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Pizzamiglio S, Ciniselli CM, de Azambuja E, Agbor-Tarh D, Moreno-Aspitia A, Suter TM, Trama A, De Santis MC, De Cecco L, Iorio MV, Silvestri M, Pruneri G, Verderio P, Di Cosimo S. Circulating microRNAs and therapy-associated cardiac events in HER2-positive breast cancer patients: an exploratory analysis from NeoALTTO. Breast Cancer Res Treat 2024:10.1007/s10549-024-07299-6. [PMID: 38689174 DOI: 10.1007/s10549-024-07299-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE The relevance of cardiotoxicity in the context of HER2-positive breast cancer is likely to increase with increasing patient treatment exposure, number of treatment lines, and prolonged survival. Circulating biomarkers to early identify patients at risk of cardiotoxicity could allow personalized treatment and follow-up measures. The aim of this study is to examine the relationship between circulating microRNAs and adverse cardiac events in HER2-positive breast cancer patients. METHODS We based our work on plasma samples from NeoALTTO trial obtained at baseline, after 2 weeks of anti-HER2 therapy, and immediately before surgery. Eleven patients experienced either a symptomatic or asymptomatic cardiac event. Circulating microRNAs were profiled in all patients presenting a cardiac event (case) and in an equal number of matched patients free of reported cardiac events (controls) using microRNA-Ready-to-Use PCR (Human panel I + II). Sensitivity analyses were performed by increasing the number of controls to 1:2 and 1:3. Normalized microRNA expression levels were compared between cases and controls using the non-parametric Kruskal-Wallis test. RESULTS Eight circulating microRNAs resulted differentially expressed after 2 weeks of anti-HER2 therapy between patients experiencing or not a cardiac event. Specifically, the expression of miR-125b-5p, miR-409-3p, miR-15a-5p, miR-423-5p, miR-148a-3p, miR-99a-5p, and miR-320b increased in plasma of cases as compared to controls, while the expression of miR-642a-5p decreases. Functional enrichment analysis revealed that all these microRNAs were involved in cardiomyocyte adrenergic signaling pathway. CONCLUSION This study provides proof of concept that circulating microRNAs tested soon after treatment start could serve as biomarkers of cardiotoxicity in a very early stage in breast cancer patients receiving anti-HER2 therapy.
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Affiliation(s)
- S Pizzamiglio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - C M Ciniselli
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - E de Azambuja
- Department of Medical Oncology, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | | | | | - T M Suter
- Swiss Cardiovascular Center, University Hospital Bern, Inselspital, Bern, Switzerland
| | - A Trama
- Unit of Evaluative Epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M C De Santis
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - L De Cecco
- Unit of Molecular Mechanisms, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M V Iorio
- Unit of Microenvironment and Biomarkers of Solid Tumors, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Silvestri
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Verderio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
| | - S Di Cosimo
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Rusakiewicz S, Tyekucheva S, Tissot-Renaud S, Chaba K, Imbimbo M, Benedetti F, Kammler R, Hornfeld J, Munzone E, Gianni L, Thurlimann B, Láng I, Pruneri G, Gray KP, Regan MR, Loi S, Colleoni M, Viale G, Kandalaft L, Coukos G, Curigliano G. Multiplexed high-throughput immune cell imaging in patients with high-risk triple negative early breast cancer: Analysis from the International Breast Cancer Study Group (IBCSG) Trial 22-00. Eur J Cancer 2024; 200:113535. [PMID: 38309015 DOI: 10.1016/j.ejca.2024.113535] [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: 11/23/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is the most aggressive breast cancer (BC) subtype, with dismal prognosis and limited option in advanced settings, yet stromal tumor infiltrating lymphocytes (sTILs) in this subtype has a predictive role. PATIENTS AND METHODS The International Breast Cancer Study Group (IBCSG) Trial 22-00 is a randomized phase III clinical trial testing the efficacy of low-dose metronomic oral Cyclophosphamide-Methotrexate (CM) maintenance following standard adjuvant chemotherapy treatment for early-stage hormone receptor-negative breast cancer patients. A case-cohort sampling was used. We characterized immune cells infiltrates in patients with TNBC by 6 plex immunofluorescence (IF) staining for CD4, FOXP3, CD3, cytokeratine and CD8 RESULTS: We confirmed that high immune CD3+ T cells as well as stromal and intra-epithelial Tregs (CD4+Foxp3+ T cells) infiltrates were associated with a better Distant Recurrence-Free Interval (DRFI), especially in LN+ patient, regardless of the treatment. More importantly, we showed that the spatial distribution of immune cells at baseline is crucial, as CM maintenance was detrimental for T cells excluded LN+ TNBC patients. CONCLUSIONS immune spatial classification on immune cells infiltrates seems crucial and could help patients' selection in clinical trial and greatly improve responses to specific therapies.
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Affiliation(s)
- S Rusakiewicz
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - S Tyekucheva
- International Breast Cancer Study Group Statistical Center, Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S Tissot-Renaud
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - K Chaba
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - M Imbimbo
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - F Benedetti
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - R Kammler
- Translational Research Coordination, International Breast Cancer Study Group, a division of ETOP IBCSG Partners Foundation, Bern, Switzerland
| | - J Hornfeld
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - E Munzone
- Division of Medical Senology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - L Gianni
- Department of Medical Oncology, Ospedale Infermi, AUSL Della Romagna, Rimini, Italy
| | - B Thurlimann
- Kantonsspital St. Gallen, St Gallen, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - I Láng
- Clinexpert-research, Budapest, Hungary
| | - G Pruneri
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; University of Milan, School of Medicine, Milan, Italy
| | - K P Gray
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Biostatistics and Research Design Core, Institutional Centers of Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA
| | - M R Regan
- International Breast Cancer Study Group Statistical Center, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - S Loi
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Cancer Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; International Breast Cancer Study Group, a division of ETOP IBCSG Partners Foundation, Bern, Switzerland
| | - M Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Department of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Viale
- Division of Medical Senology, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Department of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milan, Italy; European Institute of Oncology, IRCCS, Milan, Italy
| | - L Kandalaft
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - G Coukos
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Center of Experimental Therapeutics, Department of Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, University of Lausanne, 1011 Lausanne, Switzerland
| | - Giuseppe Curigliano
- European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy.
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3
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Nader-Marta G, Monteforte M, Agostinetto E, Cinquini M, Martins-Branco D, Langouo M, Llombart-Cusac A, Cortés J, Ignatiadis M, Torri V, Apolone G, Cappelletti V, Pruneri G, de Azambuja E, Di Cosimo S. Circulating tumor DNA for predicting recurrence in patients with operable breast cancer: a systematic review and meta-analysis. ESMO Open 2024; 9:102390. [PMID: 38460249 PMCID: PMC10940943 DOI: 10.1016/j.esmoop.2024.102390] [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: 11/29/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND The incorporation of circulating tumor DNA (ctDNA) into the management of operable breast cancer (BC) has been hampered by the heterogeneous results from different studies. We aimed to assess the prognostic value of ctDNA in patients with operable (non metastatic) BC. MATERIALS AND METHODS A systematic search of databases (PubMed/Medline, Embase, and CENTRAL) and conference proceedings was conducted to identify studies reporting the association of ctDNA detection with disease-free survival (DFS) and overall survival (OS) in patients with stage I-III BC. Log-hazard ratios (HRs) were pooled at each timepoint of ctDNA assessment (baseline, after neoadjuvant therapy, and follow-up). ctDNA assays were classified as primary tumor-informed and non tumor-informed. RESULTS Of the 3174 records identified, 57 studies including 5779 patients were eligible. In univariate analyses, ctDNA detection was associated with worse DFS at baseline [HR 2.98, 95% confidence interval (CI) 1.92-4.63], after neoadjuvant therapy (HR 7.69, 95% CI 4.83-12.24), and during follow-up (HR 14.04, 95% CI 7.55-26.11). Similarly, ctDNA detection at all timepoints was associated with worse OS (at baseline: HR 2.76, 95% CI 1.60-4.77; after neoadjuvant therapy: HR 2.72, 95% CI 1.44-5.14; and during follow-up: HR 9.19, 95% CI 3.26-25.90). Similar DFS and OS results were observed in multivariate analyses. Pooled HRs were numerically higher when ctDNA was detected at the end of neoadjuvant therapy or during follow-up and for primary tumor-informed assays. ctDNA detection sensitivity and specificity for BC recurrence ranged from 0.31 to 1.0 and 0.7 to 1.0, respectively. The mean lead time from ctDNA detection to overt recurrence was 10.81 months (range 0-58.9 months). CONCLUSIONS ctDNA detection was associated with worse DFS and OS in patients with operable BC, particularly when detected after treatment and using primary tumor-informed assays. ctDNA detection has a high specificity for anticipating BC relapse.
