of Orthopaedic Surgery, 123 Jeokgeum-ro, Danwon-gu, Ansan, 15355, Korea
| | - H J Kim
- Korea University Guro Hospital, Department of Orthopaedic Surgery, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Korea
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Choi S, Kim KK, Lee WS, Kang JM, Park YH. Living Donor Liver Transplantation in a Patient With Extensive Portomesenteric Venous Thrombosis: Case Report. Transplant Proc 2017; 48:3153-3155. [PMID: 27932170 DOI: 10.1016/j.transproceed.2016.03.029] [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] [Received: 01/24/2016] [Accepted: 03/01/2016] [Indexed: 10/20/2022]
Abstract
Extensive portomesenteric venous thrombus preventing restoration of adequate portal venous flow used to be considered a contraindication to liver transplantation. The subject was a 49-year-old male with hepatitis B cirrhosis and extensive thrombosis of portal, splenic, and superior mesenteric veins, and two large collateral vessels; one dilated and tortuous inferior to the pancreaticoduodenal vein and relevant to splanchnic venous return and the other a dilated coronary vein relevant to splenic venous return. During operation, the portal vein was anastomosed to these large collateral vessels using cryopreserved iliac vein. In conclusion, portal reconstruction with large collateral vessels in living-donor liver transplantation could be used selectively for patients with extensive portomesenteric venous thrombosis.
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Affiliation(s)
- S Choi
- Department of Surgery, Gil Medical Center, Gachon Medicine and Science, Guwol-dong, Namdong-gu, Incheon, Republic of Korea.
| | - K K Kim
- Department of Surgery, Gil Medical Center, Gachon Medicine and Science, Guwol-dong, Namdong-gu, Incheon, Republic of Korea
| | - W S Lee
- Department of Surgery, Gil Medical Center, Gachon Medicine and Science, Guwol-dong, Namdong-gu, Incheon, Republic of Korea
| | - J M Kang
- Department of Surgery, Gil Medical Center, Gachon Medicine and Science, Guwol-dong, Namdong-gu, Incheon, Republic of Korea
| | - Y H Park
- Department of Surgery, Gil Medical Center, Gachon Medicine and Science, Guwol-dong, Namdong-gu, Incheon, Republic of Korea
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Kim JY, Cho J, Kim H, Kang D, Jung HA, Lee SH, Bae S, Yu JH, Lee SK, Kim SW, Lee JE, Nam SJ, Ahn JS, Im YH, Guallar E, Park YH. Abstract P6-09-50: Impact of young age on recurrence and mortality after surgery in breast cancer: 15 years active surveillance. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction:Substantial efforts have been made to find factors associated with breast cancer (BC) recurrence and mortality after BC treatment. So far TNM stage, ER, PR, and HER2 status are considered as the major predictive markers of BC recurrence and used for treatment decision. However, most of these factors were evaluated independent from other important confounders such as age, stage, and various anti-cancer treatments because they were mostly derived from clinical trials. In Korea, up to 50% of BC patients are premenopausal women, it is not clear how age at diagnosis affect the progression and outcomes of the disease considering all known prognostic factors including TNM stage, ER, PR, and HER2 status. We aim to evaluate the impact of young age on recurrence and mortality after surgery among Korean women with BC.
Methods: This is a retrospective cohort study conducted using the data from BC registry from 2000 to 2016 at Samsung Medical Cancer, Seoul, Korea. Patients who received curative BC surgery and who had histologically-confirmed invasive BC between 2000 to 2011 were included in the study. Patients who second primary cancer or double primary cancer were excluded. Information local, regional, or distant recurrence and death until May 2016 was collected using electronic medical records and National Health Statistics. Cumulative incidence rates of distant recurrence and morality at 3-years, 5-years and 10-years were calculated using a competing-risk model. Cox proportional hazards analysis were conducted with 3 different models to take into account for potential confounding factors including age, body mass index (BMI), stage and subtype at breast cancer diagnosis, chemotherapy, radiotherapy and hormone therapy.
Results:There were 7360 BC patients with curative BC surgery between 2000 and 2011, and the average follow up duration was 75.4 months. The mean age at diagnosis was 48.4 years old (Standard deviation (SD)=±10), and 6.2% (n=459) was diagnosed younger than 35. Of total, 13.3% were stage III BC and 73.4% of patients had hormone receptor positive BC. The cumulative incidence (95%CI) of recurrence at 3, 5, and 10 years was 4.4% (3.9-4.9), 7.5% (6.8-8.2), and 14.8% (12.9-16.7) respectively. The incidence of mortality at 3, 5, and 10 years was 1.8% (1.5-2.1), 3.8% (3.3-4.3), and 10.2% (9.1-11.5) respectively. Patients who were diagnosed BC under 35 years of age had 2.14 (95% confidence interval (CI):1.74-3.10) and 1.62 (95% CI:1.02-2.56) times higher risk of distant recurrence and mortality compared to patients whose age at diagnosis were between 50 to 60 after adjusting all well-known prognostic factors including stage, subtype, and BMI at diagnosis, chemotherapy, radiotherapy and hormone therapy.
