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Kim H, Aliar K, Tharmapalan P, McCloskey CW, Kuttanamkuzhi A, Grünwald BT, Palomero L, Mahendralingam MJ, Waas M, Mer AS, Elliott MJ, Zhang B, Al-Zahrani KN, Langille ER, Parsons M, Narala S, Hofer S, Waterhouse PD, Hakem R, Haibe-Kains B, Kislinger T, Schramek D, Cescon DW, Pujana MA, Berman HK, Khokha R. Differential DNA damage repair and PARP inhibitor vulnerability of the mammary epithelial lineages. Cell Rep 2023; 42:113382. [PMID: 37883228 DOI: 10.1016/j.celrep.2023.113382] [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: 10/28/2023] Open
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Kim H, Aliar K, Tharmapalan P, McCloskey CW, Kuttanamkuzhi A, Grünwald BT, Palomero L, Mahendralingam MJ, Waas M, Mer AS, Elliott MJ, Zhang B, Al-Zahrani KN, Langille ER, Parsons M, Narala S, Hofer S, Waterhouse PD, Hakem R, Haibe-Kains B, Kislinger T, Schramek D, Cescon DW, Pujana MA, Berman HK, Khokha R. Differential DNA damage repair and PARP inhibitor vulnerability of the mammary epithelial lineages. Cell Rep 2023; 42:113256. [PMID: 37847590 DOI: 10.1016/j.celrep.2023.113256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/02/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023] Open
Abstract
It is widely assumed that all normal somatic cells can equally perform homologous recombination (HR) and non-homologous end joining in the DNA damage response (DDR). Here, we show that the DDR in normal mammary gland inherently depends on the epithelial cell lineage identity. Bioinformatics, post-irradiation DNA damage repair kinetics, and clonogenic assays demonstrated luminal lineage exhibiting a more pronounced DDR and HR repair compared to the basal lineage. Consequently, basal progenitors were far more sensitive to poly(ADP-ribose) polymerase inhibitors (PARPis) in both mouse and human mammary epithelium. Furthermore, PARPi sensitivity of murine and human breast cancer cell lines as well as patient-derived xenografts correlated with their molecular resemblance to the mammary progenitor lineages. Thus, mammary epithelial cells are intrinsically divergent in their DNA damage repair capacity and PARPi vulnerability, potentially influencing the clinical utility of this targeted therapy.
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Affiliation(s)
- Hyeyeon Kim
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Kazeera Aliar
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Pirashaanthy Tharmapalan
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Curtis W McCloskey
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | | | - Barbara T Grünwald
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Luis Palomero
- ProCURE, Catalan Institute of Oncology, Oncobell, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, 08908 Barcelona, Catalonia, Spain
| | - Mathepan J Mahendralingam
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Matthew Waas
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Arvind S Mer
- Department of Biochemistry, Microbiology & Immunology, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Mitchell J Elliott
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Bowen Zhang
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Khalid N Al-Zahrani
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Ellen R Langille
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Michael Parsons
- Department of Biochemistry, Microbiology & Immunology, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Swami Narala
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Stefan Hofer
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Paul D Waterhouse
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Razqallah Hakem
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 2N2, Canada
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Thomas Kislinger
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada
| | - Daniel Schramek
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - David W Cescon
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Miquel A Pujana
- ProCURE, Catalan Institute of Oncology, Oncobell, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, 08908 Barcelona, Catalonia, Spain
| | - Hal K Berman
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Rama Khokha
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 2N2, Canada.
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Salawu A, Wang BX, Han M, Geady C, Heirali A, Berman HK, Pfister TD, Hernando-Calvo A, Al-Ezzi EM, Stayner LA, Gupta AA, Ayodele O, Lam B, Hansen AR, Spreafico A, Bedard PL, Butler MO, Avery L, Coburn B, Haibe-Kains B, Siu LL, Abdul Razak AR. Safety, Immunologic, and Clinical Activity of Durvalumab in Combination with Olaparib or Cediranib in Advanced Leiomyosarcoma: Results of the DAPPER Clinical Trial. Clin Cancer Res 2023; 29:4128-4138. [PMID: 37566240 DOI: 10.1158/1078-0432.ccr-23-1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/21/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE Non-inflamed (cold) tumors such as leiomyosarcoma do not benefit from immune checkpoint blockade (ICB) monotherapy. Combining ICB with angiogenesis or PARP inhibitors may increase tumor immunogenicity by altering the immune cell composition of the tumor microenvironment (TME). The DAPPER phase II study evaluated the safety, immunologic, and clinical activity of ICB-based combinations in pretreated patients with leiomyosarcoma. PATIENTS AND METHODS Patients were randomized to receive durvalumab 1,500 mg IV every 4 weeks with either olaparib 300 mg twice a day orally (Arm A) or cediranib 20 mg every day orally 5 days/week (Arm B) until unacceptable toxicity or disease progression. Paired tumor biopsies, serial radiologic assessments and stool collections were performed. Primary endpoints were safety and immune cell changes in the TME. Objective responses and survival were correlated with transcriptomic, radiomic, and microbiome parameters. RESULTS Among 30 heavily pretreated patients (15 on each arm), grade ≥ 3 toxicity occurred in 3 (20%) and 2 (13%) on Arms A and B, respectively. On Arm A, 1 patient achieved partial response (PR) with increase in CD8 T cells and macrophages in the TME during treatment, while 4 had stable disease (SD) ≥ 6 months. No patients on Arm B achieved PR or SD ≥ 6 months. Transcriptome analysis showed that baseline M1-macrophage and B-cell activity were associated with overall survival. CONCLUSIONS Durvalumab plus olaparib increased immune cell infiltration of TME with clinical benefit in some patients with leiomyosarcoma. Baseline M1-macrophage and B-cell activity may identify patients with leiomyosarcoma with favorable outcomes on immunotherapy and should be further evaluated.
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Affiliation(s)
- Abdulazeez Salawu
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ben X Wang
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ming Han
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Caryn Geady
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Alya Heirali
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Hal K Berman
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Thomas D Pfister
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Alberto Hernando-Calvo
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Esmail Mutahar Al-Ezzi
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Lee-Anne Stayner
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Abha A Gupta
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Olubukola Ayodele
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Bernard Lam
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Aaron R Hansen
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Anna Spreafico
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Philippe L Bedard
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Marcus O Butler
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Avery
- Department of Statistics, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Benjamin Haibe-Kains
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Lillian L Siu
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Albiruni R Abdul Razak
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Katz L, Kiyota T, Woolman M, Wu M, Pires L, Fiorante A, Ye LA, Leong W, Berman HK, Ghazarian D, Ginsberg HJ, Das S, Aman A, Zarrine-Afsar A. Metabolic Lipids in Melanoma Enable Rapid Determination of Actionable BRAF-V600E Mutation with Picosecond Infrared Laser Mass Spectrometry in 10 s. Anal Chem 2023; 95:14430-14439. [PMID: 37695851 DOI: 10.1021/acs.analchem.3c02901] [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: 09/13/2023]
Abstract
Rapid molecular profiling of biological tissues with picosecond infrared laser mass spectrometry (PIRL-MS) has enabled the detection of clinically important histologic types and molecular subtypes of human cancers in as little as 10 s of data collection and analysis time. Utilizing an engineered cell line model of actionable BRAF-V600E mutation, we observed statistically significant differences in 10 s PIRL-MS molecular profiles between BRAF-V600E and BRAF-wt cells. Multivariate statistical analyses revealed a list of mass-to-charge (m/z) values most significantly responsible for the identification of BRAF-V600E mutation status in this engineered cell line that provided a highly controlled testbed for this observation. These metabolites predicted BRAF-V600E expression in human melanoma cell lines with greater than 98% accuracy. Through chromatography and tandem mass spectrometry analysis of cell line extracts, a 30-member "metabolite array" was characterized for determination of BRAF-V600E expression levels in subcutaneous melanoma xenografts with an average sensitivity and specificity of 95.6% with 10 s PIRL-MS analysis. This proof-of-principle work warrants a future large-scale study to identify a metabolite array for 10 s determination of actionable BRAF-V600E mutation in human tissue to guide patient care.
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Affiliation(s)
- Lauren Katz
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, ON M5G 1L7, Canada
| | - Taira Kiyota
- Ontario Institute for Cancer Research (OICR), 661 University Avenue, Suite 510, Toronto, ON M5G 0A3, Canada
| | - Michael Woolman
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, ON M5G 1L7, Canada
| | - Megan Wu
- Peter Gilgan Centre for Research and Learning & Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Layla Pires
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
| | - Alexa Fiorante
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, ON M5G 1L7, Canada
| | - Lan Anna Ye
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
| | - Wey Leong
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2C1, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
| | - Hal K Berman
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2C1, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto and the Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada
| | - Danny Ghazarian
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Howard J Ginsberg
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King's College Circle, Sixth Floor, Toronto, ON M5S 1A8, Canada
| | - Sunit Das
- Peter Gilgan Centre for Research and Learning & Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
| | - Ahmed Aman
- Ontario Institute for Cancer Research (OICR), 661 University Avenue, Suite 510, Toronto, ON M5G 0A3, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, ON M5S 3M2, Canada
| | - Arash Zarrine-Afsar
- Princess Margaret Cancer Centre, University Health Network, 101 College Street, Toronto, ON M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, ON M5G 1L7, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
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Katz L, Woolman M, Kiyota T, Pires L, Zaidi M, Hofer SO, Leong W, Wouters BG, Ghazarian D, Chan AW, Ginsberg HJ, Aman A, Wilson BC, Berman HK, Zarrine-Afsar A. Picosecond Infrared Laser Mass Spectrometry Identifies a Metabolite Array for 10 s Diagnosis of Select Skin Cancer Types: A Proof-of-Concept Feasibility Study. Anal Chem 2022; 94:16821-16830. [DOI: 10.1021/acs.analchem.2c03918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Lauren Katz
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
| | - Michael Woolman
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
| | - Taira Kiyota
- Ontario Institute for Cancer Research (OICR), 661 University Ave Suite 510, Toronto, Ontario M5G 0A3, Canada
| | - Layla Pires
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
| | - Mark Zaidi
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
| | - Stefan O.P. Hofer
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto. Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Wey Leong
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto Ontario M5G 2C1, Canada
| | - Brad G. Wouters
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
| | - Danny Ghazarian
- Department of Laboratory Medicine and Pathobiology, University of Toronto and University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Canada and Women’s College Research Institute, Women’s College Hospital, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada
| | - Howard J. Ginsberg
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - Ahmed Aman
- Ontario Institute for Cancer Research (OICR), 661 University Ave Suite 510, Toronto, Ontario M5G 0A3, Canada
- Leslie Dan, Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario M5S 3M2, Canada
| | - Brian C. Wilson
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
| | - Hal K. Berman
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada
- Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Arash Zarrine-Afsar
- Techna Institute for the Advancement of Technology for Health, University Health Network, 100 College Street, Toronto, Ontario M5G 1P5, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, Ontario M5G 1L7, Canada
- Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada
- Keenan Research Center for Biomedical Science & the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
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Hernando-Calvo A, Yang SYC, Vila-Casadesús M, Berman HK, Spreafico A, Abdul Razak AR, Lheureux S, Hansen AR, Lo Giacco D, Matito J, Pugh TJ, Bratman SV, Berché R, Saavedra Santa Gadea O, Garralda E, Elston S, Siu LL, Ohashi PS, Vivancos A, Bedard PL. External validation of the VIGex gene-expression signature (GES) as a novel predictive biomarker for immune checkpoint treatment (ICT). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2510 Background: VIGex is a 12- gene GES classifier initially developed on the Nanostring platform and validated for RNA-seq. VIGex classifies samples into Hot, intermediate-Cold (I-Cold) and Cold subgroups. The Hot subgroup as defined by VIGex has been associated with better (PFS) in patients (pts) treated on phase 1 ICT trials at Vall D’Hebron Hospital (VH) (ESMO2020). We investigated the performance of VIGex in pts treated with Pembrolizumab (P) in the INSPIRE clinical trial (NCT02644369) at Princess Margaret Cancer Centre (PM) and compared VIGex with other predictive ICT biomarkers. Methods: Pts with advanced solid tumors were treated with P 200 mg IV Q3wks. RNA-seq from baseline biopsies was performed using the Illumina NextSeq550 platform. Tumor RNA-seq data were transferred from PM to VH and classified by the VIGex algorithm blinded to clinical data. Bespoke circulating tumor DNA (ctDNA) was assayed at baseline (B) and start of cycle 3 (C3) using a pt-specific amplicon-based NGS assay (Signatera). Tumor mutational burden (TMB) was defined as the number of non-synonymous mutations per megabase and PD-L1 was assessed by immunohistochemistry (22C3). Hot subgroup (HOT) was compared to I-Cold + Cold (COLD). We defined 4 groups based on the combination of VIGex subgroups and the change in ctDNA at cycle 3 from baseline (ΔctDNA). Survival times were calculated with the Kaplan–Meier method and Cox proportional-hazard models were constructed. Results: Out of 76 pts, median age was 55y (range 21-81y), M:F 31:45, all ECOG 0-1, 16 High-grade serous ovarian, 12 triple negative breast, 12 head and neck, 10 melanoma and 26 other. Median no. of P cycles was 3 (range 1–35); follow up was 14m (range 1-67); Median PFS 10.9m and median overall survival (OS) 14m. Overall response rate (RECIST 1.1) was 24% in HOT and 10% in COLD (p = 0.22 two-sided Fisher's exact test). The HOT subgroup was significantly associated with higher OS and PFS when included in a multivariate model adjusted by tumor histology, TMB and PD-L1 (HR 0.43; 95%CI 0.23-0.81; p = 0.009) and (HR: 0.48; 95%CI 0.25-0.95; p = 0.036) respectively. A total of 57 pts had both VIGex and ΔctDNA data. The addition of ΔctDNA further improved the predictive performance of VIGex for OS (Table). Conclusions: VIGex maintained its predictive power for ICT outcomes when applied to an independent external dataset using RNA-seq. The predictive information provided by VIGex was independent of PD-L1 and TMB. Our data indicates that the addition of ΔctDNA to baseline VIGex may refine prediction for ICT outcomes. [Table: see text]