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Affiliation(s)
- G Nader-Marta
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium.
| | - M Monteforte
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - E Agostinetto
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium. https://twitter.com/ElisaAgostinett
| | - M Cinquini
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - D Martins-Branco
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium. https://twitter.com/DMBranco
| | - M Langouo
- Medical Oncology Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - A Llombart-Cusac
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Medica Scientia Innovation Research (MEDSIR), Ridgewood, New Jersey, USA; Arnau de Vilanova Hospital; Universidad Católica de Valencia, Valencia, Spain
| | - J Cortés
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Medica Scientia Innovation Research (MEDSIR), Ridgewood, New Jersey, USA; International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Group, Barcelona, Spain; Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain. https://twitter.com/JavierCortesMD
| | - M Ignatiadis
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium; Medical Oncology Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium. https://twitter.com/MIgnatiadis
| | - V Torri
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. https://twitter.com/ValterTorri
| | - G Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Cappelletti
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; University of Milan, School of Medicine, Milan, Italy. https://twitter.com/PruneriG
| | - E de Azambuja
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium; Medical Oncology Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (U.L.B), Brussels, Belgium. https://twitter.com/E_de_Azambuja
| | - S Di Cosimo
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. https://twitter.com/serenadicosimo
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4
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Chiodoni C, Sangaletti S, Lecchi M, Ciniselli CM, Cancila V, Tripodi I, Ratti C, Talarico G, Brich S, De Cecco L, Baili P, Truffi M, Sottotetti F, Piccotti F, Tripodo C, Pruneri G, Triulzi T, Corsi F, Cappelletti V, Di Cosimo S, Verderio P, Colombo MP. A three-gene signature marks the time to locoregional recurrence in luminal-like breast cancer. ESMO Open 2023; 8:101590. [PMID: 37393630 PMCID: PMC10485389 DOI: 10.1016/j.esmoop.2023.101590] [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: 02/03/2023] [Revised: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Gene expression profiling (GEP)-based prognostic signatures are being rapidly integrated into clinical decision making for systemic management of breast cancer patients. However, GEP remains relatively underdeveloped for locoregional risk assessment. Yet, locoregional recurrence (LRR), especially early after surgery, is associated with poor survival. PATIENTS AND METHODS GEP was carried out on two independent luminal-like breast cancer cohorts of patients developing early (≤5 years after surgery) or late (>5 years) LRR and used, by a training and testing approach, to build a gene signature able to intercept women at risk of developing early LRR. The GEP data of two in silico datasets and of a third independent cohort were used to explore its prognostic value. RESULTS Analysis of the first two cohorts led to the identification of three genes, CSTB, CCDC91 and ITGB1, whose expression, derived by principal component analysis, generated a three-gene signature significantly associated with early LRR in both cohorts (P value <0.001 and 0.005, respectively), overcoming the discriminatory capability of age, hormone receptor status and therapy. Remarkably, the integration of the signature with these clinical variables led to an area under the curve of 0.878 [95% confidence interval (CI) 0.810-0.945]. In in silico datasets we found that the three-gene signature retained its association, showing higher values in the early relapsed patients. Moreover, in the third additional cohort, the signature significantly associated with relapse-free survival (hazard ratio 1.56, 95% CI 1.04-2.35). CONCLUSIONS Our three-gene signature represents a new exploitable tool to aid treatment choice in patients with luminal-like breast cancer at risk of developing early recurrence.
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Affiliation(s)
- C Chiodoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Immunology Unit, Milan
| | - S Sangaletti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Immunology Unit, Milan
| | - M Lecchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Epidemiology and Data Science, Unit of Bioinformatics and Biostatistics, Milan
| | - C M Ciniselli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Epidemiology and Data Science, Unit of Bioinformatics and Biostatistics, Milan
| | - V Cancila
- University of Palermo School of Medicine, Department of Health Sciences, Tumor Immunology Unit, Palermo
| | - I Tripodi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Immunology Unit, Milan
| | - C Ratti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Immunology Unit, Milan
| | - G Talarico
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Immunology Unit, Milan
| | - S Brich
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Pathology, Milan
| | - L De Cecco
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Mechanisms Unit, Milan
| | - P Baili
- Fondazione IRCCS Istituto Nazionale dei Tumori, Analytical Epidemiology and Health Impact Unit, Milan
| | - M Truffi
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Nanomedicine, Pavia
| | - F Sottotetti
- Istituti Clinici Scientifici Maugeri IRCCS, Medical Oncology Unit, Pavia
| | - F Piccotti
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Nanomedicine, Pavia
| | - C Tripodo
- University of Palermo School of Medicine, Department of Health Sciences, Tumor Immunology Unit, Palermo; FIRC Institute of Molecular Oncology (IFOM), Milan
| | - G Pruneri
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Pathology, Milan
| | - T Triulzi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Targeting Unit, Milan
| | - F Corsi
- Istituti Clinici Scientifici Maugeri IRCCS, Surgery Department, Breast Unit, Pavia; Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan
| | - V Cappelletti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Advanced Diagnostics, Biomarkers Unit, Milan, Italy
| | - S Di Cosimo
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Advanced Diagnostics, Biomarkers Unit, Milan, Italy
| | - P Verderio
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Epidemiology and Data Science, Unit of Bioinformatics and Biostatistics, Milan
| | - M P Colombo
- Fondazione IRCCS Istituto Nazionale dei Tumori, Experimental Oncology Department, Molecular Immunology Unit, Milan.
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5
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Tarantino P, Viale G, Press MF, Hu X, Penault-Llorca F, Bardia A, Batistatou A, Burstein HJ, Carey LA, Cortes J, Denkert C, Diéras V, Jacot W, Koutras AK, Lebeau A, Loibl S, Modi S, Mosele MF, Provenzano E, Pruneri G, Reis-Filho JS, Rojo F, Salgado R, Schmid P, Schnitt SJ, Tolaney SM, Trapani D, Vincent-Salomon A, Wolff AC, Pentheroudakis G, André F, Curigliano G. ESMO expert consensus statements (ECS) on the definition, diagnosis, and management of HER2-low breast cancer. Ann Oncol 2023; 34:645-659. [PMID: 37269905 DOI: 10.1016/j.annonc.2023.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [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: 02/05/2023] [Revised: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/05/2023] Open
Abstract
Human epidermal growth factor receptor 2 (HER2)-low breast cancer has recently emerged as a targetable subset of breast tumors, based on the evidence from clinical trials of novel anti-HER2 antibody-drug conjugates. This evolution has raised several biological and clinical questions, warranting the establishment of consensus to optimally treat patients with HER2-low breast tumors. Between 2022 and 2023, the European Society for Medical Oncology (ESMO) held a virtual consensus-building process focused on HER2-low breast cancer. The consensus included a multidisciplinary panel of 32 leading experts in the management of breast cancer from nine different countries. The aim of the consensus was to develop statements on topics that are not covered in detail in the current ESMO Clinical Practice Guideline. The main topics identified for discussion were (i) biology of HER2-low breast cancer; (ii) pathologic diagnosis of HER2-low breast cancer; (iii) clinical management of HER2-low metastatic breast cancer; and (iv) clinical trial design for HER2-low breast cancer. The expert panel was divided into four working groups to address questions relating to one of the four topics outlined above. A review of the relevant scientific literature was conducted in advance. Consensus statements were developed by the working groups and then presented to the entire panel for further discussion and amendment before voting. This article presents the developed statements, including findings from the expert panel discussions, expert opinion, and a summary of evidence supporting each statement.
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Affiliation(s)
- P Tarantino
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston, USA; Department of Oncology and Hemato-Oncology, University of Milan, Milan
| | - G Viale
- Department of Pathology and Laboratory Medicine, European Institute of Oncology IRCCS, Milan, Italy
| | - M F Press
- Department of Pathology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - X Hu
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - F Penault-Llorca
- Centre de Lutte Contre le Cancer Centre Jean PERRIN, Clermont-Ferrand, France
| | - A Bardia
- Harvard Medical School, Boston, USA; Department of Medical Oncology, Massachusetts General Hospital, Boston, USA
| | - A Batistatou
- Department of Pathology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - H J Burstein
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston, USA
| | - L A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - J Cortes
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Barcelona; Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - C Denkert
- Philipps-University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - V Diéras
- Department of Medical Oncology, Centre Eugène Marquis, Rennes
| | - W Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier University, INSERM U1194, Montpellier, France
| | - A K Koutras
- Division of Oncology, Department of Medicine, University Hospital of Patras, Greece
| | - A Lebeau
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - S Loibl
- German Breast Group/GBG Forschungs GmbH, Neu-Isenburg; Goethe University Frankfurt, Frankfurt, Germany
| | - S Modi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M F Mosele
- Department of Medical Oncology, Institute Gustave Roussy, Villejuif, France
| | - E Provenzano
- Department of Histopathology, Cambridge University NHS Foundation Trust and NIH Cambridge Biomedical Research Centre, Cambridge, UK
| | - G Pruneri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - J S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - F Rojo
- Department of Pathology, IIS-Fundacion Jimenez Diaz University Hospital-CIBERONC, Madrid, Spain
| | - R Salgado
- Department of Pathology, ZAS, Antwerp, Belgium; Division of Research, Peter Mac Callum Cancer Centre, Melbourne, Australia
| | - P Schmid
- Barts Cancer Institute, Queen Mary University London, London, UK
| | - S J Schnitt
- Harvard Medical School, Boston, USA; Department of Pathology, Brigham and Women's Hospital and Breast Oncology Program, Dana-Farber Cancer Institute, Boston, USA
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston, USA
| | - D Trapani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; European Institute of Oncology, IRCCS, Milan, Italy
| | - A Vincent-Salomon
- Department of Pathology, Diagnostic and Theranostic Medicine Division, Institut Curie, PSL University, Paris, France
| | - A C Wolff
- The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA
| | | | - F André
- INSERM U981 - Molecular Predictors and New Targets in Oncology, PRISM Center for Precision Medicine, Gustave Roussy, Villejuif, France
| | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; European Institute of Oncology, IRCCS, Milan, Italy.