Conclusions: Young age at diagnosis (<35) was the most significant predictor on BC recurrence and mortality independently from BC stage and subtype. Further study is warranted to explain biologic background for the differences in outcomes in young women with BC.
Citation Format: Kim J-Y, Cho J, Kim H, Kang D, Jung HA, Lee S-H, Bae S, Yu JH, Lee SK, Kim SW, Lee JE, Nam SJ, Ahn JS, Im Y-H, Guallar E, Park YH. Impact of young age on recurrence and mortality after surgery in breast cancer: 15 years active surveillance [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-50.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - J Cho
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - H Kim
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - D Kang
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - HA Jung
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - S-H Lee
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - S Bae
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - JH Yu
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - SK Lee
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - SW Kim
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - JE Lee
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - JS Ahn
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Y-H Im
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - E Guallar
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Kan Z, Ding Y, Cho S, Lee SH, Powell E, Jung HH, Chung W, Deng S, Choi YL, Kim J, Park WY, Vizcarra P, Fernandez-Banet J, Nichols T, Ram S, Lee SK, Kim SW, Lee JE, Ching KA, Kim JY, Ahn JS, Im YH, Nam SJ, Park YH. Abstract P1-05-15: Multi-omics and immuno-oncology profiling reveal distinct molecular signatures of young Asian breast cancers. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancers (BC) in younger, premenopausal patients (YBC) tend to be more aggressive with worse prognosis, higher chance of relapse and poorer response to endocrine therapies compared to breast cancers in older patients. The proportion of YBC (age ≤ 40) among BC in East Asia is estimated to be 16-32%, significantly higher than the 7% reported in Western countries. To characterize the molecular bases of Asian YBC, we have performed whole-exome sequencing (WES) and whole-transcriptome sequencing (WTS) on tumor and matched normal samples from 134 Korean BC patients consisting of 74 YBC cases (age ≤ 40) and 60 OBC cases (age > 40). We then performed comparison analyses and integrative analyses with the TCGA BC cohort consisting of 1,116 tumors from primarily Caucasian patients, also grouped by age into YBC (age ≤ 40), IBC (40 < age ≤ 60) and OBC (age > 60).
Somatic mutation prevalence analysis identified 7 significantly mutated genes and the same top three genes – TP53, GATA3 and PIK3CA – were reported by the TCGA BC study. To identify differentially expressed (DE) genes and pathways in YBCs vs. OBCs, we performed logistic regression analyses while controlling for the confounding effects of tumor purity and stage. We were surprised to see a significant overlap in DE pathways between a comparison of adjacent normal tissues in younger vs. older TCGA cohorts and a comparison of YBC vs. OBC tumors, indicating that normal tissue compartment could contribute to observed differences between bulk tumors. To separately examine molecular signatures from tumor, stroma and normal compartments, we used non-negative matrix factorization (NMF) analyses to virtually dissect bulk tumor expression data and identified 14 factors including 3 factors associated with normal tissues, 1 factor associated with stroma and 1 factor associated with tumor infiltrating lymphocytes (TIL). Integrative analyses of tumor associated factors and DE pathways revealed that estrogen response, endocrine therapy resistance, and oxidative phosphorylation pathways are up-regulated in YBCs compared to OBCs while cell cycle and proliferation pathways are up-regulated in Asian OBCs. Interestingly, many immune and inflammation pathways correlated with the TIL factor were significantly upregulated in OBCs vs. YBCs. Using gene expression signatures representing distinct immune cell types, we classified our cohort into four subtypes of varying TIL activities and observed significant enrichment of the TIL-high subtype in OBCs compared to YBCs. These observations were confirmed by IHC analyses of four TIL markers (CD45, CD4, CD8 and CD163) in 120 tumors.
To our knowledge, this is the first large-scale multi-omics study of Asian breast cancer and would significantly contribute to the compendium of molecular data available for studying young breast cancers. The major landmarks in the molecular landscape looked similar across BCs of different ethnicities and ages, however, we have identified a number of distinguishing molecular characteristics associated with Asian YBC. The sources for some signatures were further traced to non-tumor intrinsic compartments, indicating that tumor microenvironment may play potentially important roles in driving the carcinogenesis of young breast cancers.
Citation Format: Kan Z, Ding Y, Cho S, Lee S-H, Powell E, Jung HH, Chung W, Deng S, Choi Y-l, Kim J, Park W-Y, Vizcarra P, Fernandez-Banet J, Nichols T, Ram S, Lee SK, Kim SW, Lee JE, Ching KA, Kim J-Y, Ahn JS, Im Y-H, Nam SJ, Park YH. Multi-omics and immuno-oncology profiling reveal distinct molecular signatures of young Asian breast cancers [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-05-15.
