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Flores-Torres S, Dimitriou NM, Pardo LA, Kort-Mascort J, Pal S, Peza-Chavez O, Kuasne H, Berube J, Bertos N, Park M, Mitsis GD, Ferri L, Sangwan V, Kinsella JM. Bioprinted Multicomponent Hydrogel Co-culture Tumor-Immune Model for Assessing and Simulating Tumor-Infiltrated Lymphocyte Migration and Functional Activation. ACS Appl Mater Interfaces 2023. [PMID: 37404007 DOI: 10.1021/acsami.3c02995] [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] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
The immune response against a tumor is characterized by the interplay among components of the immune system and neoplastic cells. Here, we bioprinted a model with two distinct regions containing gastric cancer patient-derived organoids (PDOs) and tumor-infiltrated lymphocytes (TILs). The initial cellular distribution allows for the longitudinal study of TIL migratory patterns concurrently with multiplexed cytokine analysis. The chemical properties of the bioink were designed to present physical barriers that immune T-cells must breech during infiltration and migration toward a tumor with the use of an alginate, gelatin, and basal membrane mix. TIL activity, degranulation, and regulation of proteolytic activity reveal insights into the time-dependent biochemical dynamics. Regulation of the sFas and sFas-ligand present on PDOs and TILs, respectively, and the perforin and granzyme longitudinal secretion confirms TIL activation when encountering PDO formations. TIL migratory profiles were used to create a deterministic reaction-advection diffusion model. The simulation provides insights that decouple passive from active cell migration mechanisms. The mechanisms used by TILs and other adoptive cell therapeutics as they infiltrate the tumor barrier are poorly understood. This study presents a pre-screening strategy for immune cells where motility and activation across ECM environments are crucial indicators of cellular fitness.
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Affiliation(s)
| | - Nikolaos M Dimitriou
- Department of Bioengineering, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Lucas Antonio Pardo
- Department of Bioengineering, McGill University, Montreal H3A 0G4, Quebec, Canada
| | | | - Sanjima Pal
- Department of Surgery, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Omar Peza-Chavez
- Department of Bioengineering, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Hellen Kuasne
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Julie Berube
- Department of Surgery, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Nicholas Bertos
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal H3G 2M1, Quebec, Canada
| | - Morag Park
- Department of Biochemistry, McGill University, Montreal H3A 0G4, Quebec, Canada
- Department of Medicine, McGill University, Montreal H3A 0G4, Quebec, Canada
- Department of Oncology, McGill University, Montreal H3A 0G4, Quebec, Canada
- Department of Pathology, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Lorenzo Ferri
- Department of Surgery, McGill University, Montreal H3A 0G4, Quebec, Canada
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal H3G 2M1, Quebec, Canada
| | - Veena Sangwan
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montreal H3A 0G4, Quebec, Canada
| | - Joseph M Kinsella
- Department of Bioengineering, McGill University, Montreal H3A 0G4, Quebec, Canada
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Pal S, Shimshoni E, Flores-Torres S, Bérubé J, Tai K, Kong I, Giannias B, Hall S, Bertos N, Sangwan V, Ingber DE, Ferri L. Abstract 168: Esophageal adenocarcinoma-on-a-chip; modeling patient specific disease progression and a step towards functional precision oncology. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-168] [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: 04/07/2023]
Abstract
Abstract
Introduction: Esophageal cancer causes sixth most cancer-related morbidity and mortality worldwide, with a survival rate of <20%. Incidence of esophageal adenocarcinoma (EA) subtype has been rising (>60%) in North America. Systemic docetaxel-based triplet chemotherapy represents the best standard of care, approx. 60% of patients showcasing innate chemo-resistance or developing acquired chemo-resistance. 3D organoids provide a robust and heterogeneous cell source but lack the stromal microenvironment. We established a high-fidelity, stromal-inclusive tumor-on-chip platform expanding on tumor heterogeneity with micro-physiological relevance and flexible complexity.
Methods: A total of 8 (4 chemo-sensitive and 4 chemo-resistant) treatment naïve patient-derived organoids (PDOs) and matched fibroblasts were selected to develop syngeneic human esophageal microtissues (tumor and adjacent) on commercially available (Emulate), compartmentalized, porous polydimethylsiloxane (PDMS) membrane-based microfluidic device. Chips accommodate organoids-derived epithelial cells at the upper mucosal channel and matched fibroblasts at the bottom stromal channel. 3D-microtissue development on the chip and treatment-induced cytotoxicity were examined for up to 11 days. We followed the FLOT (docetaxel, oxaliplatin, and 5-fluorouracil; 1:1.7:52) based chemotherapy regime on the chip and evaluated the recapitulation of patient-specific response. Epithelial barrier integrity, adenocarcinoma-associated cellular proteins, and level of cyfra 21-1 (circulating tumor biomarker) were determined on-chip grown microtissues.
Results: Real-time brightfield microscopic observations revealed that the EA chips manifest mucin production, adequate tissue tight epithelial barriers, and distinct morphological characteristics that emerged with adenocarcinoma progression. Presence of pleomorphic cells (multiple shapes and sizes), establishment of tight epithelial barriers and formation of mature microvilli was observed via electron microscopy. Patient specific tumor tissue growth were observed for maximum 12 days under a physiologically relevant media flow. Perfusion of pharmacokinetically pertinent doses of triplet chemotherapeutic compounds performed through the stromal channel and each chip recapitulated level of chemosensitivity observed in the patient. Fluorescent probes and LDH assay also demonstrated patient-specific chemo response. Confocal imaging revealed differential expression of proliferation (ki67), epithelial (CK7, E-cadherin), and mesenchymal (Vimentin) markers in each patient-derived chip.