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De Braud F, Fucà G, Ligorio F, Huber V, Ferraris C, Martelli G, Folli S, Bianchi G, Capri G, Provenzano L, Martinetti A, Ficchì A, Scaperrotta G, Depretto C, Bedognetti D, Belfiore A, Vingiani A, Pruneri G, Rivoltini L, Vernieri C. 82P Cyclic fasting-mimicking diet as a strategy to improve the efficacy of standard antitumor therapies in cancer patients. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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7
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Botticelli A, Scagnoli S, Conte P, Cremolini C, Ascierto P, Aglietta M, Mazzuca F, Capoluongo E, Malapelle U, Nuti M, D'Amati G, Cerbelli B, Pruneri G, Giannini G, Cappuzzo F, Biffoni M, Blandino G, Cognetti F, Curigliano G, Marchetti P. 70MO Genomic profiling to expand precision cancer medicine in the real world: The ROME trial. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
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8
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Lo Russo G, Sgambelluri F, Prelaj A, Galli F, Manglaviti S, Bottiglieri A, Di Mauro R, Ferrara R, Galli G, Signorelli D, De Toma A, Occhipinti M, Brambilla M, Rulli E, Triulzi T, Torelli T, Agnelli L, Brich S, Martinetti A, Dumitrascu A, Torri V, Pruneri G, Fabbri A, de Braud F, Anichini A, Proto C, Ganzinelli M, Mortarini R, Garassino M. PEOPLE (NCT03447678), a first-line phase II pembrolizumab trial, in negative and low PD-L1 advanced NSCLC: clinical outcomes and association with circulating immune biomarkers. ESMO Open 2022; 7:100645. [PMID: 36455507 PMCID: PMC9808469 DOI: 10.1016/j.esmoop.2022.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/25/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The PEOPLE trial aimed to identify new immune biomarkers in negative and low programmed death-ligand 1 (PD-L1) (0%-49%) advanced non-small-cell lung cancer (aNSCLC) patients treated with first-line pembrolizumab. Here we report the main outcomes and the circulating immune biomarkers analysis. PATIENTS AND METHODS The primary endpoint of this phase II trial was the identification of immune biomarkers associated with progression-free survival (PFS). Overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DoR) and safety were secondary endpoints. Absolute cell counts for 36 subsets belonging to innate and adaptive immunity were determined by multiparametric flow cytometry in peripheral blood at baseline and at first radiologic evaluation. An orthoblique principal components-based clustering approach and multivariable Cox regression model adjusted for clinical variables were used to analyze immune variables and their correlation with clinical endpoints. RESULTS From May 2018 to October 2020, 65 patients were enrolled. After a median follow-up of 26.4 months, the median PFS was 2.9 months [95% confidence interval (CI) 1.8-5.6 months] and median OS was 12.1 months (95% CI 8.7-17.1 months). The ORR was 21.5%, DCR was 47.7% and median DoR was 14.5 months (95% CI 6.4-24.9 months). Drug-related grade 3-4 adverse events were 9.2%. Higher T cell and natural killer (NK) cell count at baseline and at the first radiologic evaluation were associated with improved PFS, DCR and OS. On the contrary, higher myeloid cell count at baseline or at the first radiologic evaluation was significantly associated with worse OS and DCR. CONCLUSIONS Circulating immune biomarkers can contribute to predict outcomes in negative and low PD-L1 aNSCLC patients treated with first-line single-agent pembrolizumab.
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Affiliation(s)
- G. Lo Russo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Correspondence to: Dr Giuseppe Lo Russo Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, via Giacomo Venezian 1, 20133 Milan, Italy. Tel: +39-0223903829
| | - F. Sgambelluri
- Department of Research, Human Tumors Immunobiology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - A. Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - F. Galli
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - S. Manglaviti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - A. Bottiglieri
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - R.M. Di Mauro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - R. Ferrara
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - G. Galli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - D. Signorelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Medical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - A. De Toma
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M. Occhipinti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M. Brambilla
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - E. Rulli
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - T. Triulzi
- Molecular Targeting Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - T. Torelli
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L. Agnelli
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - S. Brich
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A. Martinetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - A.D. Dumitrascu
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - V. Torri
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - G. Pruneri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A. Fabbri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F. de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A. Anichini
- Department of Research, Human Tumors Immunobiology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - C. Proto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M. Ganzinelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - R. Mortarini
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M.C. Garassino
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Department of Medicine, University of Chicago Comprehensive Cancer Center, University of Chicago, Chicago, USA
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9
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Di Cosimo S, Pizzamiglio S, Sotiriou C, Ciniselli C, Triulzi T, de Cecco L, El-Abed S, Izquierdo M, de Azambuja E, Saura C, Huober J, Untch M, Lang I, Loi S, Tagliabue E, Rubio I, Vingiani A, Colombo M, Verderio P, Pruneri G. Gene expression profile at week 2 of neoadjuvant therapy course predicts outcome in HER2-positive breast cancer patients: an explorative analysis from NeoALTTO. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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10
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Paluch-Shimon S, Cardoso F, Partridge AH, Abulkhair O, Azim HA, Bianchi-Micheli G, Cardoso MJ, Curigliano G, Gelmon KA, Gentilini O, Harbeck N, Kaufman B, Kim SB, Liu Q, Merschdorf J, Poortmans P, Pruneri G, Senkus E, Sirohi B, Spanic T, Sulosaari V, Peccatori F, Pagani O. ESO-ESMO fifth international consensus guidelines for breast cancer in young women (BCY5). Ann Oncol 2022; 33:1097-1118. [PMID: 35934170 DOI: 10.1016/j.annonc.2022.07.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [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: 03/03/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 12/31/2022] Open
Abstract
We dedicate this manuscript in memory of a dear friend and colleague Bella Kaufman. The fifth International Consensus Symposium for Breast Cancer in Young Women (BCY5) took place virtually in October 2020, organized by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO). Consensus recommendations for the management of breast cancer in young women were updated from BCY4 with incorporation of new evidence to inform the guidelines. Areas of research priorities as well as specificities in different geographic and minority populations were identified. This manuscript summarizes the ESO-ESMO international consensus recommendations, which are also endorsed by the European Society of Breast Specialists (EUSOMA).
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Affiliation(s)
- S Paluch-Shimon
- Hadassah University Hospital & Faculty of Medicine, Hebrew University, Jerusalem, Israel.
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | | | - O Abulkhair
- King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia
| | - H A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | | | - M J Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - G Curigliano
- European Institute of Oncology IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - K A Gelmon
- British Columbia Cancer, Vancouver, Canada
| | | | - N Harbeck
- Breast Center, Department of OB&GYN and CCCMunich, LMU University Hospital, Munich, Germany
| | - B Kaufman
- Sheba Medical Center, Ramat Gan, Israel
| | - S B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Q Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | | | - P Poortmans
- Iridium Netwerk, Department of Radiation Oncology & University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk-Antwerp, Belgium
| | - G Pruneri
- National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - E Senkus
- Medical University of Gdansk, Gdansk, Poland
| | - B Sirohi
- Max Institute of Cancer Care, New Delhi and Gurgaon, India
| | - T Spanic
- Europa Donna Slovenia, Ljubljana, Slovenia
| | - V Sulosaari
- European Oncology Nursing Society (EONS) and Turku University of Applied Sciences, Turku, Finland
| | - F Peccatori
- European Institute of Oncology IRCCS, Milan; European Institute of Oncology IRCCS & European School of Oncology, Milan, Italy
| | - O Pagani
- Interdisciplinary Cancer Service Hospital Riviera-Chablais Rennaz, Vaud, Geneva University Hospitals, Lugano University, Swiss Group for Clinical Cancer Research (SAKK), Lugano, Switzerland
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11
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Silvestri M, Reduzzi C, Vismara M, Valenti M, Folli S, Cristofanilli M, Pruneri G, Di Cosimo S, Cappelletti V. 136P Paths of chromosomal instability and copy number alteration in circulating tumor cells of progressing early-stage breast cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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12
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Di Cosimo S, Ciniselli C, Sotiriou C, Pogue-Geile K, Fumagalli D, de Azambuja E, Venet D, De Cecco L, Pong N, Cappelletti V, Tagliabue E, Wang Y, Saura Manich C, Nuciforo P, Kuemmel S, Pusztai L, Daidone M, Pizzamiglio S, Pruneri G, Verderio P. 2MO Development of a prognostic gene-expression signature for early stage HER2-positive breast cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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13
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La Rocca E, De Santis MC, Silvestri M, Ortolan E, Valenti M, Folli S, de Braud FG, Bianchi GV, Scaperrotta GP, Apolone G, Daidone MG, Cappelletti V, Pruneri G, Di Cosimo S. Early stage breast cancer follow-up in real-world clinical practice: the added value of cell free circulating tumor DNA. J Cancer Res Clin Oncol 2022; 148:1543-1550. [PMID: 35396978 PMCID: PMC9114063 DOI: 10.1007/s00432-022-03990-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/20/2022] [Indexed: 11/28/2022]
Abstract
Purpose Physical examinations and annual mammography (minimal follow-up) are as effective as laboratory/imaging tests (intensive follow-up) in detecting breast cancer (BC) recurrence. This statement is now challenged by the availability of new diagnostic tools for asymptomatic cases. Herein, we analyzed current practices and circulating tumor DNA (ctDNA) in monitoring high-risk BC patients treated with curative intent in a comprehensive cancer center. Patients and methods Forty-two consecutive triple negative BC patients undergoing neoadjuvant therapy and surgery were prospectively enrolled. Data from plasma samples and surveillance procedures were analyzed to report the diagnostic pattern of relapsed cases, i.e., by symptoms, follow-up procedures and ctDNA. Results Besides minimal follow-up, 97% and 79% of patients had at least 1 non-recommended imaging and laboratory tests for surveillance purposes. During a median follow-up of 5.1(IQR, 4.1–5.9) years, 13 events occurred (1 contralateral BC, 1 loco-regional recurrence, 10 metastases, and 1 death). Five recurrent cases were diagnosed by intensive follow-up, 5 by symptoms, and 2 incidentally. ctDNA antedated disseminated disease in all evaluable cases excepted two with bone-only and single liver metastases. The mean time from ctDNA detection to suspicious findings at follow-up imaging was 3.81(SD, 2.68), and to definitive recurrence diagnosis 8(SD, 2.98) months. ctDNA was undetectable in the absence of disease and in two suspected cases not subsequently confirmed. Conclusions Some relapses are still symptomatic despite the extensive use of intensive follow-up. ctDNA is a specific test, sensitive enough to detect recurrence before other methods, suitable for clarifying equivocal imaging, and exploitable for salvage therapy in asymptomatic BC survivors. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-03990-7.