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Affiliation(s)
- Z Kan
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y Ding
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Cho
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S-H Lee
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - E Powell
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - HH Jung
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - W Chung
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Deng
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-l Choi
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J Kim
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - W-Y Park
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - P Vizcarra
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | | | - T Nichols
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Ram
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - KA Ching
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J-Y Kim
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JS Ahn
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-H Im
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - YH Park
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
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Park YH, Im SA, Sohn JH, Lee KS, Chae YS, Lee KH, Kim JH, Im YH, Ahn JS, Kim TY, Lee KH, Kim SB, Ahn JH, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH. Abstract OT1-01-12: A phase II, multicenter, randomized trial of eribulin plus gemcitabine (EG) vs. paclitaxel plus gemcitabine (PG) in patients with HER2-negative metastatic breast cancer as first-line chemotherapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Metastatic breast cancer (MBC) is an incurable disease and is needed to improve effective chemotherapy. Paclitaxel plus Gemcitabine (PG) combination chemotherapy is one of the preferred chemotherapeutic regimens for patients with MBC, and was found to be proper as a maintenance chemotherapy regimen with survival benefit and feasible toxicity profile. Eribulin mesylate is a non-taxane inhibitor of microtubule dynamics of the halichondrin class of antineoplastic drugs. A recent pooled analysis of two phase II studies with eribulin showed improved overall survival in in various patient subgroups with advanced/metastatic breast cancer who had previously received an anthracycline and a taxane. Furthermore, eribulin may have rational benefit compared with paclitaxel in terms of neurotoxicity. Therefore, Eribulin plus Gemcitabine (EG) combination chemotherapy may have less neurotoxocity comparing to PG.
Trial Design: Prospective randomized phase 2, open-label, two-arm, multi-center study comparing EG chemotherapy with PG chemotherapy for patients with HER-2 negative MBC as first-line chemotherapy.
Eligibility Criteria: Histologically confirmed breast cancer patients, at least 19 years of age, with no prior history of chemotherapy for metastatic, recurrent breast cancer with evaluable lesions (as per RECIST, 1.1) who have adequate hematologic, renal, and hepatic function. Patients either may or may not have a prior anthracycline containing regimen. Prior hormonal therapy as a treatment of metastatic disease is allowed.
Specific Aims:
The primary efficacy endpoint of the trial is Progression-Free Survival (PFS). The secondary efficacy endpoints are: Time to Treatment Failure (TTF); Overall Survival (OS); neuropathic scale (FACT for Taxane QOL assessment); toxicity; duration of response; Objective Response Rate (ORR); Clinical Benefit Rate. The exploratory endpoint of the study includes pharmacogenetic profile.
Statistical Methods:
The initial sample size of the present study was determined based on the data derived from a previous trial on PG maintenance chemotherapy design; 6-month PFS is 70% for PG chemotherapy. This design was hypothesized that EG chemotherapy would not be inferior to PG chemotherapy. Thus, estimated PFS for each arm is 70%. Based on this estimate, we would plan to recruit a total of 100 patients (50 per arm). Considering drop-out rate of 10%, total 112 MBC patients planned to be enrolled.
Present Accrual and Target Accrual:Enrollment has been completed as of March, 2016 with a target enrollment of 112 patients.
Contact information:Kyung Hae Jung MD, Ph.D. khjung@amc.seoul.kr
ClinicalTrials.gov Identifier: NCT02263495.
Citation Format: Park YH, Im S-A, Sohn JH, Lee KS, Chae YS, Lee KH, Kim J-H, Im Y-H, Ahn JS, Kim T-Y, Lee K-H, Kim S-B, Ahn J-H, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH. A phase II, multicenter, randomized trial of eribulin plus gemcitabine (EG) vs. paclitaxel plus gemcitabine (PG) in patients with HER2-negative metastatic breast cancer as first-line chemotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-01-12.
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Affiliation(s)
- YH Park
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - S-A Im
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - JH Sohn
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - KS Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - YS Chae
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - KH Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - J-H Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - Y-H Im
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - JS Ahn
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - T-Y Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - K-H Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - S-B Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - J-H Ahn
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - GM Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - IH Park
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - SJ Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - HS Han
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - SH Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - KH Jung
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
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Kim JY, Park D, Jung HH, Bae SY, Yu JH, Lee SK, Kim SW, Lee JE, Nam SJ, Ahn JS, Im YH, Park YH. Abstract P1-02-11: Clinical utility of serial monitoring of circulating tumor DNA (ctDNA)in patients with neoadjuvant chemotherapy (NAC) for locally advanced breast cancer (LABC). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-02-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Circulating tumor DNA (ctDNA) is a new biomarker which could guide further treatment. Characterization of tumor mutation profiles is required for informed choice of therapy, given that biological agents target specific pathways and effectiveness may be modulated by specific mutations. It would have clinical utility for neoadjuvant setting also. Thus, we assess the potency of ctDNA to predict tumor response to neoadjuvant chemotherapy(NAC) in locally advanced breast cancer(LABC).