Conclusions: Human esophageal adenocarcinoma-on-a-chip is a novel, most human-relevant biomimetic platform built on a microfluidic chip and a potential alternative to inadequate pre-clinical animal models in the future.
Citation Format: Sanjima Pal, Elee Shimshoni, Salvador Flores-Torres, Julie Bérubé, Kulsum Tai, Iris Kong, Betty Giannias, Sean Hall, Nicholas Bertos, Veena Sangwan, Donald E. Ingber, Lorenzo Ferri. Esophageal adenocarcinoma-on-a-chip; modeling patient specific disease progression and a step towards functional precision oncology [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 168.
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Affiliation(s)
- Sanjima Pal
- 1McGill University, Montreal, Quebec, Canada
| | | | | | - Julie Bérubé
- 3RI-MUHC, Montreal General Hospital, Montreal, Quebec, Canada
| | - Kulsum Tai
- 1McGill University, Montreal, Quebec, Canada
| | - Iris Kong
- 1McGill University, Montreal, Quebec, Canada
| | | | | | - Nicholas Bertos
- 3RI-MUHC, Montreal General Hospital, Montreal, Quebec, Canada
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Tai K, Pal S, Bérubé J, Kong I, Hoffman A, Bailey S, Kirbizakis A, Huang S, Strasser M, Gibbs D, Bertos N, Sangwan V, Ferri L. Abstract 5959: Dissecting the stromal drivers of gastroesophageal adenocarcinoma chemoresistance. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-5959] [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: 04/07/2023]
Abstract
Abstract
Gastroesophageal adenocarcinoma (GEA) is the fastest rising cancer in North America. Over the course of five years, the survival rate is <20%, creating an urgent need for appropriate treatments against GEA. Currently, providing patients with peri-operative systemic docetaxel triplet-based chemotherapy (DCF or FLOT) is the most effective approach to treat GEA. Despite this, for 50% of patients that do present an initial response to therapy, the tumor returns due to pre-existing or newly acquired resistance (i.e., chemoresistance) by the cancer. Researchers have shifted their focus to the tumor microenvironment (TME) as one of the factors influencing chemoresistance in patients. The TME is composed of tumor cells, immune cells and their secreted products, as well as fibroblasts. The components of the TME have been shown to interact with one another to influence tumor growth and progression. Fibroblasts are wound-healing cells that can be transformed into cancer-associated fibroblasts (CAFs) in response to stress and the release of inflammatory products. CAFs are the most abundant cells in the TME, yet their role in the chemoresponse of GEA is still unclear. Previous studies on other cancer types demonstrated that CAF expression is distinct between chemoresistant and chemo-sensitive tumors and certain CAF subpopulations may confer this resistance. This project will investigate the role of CAFs in the chemo-response of GEA using patient-derived organoids (PDOs) and CAFs from >200 GEA patients. A single-cell RNA sequencing atlas developed from >30 GEA DCF- or FLOT-treated patient samples will be used to identify CAF markers and targetable processes. CAF sub-populations will then be elucidated and correlated to tumor response. IF, FACS, and ELISA will be performed for subsequent CAF marker validation and characterization. Ex vivo drug testing with DCF or FLOT will be conducted on PDO-CAF co-cultures to recapitulate their drug response.
Citation Format: Kulsum Tai, Sanjima Pal, Julie Bérubé, Iris Kong, Adam Hoffman, Swneke Bailey, Aki Kirbizakis, Sui Huang, Michael Strasser, David Gibbs, Nicholas Bertos, Veena Sangwan, Lorenzo Ferri. Dissecting the stromal drivers of gastroesophageal adenocarcinoma chemoresistance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5959.
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Affiliation(s)
- Kulsum Tai
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Sanjima Pal
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Julie Bérubé
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Iris Kong
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Adam Hoffman
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Swneke Bailey
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Aki Kirbizakis
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Sui Huang
- 2Institute of Systems Biology, Seattle, WA
| | | | | | - Nicholas Bertos
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Veena Sangwan
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Lorenzo Ferri
- 1McGill University Health Centre Research Institute, Montreal, Quebec, Canada
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Evaristo G, Katz A, Ramírez-GarcíaLuna JL, Issac MSM, Sangwan V, Thai DV, Bertos N, Guiot MC, Camilleri-Broët S, Marcus V, Mueller C, Cools-Lartigue J, Fiset PO, Ferri LE. Relation between mismatch repair status, chemoresponse, survival and anatomic location in gastroesophageal adenocarcinoma. Can J Surg 2023; 66:E79-E87. [PMID: 36792128 PMCID: PMC9943547 DOI: 10.1503/cjs.017021] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND It has recently been reported that mismatch repair (MMR) status and microsatellite instability (MSI) status in gastroesophageal carcinomas predict surgical, chemotherapeutic and immunotherapeutic outcomes; however, there is extensive variability in the reported incidence and clinical implications of MMR/MSI status in gastroesophaegal adenocarcinomas. We characterized a Canadian surgical patient cohort with respect to MMR status, clinicopathologic correlates and anatomic tumour location. METHODS We investigated MMR and BRAF V600E status of gastroesophaegal adenocarcinomas in patients who underwent gastrectomy or esophagectomy with extended (D2) lymphadenectomy at a single centre between 2011 and 2019. We correlated patterns of MMR expression in the overall cohort and in anatomic location-defined subgroups with treatment response and overall survival using multivariate analysis. RESULTS In all, 226 cases of gastroesophaegal adenocarcinoma (63 esophageal, 98 gastroesophageal junctional and 65 gastric) were included. The MMR-deficient (dMMR) immunophenotype was found in 28 tumours (12.3%) (15 junctional [15.3%], 13 gastric [20.0%] and none of the esophageal). The majority (25 [89%]) of dMMR cases showed MLH1/PMS2 loss without concurrent BRAF V600E mutation. Two MSH2/ MSH6-deficient gastric tumours and 1 MSH6-deficient junctional tumour were detected. The pathologic response to preoperative chemotherapy was comparable in the dMMR and MMR-proficient (pMMR) cohorts. However, dMMR status was associated with significantly longer median overall survival than pMMR status (5.8 yr v. 2.4 yr, hazard ratio [HR] 1.91, 95% confidence interval [CI] 1.06-3.46), particularly in junctional tumours (4.6 yr v. 1.9 yr, HR 2.97, 95% CI 1.27-6.94). CONCLUSION Our study shows that MMR status has at least prognostic value, which supports the need for biomarker testing in gastroesophageal adenocarcinomas, including junctional adenocarcinomas. This highlights the clinical significance of determining the MMR status in all adenocarcinomas of the upper gastrointestinal tract. Response to induction chemotherapy, however, was not influenced by MMR status.