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Affiliation(s)
- E La Rocca
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Radiation Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M C De Santis
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Radiation Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M Silvestri
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - E Ortolan
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M Valenti
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - S Folli
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Breast Cancer Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - F G de Braud
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy
| | - G V Bianchi
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - G P Scaperrotta
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Radiology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - G Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M G Daidone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - V Cappelletti
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - G Pruneri
- Breast Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,School of Medicine, University of Milan, Milan, Italy.,Department of Pathology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - S Di Cosimo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
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14
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Abate RE, De Luca A, Novello S, Curigliano G, Marchetti P, Fasola G, Conte P, Milella M, Pruneri G, Frassineti L, Cremolini C, Gridelli C, Adamo V, Berardi R, Antonuzzo L, Russo A, Tondini C, Morabito A, Pinto C, Normanno N. 94P ESCAT ranking of genomic alterations collected in the Italian Registry of Actionable Mutations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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15
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Silvestri M, Vingiani A, De Cecco L, Belfiore A, Ortolan E, Veneroni S, Trama A, Cappelletti V, Pruneri G, Di Cosimo S. 12P The RODILIA pilot study for molecular screening of patients with metaplastic breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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16
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Di Cosimo S, Depretto C, Miceli R, Baili P, Sant M, Pruneri G, Vingiani A, Folli S, Bini M, De Santis M, Scaperrotta G. 64P Mammographic density to predict response to neoadjuvant chemotherapy for breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Ortolan E, Appierto V, Silvestri M, Miceli R, Veneroni S, Folli S, Pruneri G, Vingiani A, Belfiore A, Cappelletti V, Vismara M, Dell'Angelo F, De Cecco L, Bianchi GV, de Braud FG, Daidone MG, Di Cosimo S. Blood-based genomics of triple-negative breast cancer progression in patients treated with neoadjuvant chemotherapy. ESMO Open 2021; 6:100086. [PMID: 33743331 PMCID: PMC8010400 DOI: 10.1016/j.esmoop.2021.100086] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 12/19/2022] Open
Abstract
Background As neoadjuvant chemotherapy (NAC) is increasingly used in triple-negative breast cancer (TNBC), we investigated the value of circulating tumor DNA (ctDNA) for patient monitoring prior, during, and after NAC, and circulating tumor cells (CTCs) for disease characterization at clinical progression. Materials and methods Forty-two TNBC patients undergoing NAC were prospectively enrolled. Primary tumor mutations identified by targeted-gene sequencing were validated and tracked in 168 plasma samples longitudinally collected at multiple time-points by droplet digital polymerase chain reaction. At progression, plasma DNA underwent direct targeted-gene assay, and CTCs were collected and analyzed for copy number alterations (CNAs) by low-pass whole genome sequencing. Results ctDNA detection after NAC was associated with increased risk of relapse, with 2-year event-free survival estimates being 44.4% [95% confidence interval (CI) 21.4%-92.3%] versus 77.4% (95% CI 57.8%-100%). ctDNA prognostic value remained worthy even after adjusting for age, residual disease, systemic inflammatory indices, and Ki-67 [hazard ratio (HR) 1.91; 95% CI 0.51-7.08]. During follow-up, ctDNA was undetectable in non-recurrent cases with the unique exception of one showing a temporary peak over eight samples. Conversely, ctDNA was detected in 8/11 recurrent cases, and predated the clinical diagnosis up to 13 months. Notably, recurrent cases without ctDNA developed locoregional, contralateral, and bone-only disease. At clinical progression, CTCs presented chromosome 10 and 21q CNAs whose network analysis showed connected modules including HER/PI3K/Ras/JAK signaling and immune response. Conclusion ctDNA is not only associated with but is also predictive of prognosis in TNBC patients receiving NAC, and represents an exploitable tool, either alone or with CTCs, for personalized TNBC management. ctDNA was detected in 77% of early-stage TNBC patients undergoing neoadjuvant chemotherapy. Patients with still detectable ctDNA after NAC were more than twice as likely to relapse as those with undetectable levels. Detection of ctDNA during follow-up antedated clinical overt metastases up to 13 months. ctDNA was undetectable in all but one non-recurrent patient with a temporary peak in only 1 of 8 samples tested. CTCs of progressing cases lacked epithelial surface markers and showed therapeutically exploitable molecular features.
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Affiliation(s)
- E Ortolan
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Appierto
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Silvestri
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Miceli
- Clinical Epidemiology and Trial Organization Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Veneroni
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Folli
- Breast Cancer Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Vingiani
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Belfiore
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Cappelletti
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Vismara
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Dell'Angelo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L De Cecco
- Integrated Biology Platform, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G V Bianchi
- Department of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F G de Braud
- Department of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M G Daidone
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - S Di Cosimo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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18
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Ligorio F, Zambelli L, Bottiglieri A, Castagnoli L, Zattarin E, Loberfaro R, Belfiore A, Vingiani A, Pruneri G, Bianchi G, Capri G, Pupa S, de Braud F, Vernieri C. 175P Prognostic role of body mass index (BMI) in patients with Human Epidermal growth factor Receptor 2 (HER2)–positive early breast cancer treated with adjuvant trastuzumab-containing chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Paluch-Shimon S, Cardoso F, Partridge AH, Abulkhair O, Azim HA, Bianchi-Micheli G, Cardoso MJ, Curigliano G, Gelmon KA, Harbeck N, Merschdorf J, Poortmans P, Pruneri G, Senkus E, Spanic T, Stearns V, Wengström Y, Peccatori F, Pagani O. ESO-ESMO 4th International Consensus Guidelines for Breast Cancer in Young Women (BCY4). Ann Oncol 2020; 31:674-696. [PMID: 32199930 DOI: 10.1016/j.annonc.2020.03.284] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/07/2020] [Indexed: 12/16/2022] Open
Abstract
The 4th International Consensus Conference for Breast Cancer in Young Women (BCY4) took place in October 2018, in Lugano, Switzerland, organized by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO). Consensus recommendations for the management of breast cancer in young women were updated from BCY3 with incorporation of new evidence to inform the guidelines. Areas of research priorities were also identified. This article summarizes the ESO-ESMO international consensus recommendations, which are also endorsed by the European Society of Breast Specialists (EUSOMA).
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Affiliation(s)
| | - F Cardoso
- Breast Unit Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - O Abulkhair
- King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia
| | - H A Azim
- School of Medicine, Monterrey Institute of Technology, Monterrey, MX
| | | | - M-J Cardoso
- Breast Unit Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal; Nova Medical School Lisbon, Portugal
| | - G Curigliano
- European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - K A Gelmon
- British Columbia Cancer, Vancouver, Canada
| | - N Harbeck
- Breast Center, Dept. OB&GYN, University of Munich (LMU), Munich, Germany
| | | | - P Poortmans
- Institut Curie, Department of Radiation Oncology & Paris Sciences & Lettres - PSL University, Paris, France
| | - G Pruneri
- National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - E Senkus
- Medical University of Gdansk, Gdansk, Poland
| | - T Spanic
- Europa Donna Slovenia, Ljubljana, Slovenia
| | - V Stearns
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, USA
| | - Y Wengström
- Department of Neurobiology Cancer Science and Society, Karolinska Institute and Theme Cancer Karolinska University Hospital, Sweden
| | - F Peccatori
- European Institute of Oncology IRCCS & European School of Oncology, Milan, Italy
| | - O Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Geneva University Hospitals, Swiss Group for Clinical Cancer Research (SAKK), Bellinzona, Switzerland
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Di Cosimo S, Silvestri M, Dugo M, Vismara M, Reduzzi C, Pruneri G, Folli S, Cappelletti V, Daidone M. 59P Primary tumour and circulating tumour cell (CTC) copy number alterations (CNAs) in triple negative breast cancer (TNBC) patients (pts) treated with neoadjuvant chemotherapy (NAC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Morano F, Corallo S, Niger M, Barault L, Milione M, Berenato R, Moretto R, Randon G, Antista M, Belfiore A, Raimondi A, Nichetti F, Martinetti A, Battaglia L, Perrone F, Pruneri G, Falcone A, Di Bartolomeo M, de Braud F, Di Nicolantonio F, Cremolini C, Pietrantonio F. Temozolomide and irinotecan (TEMIRI regimen) as salvage treatment of irinotecan-sensitive advanced colorectal cancer patients bearing MGMT methylation. Ann Oncol 2019; 29:1800-1806. [PMID: 29860358 DOI: 10.1093/annonc/mdy197] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Non-randomized studies showed that temozolomide (TMZ) achieves an average 10% response rate in heavily pretreated metastatic colorectal cancer (mCRC) patients with promoter methylation of the DNA repair gene O6-methylguanine-DNA methyltransferase (MGMT). In this phase II trial, irinotecan and temozolomide (TEMIRI) combination regimen was assessed in irinotecan-sensitive, MGMT methylated/microsatellite stable (MSS) pretreated mCRC patients. Patients and methods Key inclusion criteria were centrally confirmed MGMT methylation by methylation-specific PCR, MSS mCRC, progression after at least two prior chemotherapy regimens for advanced disease and irinotecan-free interval >3 months. TEMIRI (TMZ 150 mg/m2 on days 1-5 plus irinotecan 100 mg/m2 on days 1, 15 q28 days) was administered for six cycles, followed by maintenance with TMZ. The primary end point was overall response rate (ORR). Exploratory translational analyses included MGMT immunohistochemistry (IHC) and methyl-BEAMing (MB). Results Between December 2014 and June 2017, 25 patients were enrolled. The primary end point was met, since six patients achieved a partial response [ORR 24%, 95% confidence interval (CI) 11% to 43%]. At a median follow-up of 15.6 months, median progression-free survival (mPFS) and overall survival (mOS) were 4.4 and 13.8 months, respectively. Only four (16%) patients had ≥ grade 3 (CTCAE 4.0) adverse events. All patients whose cancer was MGMT-positive IHC were non-responders. Consistently, patients with MGMT-negative/low tumors had a significantly longer mPFS than others (6.9 versus 2.0 months; hazard ratio = 0.29, 95% CI 0.02-0.41; P = 0.003) and a non-significant trend for longer mOS. MB testing showed similar accuracy. Conclusions TEMIRI regimen is a safe and active option in pre-treated, irinotecan-sensitive mCRC patients with MGMT methylation.