Methods: We performed targeted deep sequencing of 30 plasma DNAs and 10 matched germline DNAs from 10 LABC patients. Serial plasma DNAs were collected at diagnosis, after 1st NAC and curative surgery. For the target enrichment, we designed RNA baits covering a total of ~202kb regions of human genome including a total of 83 cancer-related genes. We constructed the sequencing libraries according to the optimized protocol that we recently reported and sequenced on Illumina HiSeq2500 aiming a mean sequencing depth of ~10,000. After excluding unmapped reads, PCR duplicates and off-target reads, the coverage depths for plasma DNA and germline DNA samples were 2,627x and 4,833x on average, respectively. NAC response was measured by residual cancer burden(RCB) score, calculated as a continuous index combining pathologic measurements of primary tumor and nodal metastases for prediction of distant relapse-free survival.
Results: We analyzed ctDNA and primary tumor tissues from 10 patients with LABC scheduled NAC followed by operation in Samsung Medical Center. Of ten LABCs, one excluded from analysis because of angiosarcoma of breast. Five samples were triple-negative breast cancers (BCs), 2 were HER2 positive BCs and others were ER positive BCs. In tumor response, 1 patient had pathologic complete response (pCR), 1 had RCB class I, 4 and 3 patients did RCB class II and III.
Of 83 genes, in analysis of ctDNA at BC diagnosis, we found 2 to 6 mutations in each samples and 3 mutations were detected averagely. Most common mutation was TP53 (6 patients), followed by PIK3CA mutation. By measuring these mutations in serial ctDNA, we found that ctDNA had disappeared after first cycle of NAC in patient with pCR. In two patients with RCB class I, ctDNA had decreased by more than 10 percent (the level of ctDNA(pg/ml): 455.9 to 30.4, 5.8 to 0.0) of primary plasma sample after first NAC. Two patients increased level of ctDNA had tumor response with RCB class III and one patient had distant tumor recurrence within 3 months after curative surgery. However, correlation between the level of ctDNA and initial stage was not observed.
Patient No.Initial stageSurgical stageRCB scoreRCB classct DNA at diagnosis (pg/5ml)ctDNA after 1st NAG (pg/5ml)Tumor recurrence12A11.3331455.930.4No22B00pCR446.60.0No33B2A1.31515.80.0No42A12.132246.255.4No52B11.7972107.811.6No63B3A4.09033401.15075.5Yes73A2B3.92235088.68536.7No
Conclusions: This preliminary result suggests that serial monitoring of ctDNA would be a potiential surrogate marker to predict tumor response and recurrence during NAC in LABC patients. Further results with long-term outcomes are warranted.
Citation Format: Kim J-Y, Park D, Jung HH, Bae SY, Yu JH, Lee SK, Kim SW, Lee JE, Nam SJ, Ahn JS, Im Y-H, Park YH. Clinical utility of serial monitoring of circulating tumor DNA (ctDNA)in patients with neoadjuvant chemotherapy (NAC) for locally advanced breast cancer (LABC) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-02-11.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - D Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - SY Bae
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Biomedical Research Institute, Samsung Medical Center, Seoul, Korea; SAIHST, Sungkyunkwan University, Seoul, Korea
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Park CY, Khan A, Pamungkas A, Sim EJ, Kang KH, Lee SY, Park YH. P1.05-026 High Resolution Metabolomics on Exhaled Breath Condensate to Discover Lung Cancer's Biomarker. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Park KH, Lee S, Park JH, Kang SY, Kim HY, Park IH, Park YH, Im YH, Lee HJ, Park S, Lee SI, Jung KH, Kim YS, Seo JH. A randomized, multi-center, open-label, phase III study of once-per-cycle DA-3031, a pegylated G-CSF, in comparison with daily filgrastim in patients receiving TAC chemotherapy for breast cancer. Support Care Cancer 2016; 25:505-511. [PMID: 27709313 DOI: 10.1007/s00520-016-3429-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/26/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE This multi-center, randomized, phase III study was conducted to demonstrate the non-inferiority of DA-3031 compared with daily filgrastim in patients during the first cycle of chemotherapy for breast cancer in terms of the duration of severe neutropenia (DSN). METHODS Seventy-four patients with breast cancer who were receiving combination chemotherapy with docetaxel, doxorubicin, and cyclophosphamide (TAC) were enrolled. All participants were randomized to receive either daily subcutaneous injections of filgrastim 100 μg/m2/day for up to 10 days or a single subcutaneous injection of DA-3031 at fixed doses of 6 mg on day 2 of each chemotherapy cycle. RESULTS The mean duration of grade 4 (G4) neutropenia in cycle 1 was 2.08 ± 0.85 days for the filgrastim group and 2.28 ± 1.14 days for the DA-3031 group. The difference between groups was 0.2 ± 1.10 days (95 % confidence interval (CI) = -0.26, 0.66), which supported non-inferiority. No statistically significant differences were observed in nadir absolute neutrophil count (ANC) (154.34/mm3 and 161.75/mm3 for the filgrastim and DA-3031 groups, respectively; P = 0.8414) or in time to ANC recovery (10.03 ± 0.75 and 9.83 ± 1.56 days in the filgrastim and DA-3031 groups, respectively; P = 0.0611) during cycle 1. Serious AEs occurred in six (15.8 %) patients receiving filgrastim and in ten (27.8 %) patients receiving DA-3031; however, none was determined to be related to the study drug. CONCLUSIONS DA-3031 and daily filgrastim are similar in regard to DSN and safety in breast cancer patients receiving TAC chemotherapy.