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Affiliation(s)
- Alberto Hernando-Calvo
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - S Y Cindy Yang
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Maria Vila-Casadesús
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Hal K. Berman
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Anna Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Stephanie Lheureux
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Aaron Richard Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Deborah Lo Giacco
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Judit Matito
- Cancer Genomics Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Trevor John Pugh
- Princess Margaret Cancer Centre, University Health Network. Ontario Institute for Cancer Research. Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Scott Victor Bratman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Roger Berché
- Oncology Data Science (ODysSey) Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Elena Garralda
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Sawako Elston
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Lillian L. Siu
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Pamela S. Ohashi
- Princess Margaret Cancer Centre, University Health Network, Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Ana Vivancos
- Cancer Genomics Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Spiliopoulou P, Yang SC, Bruce JP, Wang BX, Berman HK, Pugh TJ, Siu LL. All is not lost: learning from 9p21 loss in cancer. Trends Immunol 2022; 43:379-390. [DOI: 10.1016/j.it.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 12/11/2022]
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Cindy Yang SY, Lien SC, Wang BX, Clouthier DL, Hanna Y, Cirlan I, Zhu K, Bruce JP, El Ghamrasni S, Iafolla MAJ, Oliva M, Hansen AR, Spreafico A, Bedard PL, Lheureux S, Razak A, Speers V, Berman HK, Aleshin A, Haibe-Kains B, Brooks DG, McGaha TL, Butler MO, Bratman SV, Ohashi PS, Siu LL, Pugh TJ. Pan-cancer analysis of longitudinal metastatic tumors reveals genomic alterations and immune landscape dynamics associated with pembrolizumab sensitivity. Nat Commun 2021; 12:5137. [PMID: 34446728 PMCID: PMC8390680 DOI: 10.1038/s41467-021-25432-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 08/06/2021] [Indexed: 12/13/2022] Open
Abstract
Serial circulating tumor DNA (ctDNA) monitoring is emerging as a non-invasive strategy to predict and monitor immune checkpoint blockade (ICB) therapeutic efficacy across cancer types. Yet, limited data exist to show the relationship between ctDNA dynamics and tumor genome and immune microenvironment in patients receiving ICB. Here, we present an in-depth analysis of clinical, whole-exome, transcriptome, and ctDNA profiles of 73 patients with advanced solid tumors, across 30 cancer types, from a phase II basket clinical trial of pembrolizumab (NCT02644369) and report changes in genomic and immune landscapes (primary outcomes). Patients stratified by ctDNA and tumor burden dynamics correspond with survival and clinical benefit. High mutation burden, high expression of immune signatures, and mutations in BRCA2 are associated with pembrolizumab molecular sensitivity, while abundant copy-number alterations and B2M loss-of-heterozygosity corresponded with resistance. Upon treatment, induction of genes expressed by T cell, B cell, and myeloid cell populations are consistent with sensitivity and resistance. We identified the upregulated expression of PLA2G2D, an immune-regulating phospholipase, as a potential biomarker of adaptive resistance to ICB. Together, these findings provide insights into the diversity of immunogenomic mechanisms that underpin pembrolizumab outcomes.
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Affiliation(s)
- S Y Cindy Yang
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Scott C Lien
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Ben X Wang
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Derek L Clouthier
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Youstina Hanna
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Iulia Cirlan
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Kelsey Zhu
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jeffrey P Bruce
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Samah El Ghamrasni
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Marco A J Iafolla
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Marc Oliva
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Aaron R Hansen
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anna Spreafico
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Philippe L Bedard
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie Lheureux
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Albiruni Razak
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vanessa Speers
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Hal K Berman
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Benjamin Haibe-Kains
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
- Vector Institute, Toronto, ON, Canada
| | - David G Brooks
- Department of Immunology, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Tracy L McGaha
- Department of Immunology, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Marcus O Butler
- Department of Immunology, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott V Bratman
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Pamela S Ohashi
- Department of Immunology, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Lillian L Siu
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
- Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University of Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Trevor J Pugh
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
- Ontario Institute for Cancer Research, Toronto, ON, Canada.
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9
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Patel PS, Abraham KJ, Guturi KKN, Halaby MJ, Khan Z, Palomero L, Ho B, Duan S, St-Germain J, Algouneh A, Mateo F, El Ghamrasni S, Barbour H, Barnes DR, Beesley J, Sanchez O, Berman HK, Brown GW, El Bachir Affar, Chenevix-Trench G, Antoniou AC, Arrowsmith CH, Raught B, Pujana MA, Mekhail K, Hakem A, Hakem R. RNF168 regulates R-loop resolution and genomic stability in BRCA1/2-deficient tumors. J Clin Invest 2021; 131:140105. [PMID: 33529165 PMCID: PMC7843228 DOI: 10.1172/jci140105] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/09/2020] [Indexed: 12/23/2022] Open
Abstract
Germline mutations in BRCA1 and BRCA2 (BRCA1/2) genes considerably increase breast and ovarian cancer risk. Given that tumors with these mutations have elevated genomic instability, they exhibit relative vulnerability to certain chemotherapies and targeted treatments based on poly (ADP-ribose) polymerase (PARP) inhibition. However, the molecular mechanisms that influence cancer risk and therapeutic benefit or resistance remain only partially understood. BRCA1 and BRCA2 have also been implicated in the suppression of R-loops, triple-stranded nucleic acid structures composed of a DNA:RNA hybrid and a displaced ssDNA strand. Here, we report that loss of RNF168, an E3 ubiquitin ligase and DNA double-strand break (DSB) responder, remarkably protected Brca1-mutant mice against mammary tumorigenesis. We demonstrate that RNF168 deficiency resulted in accumulation of R-loops in BRCA1/2-mutant breast and ovarian cancer cells, leading to DSBs, senescence, and subsequent cell death. Using interactome assays, we identified RNF168 interaction with DHX9, a helicase involved in the resolution and removal of R-loops. Mechanistically, RNF168 directly ubiquitylated DHX9 to facilitate its recruitment to R-loop-prone genomic loci. Consequently, loss of RNF168 impaired DHX9 recruitment to R-loops, thereby abrogating its ability to resolve R-loops. The data presented in this study highlight a dependence of BRCA1/2-defective tumors on factors that suppress R-loops and reveal a fundamental RNF168-mediated molecular mechanism that governs cancer development and vulnerability.
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Affiliation(s)
- Parasvi S. Patel
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Karan Joshua Abraham
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Kiran Kumar Naidu Guturi
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Marie-Jo Halaby
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Zahra Khan
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Luis Palomero
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L’Hospitalet del Llobregat, Barcelona, Catalonia, Spain
| | - Brandon Ho
- Department of Biochemistry and Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
| | - Shili Duan
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Jonathan St-Germain
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Arash Algouneh
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Francesca Mateo
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L’Hospitalet del Llobregat, Barcelona, Catalonia, Spain
| | - Samah El Ghamrasni
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Haithem Barbour
- Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | - Daniel R. Barnes
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan Beesley
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Otto Sanchez
- University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Hal K. Berman
- Toronto General Research Institute, Toronto, Ontario, Canada
| | - Grant W. Brown
- Department of Biochemistry and Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
| | - El Bachir Affar
- Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
| | | | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Cheryl H. Arrowsmith
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Brian Raught
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Miquel Angel Pujana
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L’Hospitalet del Llobregat, Barcelona, Catalonia, Spain
| | - Karim Mekhail
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Anne Hakem
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
| | - Razqallah Hakem
- Princess Margaret Cancer Centre, University Health Network and Department of Medical Biophysics, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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10
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MacGregor HL, Garcia-Batres C, Sayad A, Elia A, Berman HK, Toker A, Katz SR, Shaw PA, Clarke BA, Crome SQ, Robert-Tissot C, Bernardini MQ, Nguyen LT, Ohashi PS. Tumor cell expression of B7-H4 correlates with higher frequencies of tumor-infiltrating APCs and higher CXCL17 expression in human epithelial ovarian cancer. Oncoimmunology 2019; 8:e1665460. [PMID: 31741762 PMCID: PMC6844312 DOI: 10.1080/2162402x.2019.1665460] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 01/05/2023] Open
Abstract
B7-H4, an immune suppressive member of the B7 family, is highly expressed in a wide variety of human malignancies making it an attractive immunotherapeutic target. However, the association between B7-H4 expression in the tumor microenvironment and the immune infiltrate has not been comprehensively examined. To evaluate the immune tumor microenvironment, we analyzed epithelial ovarian tumors from 28 patients using flow cytometry, immunohistochemistry, functional, and genomic analyses. We determined B7-H4 expression patterns and compared the immune infiltrates of tumors with high and low surface expression of B7-H4. Frequencies and phenotypes of tumor and immune cells were determined using multiple flow cytometry panels. Immunohistochemistry was used to analyze cellular infiltration and location. Publicly available datasets were interrogated to determine intratumoral cytokine and chemokine expression. We found that B7-H4 was predominantly expressed by tumor cells in the epithelial ovarian tumor microenvironment. Surface expression of B7-H4 on tumor cells was correlated with higher levels of infiltrating mature antigen-presenting cells. Further, expression of CXCL17, a monocyte and dendritic cell chemoattractant, correlated strongly with B7-H4 expression. T cells expressed activation markers, but T cells expressing a combination of markers associated with T cell activation/exhaustion phenotype were not prevalent. Overall, our data suggest that B7-H4 is associated with a pro-inflammatory tumor microenvironment.
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Affiliation(s)
- Heather L. MacGregor
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Carlos Garcia-Batres
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Azin Sayad
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Andrew Elia
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Hal K. Berman
- Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Aras Toker
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Sarah Rachel Katz
- Division of Gynecologic Oncology, University Health Network, Toronto, Ontario, Canada
| | - Patricia A. Shaw
- Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Blaise A. Clarke
- Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Q. Crome
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Celine Robert-Tissot
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Marcus Q. Bernardini
- Division of Gynecologic Oncology, University Health Network, Toronto, Ontario, Canada
| | - Linh T. Nguyen
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Pamela S. Ohashi
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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11
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Tharmapalan P, Mahendralingam M, Berman HK, Khokha R. Mammary stem cells and progenitors: targeting the roots of breast cancer for prevention. EMBO J 2019; 38:e100852. [PMID: 31267556 PMCID: PMC6627238 DOI: 10.15252/embj.2018100852] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/11/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022] Open
Abstract
Breast cancer prevention is daunting, yet not an unsurmountable goal. Mammary stem and progenitors have been proposed as the cells-of-origin in breast cancer. Here, we present the concept of limiting these breast cancer precursors as a risk reduction approach in high-risk women. A wealth of information now exists for phenotypic and functional characterization of mammary stem and progenitor cells in mouse and human. Recent work has also revealed the hormonal regulation of stem/progenitor dynamics as well as intrinsic lineage distinctions between mammary epithelial populations. Leveraging these insights, molecular marker-guided chemoprevention is an achievable reality.
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Affiliation(s)
| | - Mathepan Mahendralingam
- Princess Margaret Cancer CentreUniversity Health NetworkUniversity of TorontoTorontoONCanada
| | - Hal K Berman
- Princess Margaret Cancer CentreUniversity Health NetworkUniversity of TorontoTorontoONCanada
| | - Rama Khokha
- Princess Margaret Cancer CentreUniversity Health NetworkUniversity of TorontoTorontoONCanada
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12
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Mrkonjic M, Berman HK, Done SJ, Youngson B, Mulligan AM. Breast specimen handling and reporting in the post-neoadjuvant setting: challenges and advances. J Clin Pathol 2019; 72:120-132. [PMID: 30670564 DOI: 10.1136/jclinpath-2018-205598] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/23/2022]
Abstract
Neoadjuvant systemic therapy is becoming more commonly used in patients with earlier stages of breast cancer. To assess tumour response to neoadjuvant chemotherapy, pathological evaluation is the gold standard. Depending on the treatment response, the pathological examination of these specimens can be quite challenging. However, a uniform approach to evaluate post-neoadjuvant-treated breast specimens has been lacking. Furthermore, there is no single universally accepted or endorsed classification system for assessing treatment response in this setting. Recent initiatives have attempted to create a standardised protocol for evaluation of post-neoadjuvant breast specimens. This review outlines the necessary information that should be collected prior to macroscopic examination of these specimens, the recommended and most pragmatic approach to tissue sampling for microscopic examination, describes the macroscopic and microscopic features of post-therapy breast specimens, summarises two commonly used systems for classifying treatment response and outlines the critical variables that should be included in the final pathology report.