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Affiliation(s)
- Gertruda Evaristo
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Amit Katz
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - José L Ramírez-GarcíaLuna
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Marianne S M Issac
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Veena Sangwan
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Duc-Vinh Thai
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Nicholas Bertos
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Marie-Christine Guiot
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Sophie Camilleri-Broët
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Victoria Marcus
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Carmen Mueller
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Jonathan Cools-Lartigue
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Pierre O Fiset
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
| | - Lorenzo E Ferri
- From the Department of Pathology, McGill University Health Centre, Montréal, Que. (Evaristo, Thai, Guiot, Camilleri-Broët, Marcus, Fiset); the Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, Research Institute of the McGill University Health Centre, Montréal, Que. (Katz, Ramírez-GarcíaLuna, Sangwan, Mueller, Cools-Lartigue, Ferri); the Research Institute of the McGill University Health Centre, Montréal, Que. (Issac, Bertos); and the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montréal, Que. (Sangwan, Mueller, Cools-Lartigue, Ferri)
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Flores-Torres S, Jiang T, Kort-Mascort J, Yang Y, Peza-Chavez O, Pal S, Mainolfi A, Pardo LA, Ferri L, Bertos N, Sangwan V, Kinsella JM. Constructing 3D In Vitro Models of Heterocellular Solid Tumors and Stromal Tissues Using Extrusion-Based Bioprinting. ACS Biomater Sci Eng 2023; 9:542-561. [PMID: 36598339 DOI: 10.1021/acsbiomaterials.2c00998] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Malignant tumor tissues exhibit inter- and intratumoral heterogeneities, aberrant development, dynamic stromal composition, diverse tissue phenotypes, and cell populations growing within localized mechanical stresses in hypoxic conditions. Experimental tumor models employing engineered systems that isolate and study these complex variables using in vitro techniques are under development as complementary methods to preclinical in vivo models. Here, advances in extrusion bioprinting as an enabling technology to recreate the three-dimensional tumor milieu and its complex heterogeneous characteristics are reviewed. Extrusion bioprinting allows for the deposition of multiple materials, or selected cell types and concentrations, into models based upon physiological features of the tumor. This affords the creation of complex samples with representative extracellular or stromal compositions that replicate the biology of patient tissue. Biomaterial engineering of printable materials that replicate specific features of the tumor microenvironment offer experimental reproducibility, throughput, and physiological relevance compared to animal models. In this review, we describe the potential of extrusion-based bioprinting to recreate the tumor microenvironment within in vitro models.
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Affiliation(s)
| | - Tao Jiang
- Department of Intelligent Machinery and Instrument, College of Intelligence Science and Technology, National University of Defense Technology Changsha, Hunan 410073, China
| | | | - Yun Yang
- Department of Intelligent Machinery and Instrument, College of Intelligence Science and Technology, National University of Defense Technology Changsha, Hunan 410073, China
| | - Omar Peza-Chavez
- Department of Bioengineering, McGill University, Montreal, Quebec H3A 0G4, Canada
| | - Sanjima Pal
- Department of Surgery, McGill University, Montreal, Quebec H3G 2M1, Canada
| | - Alisia Mainolfi
- Department of Bioengineering, McGill University, Montreal, Quebec H3A 0G4, Canada
| | - Lucas Antonio Pardo
- Department of Bioengineering, McGill University, Montreal, Quebec H3A 0G4, Canada
| | - Lorenzo Ferri
- Department of Surgery, McGill University, Montreal, Quebec H3G 2M1, Canada.,Department of Medicine, McGill University, Montreal, Quebec H3G 2M1, Canada
| | - Nicholas Bertos
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec H4A 3J1, Canada
| | - Veena Sangwan
- Department of Surgery, McGill University, Montreal, Quebec H3G 2M1, Canada
| | - Joseph M Kinsella
- Department of Bioengineering, McGill University, Montreal, Quebec H3A 0G4, Canada
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Mihalcioiu C, Li J, Badescu D, Camirand A, Kremer N, Bertos N, Omeroglu A, Sebag M, Di Battista J, Park M, Ragoussis J, Kremer R. Improved platform for breast cancer circulating tumor cell enrichment and characterization with next-generation sequencing technology. Am J Cancer Res 2023; 13:25-44. [PMID: 36777514 PMCID: PMC9906071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/29/2022] [Indexed: 02/14/2023] Open
Abstract
Circulating tumor cells (CTCs) represent cells shed from the primary tumor or metastatic sites and can be used to monitor treatment response and tumor recurrence. However, CTCs circulate in extremely low numbers making in-depth analysis beyond simple enumeration challenging when collected from peripheral blood. Furthermore, tumor heterogeneity, a hallmark of many tumors, especially breast cancer, further complicates CTC characterization. To overcome this limitation, we developed a platform based on the large-scale isolation of CTCs by apheresis, allowing us to collect CTCs in large numbers, which were preserved live in liquid nitrogen for further characterization. Flow cytometry followed by cell sorting (FACS) was performed using a combination of antibodies directed against cell surface markers of white blood cells (CD45) and epithelial tumor cells (CK8). Analysis of subpopulations CD45+/- and CK8+/- by bulk RNA sequencing (RNAseq) and