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Affiliation(s)
- K H Park
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, 73 Inchonro, Sungbuk-Gu, Seoul, 02481, South Korea
| | - S Lee
- Division of Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - J H Park
- Division of Oncology/Hematology, Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan, South Korea
| | - S Y Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - H Y Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Pyeongchon, Anyang-si, Gyeonggi-do, South Korea
| | - I H Park
- Center for Breast Cancer and Center for Clinical Trials, National Cancer Center, Goyang-si, South Korea
| | - Y H Park
- Division of Hematology/Oncology, Department of Internal Medicine, Samsung Medical Center, Seoul, South Korea
| | - Y H Im
- Division of Hematology/Oncology, Department of Internal Medicine, Samsung Medical Center, Seoul, South Korea
| | - H J Lee
- Product Development HQ, Dong-A ST, Seoul, South Korea
| | - S Park
- Division of Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University College of Medicine, Seoul, South Korea
| | - S I Lee
- Division of Oncology/Hematology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - K H Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Y S Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Jae Hong Seo
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, 73 Inchonro, Sungbuk-Gu, Seoul, 02481, South Korea.
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Kim TY, Ahn JH, Yoon JH, Sohn JH, Kim GM, Lee KH, Park YH, Koh SJ, Lee SE, Chae Y, Lee KS, Lee KE, Won HS, Kim JH, Jeong J, Park KH, Cho EK, Im YH, Im SA, Jung KH. Abstract P1-09-09: Role of endocrine therapy in premenopausal patients with hormone receptor-positive metastatic breast cancer, compared with postmenopausal patients: Diachronic analyses from nationwide cohort in Korea (KCSG BR 14-07). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-09-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Endocrine therapy (E) has a major role in treatment of hormone receptor (HR)-positive metastatic breast cancer (MBC). However, in contrast to western countries, premenopausal patients (PRE) more prevalent (50% of all breast cancer patients) and have less options of E than postmenopausal patients (POST) in Korea where the use of LHRH agonist in combination aromatase inhibitors (AIs) in PRE is restricted. Recently we have been successfully established nationwide cohort for the patients MBC (575 patients from 26 institutes). This study was designed to evaluate the role of E especially in PRE.
Methods
The patients with MBC were prospectively or retrospectively enrolled between September 2014 and May 2015. Only menopausal status-confirmed patients (296) were analyzed. Postmenopause was defined, based on NCCN guideline. Total duration of treatment was defined as the time from start day of any first treatment to end of any last treatment. Total duration of E was defined as the sum of time duration of each E. Overall survival was calculated from the start day of any treatment for MBC to any causes of death. This work is supported by National Strategic Coordinating Center for Clinical Research (H110C2020).
Results
A total of 296 patients with HR-positive MBC were analyzed [PRE, 169 (57.1%) and POST, 127 (42.9%)]. Except age (mean 44 and 60 years), baseline characteristics including in pathology, HER2 status, initial pathologic stage, de novo metastasis versus recurrence, surgery and adjuvant treatment (chemotherapy, endocrine therapy and radiotherapy) were well balanced. 92 (54.4%) of PRE and 77 (60.6%) of POST received at least one or more E through all treatment course. 41 (24.2%) of PRE and 44 (34.6%) received E as 1st-line treatment (p=0.034). Among PRE who received 1st-line of E, 30 (71.4%) and 9 (21.4%) of PRE received 2nd- and 3rd-line E. 20 (45.4%) and 10 (22.7%) of POST received 2nd- and 3rd- or more line of E. Most of PRE (54%) received tamoxifen+/-goserelin and 32% of PRE received AIs along with ovarian suppression. 71% of POST received AIs. As initial treatment, E was more frequently used in POST than in PRE (34.6% and 24.3%, p=0.053). Overall survival (OS) of all patients was 18.2 months (95% CI, 14.8-21.5). There was no difference in OS between PRE (17.8 months, 10.9-24.8) and POST (18.5 months, 95% CI, 13.2-23.9) (P=0.337). No difference of OS was observed (E, 18.1 moths, 95% CI, 13.0-23.3; chemotherapy 21.2 moths, 95% CI, 16.8-25.5), regardless of initial treatment. Total duration of treatment of PRE and POST were 15.2 and 13.6 months, respectively with no significant difference (p=0.389). PRE (8.3 moths, 95% CI,5.7-10.8) showed the trend toward longer duration of E in comparison with POST (5.5 moths, 95% CI,4.4-6.7), however the difference did not reach statistical significance (p=0.051).