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Affiliation(s)
- Miralem Mrkonjic
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Hal K Berman
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Susan J Done
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Youngson
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Anna Marie Mulligan
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada .,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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13
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Aung KL, Bedard PL, Yu C, Boerner SL, Zuzarte PC, Ghai S, Berman HK, Serra S, Giesler A, Ahmed L, Joshua AM, Moore MJ, Oza AM, Amir E, McPherson JD, Zhang T, Sukhai MA, Stockley TL, Kamel-Reid S, Siu LL, Hansen AR. Minimally Invasive Real-Time Detection of Actionable Mutations in Patients With Metastatic Solid Tumors Using Fine-Needle and Liquid Biopsies. JCO Precis Oncol 2018; 2:1-20. [DOI: 10.1200/po.17.00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Fine-needle biopsy (FNB) and liquid biopsy are minimally invasive methods of tumor sampling that provide feasible means to assess tumor genotypes in real time. However, more data are needed to establish the strength of these methods by benchmarking against the current gold standard methods, core-needle biopsy (CNB) or surgical excision of the tumor. Patients and Methods Eligible patients with advanced solid tumors were prospectively recruited. We performed mutation profiling using matched tumor DNA obtained by CNB, FNB and liquid biopsy, and matrix-assisted laser desorption/ionization time-of-flight custom mass-spectrometry or targeted next-generation DNA sequencing. The actionability of detected mutations was determined using the OncoKB Web tool. Agreement between mutations detected in CNBs, FNBs, and circulating tumor DNA (ctDNA) was examined. Results Forty-one patients underwent tumor biopsy. Thirty CNBs (73%) and 34 FNBs (83%) had sufficient tumor and DNA for mutation profiling. Median DNA yield from CNB and FNB were 775 ng (interquartile range, 240 to 347 4ng) and 649 ng (interquartile range, 180 to1350 ng), respectively. Of 29 CNB/FNB pairs available for comparison, actionable mutation results were concordant in 28 (96%). Six of nine actionable mutations (67%) that were found by CNB, FNB, or both were detectable in ctDNA. Two additional actionable mutations were found exclusively in ctDNA. Conclusion Optimally processed FNB and liquid biopsy can be used routinely for tumor mutation profiling to identify actionable mutations.
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Affiliation(s)
- Kyaw L. Aung
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Philippe L. Bedard
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Celeste Yu
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Scott L. Boerner
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Philip C. Zuzarte
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Sangeet Ghai
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Hal K. Berman
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Stefano Serra
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Amanda Giesler
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Lailah Ahmed
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Anthony M. Joshua
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Malcolm J. Moore
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Amit M. Oza
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Eitan Amir
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - John D. McPherson
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Tong Zhang
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Mahadeo A. Sukhai
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Tracy L. Stockley
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Suzanne Kamel-Reid
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Lillian L. Siu
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
| | - Aaron R. Hansen
- Kyaw L. Aung, Philippe L. Bedard, Celeste Yu, Scott L. Boerner, Sangeet Ghai, Hal K. Berman, Stefano Serra, Amanda Giesler, Lailah Ahmed, Anthony M. Joshua, Amit M. Oza, Eitan Amir, Tong Zhang, Mahadeo A. Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University Health Network; Philippe L. Bedard, Amit M. Oza, Eitan Amir, Tracy L. Stockley, Suzanne Kamel-Reid, Lillian L. Siu, and Aaron R. Hansen, University of Toronto; Philip C. Zuzarte, Ontario Institute of Cancer
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14
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Veitch ZWN, Cescon DW, Elston S, Lien S, Yang C, Wang BX, Berman HK, Butler MO, Amir E, Elser C, Hakgor S, Giesler A, Pugh TJ, Ohashi PS, Siu LL, Bedard PL. Phase II (INSPIRE) trial of pembrolizumab (pembro) with serial immune and genomic profiling in patients (pts) with metastatic triple negative breast cancer (mTNBC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1094] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Sawako Elston
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Scott Lien
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Cindy Yang
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Ben X Wang
- Princess Margaret - University Health Network, Toronto, ON, CA
| | - Hal K. Berman
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Marcus O. Butler
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Eitan Amir
- Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Sevan Hakgor
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Trevor John Pugh
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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15
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Pezo RC, Chen TW, Berman HK, Mulligan AM, Razak AA, Siu LL, Cescon DW, Amir E, Elser C, Warr DG, Sridhar SS, Yu C, Wang L, Stockley TL, Kamel-Reid S, Bedard PL. Impact of multi-gene mutational profiling on clinical trial outcomes in metastatic breast cancer. Breast Cancer Res Treat 2017; 168:159-168. [PMID: 29177603 PMCID: PMC5847065 DOI: 10.1007/s10549-017-4580-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 09/24/2017] [Accepted: 11/14/2017] [Indexed: 11/24/2022]
Abstract
Purpose Next-generation sequencing (NGS) has identified recurrent genomic alterations in metastatic breast cancer (MBC); however, the clinical utility of incorporating routine sequencing to guide treatment decisions in this setting is unclear. We examine the frequency of genomic alterations in MBC patients from academic and community hospitals and correlate with clinical outcomes. Methods MBC patients with good performance status were prospectively recruited at the Princess Margaret Cancer Centre (PM) in Canada. Molecular profiling on DNA extracted from FFPE archival tissues was performed on the Sequenom MassArray platform or the TruSeq Amplicon Cancer Panel (TSACP) on the MiSeq platform. Clinical trial outcomes by RECIST 1.1 and time on treatment were reviewed retrospectively. Results From January 2012 to November 2015, 483 MBC patients were enrolled and 440 were genotyped. At least one somatic mutation was identified in 46% of patients, most commonly in PIK3CA (28%) or TP53 (13%). Of 203 patients with ≥ 1 mutation(s), 15% were treated on genotype-matched and 9% on non-matched trials. There was no significant difference for median time on treatment for patients treated on matched vs. non-matched therapies (3.6 vs. 3.8 months; p = 0.89). Conclusions This study provides real-world outcomes on hotspot genotyping and small targeted panel sequencing of MBC patients from academic and community settings. Few patients were matched to clinical trials with targeted therapies. More comprehensive profiling and improved access to clinical trials may increase therapeutic options for patients with actionable mutations. Further studies are needed to evaluate if this approach leads to improved clinical outcomes. Electronic supplementary material The online version of this article (10.1007/s10549-017-4580-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rossanna C Pezo
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada.,Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, Toronto, Canada
| | - Tom W Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hal K Berman
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Anna M Mulligan
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Albiruni A Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Lillian L Siu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada.,Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - David W Cescon
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Eitan Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Christine Elser
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - David G Warr
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Srikala S Sridhar
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Celeste Yu
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Lisa Wang
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - Tracy L Stockley
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Suzanne Kamel-Reid
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Philippe L Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 7-723 700 University Avenue, Toronto, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada. .,Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.
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16
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Crome SQ, Nguyen LT, Lopez-Verges S, Yang SYC, Martin B, Yam JY, Johnson DJ, Nie J, Pniak M, Yen PH, Milea A, Sowamber R, Katz SR, Bernardini MQ, Clarke BA, Shaw PA, Lang PA, Berman HK, Pugh TJ, Lanier LL, Ohashi PS. A distinct innate lymphoid cell population regulates tumor-associated T cells. Nat Med 2017; 23:368-375. [PMID: 28165478 PMCID: PMC5497996 DOI: 10.1038/nm.4278] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/04/2017] [Indexed: 12/15/2022]
Abstract
Antitumor T cells are subject to multiple mechanisms of negative regulation. Recent findings that innate lymphoid cells (ILCs) regulate adaptive T cell responses led us to examine the regulatory potential of ILCs in the context of cancer. We identified a unique ILC population that inhibits tumor-infiltrating lymphocytes (TILs) from high-grade serous tumors, defined their suppressive capacity in vitro, and performed a comprehensive analysis of their phenotype. Notably, the presence of this CD56+CD3- population in TIL cultures was associated with reduced T cell numbers, and further functional studies demonstrated that this population suppressed TIL expansion and altered TIL cytokine production. Transcriptome analysis and phenotypic characterization determined that regulatory CD56+CD3- cells exhibit low cytotoxic activity, produce IL-22, and have an expression profile that overlaps with those of natural killer (NK) cells and other ILCs. NKp46 was highly expressed by these cells, and addition of anti-NKp46 antibodies to TIL cultures abrogated the ability of these regulatory ILCs to suppress T cell expansion. Notably, the presence of these regulatory ILCs in TIL cultures corresponded with a striking reduction in the time to disease recurrence. These studies demonstrate that a previously uncharacterized ILC population regulates the activity and expansion of tumor-associated T cells.
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Affiliation(s)
- Sarah Q Crome
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Linh T Nguyen
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Sandra Lopez-Verges
- Department of Microbiology and Immunology and the Parker Institute for Cancer Immunotherapy, University of California San Francisco, San Francisco, California, USA
- Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - S Y Cindy Yang
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Departments of Medical Biophysics and Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Bernard Martin
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jennifer Y Yam
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Dylan J Johnson
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Departments of Medical Biophysics and Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Nie
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Michael Pniak
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Pei Hua Yen
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Anca Milea
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ramlogan Sowamber
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Sarah Rachel Katz
- Division of Gynecologic Oncology, University Health Network, Toronto, Ontario, Canada
| | - Marcus Q Bernardini
- Division of Gynecologic Oncology, University Health Network, Toronto, Ontario, Canada
| | - Blaise A Clarke
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Patricia A Shaw
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Philipp A Lang
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Molecular Medicine II, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Hal K Berman
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Trevor J Pugh
- Departments of Medical Biophysics and Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Lewis L Lanier
- Department of Microbiology and Immunology and the Parker Institute for Cancer Immunotherapy, University of California San Francisco, San Francisco, California, USA
| | - Pamela S Ohashi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Departments of Medical Biophysics and Immunology, University of Toronto, Toronto, Ontario, Canada
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17
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Stockley TL, Oza AM, Berman HK, Leighl NB, Knox JJ, Shepherd FA, Chen EX, Krzyzanowska MK, Dhani N, Joshua AM, Tsao MS, Serra S, Clarke B, Roehrl MH, Zhang T, Sukhai MA, Califaretti N, Trinkaus M, Shaw P, van der Kwast T, Wang L, Virtanen C, Kim RH, Razak ARA, Hansen AR, Yu C, Pugh TJ, Kamel-Reid S, Siu LL, Bedard PL. Molecular profiling of advanced solid tumors and patient outcomes with genotype-matched clinical trials: the Princess Margaret IMPACT/COMPACT trial. Genome Med 2016; 8:109. [PMID: 27782854 PMCID: PMC5078968 DOI: 10.1186/s13073-016-0364-2] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [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: 06/19/2016] [Accepted: 10/11/2016] [Indexed: 12/23/2022] Open
Abstract
Background The clinical utility of molecular profiling of tumor tissue to guide treatment of patients with advanced solid tumors is unknown. Our objectives were to evaluate the frequency of genomic alterations, clinical “actionability” of somatic variants, enrollment in mutation-targeted or other clinical trials, and outcome of molecular profiling for advanced solid tumor patients at the Princess Margaret Cancer Centre (PM). Methods Patients with advanced solid tumors aged ≥18 years, good performance status, and archival tumor tissue available were prospectively consented. DNA from archival formalin-fixed paraffin-embedded tumor tissue was tested using a MALDI-TOF MS hotspot panel or a targeted next generation sequencing (NGS) panel. Somatic variants were classified according to clinical actionability and an annotated report included in the electronic medical record. Oncologists were provided with summary tables of their patients’ molecular profiling results and available mutation-specific clinical trials. Enrolment in genotype-matched versus genotype-unmatched clinical trials following release of profiling results and response by RECIST v1.1 criteria were evaluated. Results From March 2012 to July 2014, 1893 patients were enrolled and 1640 tested. After a median follow-up of 18 months, 245 patients (15 %) who were tested were subsequently treated on 277 therapeutic clinical trials, including 84 patients (5 %) on 89 genotype-matched trials. The overall response rate was higher in patients treated on genotype-matched trials (19 %) compared with genotype-unmatched trials (9 %; p < 0.026). In a multi-variable model, trial matching by genotype (p = 0.021) and female gender (p = 0.034) were the only factors associated with increased likelihood of treatment response. Conclusions Few advanced solid tumor patients enrolled in a prospective institutional molecular profiling trial were treated subsequently on genotype-matched therapeutic trials. In this non-randomized comparison, genotype-enrichment of early phase clinical trials was associated with an increased objective tumor response rate. Trial registration NCT01505400 (date of registration 4 January 2012). Electronic supplementary material The online version of this article (doi:10.1186/s13073-016-0364-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tracy L Stockley
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Amit M Oza
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Hal K Berman
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Natasha B Leighl
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Jennifer J Knox
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Frances A Shepherd
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Eric X Chen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Monika K Krzyzanowska
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Neesha Dhani
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Anthony M Joshua
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Ming-Sound Tsao
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Stefano Serra
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Blaise Clarke
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Michael H Roehrl
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Tong Zhang
- Laboratory Medicine Program, University Health Network, Toronto, Canada
| | - Mahadeo A Sukhai
- Laboratory Medicine Program, University Health Network, Toronto, Canada
| | - Nadia Califaretti
- Department of Oncology, Grand River Regional Cancer Centre, Kitchener-Waterloo, Canada.,Department of Oncology, McMaster University, Faculty of Health Sciences, Hamilton, Canada
| | - Mateya Trinkaus
- Department of Medicine, Markham Stouffville Hospital, Markham, Canada
| | - Patricia Shaw
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Theodorus van der Kwast
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Lisa Wang
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - Carl Virtanen
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.,Princess Margaret Research Institute, Princess Margaret Cancer Centre, Toronto, Canada
| | - Raymond H Kim
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Albiruni R A Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Celeste Yu
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Trevor J Pugh
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Princess Margaret Research Institute, Princess Margaret Cancer Centre, Toronto, Canada
| | - Suzanne Kamel-Reid
- Laboratory Medicine Program, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Lillian L Siu
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada.,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Philippe L Bedard
- Cancer Genomics Program, Princess Margaret Cancer Centre, Toronto, Canada. .,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, M5G 2M9, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada.