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Affiliation(s)
- F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Corallo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Niger
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Barault
- Department of Oncology, University of Turin, Candiolo, Turin, Italy; Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Turin, Italy
| | - M Milione
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Berenato
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Moretto
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - G Randon
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Antista
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Belfiore
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Raimondi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Nichetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Martinetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Battaglia
- Colorectal Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Perrone
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - A Falcone
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - M Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - F Di Nicolantonio
- Department of Oncology, University of Turin, Candiolo, Turin, Italy; Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Turin, Italy
| | - C Cremolini
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy.
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Volpari T, De Santis F, Bracken AP, Pupa SM, Buschbeck M, Wegner A, Di Cosimo S, Lisanti MP, Dotti G, Massaia M, Pruneri G, Anichini A, Fortunato O, De Braud F, Del Vecchio M, Di Nicola M. Anticancer innovative therapy: Highlights from the ninth annual meeting. Cytokine Growth Factor Rev 2019; 51:1-9. [PMID: 31862236 DOI: 10.1016/j.cytogfr.2019.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Ninth Annual Conference of "Anticancer Innovative Therapy", organized by Fondazione IRCCS Istituto Nazionale dei Tumori di Milano (Fondazione IRCCS INT) and hosted by Hotel Michelangelo, was held in Milan on 25 January 2019. Cutting-edge science was presented in two main scientific sessions: i) pre-clinical evidences and new targets, and ii) clinical translation. The Keynote lecture entitled "Cancer stem cells (CSCs): metabolic strategies for their identification and eradication" presented by M. Lisanti, was one of the highlights of the conference. One key concept of the meeting was how the continuous advances in our knowledge about molecular mechanisms in various fields of research (cancer metabolism reprogramming, epigenetic regulation, transformation/invasiveness, and immunology, among others) are driving cancer research towards more effective personalized antineoplastic strategies. Specifically, recent preclinical data on the following topics were discussed: 1. Polycomb group proteins in cancer; 2. A d16HER2 splice variant is a flag of HER2 addiction across HER2-positive cancers; 3. Studying chromatin as a nexus between translational and basic research; 4. Metabolomic analysis in cancer patients; 5. CDK4-6 cyclin inhibitors: clinical activity and future perspectives as immunotherapy adjuvant; and 6. Cancer stem cells (CSCs): metabolic strategies for their identification and eradication. In terms of clinical translation, several novel approaches were presented: 1. Developing CAR-T cell therapies: an update of preclinical and clinical development at University of North Carolina; 2. Vγ9Vδ2 T-cell activation and immune suppression in multiple myeloma; 3. Predictive biomarkers for real-world immunotherapy: the cancer immunogram model in the clinical arena; and 4. Mechanisms of resistance to immune checkpoint blockade in solid tumors. Overall, the pre-clinical and clinical findings presented could pave the way to identify novel actionable therapeutic targets to significantly enhance the care of persons with cancer.
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Affiliation(s)
- T Volpari
- Immunotherapy and Innovative Therapeutics Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F De Santis
- Immunotherapy and Innovative Therapeutics Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A P Bracken
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, Ireland
| | - S M Pupa
- Molecular Targeting Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Buschbeck
- Josep Carreras Leukemia Research Institute (IJC), Campus ICO-Germans Trias I Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - A Wegner
- Technische Universiät Braunschweig, Department of Bioinfomatics and Biochemistry and Braunschweig Integrated Center of Systems Biology (BRICS), Rebenring 56, 38106, Braunschweig, Germany
| | - S Di Cosimo
- Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M P Lisanti
- Translational Medicine, Biomedical Research Centre, School of Environment and Life Sciences, University of Salford, Greater Manchester, United Kingdom
| | - G Dotti
- Lineberger Comprehensive Cancer Center and Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC, United States
| | - M Massaia
- Laboratorio di Immunologia dei Tumori del Sangue, Centro Interdipartimentale di Ricerca in Biologia Molecolare, Università degli Studi di Torino, Turin, Italy; SC Ematologia, AO S. Croce e Carle, Cuneo, Italy
| | - G Pruneri
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - A Anichini
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - O Fortunato
- Tumor Genomics Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F De Braud
- Medical Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Del Vecchio
- Immunotherapy and Innovative Therapeutics Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Unit of Melanoma Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Di Nicola
- Immunotherapy and Innovative Therapeutics Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Medical Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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23
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Di Cosimo S, Appierto V, Silvestri M, Ortolan E, De Cecco L, Veneroni S, Pruneri G, Vingiani A, Belfiore A, Scaperrotta G, Folli S, Daidone MG. Primary tumor somatic mutations in the blood of women with ductal carcinoma in situ of the breast. Ann Oncol 2019; 31:435-437. [PMID: 32067686 DOI: 10.1016/j.annonc.2019.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/28/2019] [Indexed: 01/02/2023] Open
Affiliation(s)
- S Di Cosimo
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Appierto
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Silvestri
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Ortolan
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L De Cecco
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Veneroni
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; University of Milan, Milan, Italy
| | - A Vingiani
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; University of Milan, Milan, Italy
| | - A Belfiore
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Scaperrotta
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Folli
- Breast Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M G Daidone
- Department of Applied Research and Technical Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Pagani O, Del Grande M, Peccatori F, de Wolf C, Pruneri G, Mattei L, Richetti A, Presilla S, Sabyrbekova T, Bakirova N, Soldak T, Abdyldaev D, Abdyldaev T, Aliev I, Aralbaev R, Naizabekova S, Shaimurzaeva B, Shimkina O, Marti R, Cavalli F. Setting up breast services improvements and learning bridges in Kyrgyzstan: The SILK project. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Giovannoni S, Garbi A, Parma G, Lapresa M, Zaccarelli E, Vingiani A, Ardoino I, Pruneri G, Colombo N. Tumour-infiltrating lymphocytes (TILs) in patients with epithelial ovarian cancer undergoing neoadjuvant chemotherapy: A retrospective study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Normanno N, Curigliano G, Jommi C, Martini N, Marchetti A, Marchetti P, Pedrini A, Pruneri G. The new mutational model in oncology. What changes in welfare, clinical practice, research, and regulatory procedures? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz263.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Galli G, Fabbri A, Ferrara R, Prelaj A, Proto C, Signorelli D, De Toma A, Pagani F, Zilembo N, Ganzinelli M, Pruneri G, de Braud F, Garassino M, Lo Russo G. Accuracy of pathologic evaluation for thymic epithelial tumors in an Italian reference centre. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Niger M, Morano F, Manglaviti S, Nichetti F, Tamborini E, Perrone F, Marcuzzo M, Peverelli G, Brambilla M, Pagani F, Torchio M, Ottini A, Antista M, Pietrantonio F, Pusceddu S, Pruneri G, Di Bartolomeo M, De Braud F. Is MGMT methylation a new therapeutic target for biliary tract cancer? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Niger M, Morano F, Manglaviti S, Nichetti F, Perrone F, Tamborini E, Marcuzzo M, Raimondi A, Peverelli G, Brambilla M, Pagani F, Torchio M, Prisciandaro M, Antista M, Pietrantonio F, Pusceddu S, Pruneri G, De Braud F, Di Bartolomeo M. MGMT methylation in metastatic pancreatic cancer (mPAC): A single center experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Galli G, Ferrara R, Pagani F, De Toma A, Lo Russo G, Signorelli D, Prelaj A, Zilembo N, Ganzinelli M, Brich S, Fabbri A, Sangaletti S, Pruneri G, Colombo M, de Braud F, Garassino M, Proto C. Prognostic role of CD73 in metastatic non small cell lung cancer according to the presence of driver alterations. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Galli G, Imbimbo M, Busico A, Perrone F, Tamborini E, Fabbri A, Marano G, Biganzoli D, Ferrara R, Lo Russo G, Prelaj A, Proto C, Zilembo N, De Toma A, Pagani F, Randon G, Ganzinelli M, Biganzoli E, Pruneri G, De Braud F, Garassino M, Signorelli D. P2.09-05 Clinical and Biological Characterization of Lung Enteric Adenocarcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lo Russo G, Signorelli D, Proto C, Galli G, Prelaj A, Ferrara R, Sommariva M, Moro M, Cancila V, Ganzinelli M, Brich S, Sangaletti S, Pruneri G, Tripodo C, Colombo M, Rivoltini L, Balsari A, Sozzi G, Boeri M, Garassino M. OA14.06 Hyperprogressive Disease in Advanced Non–Small Cell Lung Cancer Patients Treated with Immune Checkpoint Inhibitors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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De Santis MC, La Rocca E, Meneghini E, Bregni G, Di Lorenzo G, Galli G, Di Nicola M, Folli S, Gennaro M, Pruneri G, Paolini B, Daidone MG, De Braud F, Apolone G, Sant M, Di Cosimo S. Axillary nodal involvement by primary tumor features in early breast cancer: an analysis of 2600 patients. Clin Transl Oncol 2019; 22:786-792. [PMID: 31372896 DOI: 10.1007/s12094-019-02188-7] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Primary tumor characteristics, which are readily available to all clinicians, may aid in selecting the optimal adjuvant therapy for patients with breast cancer (BC). Herein, we investigated the relationship between tumor size, hormone receptor and HER2 status, Ki67 and age with axillary lymph node metastases (ALNM) in early-BC patients. METHODS We analyzed data on consecutive 2600 early-BC cases collected in the registry of Fondazione IRCC Istituto Nazionale dei Tumori, Milano, Italy. Correlation between Ki67 and primary tumor size (T-size) was calculated by Spearman's rank correlation coefficient. Association of ALNM with Ki67 and other tumor characteristics was investigated by logistic regression. Adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated in all cases, and separately analyzed according to age, T-size and BC subtype. RESULTS Large tumor size strongly associated to ALNM, with an adjusted odds ratio (OR) for each 5-mm increase of 1.32 (95% CI 1.24-1.41), except for triple-negative BC (TNBC) cases. In tumors =10 mm, without lymphovascular invasion, representing the strongest predictor of ALNM (OR 6.09, 95% CI 4.93-7.53), Ki67 resulted particularly informative, with a fourfold increased odds of ALNM for values > 30%. CONCLUSIONS These results raise the question whether axillary node status is redundant in cases with exceptionally good features, i.e., small tumors with low Ki67, or in those candidate to adjuvant systemic treatment/radiotherapy anyway including TNBC, and support the incorporation of primary BC tumor characteristics as stratification factors in ongoing trials aiming at de-escalating axillary surgical procedures.