Conclusion
E was more commonly used as 1st-line therapy in POST than in PRE. Although PRE had limited options of E, E was used in long duration of treatment especially in PRE. These findings suggested that E had a role in treatment for PRE with HR-positive MBC and could be used in treatment for PRE with good efficacy.
Citation Format: Kim T-Y, Ahn J-H, Yoon JH, Sohn JH, Kim GM, Lee KH, Park YH, Koh S-J, Lee SE, Chae Y, Lee KS, Lee KE, Won HS, Kim JH, Jeong J, Park KH, Cho EK, Im Y-H, Im S-A, Jung KH. Role of endocrine therapy in premenopausal patients with hormone receptor-positive metastatic breast cancer, compared with postmenopausal patients: Diachronic analyses from nationwide cohort in Korea (KCSG BR 14-07). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-09.
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Affiliation(s)
- T-Y Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - J-H Ahn
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - JH Yoon
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - JH Sohn
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - GM Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KH Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - YH Park
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - S-J Koh
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - SE Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - Y Chae
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KS Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KE Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - HS Won
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - JH Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - J Jeong
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KH Park
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - EK Cho
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - Y-H Im
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - S-A Im
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KH Jung
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
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Lee JK, Kang D, Choi EK, Kong S, Lee SK, Lee JE, Han W, Park YH, Ahn JS, Im YH, Noh DY, Nam SJ, Cho J. Abstract P1-10-31: Impact of increased physical activities after diagnosis on fatigue and overall pain during cancer treatment: A prospective cohort study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-10-31] [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
Existing evidence strongly suggests that exercise is not only safe but also feasible during cancer treatment. Physical activity is recommended for improving multiple post-treatment adverse effects on bone health, muscle strength, and other quality-of-life measures. Yet, limited evidence exists regarding effect of increased physical activity after diagnosis on symptoms management of breast cancer patients.
Methods
A total of 422 patients were recruited from July 2010 to July 2011 at two cancer hospitals in Seoul, Korea. Physical activity in sports (PAS) was assessed using Minnesota Leisure Time Physical Activity Questionnaire before and 2 weeks, 3-, 6-, 12-, 24- and 36-months after diagnosis. Physical symptoms including fatigue, pain, arm symptom, and insomnia were measured using EORTC-C30 and BR23. Growth mixture models were used to identify trajectory classes of physical activity patterns. Multivariate analysis was used to find impact of PAS on symptom management using SAS.
Results
Three distinct PAS groups were identified according to 3-year change patterns: moderate to moderate (MM): 40.8%, none to moderate (NM): 31.1% and moderate to high (MH): 28.1%. The LM and MH group increased PAS from diagnosis but it began to decrease from 1 year after diagnosis. Compared to the MM, the NM and MH reported significantly lower level of fatigue (MM:40.7, NM:32.2, MH:33.7), pain(MM:28.0, NM:25.6, MH:20.6), systemic therapy side effects (MM:26.9, NM:22.6, MH:21.8), and breast symptoms (MM:25.4, NM:21.7, MH:20.2) during active treatment (6 months after diagnosis).
Change patterns of quality of life according to trajectory groups At diagnosis2 weeks3 months6 months12 months24 months36 monthsFatigueMM31.3±1.930.2±1.935.3±2.0140.7±2.1137.8±2.1138.5±2.1141.0±2.21NM30.2±1.928.2±1.931.9±2.132.2±2.2233.6±2.135.6±2.2137.8±2.31MH28.8±2.327.4±2.233.0±2.433.7±2.51233.9±2.4136.2±2.5137.1±2.51PainMM15.1±1.531.3±1.9123.2±2.0128.0±2.0123.5±2.0122.0±2.0121.2±1.91NM15.4±1.532.4±2.023.3±2.0125.6±2.122.7±2.021.1±2.123.8±2.01MH17.2±1.828.4±2.3121.2±2.320.6±2.4219.7±2.321.1±2.318.6±2.2Systemic therapy side effectsMM16.8±1.114.3±1.2133.2±1.7126.9±1.5125.4±1.5126.2±1.6128.6±1.71NM15.0±1.114.5±1.235.2±1.7122.6±1.61222.0±1.6124.5±1.7127.7±1.81MH15.6±1.412.9±1.4134.4±2.0121.8±1.81221.8±1.7122.1±1.9124.7±2.01Breast symptomsMM13.8±1.226.4±1.6120.8±1.5125.4±1.6123.6±1.6119.2±1.7119.6±1.71NM13.0±1.224.7±1.6119.6±1.5121.7±1.61222.3±1.7119.9±1.8119.1±1.81MH16.0±1.424.1±1.8119.4±1.820.2±1.81217.8±1.8217.4±2.014.0±1.92*adjusted with age, stage, and radiotherapy 1 p<0.05 (differences from baseline within group), 2 p<0.05 (differences from MM group within time)
Conclusion
The results of the study confirmed that increased physical activity after diagnosis, even with patients who did not exercise at all before diagnosis, helps to control fatigue, pain, systemic side effects, and breast symptoms during treatment. It is necessary to find ways to promote physical activity after diagnosis and help patients to stay active during treatment.