the CD45-/CK8 positive population by single-cell RNAseq was performed. The CD45- population was enriched using CD45 magnetic beads separation and examined by IHC for pan-cytokeratin and immunofluorescence (IF) for specific markers, including the elusive circulating cancer stem cells (CSCs). CSC-rich mammospheres were grown in vitro for further analysis and treated to examine their response to chemotherapeutic agents. Finally, mammospheres were transplanted into the mammary fat pad and bone of immunodeficient mice to examine tumor growth in vivo. This platform enables the detection and collection of CTCs in early and late-stage breast cancer patients of every subtype. Markers including CD44/24, ALDH1 and CXCR4 were identified by IF and showed high expression following mammosphere culture, which responded predictably to chemotherapeutic agents. Mammospheres were also transplanted into nude mice and induced tumors in the mammary fat pad and bone following intra-tibial transplantation. Finally, bulk RNA analysis of the FACS isolated CD45+/- and CK8+/- cells showed a clear separation of CD45- away from CD45+ populations. Single-cell RNAseq of the FACS isolated CD45-/CK8+ cells showed the presence of 4-5 clusters, confirming the high degree of heterogeneity of CTCs. Our platform for large-scale isolation of CTCs using apheresis is suitable for an in-depth analysis of the cancer phenotype and may eventually allow evaluation in real-time of the disease process to optimize cancer regimens.
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Affiliation(s)
- Catalin Mihalcioiu
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Jiarong Li
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Dunarel Badescu
- McGill University Génome Centre, Department of Human GeneticsMontréal, Québec, Canada
| | - Anne Camirand
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Nathaniel Kremer
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Nicholas Bertos
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Atilla Omeroglu
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Michael Sebag
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - John Di Battista
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
| | - Morag Park
- Breast Cancer Functional Genomics Group, Rosalind and Morris Goodman Cancer Centre, McGill UniversityMontréal, Québec, Canada
| | - Jiannis Ragoussis
- McGill University Génome Centre, Department of Human GeneticsMontréal, Québec, Canada
| | - Richard Kremer
- Department of Medicine, McGill University Health CentreGlen Site, 1001 Boul. Décarie, Mail Drop EM1.3229, Montréal, Québec, H4A 3J1, Canada
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7
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Al-Marzouki L, Stavrakos VS, Pal S, Giannias B, Bourdeau F, Rayes R, Bertos N, Najmeh S, Spicer JD, Cools-Lartigue J, Bailey SD, Ferri L, Sangwan V. Soluble factors in malignant ascites promote the metastatic adhesion of gastric adenocarcinoma cells. Gastric Cancer 2023; 26:55-68. [PMID: 36059037 DOI: 10.1007/s10120-022-01338-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Adenocarcinoma of the proximal stomach is the fastest rising malignancy in North America. It is commonly associated with peritoneal accumulation of malignant ascites (MA), a fluid containing cancer and inflammatory cells and soluble proteins. Peritoneal metastasis (PM) is the most common site of gastric cancer (GC) progression after curative-intent surgery and is the leading cause of death among GC patients. METHODS/RESULTS Using a panel of gastric adenocarcinoma cell lines (human: MKN 45, SNU-5; murine: NCC-S1M), we demonstrate that prior incubation of GC cells with MA results in a significant (> 1.7-fold) increase in the number of cells capable of adhering to human peritoneal mesothelial cells (HPMC) (p < 0.05). We then corroborate these findings using an ex vivo PM model and show that MA also significantly enhances the ability of GC cells to adhere to strips of human peritoneum (p < 0.05). Using a multiplex ELISA, we identify MIF and VEGF as consistently elevated across MA samples from GC patients (p < 0.05). We demonstrate that agents that block the effects of MIF or VEGF abrogate the ability of MA to stimulate the adhesion of GC cells to adhere to human peritoneum and promote both ex vivo and in vivo metastases. CONCLUSION Agents targeting MIF or VEGF may be relevant to the treatment or prevention of PM in GC patients.
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Affiliation(s)
- Luai Al-Marzouki
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Vivian S Stavrakos
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Sanjima Pal
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Betty Giannias
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - France Bourdeau
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Roni Rayes
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Nicholas Bertos
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Sara Najmeh
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Thoracic and Upper GI Surgery, Montreal General Hospital, 1650 Cedar Avenue, Room L8-325, Montreal, QC, H3G 1A4, Canada
| | - Jonathan D Spicer
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Thoracic and Upper GI Surgery, Montreal General Hospital, 1650 Cedar Avenue, Room L8-325, Montreal, QC, H3G 1A4, Canada
| | - Jonathan Cools-Lartigue
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Thoracic and Upper GI Surgery, Montreal General Hospital, 1650 Cedar Avenue, Room L8-325, Montreal, QC, H3G 1A4, Canada
| | - Swneke D Bailey
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Lorenzo Ferri
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada.
- Division of Thoracic and Upper GI Surgery, Montreal General Hospital, 1650 Cedar Avenue, Room L8-325, Montreal, QC, H3G 1A4, Canada.
| | - Veena Sangwan
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Division of Experimental Surgery, Department of Medicine, McGill University, Montreal, QC, Canada.