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Affiliation(s)
- M C De Santis
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E La Rocca
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,School of Medicine, Università degli Studi di Milan, Milan, Italy
| | - E Meneghini
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Bregni
- Medical Oncology, Ospedale Policlinico S. Martino IRCCS, Genova, Italy
| | - G Di Lorenzo
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,School of Medicine, Università degli Studi di Milan, Milan, Italy
| | - G Galli
- School of Medicine, Università degli Studi di Milan, Milan, Italy.,Division of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Di Nicola
- Division of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Folli
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Gennaro
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- School of Medicine, Università degli Studi di Milan, Milan, Italy.,Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - B Paolini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M G Daidone
- Biomarker Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G Amadeo 42, 20133, Milan, Italy
| | - F De Braud
- School of Medicine, Università degli Studi di Milan, Milan, Italy.,Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Sant
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Di Cosimo
- Biomarker Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G Amadeo 42, 20133, Milan, Italy.
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Di Cosimo S, Appierto V, Ortolan E, Dell’Angelo F, Silvestri M, Bianchi G, Folli S, De Cecco L, Pruneri G, Daidone M. Circulating tumor DNA and disease recurrence in early stage breast cancer: From a case-control study to a prospective longitudinal trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz096.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bossi P, Perrone F, Serafini M, Pruneri G, Piazza C, Licitra L, De Cecco L. OC-042 Genomic characterization of oral premalignant lesions to identify high-risk molecular clusters. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30208-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dodero A, Guidetti A, Tucci A, Barretta F, Novo M, Devizzi L, Re A, Passi A, Pellegrinelli A, Pruneri G, Miceli R, Testi A, Pennisi M, Di Chio MC, Matteucci P, Carniti C, Facchetti F, Rossi G, Corradini P. Dose-adjusted EPOCH plus rituximab improves the clinical outcome of young patients affected by double expressor diffuse large B-cell lymphoma. Leukemia 2019; 33:1047-1051. [PMID: 30631117 PMCID: PMC6756077 DOI: 10.1038/s41375-018-0320-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/05/2018] [Accepted: 11/06/2018] [Indexed: 01/15/2023]
Affiliation(s)
- A Dodero
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Guidetti
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. .,Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy.
| | - A Tucci
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - F Barretta
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Novo
- Department of Hematology, Azienda Ospedaliero Universitaria Citta' della Salute e della Scienza di Torino, Torino, Italy
| | - L Devizzi
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Re
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - A Passi
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - A Pellegrinelli
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - G Pruneri
- Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy.,Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Testi
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Pennisi
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M C Di Chio
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - P Matteucci
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - C Carniti
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - F Facchetti
- Department of Pathology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - G Rossi
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - P Corradini
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy
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Klauschen F, Müller KR, Binder A, Bockmayr M, Hägele M, Seegerer P, Wienert S, Pruneri G, de Maria S, Badve S, Michiels S, Nielsen T, Adams S, Savas P, Symmans F, Willis S, Gruosso T, Park M, Haibe-Kains B, Gallas B, Thompson A, Cree I, Sotiriou C, Solinas C, Preusser M, Hewitt S, Rimm D, Viale G, Loi S, Loibl S, Salgado R, Denkert C. Scoring of tumor-infiltrating lymphocytes: From visual estimation to machine learning. Semin Cancer Biol 2018; 52:151-157. [DOI: 10.1016/j.semcancer.2018.07.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 12/12/2022]
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Farè E, Sdao S, Damian S, Cresta S, Del Vecchio M, Di Bartolomeo M, Di Guardo L, Duca M, Indini A, Necchi A, Niger M, Prisciandaro M, Procopio G, Raggi D, Verzoni E, Pruneri G, Di Nicola M, de Braud F. Hyperprogression during immuno-checkpoint inhibitors (ICIs): A clinically significant problem? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perone Y, Rodríguez Meira A, Farruggia A, Győrffy B, Ion C, Pruneri G, Lim A, Calvo F, Magnani L. PO-357 SREBP1 drives cell-autonomous cytoskeletal changes by KRT80 remodelling during ERα breast cancer progression. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Johansson H, Gandini S, Aristarco V, Macis D, Guerrieri-Gonzaga A, Serrano D, Pruneri G, Lazzeroni M, Viale G, Toesca A, Rajasekaran A, Bonanni B, DeCensi A. Abstract P4-08-05: Impact of common polymorphisms of CYP19A1 and UGT2B17 gene deletion on early endocrine-responsive postmenopausal breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-08-05] [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 Polymorphisms of genes involved in estrogen production have been linked to breast cancer risk, prognosis and treatment response. Polymorphisms of the aromatase gene CYP19A1 influence its activity. The UGT2B17 catalyzes glucuronic acid transfer to a variety of substrates, including steroids and drugs like the aromatase inhibitor exemestane. We investigated the impact of two variants of CYP19A1 (rs10046, rs4646) and the UGT2B17 gene deletion on disease outcome in 125 postmenopausal women operated for ER-positive primary breast cancer enrolled in a randomized pre-surgical trial.
Patients Briefly, upon informed consent, postmenopausal patients with ER-positive breast cancer (stage T1–2, N0–1, M0) eligible for surgery were randomized to receive either exemestane (25 mg/day), or celecoxib (800 mg/day), or placebo for 6 weeks prior to surgery at the European Institute of Oncology (2004-2008). Exemestane showed a significant 10% absolute reduction in Ki67 labeling index compared to the other two arms. Serum and whole blood was taken at baseline and the day before surgery and stored at -80°C until assayed.
Methods DNA was extracted from blood by QIAamp DNA Blood Kits. The CYP19A1 rs1004/rs46466 were analyzed by Taqman genotyping assays in real-time PCR. The UGT2B17 deletion was estimated by copy number assay (Lifetechnologies). Serum estradiol (E2) and estrone (E1) levels were measured by gas chromatography tandem mass spectrometry detection (GS-MS/MS) after liquid-liquid extraction. The lower limit of quantitation were 0.625 pg/mL for estradiol and 1.56 pg/mL for estrone. The association of genetic polymorphisms with “any event” was assessed by the Cox proportional hazards models adjusted for confounders.
Results The genetic polymorphisms did not deviate from Hardy-Weinberg equilibrium (P-value >0.41) and minor allele frequency of rs10046 (A/G), rs4646 (C/A), and UGT2B17Del were 0.45, 0.22, and 0.31, respectively. The rs10046 A and rs4646 C alleles were associated with higher estrogen levels. Carriers of rs10046 AA had median levels of 7.57 pg/ml E2 and 35.9 pg/mL E1 versus 3,9 pg/mL E2 and 27.4 E1 pg/mL in CA/AA genotypes (P<0.003). Carriers of rs4646 CC had 5.6 pg/ml E2 and 30.45 pg/mL E1 versus 3,95 pg/mL E2 and 27.4 E1 pg/mL in CA/AA genotypes (P=0.05 only for E1). After 6 weeks treatment with exemestane, we observed steeper decreases in estrogen levels in the rs10046 AA/rs4646 CC carriers (P=0.02 for E2). After a median follow-up of 7 years we found that women carrying at least one SNP of rs10046 and one SNP of rs4646 had a better prognosis compared with women carrying homozygote wt SNPs (HR=0.44; 95% CI: 0.2-0.99 P=0.049). Similarly, the UGT2B17 deletion was associated with a better prognosis (HR= 0.43; 95% CI: 0.19-0.97; P=0.0439). There was no interaction with pre-surgical or adjuvant treatment.
Conclusions Our analysis confirms previous findings of an association of CYP19A1 rs10046/rs4646 with estrogen levels in postmenopausal women. Interestingly, the carriers of the variants associated with lower estrogen levels at diagnosis had better prognosis. Further genomic profiling in larger trials aimed to enhance tailored treatment efficacy in endocrine-responsive postmenopausal breast cancer are warranted.