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18
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Mandilaras V, Lheureux S, Stjepanovic N, Burnier J, Wilson MK, Wang L, Clarke B, Shaw PA, Berman HK, Kim R, Randall Armel S, McCuaig J, Volenik A, Ahmed L, Misyura M, Bedard PL, Siu LL, Kamel-Reid S, Stockley T, Oza AM. Germline and somatic homologous recombination gene mutations in high-grade serous ovarian cancer and clinical outcome. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Julia Burnier
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Michelle K. Wilson
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Lisa Wang
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Blaise Clarke
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | | | - Hal K. Berman
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Raymond Kim
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Susan Randall Armel
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Jeanna McCuaig
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Alexandra Volenik
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Lailah Ahmed
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Maksym Misyura
- University Health Network, Genome Diagnostics, Laboratory Medicine Program, Toronto, ON, Canada
| | - Philippe L. Bedard
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | | | - Suzanne Kamel-Reid
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Tracy Stockley
- University Health Network, Genome Diagnostics, Laboratory Medicine Program, Toronto, ON, Canada
| | - Amit M. Oza
- Princess Margaret Cancer Centre, Toronto, ON, Canada
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19
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Bedard PL, Oza A, Clarke B, Tsao MS, Leighl NB, Chen EX, Razak A, Berman HK, Serra S, Roehrl M, Califaretti N, Trinkaus M, Zhang T, Sukhai MA, Milea A, Hansen AR, Pugh TJ, Stockley T, Kamel-Reid S, Siu LL. Abstract PR03: Molecular profiling of advanced solid tumors at Princess Margaret Cancer Centre and patient outcomes with genotype-matched clinical trials. Clin Cancer Res 2016. [DOI: 10.1158/1557-3265.pmsclingen15-pr03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: IMPACT and COMPACT are ongoing clinical trials at Princess Margaret (PM) to match advanced solid tumor patients with actionable somatic mutations to clinical trials with investigational therapies [NCT01505400]. We compared the outcome of patients profiled at PM treated on genotype-matched versus genotype-unmatched clinical trials.
Methods: Patients with advanced solid tumors treated at PM or collaborating local institutions with available formalin fixed paraffin-embedded (FFPE) tumor tissue were prospectively consented for molecular profiling during standard treatment. Only patients with ECOG performance status ≤1 who were considered therapeutic trial candidates by their treating oncologist were eligible. Following pathology review, tumor DNA from FFPE blocks or unstained slides was extracted and genotyped using a customized Sequenom SNP genotyping panel (23 genes, 279 mutations) or a targeted next generation sequencing (NGS) panel, either the Illumina MiSeq TruSeq Amplicon Cancer Panel (48 genes, 212 amplicons) or the Ion Proton Ampliseq Cancer Hotspot Panel version 2 (50 genes, 207 amplicons) with ≤500x coverage in a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. An annotated molecular profiling report with somatic variants classified according to clinical actionability was included in the patient's electronic medical record. Oncologists were provided with regular summary tables of their patients' molecular profiling results and mutation-specific clinical trial listings to facilitate genotype-matched trial enrolment.
Results: From March 2012 to July 2014, 1893 patients were enrolled with gynaecological (22%), breast (18%), lung (18%) colorectal (17%), pancreatobiliary (8%), upper aerodigestive (6%), genitourinary (5%), and other (5%) cancers. Patients had received a median of 4 prior systemic treatments (range 1-23). Of 253 (13%) screen failures, 10% were for insufficient tissue and 3% for clinical deterioration or other reasons. Patients were more likely to have one or more somatic mutations identified by NGS testing [597/813 (73%); average 1.23 mutations/patient; range 0-9 mutations/patient] compared with SNP genotyping [341/827 (41%); average 0.46 mutations/patient; range 0-2 mutations/patient; p<0.0001]. After a median follow-up of 18 months, a total of 244 patients (13%) were treated on 287 therapeutic clinical trials, including 84 patients (4%) on 92 genotype-matched trials. There was no difference in the proportion of trial enrolment onto genotype-matched therapies between patients profiled on Sequenom compared with targeted NGS [63/176 (36%) vs 29/101 (29%); p=0.23). Patients with pancreatobiliary and upper aerodigestive tract cancers were least likely to be treated on genotype-matched trials. A higher proportion of patients enrolled in genotype-matched trials were treated in phase I studies (80%) compared with genotype-unmatched trials (45%; p<0.001). The overall response rate by RECIST version 1.1 was higher in patients treated on genotype-matched trials (20%) compared with genotype-unmatched trials (11%; p<0.04). Patients treated on genotype-matched trials were more likely to achieve a best response of any shrinkage in the sum of their target lesions (61%) compared with patients treated on genotype-unmatched trials (32%; p<0.001).
Conclusions: Few advanced solid tumor patients enrolled in a prospective institutional molecular profiling program were subsequently treated on genotype-matched therapeutic trials. Compared with SNP genotyping, profiling with a broader NGS panel did not increase the likelihood of receiving treatment on a genotype-matched trial. In this non-randomized comparison, genotype-enrichment of early phase clinical trials was associated with an increased objective tumor response rate. Greater efforts should be made to expand opportunities for genotype-trial matching and further studies are needed to evaluate the clinical utility of targeted NGS profiling.
This abstract is also presented as Poster 18.
Citation Format: Philippe L. Bedard, Amit Oza, Blaise Clarke, Ming-Sound Tsao, Natasha B. Leighl, Eric X. Chen, Albiruni Razak, Hal K. Berman, Stefano Serra, Michael Roehrl, Nadia Califaretti, Mateya Trinkaus, Tong Zhang, Mahadeo A. Sukhai, Anca Milea, Aaron R. Hansen, Trevor J. Pugh, Tracy Stockley, Suzanne Kamel-Reid, Lillian L. Siu. Molecular profiling of advanced solid tumors at Princess Margaret Cancer Centre and patient outcomes with genotype-matched clinical trials. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Integrating Clinical Genomics and Cancer Therapy; Jun 13-16, 2015; Salt Lake City, UT. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(1_Suppl):Abstract nr PR03.
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Affiliation(s)
| | - Amit Oza
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
| | - Blaise Clarke
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
| | | | | | - Eric X. Chen
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
| | | | - Hal K. Berman
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
| | - Stefano Serra
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
| | | | | | | | - Tong Zhang
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
| | | | - Anca Milea
- 1Princess Margaret Cancer Centre, Toronto, ON, Canada,
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20
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Clarke KV, Amir E, Berman HK, Maganti M, Sridhar SS. Association between pretreatment neutrophil to lymphocyte ratio (NLR) and complete pathological response (pCR) in breast cancer patients treated with neoadjuvant chemotherapy (NACT). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e11588] [Citation(s) in RCA: 2] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Eitan Amir
- Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hal K. Berman
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | | | - Srikala S. Sridhar
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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21
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Stjepanovic N, Wilson MK, Oza AM, Clarke B, Berman HK, Amir E, Mackay H, Shaw P, Butler MO, Mulligan AM, Milea A, Ahmed L, Volenik A, Wang L, Pugh TJ, Stockley T, Kim RH, Siu LL, Kamel-Reid S, Bedard PL. Somatic mutation profiling of advanced breast and ovarian cancers according to germline BRCA1/2 mutation status. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Neda Stjepanovic
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Amit M. Oza
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Blaise Clarke
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Hal K. Berman
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Eitan Amir
- Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Helen Mackay
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | | | | | - Anca Milea
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Lailah Ahmed
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Lisa Wang
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Trevor John Pugh
- Princess Margaret Cancer Centre / Ontario Cancer Institute, Toronto, ON, Canada
| | | | - Raymond H Kim
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Suzanne Kamel-Reid
- Laboratory Genetics, University Health Network, Toronto, Toronto, ON, Canada
| | - Philippe L. Bedard
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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22
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Harris IS, Treloar AE, Inoue S, Sasaki M, Gorrini C, Lee KC, Yung KY, Brenner D, Knobbe-Thomsen CB, Cox MA, Elia A, Berger T, Cescon DW, Adeoye A, Brüstle A, Molyneux SD, Mason JM, Li WY, Yamamoto K, Wakeham A, Berman HK, Khokha R, Done SJ, Kavanagh TJ, Lam CW, Mak TW. Glutathione and thioredoxin antioxidant pathways synergize to drive cancer initiation and progression. Cancer Cell 2015; 27:211-22. [PMID: 25620030 DOI: 10.1016/j.ccell.2014.11.019] [Citation(s) in RCA: 619] [Impact Index Per Article: 68.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/15/2014] [Accepted: 11/18/2014] [Indexed: 02/07/2023]
Abstract
Controversy over the role of antioxidants in cancer has persisted for decades. Here, we demonstrate that synthesis of the antioxidant glutathione (GSH), driven by GCLM, is required for cancer initiation. Genetic loss of Gclm prevents a tumor's ability to drive malignant transformation. Intriguingly, these findings can be replicated using an inhibitor of GSH synthesis, but only if delivered prior to cancer onset, suggesting that at later stages of tumor progression GSH becomes dispensable potentially due to compensation from alternative antioxidant pathways. Remarkably, combined inhibition of GSH and thioredoxin antioxidant pathways leads to a synergistic cancer cell death in vitro and in vivo, demonstrating the importance of these two antioxidants to tumor progression and as potential targets for therapeutic intervention.
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Affiliation(s)
- Isaac S Harris
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Medical Biophysics, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Aislinn E Treloar
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Medical Biophysics, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Satoshi Inoue
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Masato Sasaki
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Infection and Host Defense, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai, Miyagi 981-8558, Japan
| | - Chiara Gorrini
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Kim Chung Lee
- Department of Pathology, The University of Hong Kong, Hong Kong, China
| | - Ka Yi Yung
- Department of Pathology, The University of Hong Kong, Hong Kong, China
| | - Dirk Brenner
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Infection and Immunity, Luxembourg Institute of Health, 84, Val Fleuri, 1526 Luxembourg, Luxembourg
| | | | - Maureen A Cox
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Andrew Elia
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Thorsten Berger
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - David W Cescon
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Medical Biophysics, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Adewunmi Adeoye
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Laboratory Medicine Program, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Laboratory Medicine and Pathobiology, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Anne Brüstle
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Sam D Molyneux
- Department of Medical Biophysics, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Ontario Cancer Institute, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Jacqueline M Mason
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Wanda Y Li
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Kazuo Yamamoto
- Division of Cell Function Research Support, Biomedical Research Support Center, Nagasaki University School of Medical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Andrew Wakeham
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Hal K Berman
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Laboratory Medicine Program, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Laboratory Medicine and Pathobiology, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Rama Khokha
- Department of Medical Biophysics, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Ontario Cancer Institute, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Susan J Done
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Laboratory Medicine Program, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Laboratory Medicine and Pathobiology, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada
| | - Terrance J Kavanagh
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - Ching-Wan Lam
- Department of Pathology, The University of Hong Kong, Hong Kong, China
| | - Tak W Mak
- The Campbell Family Institute for Breast Cancer Research, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Medical Biophysics, University Health Network, 620 University Avenue, Toronto, ON M5G 2M9, Canada.