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8
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Sangwan V, Al-Marzouki L, Pal S, Stavrakos V, Alzahrani M, Antonatos D, Nevo Y, Camilleri-Broët S, Rayes R, Bourdeau F, Giannias B, Bertos N, Bailey S, Rousseau S, Cools-Lartigue J, Spicer JD, Ferri L. Inhibition of LPS-mediated TLR4 activation abrogates gastric adenocarcinoma-associated peritoneal metastasis. Clin Exp Metastasis 2022; 39:323-333. [PMID: 34767138 DOI: 10.1007/s10585-021-10133-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/06/2021] [Indexed: 01/20/2023]
Abstract
Surgical resection, the cornerstone of curative intent treatment for gastric adenocarcinoma, is associated with a high rate of infection-related post-operative complications, leading to an increased incidence of metastasis to the peritoneum. However, the mechanisms underlying this process are poorly understood. Lipopolysaccharide (LPS), an antigen from Gram-negative bacteria, represents a potential mechanism via induction of local and systemic inflammation through activation of Toll-like receptor (TLR). Here, we use both a novel ex vivo model of peritoneal metastasis and in vivo animal models to assess gastric cancer cell adhesion to peritoneum both before and after inhibition of the TLR4 pathway. We demonstrate that activation of TLR4 by either LPS or Gram-negative bacteria (E. coli) significantly increases the adherence of gastric cancer cells to human peritoneal mesothelial cells, and that this increased adherence is abrogated by inhibition of the TLR4 signal cascade and downstream TAK1 and MEK1/2 pathways. We also demonstrate that the influence of LPS on adherence extends to peritoneal tissue and metastatic spread. Furthermore, we show that loss of TLR4 at the site of metastasis reduces tumor cell adhesion, implicating the TLR4 signaling cascade in potentiating metastatic adhesion and peritoneal spread. These results identify potential therapeutic targets for the clinical management of patients undergoing resection for gastric cancer.
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Affiliation(s)
- Veena Sangwan
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Luai Al-Marzouki
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Sanjima Pal
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Vivian Stavrakos
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Malak Alzahrani
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada.,Department of Pathology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Dorothy Antonatos
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Yehonatan Nevo
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Sophie Camilleri-Broët
- Department of Pathology, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Roni Rayes
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - France Bourdeau
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Betty Giannias
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Nicholas Bertos
- Research Institute - McGill University Health Centre, Montreal, Canada
| | - Swneke Bailey
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Simon Rousseau
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Jonathan Cools-Lartigue
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Jonathan D Spicer
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Canada
| | - Lorenzo Ferri
- Division of Thoracic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada. .,Research Institute - McGill University Health Centre, Montreal, Canada. .,Departments of Surgery and Oncology, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Room L8-505, Montreal, Quebec, H3G 1A4, Canada.
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9
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Gómez-Cuadrado L, Bullock E, Mabruk Z, Zhao H, Souleimanova M, Noer PR, Turnbull AK, Oxvig C, Bertos N, Byron A, Dixon JM, Park M, Haider S, Natrajan R, Sims AH, Brunton VG. Characterisation of the Stromal Microenvironment in Lobular Breast Cancer. Cancers (Basel) 2022; 14:cancers14040904. [PMID: 35205651 PMCID: PMC8870100 DOI: 10.3390/cancers14040904] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/25/2022] [Accepted: 02/06/2022] [Indexed: 11/16/2022] Open
Abstract
Invasive lobular carcinoma (ILC) is the second most common histological subtype of breast cancer, and it exhibits a number of clinico-pathological characteristics distinct from the more common invasive ductal carcinoma (IDC). We set out to identify alterations in the tumor microenvironment (TME) of ILC. We used laser-capture microdissection to separate tumor epithelium from stroma in 23 ER + ILC primary tumors. Gene expression analysis identified 45 genes involved in regulation of the extracellular matrix (ECM) that were enriched in the non-immune stroma of ILC, but not in non-immune stroma from ER+ IDC or normal breast. Of these, 10 were expressed in cancer-associated fibroblasts (CAFs) and were increased in ILC compared to IDC in bulk gene expression datasets, with PAPPA and TIMP2 being associated with better survival in ILC but not IDC. PAPPA, a gene involved in IGF-1 signaling, was the most enriched in the stroma compared to the tumor epithelial compartment in ILC. Analysis of PAPPA- and IGF1-associated genes identified a paracrine signaling pathway, and active PAPP-A was shown to be secreted from primary CAFs. This is the first study to demonstrate molecular differences in the TME between ILC and IDC identifying differences in matrix organization and growth factor signaling pathways.
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Affiliation(s)
- Laura Gómez-Cuadrado
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
| | - Esme Bullock
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
| | - Zeanap Mabruk
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
| | - Hong Zhao
- Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3, Canada; (H.Z.); (M.S.); (M.P.)
| | - Margarita Souleimanova
- Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3, Canada; (H.Z.); (M.S.); (M.P.)
| | - Pernille Rimmer Noer
- Department of Molecular Biology and Genetics, University of Aarhus, DK-8000 Aarhus C, Denmark; (P.R.N.); (C.O.)
| | - Arran K. Turnbull
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
| | - Claus Oxvig
- Department of Molecular Biology and Genetics, University of Aarhus, DK-8000 Aarhus C, Denmark; (P.R.N.); (C.O.)
| | - Nicholas Bertos
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Adam Byron
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
| | - J. Michael Dixon
- Edinburgh Breast Unit, University of Edinburgh, Edinburgh EH4 2XU, UK;
| | - Morag Park
- Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3, Canada; (H.Z.); (M.S.); (M.P.)
| | - Syed Haider
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.H.); (R.N.)
| | - Rachael Natrajan
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.H.); (R.N.)
| | - Andrew H. Sims
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
| | - Valerie G. Brunton
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; (L.G.-C.); (E.B.); (Z.M.); (A.K.T.); (A.B.)