Citation Format: Johansson H, Gandini S, Aristarco V, Macis D, Guerrieri-Gonzaga A, Serrano D, Pruneri G, Lazzeroni M, Viale G, Toesca A, Rajasekaran A, Bonanni B, DeCensi A. Impact of common polymorphisms of CYP19A1 and UGT2B17 gene deletion on early endocrine-responsive postmenopausal breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-08-05.
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Affiliation(s)
- H Johansson
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - S Gandini
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - V Aristarco
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - D Macis
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - A Guerrieri-Gonzaga
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - D Serrano
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - G Pruneri
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - M Lazzeroni
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - G Viale
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - A Toesca
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - A Rajasekaran
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - B Bonanni
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
| | - A DeCensi
- European Institute of Oncology, Milan, Italy; inVentiv Health,, USA, Princeton, NJ; E.O. Ospedali Galliera, Genoa, Italy
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Magnani L, Pruneri G, Patten DK, Corleone G, Győrffy B, Erdős E, Saiakhova A, Goddard K, Vingiani A, Shousha S, Pongor LS, Hadjiminas DJ, Schiavon G, Barry P, Palmieri C, Coombes RC, Scacheri P. Abstract P2-04-01: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-04-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- L Magnani
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - G Pruneri
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - DK Patten
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - G Corleone
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - B Győrffy
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - E Erdős
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - A Saiakhova
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - K Goddard
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - A Vingiani
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - S Shousha
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - LS Pongor
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - DJ Hadjiminas
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - G Schiavon
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - P Barry
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - C Palmieri
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - RC Coombes
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
| | - P Scacheri
- Imperial College London, United Kingdom; Biobank for Translational Medicine Unit, European Institute of Oncology, Milan and University of Milan, School of Medicine, Italy; 2MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Hungarian Academy of Sciences, Hungary; University of Debrecen, Hungary; Case Comprehensive Cancer Center, Case Western Reserve University; Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom; European Institute of Oncology, Italy; Imperial, College London, Charing Cross, United Kingdom; Translational Science, IMED Oncology, AstraZeneca, Cambridge, United Kingdom; The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, United Kingdom; Institute of Translational Medicine University of Liverpool, Clatterbridge Cancer Centre, NHS Foundation Trust, and Royal Liverpool University Hospital, United Kingdom
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Nguyen B, Venet D, Desmedt C, Pruneri G, Peccatori F, Mardis ER, Azim HA, Rothé F, Sotiriou C. Abstract P2-05-01: Whole genome sequencing reveals enrichment of mutations in mucin gene family in breast cancer diagnosed during pregnancy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Pregnancy is known to modulate breast cancer (BC) risk. Different reproductive behaviors have been shown to impact not only the risk of developing BC but also the phenotypes of these tumors. Breast cancer diagnosed during pregnancy (BCP) is a rare disease but could serve as a good model to understand how pregnancy modulates BC biology. In this project, we aim to interrogate the effect of pregnancy on the biology of BC by performing whole genome sequencing (WGS) using a unique series of BC patients diagnosed during pregnancy (BCP).
Method
Whole genome sequencing was performed for 35 BCP and 20 non-pregnant controls matched for age and stage with available clinic-pathological data. DNA extracted from primary tumor and matched adjacent normal FFPE tissues was assessed using WGS on Illumina HiSeqXTen platform targeting 60x and 30x coverage for tumor and normal DNA respectively. Briefly, 2x150bp paired end sequence data were generated, cleaned, trimmed and aligned to the reference genome (hg19) using bwa-mem. Somatic mutations were detected using Strelka and annotated using SnpEff. Mutational signatures were extracted using deconstructSigs. Differences on mutational profiles between BCP and case controls were assessed using Wilcoxon test for continuous variables and Fisher exact test for categorical variables.
Result
No difference in clinic-pathological features was observed between BCP and control patients. A median of 10084 and 13829 SNVs and of 26 and 21 indels were identified in the BCP and controls respectively, no significant difference between the two groups being observed (p = 0.703 and p = 0.851). Of interest, a significantly higher number of mutations was found in the BCP as compared to the control group when considering only mutations associated with a deleterious effect (median: 20 vs. 12, p = 0.027). As expected, TP53 and PIK3CA were the most frequently mutated genes both in BCP and control cases without any significant difference between the groups (34.3% vs. 22.2%, p = 0.53 and 20.0% vs. 16.7%, p = 1, respectively). Interestingly, there was a significant enrichment of non-silent mutations in the mucin genes family (MUC2, MUC4, MUC12, MUC16, MUC17, MUC20) in the BCP group: 45.7% of BCP vs. 11.1% of control cases had at least one such mutation (p = 0.015). A similar significant result (45.7% vs. 23.1%, p = 0.034) was found when comparing BCP with BC control cases from the TCGA dataset (selected to have similar age, ER and PR distribution, N = 56). When comparing the distribution of the twelve BC mutational signatures, a borderline significant enrichment with a signature depicting mismatch-repair deficiency (signature 20) was observed in the BCP patients (p = 0.059).
Conclusion
This is the first study reporting the mutational landscape of breast cancer diagnosed during pregnancy using WGS. We found that BCP are associated with a higher number of putative driver mutations including mutations in mucin genes, shown to be implicated in tumorigenesis. Furthermore, BCP were enriched with a mismatch-repair deficiency signature. These results could open new avenues for the development of targeted therapeutic approaches for patients diagnosed with breast cancer during pregnancy.
Citation Format: Nguyen B, Venet D, Desmedt C, Pruneri G, Peccatori F, Mardis ER, Azim HA, Rothé F, Sotiriou C. Whole genome sequencing reveals enrichment of mutations in mucin gene family in breast cancer diagnosed during pregnancy [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 P2-05-01.
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Affiliation(s)
- B Nguyen
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - D Venet
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - C Desmedt
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - G Pruneri
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - F Peccatori
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - ER Mardis
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - HA Azim
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - F Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
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Guerrieri-Gonzaga A, Gandini S, Serrano D, Lazzeroni M, Pruneri G, Varricchio C, Cazzaniga M, Leonardi MC, Galimberti V, Viale G, De Censi A, Bonanni B. Abstract P4-15-06: Low dose tamoxifen lowers recurrences after mastectomy for in situ neoplasia. Ten-year results of a monoinstitutional study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-15-06] [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
There is no agreement upon the need of a preventive treatment after breast mastectomy for in situ neoplasia. Low-dose tamoxifen (5 mg/day) has comparable antiproliferative effect than the standard dose of 20 mg/day in biomarker trials and has been shown to halve ipsilateral recurrence in a large cohort of postmenopausal ER positive DCIS treated with breast conserving surgery (Guerrieri-Gonzaga et al., Int J Cancer 2016).
Here we investigated the effect of low dose tamoxifen in patients treated with mastectomy for an in situ neoplasia and followed-up in a single Institution for a median of 10 years.
Our cohort consists of 404 consecutive premenopausal (n=281) or postmenopausal (n=123) women who underwent unilateral mastectomy at the European Institute of Oncology (IEO), with or without nipple preservation, between 1996 and 2011. Patients had a diagnosis of pure LCIS (n=12) or ER positive (ER>1%) DCIS (n=363) or both (n=29) and were treated with tamoxifen 5 mg/day (n=162) or no treatment (n=242) upon medical judgment, patient preference and/or clinical trial assignment. The main subject and tumor characteristics are reported in table 1.
Patient and tumor characteristics No tam (n=242)Low dose tam (n=162)P-valueMedian age, years (IQR)46 (41, 54)47 (42, 51)0.65Premenopausal status (n, %)160 (66)121 (75)0.07Median BMI (kg/m2, IQR)22 (20, 25)22 (20, 24)0.7Breast cancer family history (%)29320.44Histology (LCIS, DCIS, both; %)4/92/42/86/120.01Grading (G1,G2,G3;%)11/59/2918/61/200.04Median ER (%, IQR)90 (70, 95)90 (80, 95)0.005Median PgR (%, IQR)40 (5, 80)68 (25, 90)0.0002Median Ki67 (%, IQR)15 (10, 23)14 (10, 20)0.03Radiotherapy (n, %)95 (39)76 (47)0.13
After a median follow-up of 10 years (range 4-21 years) and a median low dose tamoxifen treatment of 4.9 years (IQR 2.7, 5.0), a total of 85 events were observed (28 in situ, 40 invasive breast cancers, 3 metastatic diseases, 12 other primary cancers, 2 deaths). A total of 36 ipsilateral breast events (23 versus 13 in the no tam versus tam group, respectively), 32 contralateral breast events (22 versus 10 in the no tam versus tam, respectively) and 17 other events (11 versus 6 in the no tam versus tam, respectively) occurred. Overall, eleven deaths (3%) occurred and no endometrial cancers were observed. A time-dependent competing risk model was applied for tamoxifen use and we have shown that low-dose tamoxifen was associated with a 48% reduction on all breast events (adjusted HR=0.52, 95% CI: 0.31–0.88, p=0.01), adjusting for radiotherapy and age.
Although limited by the observational nature of the study, we show for the first time that treatment with low dose tamoxifen is effective and safe in women who underwent mastectomy for non-invasive breast neoplasms and should be taken into consideration as a risk reduction strategy for premenopausal and postmenopausal women with breast intraepithelial neoplasia.
Citation Format: Guerrieri-Gonzaga A, Gandini S, Serrano D, Lazzeroni M, Pruneri G, Varricchio C, Cazzaniga M, Leonardi MC, Galimberti V, Viale G, De Censi A, Bonanni B. Low dose tamoxifen lowers recurrences after mastectomy for in situ neoplasia. Ten-year results of a monoinstitutional study [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 P4-15-06.