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23
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Rahbar R, Lin A, Ghazarian M, Yau HL, Paramathas S, Lang PA, Schildknecht A, Elford AR, Garcia-Batres C, Martin B, Berman HK, Leong WL, McCready DR, Reedijk M, Done SJ, Miller N, Youngson B, Suh WK, Mak TW, Ohashi PS. B7-H4 expression by nonhematopoietic cells in the tumor microenvironment promotes antitumor immunity. Cancer Immunol Res 2014; 3:184-95. [PMID: 25527357 DOI: 10.1158/2326-6066.cir-14-0113] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The B7 family plays a critical role in both positive and negative regulation of immune responses by engaging a variety of receptors on lymphocytes. Importantly, blocking coinhibitory molecules using antibodies specific for CTLA-4 and PD-1 enhances tumor immunity in a subset of patients. Therefore, it is critical to understand the role of different B7 family members since they may be suitable therapeutic targets. B7-H4 is another member that inhibits T-cell function, and it is also upregulated on a variety of tumors and has been proposed to promote tumor growth. Here, we investigate the role of B7-H4 in tumor development and show that B7-H4 expression inhibits tumor growth in two mouse models. Furthermore, we show that B7-H4 expression is required for antitumor immune responses in a mouse model of mammary tumorigenesis. We found that the expression levels of B7-H4 correlate with MHC class I expression in both mouse and human samples. We show that IFNγ upregulates B7-H4 expression on mouse embryo fibroblasts and that the upregulation of B7-H4 on tumors is dependent on T cells. Notably, patients with breast cancer with increased B7-H4 expression show a prolonged time to recurrence. These studies demonstrate a positive role for B7-H4 in promoting antitumor immunity.
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Affiliation(s)
- Ramtin Rahbar
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Albert Lin
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Magar Ghazarian
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Helen-Loo Yau
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Sangeetha Paramathas
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Philipp A Lang
- Department of Molecular Medicine II, Heinrich Heine University Dösseldorf, Dösseldorf, Germany
| | - Anita Schildknecht
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Alisha R Elford
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Carlos Garcia-Batres
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Bernard Martin
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Hal K Berman
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Laboratory Medicine Program, University Health Network (UHN), Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Wey L Leong
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - David R McCready
- Department of Surgical Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Michael Reedijk
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Susan J Done
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Laboratory Medicine Program, University Health Network (UHN), Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Naomi Miller
- Laboratory Medicine Program, University Health Network (UHN), Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Youngson
- Laboratory Medicine Program, University Health Network (UHN), Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Woong-Kyung Suh
- Immune Regulation Laboratory, Institut de Recherches Cliniques de Montreal (IRCM), Montreal, Quebec, Canada
| | - Tak W Mak
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Pamela S Ohashi
- Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Department of Immunology, University of Toronto, Toronto, Ontario, Canada. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
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24
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Milea A, George SHL, Matevski D, Jiang H, Madunic M, Berman HK, Gauthier ML, Gallie B, Shaw PA. Retinoblastoma pathway deregulatory mechanisms determine clinical outcome in high-grade serous ovarian carcinoma. Mod Pathol 2014; 27:991-1001. [PMID: 24336157 DOI: 10.1038/modpathol.2013.218] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/01/2013] [Accepted: 10/06/2013] [Indexed: 01/08/2023]
Abstract
Alterations in the retinoblastoma pathway are frequent in ovarian/tubal high-grade serous cancers, but the mechanism of deregulation and the impact on patient outcome are poorly understood. A cohort of 334 high-grade serous carcinomas was studied by immunohistochemical analysis of RB1, p16, cyclin D1, cyclin E1, and Ki67. Additional detailed analyses including RB1 allelic deletion (n=42), mutation (n=75), methylation (n=31), and SNP array analyses (n=75) were performed on cases with clinical parameters, including age, debulking status, treatment, and clinical outcome. p16/RB1 expression results yielded three distinct clinically relevant subgroups upon multivariable analysis controlling for stage, debulking status, and treatment types: p16 homogeneous/RB1+ with the shortest progression-free survival (median 15 months (95% CI: 13-18); P=0.016) compared with the p16 heterogeneous/RB1+ subgroup (median 22 months (95% CI: 16-32)) and the p16 homogeneous/RB1- subgroup (median 20 months (95% CI: 15-24)). Patients in the p16 homo/RB1- subgroup showed a significant increase in overall survival (>60 months; P=0.013), which suggests an increase in sensitivity to cytotoxic agents. Analyses of Rb pathway mechanistic differences among these groups revealed frequent RB1 genomic alterations such as RB1 allelic loss and/or large spanning deletions (83%) in the p16 homo/RB1- subgroups, also indicating that RB1 deletions are frequent in high-grade serous carcinoma. CCNE1 gene gains/amplifications were frequent in the p16 homogeneous/RB1+ subgroup (68%) and cyclin D1 protein overexpression was predominantly characteristic of the p16 heterogeneous/RB1+ subgroup. These subcategories occur early in tumor progression and are seen with similar frequency in the cancer precursor lesion, serous tubal intra-epithelial carcinoma. Overall, this study uniquely identifies multiple non-synonymous mechanisms of retinoblastoma pathway deregulation that correlate with significantly different clinical outcomes. Furthermore, deregulations identified in precursor lesions suggest a key role of this pathway in serous tumor development. Recognition of these categories may identify patients with increased sensitivity to chemotherapy and new opportunities for novel therapeutics.
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Affiliation(s)
- Anca Milea
- 1] Campbell Family Institute for Breast Cancer Research, Toronto, ON, Canada [2] Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada [3] Princess Margaret Cancer Centre, Toronto, ON, Canada [4] Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Sophia H L George
- 1] Campbell Family Institute for Breast Cancer Research, Toronto, ON, Canada [2] Princess Margaret Cancer Centre, Toronto, ON, Canada [3] Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Donco Matevski
- 1] Department of Pathology, University Health Network, Toronto, ON, Canada [2] Impact Genetics, Toronto, ON, Canada
| | - Haiyan Jiang
- 1] Princess Margaret Cancer Centre, Toronto, ON, Canada [2] Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Mary Madunic
- 1] Princess Margaret Cancer Centre, Toronto, ON, Canada [2] Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Hal K Berman
- 1] Campbell Family Institute for Breast Cancer Research, Toronto, ON, Canada [2] Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada [3] Princess Margaret Cancer Centre, Toronto, ON, Canada [4] Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Mona L Gauthier
- 1] Campbell Family Institute for Breast Cancer Research, Toronto, ON, Canada [2] Princess Margaret Cancer Centre, Toronto, ON, Canada [3] Department of Pathology, University Health Network, Toronto, ON, Canada [4] Department of Medical Biophyics, University of Toronto, Toronto, ON, Canada
| | - Brenda Gallie
- 1] Princess Margaret Cancer Centre, Toronto, ON, Canada [2] Department of Pathology, University Health Network, Toronto, ON, Canada [3] Impact Genetics, Toronto, ON, Canada [4] Department of Medical Biophyics, University of Toronto, Toronto, ON, Canada [5] Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Patricia A Shaw
- 1] Campbell Family Institute for Breast Cancer Research, Toronto, ON, Canada [2] Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada [3] Princess Margaret Cancer Centre, Toronto, ON, Canada [4] Department of Pathology, University Health Network, Toronto, ON, Canada
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25
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Feigin ME, Akshinthala SD, Araki K, Rosenberg AZ, Muthuswamy LB, Martin B, Lehmann BD, Berman HK, Pietenpol JA, Cardiff RD, Muthuswamy SK. Mislocalization of the cell polarity protein scribble promotes mammary tumorigenesis and is associated with basal breast cancer. Cancer Res 2014; 74:3180-94. [PMID: 24662921 DOI: 10.1158/0008-5472.can-13-3415] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Scribble (SCRIB) localizes to cell-cell junctions and regulates establishment of epithelial cell polarity. Loss of expression of SCRIB functions as a tumor suppressor in Drosophila and mammals; conversely, overexpression of SCRIB promotes epithelial differentiation in mammals. Here, we report that SCRIB is frequently amplified, mRNA overexpressed, and protein is mislocalized from cell-cell junctions in human breast cancers. High levels of SCRIB mRNA are associated with poor clinical prognosis, identifying an unexpected role for SCRIB in breast cancer. We find that transgenic mice expressing a SCRIB mutant [Pro 305 to Leu (P305L)] that fails to localize to cell-cell junctions, under the control of the mouse mammary tumor virus long terminal repeat promoter, develop multifocal hyperplasia that progresses to highly pleomorphic and poorly differentiated tumors with basal characteristics. SCRIB interacts with phosphatase and tensin homolog (PTEN) and the expression of P305L, but not wild-type SCRIB, promotes an increase in PTEN levels in the cytosol. Overexpression of P305L, but not wild-type SCRIB, activates the Akt/mTOR/S6K signaling pathway. Human breast tumors overexpressing SCRIB have high levels of S6K but do not harbor mutations in PTEN or PIK3CA, identifying SCRIB amplification as a mechanism of activating PI3K signaling in tumors without mutations in PIK3CA or PTEN. Thus, we demonstrate that high levels of mislocalized SCRIB functions as a neomorph to promote mammary tumorigenesis by affecting subcellular localization of PTEN and activating an Akt/mTOR/S6kinase signaling pathway.
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Affiliation(s)
- Michael E Feigin
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - S Dipikaa Akshinthala
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Kiyomi Araki
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Avi Z Rosenberg
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Lakshmi B Muthuswamy
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Bernard Martin
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Brian D Lehmann
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Hal K Berman
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Jennifer A Pietenpol
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Robert D Cardiff
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
| | - Senthil K Muthuswamy
- Authors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, TennesseeAuthors' Affiliations: Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Princess Margaret Cancer Center, Campbell Family Institute for Breast Cancer Research, Department of Medical Biophysics, University of Toronto; Ontario Institute for Cancer Research, Ontario, Canada; Center for Comparative Medicine, University of California, Davis, Davis, California; and Department of Biochemistry, Vanderbilt University, Nashville, Tennessee
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Menjak IB, Maki E, Chung C, Berman HK, McCready DR, Sridhar SS. Abstract P1-13-14: Discordance of ER and PR status between primary and recurrent breast cancer in association with endocrine therapy. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-13-14] [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: Discordance in tumor receptor status between primary and recurrent tumors has been previously reported. Discordant ER/PR status has been used to differentiate recurrences from new primaries. We evaluated discordance rates of ER and PR expression between the primary and locoregional/contralateral recurrences and examined the relationship with adjuvant endocrine therapy (ET).
Methods: We conducted a retrospective chart review of breast cancer patients (pts) treated with lumpectomy and adjuvant locoregional radiation (RT) from 1999-2005 at the Princess Margaret Cancer Centre. Tumor recurrence was classified as locoregional recurrence (LRR) for ipsilateral breast or lymph node recurrence, contralateral disease (CD) or distant recurrence. ER and PR were assessed by immunohistochemistry; positive if >10% tumor cells staining, borderline if 10% staining, and negative if <10% staining. Univariate analyses were applied to determine the association of receptor discordance with age, menopausal status, tumor grade, endocrine therapy or adjuvant chemotherapy.
Results: All 441 pts had a lumpectomy with negative margins and RT, and had a median follow-up of 8.3 years. The median age at primary surgery was 57, and 67% of pts were postmenopausal. ET (tamoxifen and/or aromatase inhibitors) was initiated in 294 (84%) eligible patients. There were 24 (5.4%) pts with LRR, 20 (4.5%) pts with CD, and 28 (6.3%) with distant metastases. Nine pts with LRR also had distant disease, and 3 pts with CD also had distant disease. Among pts with LRR, 17 had ER/PR status available for comparison. Discordance rates for ER and PR were (1/17) 5.9% and (3/17) 17.6%, respectively, and the most common change was ER becoming positive, and PR becoming negative (75%). For pts with CD, 18 had ER/PR status available for comparison. Discordance rates for ER and PR were (7/18) 38.9% and (9/18) 50%, respectively. The most common change was ER becoming positive (86%), and PR becoming positive (75%). Distant disease receptor status was only available for two patients, therefore not included. The patient with LRR and discordant ER did not receive ET, while pts with LRR and discordant PR all received ET. Among patients with CD, 15% of patients with discordant ER status received ET, and 33% with discordant PR received ET. There was no statistically significant association between discordance rates in either LRR or CD groups and use of ET. Similarly, discordance rates were not associated with the other patient or tumor variables studied, or the development of distant metastases or death.
Conclusions: Discordance of ER and PR expression was low in LRR and higher in CD, where the majority of changes were from negative to positive receptor status. Receptor discordance was not associated with endocrine therapy. This study suggests that the biology of LRR and CD may be different, and re-evaluation of receptor status could lead to additional treatment options becoming available from an endocrine standpoint.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-13-14.