- Correspondence:
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10
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Johnson G, Vergis A, Unger B, Park J, Gillman L, Hickey K, Pace D, Azin A, Guidolin K, Lam-Tin-Cheung K, Chadi S, Quereshy F, Guidolin K, Catton J, Rubin B, Bell J, Marangos J, Heesters A, Stuart-McEwan T, Quereshy F, Shariff F, Wright F, Ahmed N, Nadler A, Hallet J, Gentles J, Chen L, Hwang H, Parapini M, Hirpara D, Sidhu R, Scott T, Karimuddin A, Guo R, Nguyen A, Osborn J, Wiseman S, Nabata K, Ertel E, Hwang H, Lenet T, Baker L, Park L, Vered M, Zahrai A, Shorr R, Davis A, McIsaac D, Tinmouth A, Fergusson D, Martel G, Nabata K, Rummel S, Stefic-Cubic M, Karimuddin A, Stewart M, Melck A, McKechnie T, Anpalagan T, Ichhpuniani S, Lee Y, Ramji K, Eskicioglu C, Zhu A, Deng S, Greene B, Tsang M, Palter V, Jayaraman S, McKechnie T, Mann A, Tittley J, Cadeddu M, Nguyen M, Madani A, Pasternak J, McKechnie T, Ramji K, Hong D, Qu L, Istl A, Tang E, Gray D, Zuckerman J, Coburn N, Callum J, McLeod R, Pearsall E, Lin Y, Turgeon A, Martel G, Hallet J, Mahar A, Kammili A, Kriviraltcheva-Kaneva P, Lee L, Cools-Lartigue J, Ferri L, Mueller C, Zuckerman J, Haas B, Tillman B, Guttman M, Chesney T, Zuk V, Mahar A, Hsu A, Chan W, Vasdev R, Coburn N, Hallet J, D'Souza K, Huynh C, Ling LCJ, Warburton R, Hwang H, Hameed M, Glass L, Williamson H, Murphy P, Tang E, Leslie K, Hawel J, Kerr L, Zablotny S, Roldan H, He W, Jiang X, Zheng B, Lee L, Fiore J, Feldman L, Fried G, Mueller C, Valanci S, Balvardi S, Cipolla J, Kaneva P, Demyttenaere S, Boutros M, Lee L, Feldman L, Fiore J, Balvardi S, Alhashemi M, Cipolla J, Lee L, Fiore J, Feldman L, Miles A, Purich K, Verhoeff K, Shapiro J, Bigam D, Kung J, Fecso A, Chesney T, Mosko J, Skubleny D, Hamilton P, Ghosh S, Widder S, Schiller D, Do U, El Kefraoui C, Pook M, Barone N, Balvardi S, Montgomery H, Nguyen-Powanda P, Rajabiyazdi F, Elhaj H, Lapointe-Gagner M, Olleik G, Kaneva P, Antoun A, Safa N, Di Lena E, Meterissian S, Meguerditchian A, Fried G, Alhashemi M, Lee F, Baldini G, Feldman L, Fiore J, Serrano Aybar PE, Parpia S, Ruo L, Tywonek K, Lee S, O'Neill C, Faisal N, Alfayyadh A, Gundayao M, Meyers BM, Habashi R, Kruse C, McKechnie T, Levin M, Aldrich K, Grantcharov T, Langerman A, Forbes H, Anantha R, Fawcett V, Hetherington A, Pravong V, Gervais M, Rakovich G, Selvam R, Hu R, Musselman R, Raiche I, Moloo H, Liu R, Elnahas A, Alkhamesi N, Hawel J, Tang E, Alnumay A, Schlachta C, Walser E, Zhang C, Cristancho S, Ott M, Lee A, Niu B, Balaa F, Gawad N, Ren K, Qiu Y, Hamann K, How N, Leveille C, Davidson A, Eqbal A, Sardiwalla Y, Korostensky M, McKechnie T, Lee E, Yang I, Ren K, Muaddi H, Stukel T, de Mestral C, Nathens A, Karanicolas P, Frigault J, Lemieux S, Breton D, Bouchard P, Bouchard A, Grégoire R, Letarte F, Bouchard G, Drolet S, Frigault J, Avoine S, Drolet S, Letarte F, Bouchard A, Gagné J, Thibault C, Grégoire R, Jutras Bouthillette N, Gosselin M, Bouchard P, Rosenzveig A, Stuleanu T, Jarrar A, Kolozsvari N, Skelhorne-Gross G, Nenshi R, Jerath A, Gomez D, Singh K, Amir T, Liu E, Farquharson S, Mao R, Lan L, Yan J, Allard-Coutu A, Mierzwa A, Tin R, Brisebois R, Bradley N, Wigen R, Walser E, Hartford L, Van Koughnett J, Vogt K, Hilsden R, Parry N, Allen L, Leslie K, Raskin R, Jones J, Neumann K, Dwyer C, Strickland M, Bradley N, O'Dochartaigh D, Lobay K, Kabaroff A, Chang E, Widder S, Anantha R, Sun W, Beck J, Anantha R, Liu R, Davidson J, Jones S, Van Hooren T, Van Koughnett J, Ott M, Schmitz E, Raiche I, Sun W, El Hafid M, Dang J, Mocanu V, Lutzak G, Sultanian R, Wong C, Karmali S, Schmitz E, Petrera M, Pickell M, Auer R, Patro N, Li B, Lee Y, Wilson H, Mocanu V, Sun W, Dang J, Jogiat U, Kung J, Switzer N, Karmali S, Wong C, Li C, Al Hinai A, Cieply A, Hawes H, Joos E, Saleh A, Li C, Saleh A, Engels P, Drung