Citation Format: Lee JK, Kang D, Choi E-K, Kong S, Lee S-K, Lee JE, Han W, Park YH, Ahn JS, Im YH, Noh D-Y, Nam S-J, Cho J. Impact of increased physical activities after diagnosis on fatigue and overall pain during cancer treatment: A prospective cohort study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-31.
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Affiliation(s)
- JK Lee
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - D Kang
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - E-K Choi
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - S Kong
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - S-K Lee
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - JE Lee
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - W Han
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - YH Park
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - JS Ahn
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - YH Im
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - D-Y Noh
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - S-J Nam
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - J Cho
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center; Health, Behavior and Society, SAHIST, Sungkyunkwan University; Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Surgery, Seoul National University Hospital; Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine
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Lu YS, Ro J, Tseng LM, Chao TY, Chitapanarux I, Valenti R, Canatar A, Salomon H, Park YH. Abstract P4-13-27: A phase Ib dose de-escalation study of combined tamoxifen and goserelin acetate with alpelisib (BYL719) or buparlisib (BKM120) in premenopausal patients with HR+/HER2– locally advanced or metastatic breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: Growing evidence suggests that concomitant inhibition of the phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin pathway could enhance and extend the clinical benefit of endocrine therapies in hormone receptor-positive (HR+) metastatic breast cancer (mBC). In this Phase Ib study (NCT02058381), alpelisib (a p110α-selective inhibitor) or buparlisib (a pan-PI3K inhibitor) was combined with tamoxifen and goserelin acetate in premenopausal women with mBC, a more prevalent patient population in Asian vs Western countries.
Methods: Premenopausal women with HR+/human epidermal growth factor receptor 2-negative (HER2–) locally advanced or mBC and no prior endocrine therapy for metastatic disease were recruited in Taiwan, Republic of Korea, and Thailand. Patients (pts) received tamoxifen (20 mg once daily [QD]) and goserelin (3.6 mg Q28D) with either alpelisib (350 mg QD; Group 1) or buparlisib (100 mg QD; Group 2) on a continuous dosing schedule in 28-day cycles. The primary objective was to define the recommended Phase II dose (RP2D) for each combination, based on dose-limiting toxicities (DLTs) observed during Cycle 1, using a dose de-escalation design. Secondary objectives included pharmacokinetics, safety and tolerability (per Common Terminology Criteria for Adverse Events v4.03), efficacy (per Response Evaluation Criteria In Solid Tumors v1.1), and impact on quality of life.
Results: As of February 2, 2015, 12 pts, all Asian, have been treated in the first cohort. In Group 1, 6 pts with a median age of 43 were treated with alpelisib (350 mg starting dose), and no DLTs were observed in Cycle 1. In Group 2, 6 pts with a median age of 47 were treated with buparlisib (100 mg starting dose), and 1 DLT of Grade (G) 3 alanine aminotransferase/aspartate aminotransferase elevation was observed. In Group 1, significant toxicities included hypokalemia (G3: 1 pt), rash (G3: 1 pt; G1/2: 2 pts), anemia (G3: 1 pt), leukopenia (G3: 1 pt), and infections (G3: 1 pt; G1/2: 1 pt); no G4 toxicities were reported. In Group 2, significant toxicities included liver toxicity (G4: 1 pt; G3: 1 pt; G1/2: 2 pts), psychiatric disorders (G4: 1 pt; G3: 1 pt; G1/2: 1 pt), rash (G3: 1 pt; G1/2: 2 pts), hypertension (G3: 1 pt; G1/2: 1 pt), and hyperglycemia (G3: 1 pt). No pts in Group 1, and 5/6 pts in Group 2, have discontinued treatment due to adverse events (AEs). Median treatment duration was 110 days in Group 1 and 71 days in Group 2.
Conclusions: The combination of alpelisib (350 mg) with tamoxifen and goserelin resulted in a manageable toxicity profile. Meanwhile, the same combination with full-dose buparlisib (100 mg) was less well tolerated; despite the appearance of only one DLT during Cycle 1, the majority of pts subsequently stopped treatment due to AEs. An expansion phase is ongoing, and results will be integrated with safety, tolerability, and efficacy results for the first 15 pts enrolled in each group. PIK3CA status at baseline will also be assessed.