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Affiliation(s)
- A Guerrieri-Gonzaga
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - S Gandini
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - D Serrano
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - M Lazzeroni
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - G Pruneri
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - C Varricchio
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - M Cazzaniga
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - MC Leonardi
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - V Galimberti
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - G Viale
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - A De Censi
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
| | - B Bonanni
- European Institute of Oncology, Milan, Italy; E.O. Ospedali Galliera, Genoa, Italy
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Nishiyama K, Knaster J, Okumura Y, Marqueta A, Pruneri G, Scantamburlo F, Sakamoto K, Sugimoto M, Kasugai A, Hirata Y, Kondo K, Ikeda Y, Maebara S, Ichimiya R, Shinya T, Ihara A, Kitano T, Beauvais PY, Gobin R, Bolzon B. Development of calorimetry methodology for beam current measurement of the Linear IFMIF Prototype Accelerator (LIPAc). Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2017.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Criscitiello C, Bayar M, Curigliano G, Symmans F, Desmedt C, Bonnefoi H, Sinn B, Pruneri G, Vicier C, Pierga J, Denkert C, Loibl S, Sotiriou C, Michiels S, André F. A gene signature to predict high tumor-infiltrating lymphocytes after neoadjuvant chemotherapy and outcome in patients with triple-negative breast cancer. Ann Oncol 2018; 29:162-169. [DOI: 10.1093/annonc/mdx691] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Pruneri G, Lazzeroni M, Bagnardi V, Tiburzio GB, Rotmensz N, DeCensi A, Guerrieri-Gonzaga A, Vingiani A, Curigliano G, Zurrida S, Bassi F, Salgado R, Van den Eynden G, Loi S, Denkert C, Bonanni B, Viale G. The prevalence and clinical relevance of tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ of the breast. Ann Oncol 2017; 28:321-328. [PMID: 28426105 DOI: 10.1093/annonc/mdw623] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [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: 12/13/2022] Open
Abstract
Background Tumor-infiltrating lymphocytes (TILs) are a robust prognostic adjunct in invasive breast cancer, but their clinical role in ductal carcinoma in situ (DCIS) has not been ascertained. Patients and methods We evaluated the prevalence and clinical relevance of TILs in a well annotated series of 1488 consecutive DCIS women with a median follow-up of 8.2 years. Detailed criteria for TILs evaluation were pre-defined involving the International Immuno-Oncology Biomarker Working Group. TILs percentage was considered both as a continuous and categorical variable. Levels of TILs were examined for their associations with ipsilateral breast event (IBE), whether in situ or invasive. Results Of the 1488 patients with DCIS under study, 35.1% had <1%, 58.3% 1-49% and 6.5% ≥50% peri-ductal stromal lymphocytes. The interobserver agreement in TILs evaluation, measured by the intraclass correlation coefficient (ICC) was 0.96 (95% CI 0.95-0.97). At univariable analysis, clinical factors significantly associated with TILs (P ≤0.001) were intrinsic subtype, grade, necrosis, type of surgery. Her-2 positive DCIS were more frequently associated with TILs (24% of patients with TILs ≥50%), followed by the triple negative (11%), Luminal B/Her-2 positive (9%) and Luminal A/B subtypes (1%) (P < 0.0001). We did not find any association between TILs as a continuous variable and the risk of IBEs. Likewise, when patients were stratified by TILs percentage (<1%, between 1% and 49.9%, and ≥50%), no statistically significant association was observed (10-year cumulative incidence of IBEs: 19%, 17.3%, and 18.7% respectively, P = 0.767). Conclusion TILs occur more frequently in the Her-2 positive DCIS. Although we did not find a significant association between TILs and the 10-year risk of IBE, our data suggest that immunotherapies might be considered in subsets of DCIS patients.
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Affiliation(s)
- G Pruneri
- Department of Pathology, European Institute of Oncology, Milan.,School of Medicine, University of Milan, Milan
| | - M Lazzeroni
- Cancer Prevention and Genetics, European Institute of Oncology, Milan
| | - V Bagnardi
- Epidemiology and Biostatistics, European Institute of Oncology, Milan.,Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan
| | - G B Tiburzio
- Department of Pathology, European Institute of Oncology, Milan
| | - N Rotmensz
- Epidemiology and Biostatistics, European Institute of Oncology, Milan
| | - A DeCensi
- Cancer Prevention and Genetics, European Institute of Oncology, Milan.,Division of Medical Oncology, E.O. Ospedali Galliera, Genoa
| | | | - A Vingiani
- Department of Pathology, European Institute of Oncology, Milan
| | - G Curigliano
- Experimental Therapeutics European Institute of Oncology, Milan
| | - S Zurrida
- Division of Senology, European Institute of Oncology, Milan, Italy
| | - F Bassi
- Division of Senology, European Institute of Oncology, Milan, Italy
| | - R Salgado
- Department of Pathology, GZA, Breast Cancer Translational Research Group, Jules Bordet Institute, Brussels
| | - G Van den Eynden
- Molecular Immunology Lab, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Loi
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre University of Melbourne, East Melbourne, Victoria, Australia
| | - C Denkert
- Institute of Pathology Charité University Hospital, Berlin, Germany and German Cancer Consortium, Berlin, Germany
| | - B Bonanni
- Cancer Prevention and Genetics, European Institute of Oncology, Milan
| | - G Viale
- Department of Pathology, European Institute of Oncology, Milan.,School of Medicine, University of Milan, Milan
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Pruneri G, Cara P, Heidinger R, Kasugai A, Knaster J, Ohira S, Okumura Y, Sakamoto K. Conventional facilities of the linear IFMIF prototype accelerator (LIPAc). Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.03.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Criscitiello C, Bagnardi V, Pruneri G, Vingiani A, Esposito A, Rotmensz N, Curigliano G. Prognostic value of tumor-infiltrating lymphocytes in small HER2-positive breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Criscitiello C, Bayar M, Curigliano G, Symmans F, Desmedt C, Bonnefoi H, Sinn B, Pruneri G, Vicier C, Pierga JY, Denkert C, Loibl S, Sotiriou C, Michiels S, André F. A gene signature of chemo-immunization to predict outcome in patients with triple negative breast cancer treated with anthracycline-based neoadjuvant chemotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Desmedt C, Pingitore J, Rothé F, Rouas G, Bertucci F, Galant C, Rotmensz N, van den Eynden G, Salgado R, Larsimont D, Pruneri G, Sotiriou C. Abstract P3-04-04: Detection of ESR1 mutations in matched primary and metastatic samples from endocrine-resistant lobular breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-04-04] [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:
Invasive lobular breast cancer (ILBC) represents the second most common histology of breast cancer (BC) and accounts for 10-15% of all invasive cases. Since >90% of ILBCs express the estrogen receptor (ER, coded by the ESR1 gene), the vast majority of these patients receive endocrine therapy. ESR1 mutations have mainly been identified in metastases from ER-positive BC at a frequency ranging from 11 to 50% and were shown to be associated with resistance to endocrine therapy. Nevertheless, ESR1 mutations have never been assessed in metastatic ILBC, hence the present study.
Patients and methods:
We aimed at interrogating the five most commonly reported ESR1 mutations (Y537S/C/N, D538G, E380Q) by droplet digital PCR (BioRad) in matched primary, axillary and metastatic ILBC samples (N=212) from 69 endocrine-resistant patients collected retrospectively from five hospitals.
Results:
We present here the results for the two most frequent ESR1 mutations (Y537S and D538G); data from the remaining mutations will be available at the time of the conference. We observed Y537S and D538G mutations in metastases from three and four patients, respectively. For one patient, the sampled metastasis harbored both the Y537S and the D538G mutations, confirming that ESR1 polyclonality can be present in the same metastasis. For another patient, two metastases were sampled and the D538G mutation was only present in one metastasis. Intriguingly, for two patients we observed D538G mutations only in the primary tumor but not in the corresponding metastasis, and for another only in an axillary lymph node. We could hypothesize that the clone carrying the mutation in the early setting has been removed either by the primary surgery or subsequent adjuvant chemotherapy. The ESR1 Y537S and D538G mutational frequencies observed in our metastatic ILC cohort (3/69, 4.35% and 4/69, 5.80%, respectively) are not statistically different from the frequencies reported in breast cancer metastases in the literature across the different studies (6.62% and 6.20%, respectively). All patients with ESR1-mutated metastases received at least 4 years of endocrine therapy and all but one were treated with an aromatase inhibitor (AI). However, half of these patients received exclusively endocrine therapy in the adjuvant setting.
Conclusion:
This is to the best of our knowledge, the first metastatic ILBC series in which the most frequently reported ESR1 mutations are being investigated, and the largest series in which ESR1 mutations are being investigated in matched metastatic, primary tumor and axillary lymph node samples. The frequencies that we found for the Y537S and D538G mutations are in line with those reported in the literature in metastatic biopsies for the general BC population. We further demonstrated using multiple samples from the primary tumor and an ultra-sensitive technology that there was no patient presenting an ESR1 mutation both in the early and metastatic disease. Data on the remaining mutations (Y537S/N, E380Q) will complete these results.
Citation Format: Desmedt C, Pingitore J, Rothé F, Rouas G, Bertucci F, Galant C, Rotmensz N, van den Eynden G, Salgado R, Larsimont D, Pruneri G, Sotiriou C. Detection of ESR1 mutations in matched primary and metastatic samples from endocrine-resistant lobular breast cancer patients [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 P3-04-04.
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Affiliation(s)
- C Desmedt
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - J Pingitore
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - F Rothé
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - G Rouas
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - F Bertucci
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - C Galant
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - N Rotmensz
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - G van den Eynden
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - R Salgado
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - D Larsimont
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - G Pruneri
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
| | - C Sotiriou
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Institut Paoli-Calmettes, Marseille; Cliniques Universitaires Saint Luc, Brussels, Belgium; European Institute of Oncology, University of Milan, Milan
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