J, Allen L, Leslie K, Pang G, Kwong M, Schlachta C, Alkhamesi N, Hawel J, Elnahas A, Guidolin K, Ellsmere J, Chadi S, Quereshy F, Chang D, Hutter M, Spence R, Abou Khalil M, Boutros M, Vasilevsky C, Morin N, Longtin Y, Liberman S, Demyttenaere S, Montpetit P, Poirier M, Mukherjee K, Sebajang H, Younan R, Schwenter F, De Broux E, Larsen K, Skelhorne-Gross G, Beckett A, Nantais J, Gomez D, Lan L, Mao R, Kay J, Lohre R, Ayeni O, Goel D, de Sa D, He R, Hylton D, Bedard E, Johnson S, Laing B, Valji A, Hanna W, Turner S, Akhtar-Danesh G, Akhtar-Danesh N, Shargall Y, Akhtar-Danesh G, Akhtar-Danesh N, Shargall Y, Hirpara D, Gupta V, Kidane B, Limbachia J, Sullivan K, Farrokhyar F, Leontiadis G, Patel Y, Churchill I, Hylton D, Xie F, Seely A, Spicer J, Kidane B, Turner S, Yasufuku K, Hanna W, Jogiat U, Sun W, Dang J, Mocanu V, Kung J, Karmali S, Turner S, Switzer N, Patel Y, Churchill I, Sullivan K, Beauchamp M, Wald J, Mbuagbaw L, Agzarian J, Shargall Y, Finley C, Fahim C, Hanna W, Abbas M, Olaiya O, Begum H, Mbuagbaw L, Finley C, Hanna W, Agzarian J, Shargall Y, Ednie A, Palma D, Warner A, Malthaner R, Fortin D, Qiabi M, Nayak R, Nguyen T, Louie A, Rodrigues G, Yaremko B, Laba J, Inculet R, Alaichi J, Patel Y, Hanna W, Turner S, Mador B, Lai H, White J, Kim M, Hirpara D, Kidane B, Louie A, Zuk V, Darling G, Rousseau M, Chesney T, Coburn N, Hallet J, Lee Y, Samarasinghe Y, Lee M, Thiru L, Shargall Y, Finley C, Hanna W, Levine O, Juergens R, Agzarian J, Nayak R, Brogly S, Li W, Lougheed D, Petsikas D, Mistry N, Gatti A, Churchill I, Patel Y, Hanna W, Abdul S, Anestee C, Gilbert S, Sundaresan S, Seely A, Villeneuve P, Maziak D, Razzak R, Ashrafi A, Tregobov N, Hassanzadeh N, Stone S, Panjwani A, Bong T, Bond R, Hafizi A, De Meo M, Rayes R, Milette S, Vagai M, Usatii M, Chandrasekaran A, Giannias B, Bourdeau F, Sangwan V, Bertos N, Moraes C, Huang S, Quail D, Walsh L, Camilleri-Broet S, Fiset P, Cools-Lartigue J, Ferri L, Spicer J, Kammili A, Bilgic E, Quaiattini A, Maurice-Ventouris M, Najmeh S, Mueller C, Esther L, Begum H, Agzarian J, Hanna W, Finley C, Shargall Y, Lee Y, Lu J, Malhan R, Shargall Y, Finley C, Hanna W, Agzarian J, Brophy S, Brennan K, French D, Resende V, Momtazi M, Solaja O, Gilbert S, Maziak D, Seely A, Sundaresan S, Villeneuve P, Sisson D, Donahoe L, Bedard P, Hansen A, De Perrot M, Alghamedi A, Simone A, Begum H, Hanna W, Shargall Y, Turner S, Huang J, Lai H, Bedard E, Shargall Y, Murthy S, Lin J, Darling G, Malthaner R, Kidane B, Seely A, Li H, Crowther M, Linkins L, Lau E, Schneider L, Hanna W, Finley C, Agzarian J, Douketis J, Greenberg B, Gupta V, Allen-Avodabo C, Davis L, Zhao H, Kidane B, Darling G, Coburn N, Huynh C, Cools-Lartigue J, Ferri L, Najmeh S, Sirois C, Mulder D, Spicer J, Al Rawahi A, Aftab Abdul S, Nguyen D, Anstee C, Delic E, Gilbert S, Maziak D, Villeneuve P, Seely A, Sisson D, Sasewich H, Islam T, Low D, Darling G, Turner S, Humer M, Abdul S, Nguyen D, Al Rawahi A, Anstee C, Delic E, Gilbert S, Villeneuve P, Maziak D, Seely A, Le Nguyen D, Aftab Abdul S, Al Rawahi A, Anstee C, Delic E, Gilbert S, Villeneuve P, Maziak D, Seely A, Patel Y, Kay M, Churchill I, Sullivan K, Shargall Y, Shayegan B, Adili A, Hanna W, Kaafarani M, Huynh C, Chouiali F, Muthukrishnan N, Maleki F, Ovens K, Gold M, Sorin M, Falutz R, Rayes R, Forghani R, Spicer J, Hunka N, Kennedy R, Bigsby R, Bharadwaj S, Gowing S, Churchill I, Gatti A, Hylton D, Sullivan K, Patel Y, Farrokhyar F, Leontiadis G, Hanna W, Finley C, Begum H, Pearce K, Agzarian J, Hanna W, Shargall Y, Akhtar-Danesh N, Jones D, Anstee C, Kumar S, Gingrich M, Simone A, Ahmadzai Z, Thavorn K, Seely A, Gupta V, Namavarian A, Mohammed A, Uddin S, Jones D, Behzadi A, Brar A, Qu L, Qiabi M, Nayak R, Malthaner R, Peters E, Buduhan G, Tan L, Liu R, Srinathan S, Kidane B, Gupta V, Levy J, Kidane B, Mahar A, Ringash