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Affiliation(s)
- IB Menjak
- Princess Margaret Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Analytica Statistical Consulting, Toronto, ON, Canada
| | - E Maki
- Princess Margaret Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Analytica Statistical Consulting, Toronto, ON, Canada
| | - C Chung
- Princess Margaret Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Analytica Statistical Consulting, Toronto, ON, Canada
| | - HK Berman
- Princess Margaret Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Analytica Statistical Consulting, Toronto, ON, Canada
| | - DR McCready
- Princess Margaret Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Analytica Statistical Consulting, Toronto, ON, Canada
| | - SS Sridhar
- Princess Margaret Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Analytica Statistical Consulting, Toronto, ON, Canada
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Menjak IB, Maki E, Berman HK, Chung C, McCready DR, Sridhar SS. Impact of endocrine therapy in early-stage breast cancer on time to locoregional recurrence. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.26_suppl.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
64 Background: Locoregional recurrence (LR) remains a major source of morbidity and mortality in breast cancer. Our primary aim was to evaluate the impact of endocrine therapy (ET) on time to LR. Methods: A retrospective chart review of breast cancer patients (pts) treated with lumpectomy and locoregional radiation from 1999-2005 at the Princess Margaret Cancer Centre was carried out. LR was defined as ipsilateral breast or lymph node recurrence. Kaplan-Meier estimates of survival and univariate analyses were performed for age, menopausal status, tumor and nodal stage, grade, receptor status, adjuvant chemotherapy (AC) and ET. Results: Of 440 pts evaluated, the mean age at primary resection was 56 years (yrs) (range 40-79), and 67% were postmenopausal. The majority had ductal carcinomas (87%) and grade 1-2 (68%) tumors. Tumor distribution was 315 (72%) T1, 120 (27%) T2, 4 (1%) T3; 138 (31%) were node positive. Receptor status was ER/PR+HER2- 206 (47%), ER+PR+HER2unknown 80 (18%), ER-PR-HER2unknown 41 (9%), and triple negative 37 (8%). AC was used in 190 (43%). ET (tamoxifen and/or aromatase inhibitors) was initiated in 294 (84%) eligible pts, and 267/294 (91%) completed a minimum duration of ≥2 yrs. Overall, LR occurred in 24 (5%) pts, and 8/24 (33%) pts with LR also had distant metastases. Average time from surgery to LR was 5.4 yrs (range 8 months-12 yrs). The average duration of ET in pts with LR was 4.3 yrs (range 0-8), and 5.8 yrs (range 0-12) without LR. Of ER/PR+ pts with LR, 3/15 (20%) did not receive ET. At the time of LR, 5 (33%) pts were receiving ET. After stopping ET, 2 (13%) recurred 0-2 yrs, 3 (20%) at 4-5 yrs, and 2 (13%) at 7-8 yrs. Treatment with at least 2 yrs of ET predicted for fewer recurrences: at 2 yrs LR-free rate was 100% vs 90% for <2 yrs ET; at 5 yrs 99.6% vs 84%; and at 8 yrs 98.2% vs 84% (p=0.0092). ER/PR+HER2- pts had lower LR risk (p=0.028), and ER-/PR-/HER+ had higher LR risk (p=0.029). The remaining variables were not associated with risk of LRs. Survival post-LR was 90% (95%CI 64-97%) at 2 yrs and 65% (95%CI 34-84%) at 5 yrs. Conclusions: Pts who completed at least 2 yrs of ET had significantly lower risk of LR. The average time to LR was 5.4 years, and pts with LR had decreased survival at 5 yrs post-recurrence.
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Affiliation(s)
- Ines B. Menjak
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ellen Maki
- Analytica Statistical Consulting, Inc., Toronto, ON, Canada
| | - Hal K. Berman
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Caroline Chung
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - David R. McCready
- University Health Network-Princess Margaret Hospital, Toronto, ON, Canada
| | - Srikala S. Sridhar
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
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Gorrini C, Baniasadi PS, Harris IS, Silvester J, Inoue S, Snow B, Joshi PA, Wakeham A, Molyneux SD, Martin B, Bouwman P, Cescon DW, Elia AJ, Winterton-Perks Z, Cruickshank J, Brenner D, Tseng A, Musgrave M, Berman HK, Khokha R, Jonkers J, Mak TW, Gauthier ML. BRCA1 interacts with Nrf2 to regulate antioxidant signaling and cell survival. J Biophys Biochem Cytol 2013. [DOI: 10.1083/jcb.2022oia57] [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: 11/22/2022] Open
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Gorrini C, Baniasadi PS, Harris IS, Silvester J, Inoue S, Snow B, Joshi PA, Wakeham A, Molyneux SD, Martin B, Bouwman P, Cescon DW, Elia AJ, Winterton-Perks Z, Cruickshank J, Brenner D, Tseng A, Musgrave M, Berman HK, Khokha R, Jonkers J, Mak TW, Gauthier ML. BRCA1 interacts with Nrf2 to regulate antioxidant signaling and cell survival. ACTA ACUST UNITED AC 2013; 210:1529-44. [PMID: 23857982 PMCID: PMC3727320 DOI: 10.1084/jem.20121337] [Citation(s) in RCA: 202] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BRCA1 deficiency results in impaired Nrf2-mediated antioxidant responses followed by cell death, with estradiol rescuing the effect by inducing Nrf2 stabilization. Oxidative stress plays an important role in cancer development and treatment. Recent data implicate the tumor suppressor BRCA1 in regulating oxidative stress, but the molecular mechanism and the impact in BRCA1-associated tumorigenesis remain unclear. Here, we show that BRCA1 regulates Nrf2-dependent antioxidant signaling by physically interacting with Nrf2 and promoting its stability and activation. BRCA1-deficient mouse primary mammary epithelial cells show low expression of Nrf2-regulated antioxidant enzymes and accumulate reactive oxygen species (ROS) that impair survival in vivo. Increased Nrf2 activation rescues survival and ROS levels in BRCA1-null cells. Interestingly, 53BP1 inactivation, which has been shown to alleviate several defects associated with BRCA1 loss, rescues survival of BRCA1-null cells without restoring ROS levels. We demonstrate that estrogen treatment partially restores Nrf2 levels in the absence of BRCA1. Our data suggest that Nrf2-regulated antioxidant response plays a crucial role in controlling survival downstream of BRCA1 loss. The ability of estrogen to induce Nrf2 posits an involvement of an estrogen-Nrf2 connection in BRCA1 tumor suppression. Lastly, BRCA1-mutated tumors retain a defective antioxidant response that increases the sensitivity to oxidative stress. In conclusion, the role of BRCA1 in regulating Nrf2 activity suggests important implications for both the etiology and treatment of BRCA1-related cancers.
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Affiliation(s)
- Chiara Gorrini
- The Campbell Family Institute for Breast Cancer Research, University Health Network, Toronto, Ontario M5G 2M9, Canada
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Bedard PL, Oza AM, Tsao MS, Leighl NB, Shepherd FA, Chen EX, Tannock I, Krzyzanowska MK, Dhani NC, Clarke B, Berman HK, Serra S, Craddock KJ, Chadwick D, Zhang T, Sukhai MA, Yu C, Hansen AR, Kamel-Reid S, Siu LL. Princess Margaret Cancer Centre (PMCC) Integrated Molecular Profiling in Advanced Cancers Trial (IMPACT) using genotyping and targeted next-generation sequencing (NGS). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.11002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11002 Background: IMPACT is an institution-wide screening program to identify patients (pts) treated at PMCC with somatic alterations that can be matched to targeted therapies. Methods: Pts with advanced breast, colorectal (CRC), non-small cell lung (NSCLC), ovarian cancers and selected other solid tumors treated at PMCC were eligible. Tumor DNA was isolated from a FFPE archived sample and genotyped using a customized Sequenom panel (23 genes, 280 mutations) in a CLIA-certified laboratory. Verified mutations were reported in pts electronic health records. Selected FFPE samples were further characterized by NGS with the Illumina MiSeq TruSeq Amplicon Cancer Panel (48 genes, 212 amplicons, ≥500x coverage) for platform validation. Results: From Mar 1/12-Jan 10/13, 485 pts were enrolled with median 1 prior treatment for advanced disease (range 0-6). Of 33 (7%) screen failures, 5% were for insufficient tissue and 2% for clinical deterioration. Median DNA quantity from FFPE = 4250ng (range 15-32550ng). The median time from tissue receipt to reporting was 5 weeks (range 1-23). Mutations were identified by Sequenom in 137/349 (39%) pts, including 24/79 (30%) breast, 40/80 (50%) CRC, 54/88 (61%) NSCLC, 17/78 (22%) ovarian, and 2/24 (8%) other cancers. Mutations detected were: 76 KRAS, 35 PIK3CA, 22 EGFR, 5 NRAS, 5 ERBB2, 5 CTNNB1, 4 BRAF, and 1 AKT1. MiSeq was concordant with Sequenom in 112/113 (99%) pts, with mutations identified in 94/114 (82%). The average number of mutations detected by MiSeq was 1.72/pt (range 0-7) compared with 0.49/pt by Sequenom (range 0-2). After a median follow up of 5.0 months, 31/137 (23%) pts with mutations have been matched to targeted therapies, including 14 pts enrolled in clinical trials (15 trials) matched to their genotype. Of the 10 trial pts with at least one response assessment, 3 PR (1 confirmed) and 2 SD ≥ 24 weeks have been observed. Conclusions: Molecular profiling can be integrated into the routine care of advanced cancer pts. Genotyping and targeted NGS are feasible in a clinical laboratory using stored archival FFPE tumor samples. NGS identifies additional actionable mutations to inform clinical-decision making. Clinical trial information: NCT01505400.
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Affiliation(s)
- Philippe L. Bedard
- Princess Margaret Cancer Center, University Health Network, Division of Medical Oncology & Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Amit M. Oza
- Princess Margaret Cancer Center, University Health Network, Division of Medical Oncology & Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ming-Sound Tsao
- Department of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | | | - Eric Xueyu Chen
- Princess Margaret Cancer Center, University Health Network, Division of Medical Oncology & Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ian Tannock
- Princess Margaret Hospital, Toronto, ON, Canada
| | | | - Neesha C. Dhani
- Princess Margaret Cancer Center, University Health Network, Division of Medical Oncology & Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Blaise Clarke
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Hal K. Berman
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Stefano Serra
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Kenneth J. Craddock
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Dianne Chadwick
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | - Tong Zhang
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
| | | | - Celeste Yu
- Princess Margaret Cancer Center, University Health Network, Division of Medical Oncology & Hematology, Toronto, ON, Canada
| | - Aaron Richard Hansen
- Princess Margaret Cancer Center, University Health Network, Division of Medical Oncology & Hematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Suzanne Kamel-Reid
- University Health Network, Department of Pathology and Laboratory Medicine, Toronto, ON, Canada
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DeFilippis RA, Chang H, Dumont N, Rabban JT, Chen YY, Fontenay GV, Berman HK, Gauthier ML, Zhao J, Hu D, Marx JJ, Tjoe JA, Ziv E, Febbraio M, Kerlikowske K, Parvin B, Tlsty TD. CD36 repression activates a multicellular stromal program shared by high mammographic density and tumor tissues. Cancer Discov 2012; 2:826-39. [PMID: 22777768 DOI: 10.1158/2159-8290.cd-12-0107] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
UNLABELLED Although high mammographic density is considered one of the strongest risk factors for invasive breast cancer, the genes involved in modulating this clinical feature are unknown. Tissues of high mammographic density share key histologic features with stromal components within malignant lesions of tumor tissues, specifically low adipocyte and high extracellular matrix (ECM) content. We show that CD36, a transmembrane receptor that coordinately modulates multiple protumorigenic phenotypes, including adipocyte differentiation, angiogenesis, cell-ECM interactions, and immune signaling, is greatly repressed in multiple cell types of disease-free stroma associated with high mammographic density and tumor stroma. Using both in vitro and in vivo assays, we show that CD36 repression is necessary and sufficient to recapitulate the above-mentioned phenotypes observed in high mammographic density and tumor tissues. Consistent with a functional role for this coordinated program in tumorigenesis, we observe that clinical outcomes are strongly associated with CD36 expression. SIGNIFICANCE CD36 simultaneously controls adipocyte content and matrix accumulation and is coordinately repressed in multiple cell types within tumor and high mammographic density stroma, suggesting that activation of this stromal program is an early event in tumorigenesis. Levels of CD36 and extent of mammographic density are both modifiable factors that provide potential for intervention.