Citation Format: Lu Y-S, Ro J, Tseng L-M, Chao T-Y, Chitapanarux I, Valenti R, Canatar A, Salomon H, Park YH. A phase Ib dose de-escalation study of combined tamoxifen and goserelin acetate with alpelisib (BYL719) or buparlisib (BKM120) in premenopausal patients with HR+/HER2– locally advanced or metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-27.
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Affiliation(s)
- Y-S Lu
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - J Ro
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - L-M Tseng
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - T-Y Chao
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - I Chitapanarux
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - R Valenti
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - A Canatar
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - H Salomon
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
| | - YH Park
- National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center, Goyang, Korea; Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University – Shuang Ho Hospital, Taipei, Taiwan; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Novartis Pharma AG, Basel, Switzerland; Novartis Pharma S.A.S., Paris, France; Samsung Medical Center, Seoul, Korea
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Kim JY, Ahn T, Jung HH, Park K, Do IG, Kil WH, Kim SW, Lee JE, Nam SJ, Ahn JS, Park YH, Im YH. Abstract P2-08-19: Prognostication of HER family gene expression collaborate with ESR1 expression in patients with triple negative breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-08-19] [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: Triple-negative breast cancer (TNBC) consists of heterogeneous sub-population. Although many investigators made an effort to categorize and classify TNBCs using genetic expressions, it is still needed to be defined for prognostication Traditionally, HER family genes have been known to contribute mammalian glands formation and breast cancer generation as well as ESR gene. Moreover, target agents for HER family genes have been already developed. Accordingly, we investigated the expression profiles of HER family genes with ESR in patients with TNBC to categorize into sub-types and determine the prognostic value of HER family genes in search of clinical implications.
Methods : We investigated the results of the nCounter expression assay (NanoString®) for ERBB1, ERBB2, ERBB3, ERBB4 and ESR1 using mRNA extract from paraffin-embedded tumor tissues in 203 patients diagnosed as TNBC. We used the results of nCounter expression assay using 84 TNBC tissues for validation and 52 breast cancer tissues diagnosed as other subtypes to control the expression assay results of these five genes.
Results: Two-hundred and three patients were diagnosed as TNBC from 2000 to 2004 and received adjuvant chemotherapy after curative surgery. Eighty-four TNBC patients for validation set and 52 patients diagnosed as other subtypes for control set were selected from the patients diagnosed as breast cancer from 2005 to 2010 and received curative surgery. Through analyzing 5 genes using the nCounter expression profiles from 203 TNBC tissues, we found that increased expression of ERBB4 was associated with poor prognosis by survival analysis (5 year disease recurrence free survival (DRFS), low vs. high expression [cut-off: median]: 90.1% vs. 80.2%; p =.002). This trend was still remained in validation set composed of TNBC (5 year DRFS, low vs. high expression [cut-off : median]: 61.1% vs. 44.0%), whereas was not observed in other subtypes of breast cancer (44.4% vs. 80.8%). The Kaplan-Meier estimates of the rates of 5 year DRFS in the subgroups classified according to the level of 5 genes expression showed that the group of higher expression of all HER family genes and lower expression of ESR1 gene had dismal prognosis rather than other groups in patients with TNBC (5 year DRFS, this group vs. others: 50.0% vs. 88.2%; p <.001). In a multivariate Cox regression model, ERBB4 expression identified as a useful marker for predicting long-term prognosis in patients with TNBC although other HER family genes and ESR1 expressions did not predict prognosis of TNBC with statistical significance (Table 1).
Impact of the m RNA expression levels of ERBB family and ESR1 on DRFS Hazard Ratio95% CIP-valueStage <.001I1.0NA IIA1.200.40-3.57 IIB3.751.20-11.74 IIIA5.461.55-9.24 IIIC59.9214.30-251.12 EGFR .167Low1.0NA High1.690.80-3.55 ERBB2 .057Low1.0NA High0.430.18-1.03 ERBB3 .061Low1.0NA High2.200.96-5.04 ERBB4 .016Low1.0NA High2.681.20-5.95 ESR1 .113Low1.0NA High0.570.28-1.15
Conclusions: The expression profile of HER family genes could be used as a prognostic marker in patients with TNBC. Further study is needed to identify the expression profiles of HER family gene as predictive marker of HER targeting treatment in patients with TNBC.
Citation Format: Kim J-Y, Ahn T, Jung HH, Park K, Do I-G, Kil WH, Kim SW, Lee JE, Nam SJ, Ahn JS, Park YH, Im Y-H. Prognostication of HER family gene expression collaborate with ESR1 expression in patients with triple negative breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-19.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea
| | - T Ahn
- Samsung Medical Center, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea
| | - I-G Do
- Samsung Medical Center, Seoul, Korea
| | - WH Kil
- Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Seoul, Korea
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