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Affiliation(s)
- Rosa Anna DeFilippis
- Department of Pathology, Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA 94143, USA
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Radisky DC, Santisteban M, Berman HK, Gauthier ML, Frost MH, Reynolds CA, Vierkant RA, Pankratz VS, Visscher DW, Tlsty TD, Hartmann LC. p16(INK4a) expression and breast cancer risk in women with atypical hyperplasia. Cancer Prev Res (Phila) 2011; 4:1953-60. [PMID: 21920875 DOI: 10.1158/1940-6207.capr-11-0282] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
p16, a nuclear protein encoded by the p16(INK4a) gene, is a regulator of cell-cycle regulation. Previous studies have shown that expression of p16 in tissue biopsies of patients with ductal carcinoma in situ (DCIS) is associated with increased risk of breast cancer, particularly when considered in combination with other markers such as Ki-67 and COX-2. Here, we evaluated how expression of p16 in breast tissue biopsies of women with atypical hyperplasia (AH), a putative precursor lesion to DCIS, is associated with subsequent development of cancer. p16 expression was assessed by immunohistochemistry in archival sections from 233 women with AH diagnosed at the Mayo Clinic. p16 expression in the atypical lesions was scored by percentage of positive cells and intensity of staining. We also studied coexpression of p16, with Ki-67 and COX-2, biomarkers of progression in AH. Risk factor and follow-up data were obtained via study questionnaire and medical records. Forty-seven patients (20%) developed breast cancer with a median follow-up of 14.5 years. Staining of p16 was increased in older patients relative to younger patients (P = 0.0025). Although risk of developing breast cancer was not associated with increased p16 expression, joint overexpression of Ki-67 and COX-2 was found to convey stronger risk of breast cancer in the first 10 years after diagnosis as compared with one negative marker (P < 0.01). However, the addition of p16 levels did not strengthen this association. p16 overexpression, either alone or in combination with COX-2 and Ki-67, does not significantly stratify breast cancer risk in women with AH.
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Affiliation(s)
- Derek C Radisky
- Division of Biochemistry/Molecular Biology, Mayo Clinic in Jacksonville, Jacksonville, Florida 32224, USA.
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Milea AL, George S, Berman HK, Gauthier ML, Shaw PA. Abstract 333: The role of the retinoblastoma pathway (Rb) in high grade serous ovarian varcinoma (HGSC). Cancer Res 2011. [DOI: 10.1158/1538-7445.am2011-333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The Rb pathway functions as a cell cycle checkpoint and deregulation of its components, commonly found in malignancies, causes progression from G1 to S phase, promoting cellular proliferation. Because of Rb's central role in checkpoint regulation, abrogation of the pathway can occur through multiple non-redundant mechanisms including Rb loss, hypermethylation or mutation, and CCND1 or CCNE amplification. Emerging evidence shows that tumour types can often be distinguished by particular alterations in one member of the pathway suggesting that different mechanisms of Rb abrogation may regulate tumour behaviour. We hypothesize that Rb pathway deregulation is frequent in HGSC, the most common and most aggressive histotype of ovarian cancer, and that the mechanism of Rb pathway deregulation identifies clinically distinct subgroups of HGSC.
Micro-dissected epithelium from HGSC and normal FTE samples were analyzed for differential gene expression using the Affymetrix U133 Plus 2.0 gene-chips, and expression values for p53, p21, p27, p16, CCND1, CCNE and Rb genes determined. Protein expression was assessed by immunohistochemistry (IHC) on tissue microarrays composed of ovarian/tubal carcinomas inclusive of the major histotypes. Digitized stained slides were quantified using automated image analysis and correlated with clinico-pathologic variables including outcome. Rb loss of heterozygosity (LOH) was tested by an Rb diagnostics protocol involving D13S153 and RB1.2 polymorphic marker analyses using PCR amplification, followed by comparisons of the tumour and its corresponding normal sample by MicroGene Clipper sequencers.
Gene expression analysis showed statistically significant over-expression of p53, CCNE E2F1/3 and p16 and down-regulation of p21 and CCND1 in HGSC compared to normal fallopian tube epithelium (p<0.001). Protein expression determined by IHC analysis of HGSC revealed a similar pattern of expression when compared to normal fallopian tube, the site of origin of this carcinoma. There were important differences in the expression of these proteins between HGSC subgroups, where up-regulation was observed for p16, CCNE, CCND1 and BIRC5 in 58.3%, 57%, 33.3%, and 58.3% respectively. Rb however, showed no statistically significant differences at the RNA level, but 40% of all HGSC profiled had a significant decrease in protein expression. Interestingly, LOH analysis revealed 76% of HGSC had Rb inactivation at the gene level. Furthermore, we observed statistically significant correlations (p=0.029) between p16 over-expression and Rb protein loss, using Fisher's Exact test.
HGSC is characterized by both genetic and protein abrogation in the Rb pathway. Additionally, we observed differences in the mechanism of this G1/S checkpoint inactivation amongst HGSC patient samples which may represent important biological/clinical differences amongst sub-groups of serous cancer patients.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 333. doi:10.1158/1538-7445.AM2011-333
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Affiliation(s)
- Anca L. Milea
- 1Department of Laboratory Medicine and Pathology, University of Toronto, The Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, Ontario, Canada
| | - Sophia George
- 2The Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, Ontario, Canada
| | - Hal K. Berman
- 3Department of Laboratory Medicine and Pathology, University of Toronto, The Campbell Family Institute of Breast Cancer Research, University Health Network, Toronto, Ontario, Canada
| | - Mona L. Gauthier
- 4University of Toronto, The Campbell Family Institute of Breast Cancer Research, University Health Network, Department of Medical Biophysics, Toronto, Ontario, Canada
| | - Patricia A. Shaw
- 5Department of Laboratory Medicine and Pathology, University of Toronto, University Health Network, Toronto, Ontario, Canada
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Kerlikowske K, Molinaro AM, Gauthier ML, Berman HK, Waldman F, Bennington J, Sanchez H, Jimenez C, Stewart K, Chew K, Ljung BM, Tlsty TD. Biomarker expression and risk of subsequent tumors after initial ductal carcinoma in situ diagnosis. J Natl Cancer Inst 2010; 102:627-37. [PMID: 20427430 DOI: 10.1093/jnci/djq101] [Citation(s) in RCA: 264] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Studies have failed to identify characteristics of women who have been diagnosed with ductal carcinoma in situ (DCIS) and have a high or low risk of subsequent invasive cancer. METHODS We conducted a nested case-control study in a population-based cohort of 1162 women who were diagnosed with DCIS and treated by lumpectomy alone from 1983 to 1994. We collected clinical characteristics and information on subsequent tumors, defined as invasive breast cancer or DCIS diagnosed in the ipsilateral breast containing the initial DCIS lesion or at a regional or distant site greater than 6 months after initial treatment of DCIS (N = 324). We also conducted standardized pathology reviews and immunohistochemical staining for the estrogen receptor (ER), progesterone receptor, Ki67 antigen, p53, p16, epidermal growth factor receptor-2 (ERBB2, HER2/neu oncoprotein), and cyclooxygenase-2 (COX-2) on the initial paraffin-embedded DCIS tissue. Competing risk models were used to determine factors associated with risk of subsequent invasive cancer vs DCIS, and cumulative incidence survival functions were used to estimate 8-year risk. RESULTS Factors associated with subsequent invasive cancer differed from those associated with subsequent DCIS. Eight-year risk of subsequent invasive cancer was statistically significantly (P = .018) higher for women with initial DCIS lesions that were detected by palpation or that were p16, COX-2, and Ki67 triple positive (p16(+)COX-2(+)Ki67(+)) (19.6%, 95% confidence interval [CI] = 18.0% to 21.3%) than for women with initial lesions that were detected by mammography and were p16, COX-2, and Ki67 triple negative (p16(-)COX-2(-)Ki67(-)) (4.1%, 95% CI = 3.4% to 5.0%). In a multivariable model, DCIS lesions that were p16(+)COX-2(+)Ki67(+) or those detected by palpation were statistically significantly associated with subsequent invasive cancer, but nuclear grade was not. Eight-year risk of subsequent DCIS was highest for women with DCIS lesions that had disease-free margins of 1 mm or greater combined with either ER(-)ERBB2(+)Ki67(+) or p16(+)COX-2(-)Ki67(+) status (23.6%, 95% CI = 18.1% to 34.0%). CONCLUSION Biomarkers can identify which women who were initially diagnosed with DCIS are at high or low risk of subsequent invasive cancer, whereas histopathology information cannot.
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Berman HK, Gauthier ML, Tlsty TD. Premalignant breast neoplasia: a paradigm of interlesional and intralesional molecular heterogeneity and its biological and clinical ramifications. Cancer Prev Res (Phila) 2010; 3:579-87. [PMID: 20424132 DOI: 10.1158/1940-6207.capr-10-0073] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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
As is well established in invasive breast disease, it is becoming increasingly clear that molecular heterogeneity, both between and within lesions, is a prevalent, distinct phenotype of premalignant lesions of the breast. Key pathways of tumorigenesis modulate critical features of premalignant lesions such as proliferation, differentiation, stress response, and even the generation of diversity. Current studies show that evaluation of these lesions may provide clinically useful information on future tumor formation as well as biological insights into the origin and functional significance of this distinct phenotype.
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Affiliation(s)
- Hal K Berman
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Gauthier ML, Berman HK, Miller C, Kozakeiwicz K, Chew K, Moore D, Rabban J, Chen YY, Kerlikowske K, Tlsty TD. Abrogated response to cellular stress identifies DCIS associated with subsequent tumor events and defines basal-like breast tumors. Cancer Cell 2007; 12:479-91. [PMID: 17996651 PMCID: PMC3605202 DOI: 10.1016/j.ccr.2007.10.017] [Citation(s) in RCA: 172] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 08/06/2007] [Accepted: 10/11/2007] [Indexed: 01/18/2023]
Abstract
Approximately 15%-30% of women diagnosed with ductal carcinoma in situ (DCIS) develop a subsequent tumor event within 10 years after surgical lumpectomy. To date, little is known about the molecular pathways that confer this differential risk for developing subsequent disease. In this study, we demonstrate that expression of biomarkers indicative of an abrogated response to cellular stress predicts DCIS with worse outcome and is a defining characteristic of basal-like invasive tumors. Mechanistic studies identify the Rb pathway as a key regulator of this response. Conversely, biomarkers indicative of an intact response to cellular stress are strongly associated with a disease-free prognosis. Assessment of these biomarkers in DCIS begins to allow prediction of tumor formation years before it actually occurs.
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Affiliation(s)
- Mona L. Gauthier
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Hal K. Berman
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
- Department of Pathology, University of Toronto, Toronto, ON, Canada, M5G 2C1
| | - Caroline Miller
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Krystyna Kozakeiwicz
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Karen Chew
- Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA 94143
| | - Dan Moore
- California Pacific Medical Center, San Francisco, CA 94107
- Departments of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143
| | - Joseph Rabban
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Yunn Yi Chen
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Karla Kerlikowske
- Departments of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143
- General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, CA 94121
| | - Thea D. Tlsty
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
- Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA 94143
- *Correspondence:
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Degnim AC, Visscher DW, Berman HK, Frost MH, Sellers TA, Vierkant RA, Maloney SD, Pankratz VS, de Groen PC, Lingle WL, Ghosh K, Penheiter L, Tlsty T, Melton LJ, Reynolds CA, Hartmann LC. Stratification of breast cancer risk in women with atypia: a Mayo cohort study. J Clin Oncol 2007; 25:2671-7. [PMID: 17563394 DOI: 10.1200/jco.2006.09.0217] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Atypical hyperplasia is a well-recognized risk factor for breast cancer, conveying an approximately four-fold increased risk. Data regarding long-term absolute risk and factors for risk stratification are needed. PATIENTS AND METHODS Women with atypical hyperplasia in the Mayo Benign Breast Disease Cohort were identified through pathology review. Subsequent breast cancers were identified via medical records and a questionnaire. Relative risks (RRs) were estimated using standardized incidence ratios, comparing the observed number of breast cancers with those expected based on Iowa Surveillance, Epidemiology, and End Results (SEER) data. Age, histologic factors, and family history were evaluated as risk modifiers. Plots of cumulative breast cancer incidence provided estimates of risk over time. RESULTS With mean follow-up of 13.7 years, 66 breast cancers (19.9%) occurred among 331 women with atypia. RR of breast cancer with atypia was 3.88 (95% CI, 3.00 to 4.94). Marked elevations in risk were seen with multifocal atypia (eg, three or more foci with calcifications [RR, 10.35; 95% CI, 6.13 to 16.4]). RR was higher for younger women (< 45; RR, 6.76; 95% CI, 3.24 to 12.4). Risk was similar for atypical ductal and atypical lobular hyperplasia, and family history added no significant risk. Breast cancer risk remained elevated over 20 years, and the cumulative incidence approached 35% at 30 years. CONCLUSION Among women with atypical hyperplasia, multiple foci of atypia and the presence of histologic calcifications may indicate "very high risk" status (> 50% risk at 20 years). A positive family history does not further increase risk in women with atypia.
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Affiliation(s)
- Amy C Degnim
- Division of General Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Gauthier ML, Pickering CR, Miller CJ, Fordyce CA, Chew KL, Berman HK, Tlsty TD. p38 Regulates Cyclooxygenase-2 in Human Mammary Epithelial Cells and Is Activated in Premalignant Tissue. Cancer Res 2005; 65:1792-9. [PMID: 15753376 DOI: 10.1158/0008-5472.can-04-3507] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The immediate-early gene, cyclooxygenase-2 (COX-2), is induced in a variety of inflammatory and neoplastic processes and is believed to play an important role in tumorigenesis. In this study, we identify an important upstream regulatory pathway of COX-2 expression in variant human mammary epithelial cells (vHMEC), which has been shown to exhibit phenotypes important for malignancy. We find that the stress-activated kinase, p38, is phosphorylated and activated in vHMEC compared with HMEC and is responsible for the expression of COX-2 in vHMEC as cells grow in culture. Furthermore in this capacity, p38 acts to stabilize the COX-2 transcript rather than activate COX-2 transcription. Inhibition of p38 kinase, using a chemical inhibitor, down-regulates COX-2 and decreases cell survival. Examination of archived tissue from women with ductal carcinoma in situ reveals epithelial cells that not only overexpress COX-2 but also have an abundance of activated phospho-p38 in the nucleus and cytoplasm, mirroring the expression observed in vitro. These epithelial cells are found within premalignant lesions as well as in fields of morphologically normal tissue that surround the lesions. In contrast, low phospho-p38 staining was observed in the majority of normal tissue obtained from reduction mammoplasty. These data help define the regulation of COX-2 expression in early carcinogenesis and provide alternative candidates for targeted prevention of COX-2-induced phenotypes and breast cancer.
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Affiliation(s)
- Mona L Gauthier
- Department of Pathology, University of California San Francisco Comprehensive Cancer Center, University of California at San Francisco, San Francisco, California 94143-0511, USA
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Lerín C, Montell E, Berman HK, Newgard CB, Gómez-Foix AM. Overexpression of protein targeting to glycogen in cultured human muscle cells stimulates glycogen synthesis independent of glycogen and glucose 6-phosphate levels. J Biol Chem 2000; 275:39991-5. [PMID: 10998419 DOI: 10.1074/jbc.m006251200] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
There is growing evidence that glycogen targeting subunits of protein phosphatase-1 play a critical role in regulation of glycogen metabolism. In the current study, we have investigated the effects of adenovirus-mediated overexpression of a specific glycogen targeting subunit known as protein targeting to glycogen (PTG) in cultured human muscle cells. PTG was overexpressed both in muscle cells cultured at high glucose (glycogen replete) or in cells incubated for 18 h in the absence of glucose and then incubated in high glucose (glycogen re-synthesizing). In both glycogen replete and glycogen resynthesizing cells, PTG overexpression caused glycogen to be synthesized at a linear rate 1-5 days after viral treatment, while in cells treated with a virus lacking a cDNA insert (control virus), glycogen content reached a plateau at day 1 with no further increase. In the glycogen replete PTG overexpressing cells, glycogen content was 20 times that in controls at day 5. Furthermore, in cells undergoing glycogen resynthesis, PTG overexpression caused a doubling of the initial rate of glycogen synthesis over the first 24 h relative to cells treated with control virus. In both sets of experiments, the effects of PTG on glycogen synthesis were correlated with a 2-3-fold increase in glycogen synthase activity state, with no changes in glycogen phosphorylase activity. The alterations in glycogen synthase activity were not accompanied by changes in the intracellular concentration of glucose 6-phosphate. We conclude that PTG overexpression activates glycogen synthesis in a glucose 6-phosphate-independent manner in human muscle cells while overriding glycogen-mediated inhibition. Our findings suggest that modulation of PTG expression in muscle may be a mechanism for enhancing muscle glucose disposal and improving glucose tolerance in diabetes.
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Affiliation(s)
- C Lerín
- Departament de Bioquimica i Biologia Molecular, Universitat de Barcelona, Marti i Franquès, 1, 08028 Barcelona, Spain
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Gasa R, Jensen PB, Berman HK, Brady MJ, DePaoli-Roach AA, Newgard CB. Distinctive regulatory and metabolic properties of glycogen-targeting subunits of protein phosphatase-1 (PTG, GL, GM/RGl) expressed in hepatocytes. J Biol Chem 2000; 275:26396-403. [PMID: 10862764 DOI: 10.1074/jbc.m002427200] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Glycogen-targeting subunits of protein phosphatase-1 facilitate interaction of the phosphatase with enzymes of glycogen metabolism. We have shown that overexpression of one member of the family, protein targeting to glycogen (PTG), causes large increases in glycogen storage in isolated hepatocytes or intact rat liver. In the current study, we have compared the metabolic and regulatory properties of PTG (expressed in many tissues), with two other members of the gene family, G(L) (expressed primarily in liver) and G(M)/R(Gl) (expressed primarily in striated muscle). Adenovirus-mediated expression of these proteins in hepatocytes led to the following key observations. 1) G(L) has the highest glycogenic potency among the three forms studied. 2) Glycogen synthase activity ratio is much higher in G(L)-overexpressing cells than in PTG or G(M)/R(Gl)-overexpressing cells. Thus, at moderate levels of G(L) overexpression, glycogen synthase activity is increased by insulin treatment, but at higher levels of G(L) expression, insulin is no longer required to achieve maximal synthase activity. In contrast, cells with high levels of PTG overexpression retain dose-dependent regulation of glycogen synthesis and glycogen synthase enzyme activity by insulin. 3) G(L)- and G(M)/R(Gl)-overexpressing cells exhibit a strong glycogenolytic response to forskolin, whereas PTG-overexpressing cells are less responsive. This difference may be explained in part by a lesser forskolin-induced increase in glycogen phosphorylase activity in PTG-overexpressing cells. Based on these results, we suggest that expression of either G(L) or G(M)/R(Gl) in liver of diabetic animals may represent a strategy for lowering of blood glucose levels in diabetes.
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Affiliation(s)
- R Gasa
- Departments of Biochemistry & Internal Medicine and Touchstone Center for Diabetes Research, University of Texas Southwestern Medical Center, Dallas, Texas 75235, USA
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O'Doherty RM, Jensen PB, Anderson P, Jones JG, Berman HK, Kearney D, Newgard CB. Activation of direct and indirect pathways of glycogen synthesis by hepatic overexpression of protein targeting to glycogen. J Clin Invest 2000; 105:479-88. [PMID: 10683377 PMCID: PMC289167 DOI: 10.1172/jci8673] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Glycogen-targeting subunits of protein phosphatase-1, such as protein targeting to glycogen (PTG), direct the phosphatase to the glycogen particle, where it stimulates glycogenesis. We have investigated the metabolic impact of overexpressing PTG in liver of normal rats. After administration of PTG cDNA in a recombinant adenovirus, animals were fasted or allowed to continue feeding for 24 hours. Liver glycogen was nearly completely depleted in fasted control animals, whereas glycogen levels in fasted or fed PTG-overexpressing animals were 70% higher than in fed controls. Nevertheless, transgenic animals regulated plasma glucose, triglycerides, FFAs, ketones, and insulin normally in the fasted and fed states. Fasted PTG-overexpressing animals receiving an oral bolus of [U-(13)C]glucose exhibited a large increase in hepatic glycogen content and a 70% increase in incorporation of [(13)C]glucose into glycogen. However, incorporation of labeled glucose accounted for only a small portion of the glycogen synthesized in PTG-overexpressing animals, consistent with our earlier finding that PTG promotes glycogen synthesis from gluconeogenic precursors. We conclude that hepatic PTG overexpression activates both direct and indirect pathways of glycogen synthesis. Because of its ability to enhance glucose storage without affecting other metabolic indicators, the glycogen-targeting subunit may prove valuable in controlling blood glucose levels in diabetes.
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Affiliation(s)
- R M O'Doherty
- Gifford Laboratories for Diabetes Research, Marjorie Touchstone Diabetes Center, Department of Biochemistry, Dallas, Texas, USA
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Abstract
Fuel homeostasis in mammals is accomplished by the interplay between tissues and organs with distinct metabolic roles. These regulatory mechanisms are disrupted in obesity and diabetes, leading to a renewed emphasis on discovery of molecular and pharmacologic methods for reversing metabolic disorders. In this chapter, we review the use of recombinant adenoviral vectors as tools for delivering metabolic regulatory genes to cells in culture and to tissues of intact animals. Included are studies on the use of these vectors for gaining insights into the biochemical mechanisms that regulate glucose-stimulated insulin secretion from pancreatic islet beta-cells. We also highlight their use for understanding the function of newly discovered genes that regulate glycogen metabolism in liver and other tissues, and for evaluating "candidate" genes such as glucose-6-phosphatase, which may contribute to development of metabolic dysfunction in pancreatic islets and liver. Finally, we discuss the use of adenoviral and related vectors for causing chronic increases in the levels of circulating hormones. These examples serve to highlight the power of viral gene transfer vectors as tools for understanding metabolic regulatory mechanisms.
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Affiliation(s)
- P A Antinozzi
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas 75235, USA
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Berman HK, O'Doherty RM, Anderson P, Newgard CB. Overexpression of protein targeting to glycogen (PTG) in rat hepatocytes causes profound activation of glycogen synthesis independent of normal hormone- and substrate-mediated regulatory mechanisms. J Biol Chem 1998; 273:26421-5. [PMID: 9756875 DOI: 10.1074/jbc.273.41.26421] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Protein targeting to glycogen (PTG), also known as PPP1R5, is a widely expressed member of a growing family of proteins that target protein phosphatase-1 (PP-1) to glycogen particles. Because PTG also binds to glycogen synthase and phosphorylase kinase, it has been suggested that it serves as a "scaffold" for efficient activation of glycogen synthesis. However, very little is known about the metabolic effects of PTG. In this study, we have used recombinant adenovirus to overexpress PTG in primary rat hepatocytes, a cell type with high glycogenic capacity. We find that overexpression of PTG potently activates glycogen synthesis in cultured hepatocytes. Surprisingly, the glycogenic effect of PTG is observed even in the complete absence of carbohydrates or insulin in the culture medium. Furthermore, glycogenolytic agents such as forskolin or glucagon are largely ineffective at activating glycogen degradation in PTG overexpressing hepatocytes, even though large increases in cAMP levels are demonstrated. These metabolic effects of PTG overexpression are accompanied by a 3.6-fold increase in glycogen synthase activation state and a 40% decrease in glycogen phosphorylase activity. Our results are consistent with a model in which PTG overexpression "locks" the hepatocyte in a glycogenic mode, presumably via its ability to promote interaction of enzymes of glycogen metabolism with PP-1.
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Affiliation(s)
- H K Berman
- Gifford Laboratories for Diabetes Research and the Departments of Biochemistry and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75235, USA
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Abstract
Adenovirus-mediated overexpression of the glucose phosphorylating enzyme glucokinase causes large changes in glycolytic flux and glucose storage in isolated rat hepatocytes, but not in pancreatic islets. We have used the well-differentiated insulinoma cell line INS-1 to investigate the basis for these apparent cell-type specific differences. We find that 2- or 5-[3H]glucose usage is increased at low (</=5 mM) but not high glucose concentrations in INS-1 cells treated with a recombinant adenovirus containing the glucokinase cDNA (AdCMV-GKI), while glucose usage is increased at both low and high glucose concentrations in similarly treated hepatocytes. Utilization of 2-[3H]glucose in INS-1 cells is suppressed in glucokinase overexpressing INS-1 cells in a rapid, glucose concentration-dependent, and reversible fashion, while such regulation is largely absent in hepatocytes. Levels of hexose phosphates (glucose-6-phosphate, fructose-6-phosphate, and fructose-1,6-bisphosphate) were profoundly and rapidly elevated following the switch to high glucose in either AdCMV-GKI-treated INS-1 cells or hepatocytes relative to controls. In contrast, triose phosphate levels (glyceraldehyde-3-phosphate + dihydroxyacetone phosphate) were much higher in AdCMV-GKI-treated INS-1 cells than in similarly treated hepatocytes, suggesting limited flux throught the glyceraldehyde-3-phosphate dehydrogenase (G3PDH) step in the former cells. Hepatocytes were found to contain approximately 62 times more lactate dehydrogenase (LDH) activity than INS-1 cells, and this was reflected in a 3-fold increase in lactate production in AdCMV-GKI-treated hepatocytes relative to similarly treated INS-1 cells. Since the amounts of G3PDH activity in INS-1 and hepatocyte extracts are similar, we suggest that flux through this step in INS-1 cells is limited by failure to regenerate NAD in the LDH reaction and that a fundamental difference between hepatocytes and islet beta-cells is the limited capacity of the latter to metabolize glycolytic intermediates beyond the G3PDH step.
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Affiliation(s)
- H K Berman
- Gifford Laboratories for Diabetes Research, University of Texas Southwestern Medical Center, Dallas, Texas 75235, USA
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Affiliation(s)
- C B Newgard
- Department of Biochemistry and Internal Medicine, Gifford Laboratory for Diabetes Research, University of Texas Southwestern Medical Center, Dallas 75235, USA
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