J, Sutradhar R, Darling G, Coburn N, Robinson M, Bednarek L, Buduhan G, Liu R, Tan L, Srinathan S, Kidane B, Wang H, French D, MacDonald D, Graham K, Enns S, Buduhan G, Srinathan S, Liu R, Tan A, Kidane B, Bruinooge A, Poole E, Pascoe C, Karakach T, Buduhan G, Tan L, Srinathan S, Halayko A, Kidane B, Verhoeff K, Mocanu V, Fang B, Dang J, Kung J, Switzer N, Birch D, Karmali S, Johnson G, Singh H, Vergis A, Park J, Hershorn O, 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Moon J, Marinescu D, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Moon J, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Salama E, Alrashid F, Vasilevsky C, Ghitulescu G, Faria J, Morin N, Boutros M, Wiseman V, Zhang L, MacDonald P, Merchant SM, Wattie Barnett K, Caycedo-Marulanda A, Patel SV, Harra Z, Vasilevsky C, Ghitulescu G, Morin N, Boutros M, Pang A, Hegagi M, Alqahtani M, Morin N, Ghitulescu G, Vasilevsky C, Boutros M, Alghaithi N, Marinescu D, Al-Masrouri S, Pang A, Vasilevsky C, Boutros M, Papillon E, Kasteel N, Kaur G, Bindra S, Malhotra A, Graham C, MacLean A, Beck P, Jijon H, Ferraz J, Buie W, Szwimer R, Moon J, Demian M, Pang A, Morin N, Vasilevsky C, Rajabiyazdi F, Boutros M, Azin A, Merchant S, Kong W, Gyawali B, Hanna T, Chung W, Nanji S, Patel S, Booth C, Li V, Awan A, Serrano P, Jacobson M, Chanco M, Wen V, Singh N, Peiris L, Pasieka J, Ghatage P, Buie D, MacLean T, Bouchard-Fortier A, Mack L, Marini W, Zheng W, Swallow C, 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Eymae D, Lee K, Brar S, Conner J, Magalhaes M, Swallow C, Allen K, Baliski C, Cyr D, Sari A, Messenger D, Driman D, Assarzadegan N, Juda A, Swallow C, Kennedy E, Brar M, Conner J, Kirsch R, Allard-Coutu A, Singh K, Lamontagne A, Gamache Y, Allard-Coutu A, Mardinger C, Lee C, Duckworth R, Brindle M, Fraulin F, Austen L, Kortbeek J, Hyndman M, Nguyen D, Jamjoum G, Meguerditchian A, Langer S, Yuan Xu Y, Kong S, Quan M, Lim D, Retrouvey H, Kerrebijn I, Butler K, O'Neill A, Cil T, Zhong T, Hofer S, McCready D, Metcalfe K, Lim D, Greene B, Look Hong N, Parapini M, Skipworth J, Mah A, Desai S, Chung S, Scudamore C, Segedi M, Vasilyeva E, Li J, Kim P, Verhoeff K, Deprato A, Purich K, Kung J, Bigam D, Dajani K, Lenet T, Gilbert R, Smoot R, Martel G, Tzeng C, Rocha F, Yohanathan L, Cleary S, Bertens K, Reyna-Sepulveda F, Badrudin D, Gala-Lopez B, Hanna N, Brogly S, Wei X, Booth C, Nanji S, Zuckerman J, Coburn N, Mahar A, Callum J, Kaliwal Y, Jayaraman S, Wei A, Martel G, Hallet J, Zuckerman J, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Henault D, Barrette B, Pelletier S, Thebault P, Beaudry-Simoneau E, Rong Z, Plasse M, Dagenais ARM, Létourneau R, Lapointe R, Vandenbroucke-Menu F, Nguyen B, Soucy G, Turcotte S, Lemke M, Waugh E, Leslie K, Quan D, Skaro A, Tang E, Lund M, Allen L, Glinka J, Jada G, Quan D, Skaro A, Tang E, Park L, Daza J, Li V, Msallak H, Zhang B, Workneh A, Faisal S, Faisal R, Fabbro M, Gu C, Claassen M, Zuk V, Hallet J, Martel G, Sapisochin G, Serrano P, Glinka J, Skaro A, Leslie K, Jada G, Quan D, Tang E, Waugh E, Lemke M, Glinka J, Skaro A, Leslie K, Tang E, Waugh E, Breadner D, Liu R, Tang E, Allen L, Welch S, Skaro A, Leslie K, Glinka J, Waugh E, Tang E, Jada G, Quan D, Skaro A, Webb A, Lester E, Shapiro A, Eurich D, Bigam D, Essaji Y, Shrader H, Nayyar A, Suraju M, Williams-Perez S, Ear P, Chan C, Smith V, Rivers-Bowerman M, Costa A, Stueck A, Campbell N, Allen S, Gala-Lopez B, Gilbert R, Lenet T, Cleary S, Smoot R, Tzeng C, Rocha F, Martel G, Bertens K, Mir Z, Golding H, McKeown S, Nanji S, Flemming J, Groome P, Mir Z, Djerboua M, Nanji S, Flemming J, Groome P, Elbekri S, Turcotte S, Girard E, Morency-Potvin P, Lapointe R, Vandenbroucke-Menu F, Dagenais M, Roy A, Letourneau R, Plasse M, Simoneau E, Rong Z, Zuker N, Oakley M, Chartrand G, Misheva B, Bendavid Y, Frigault J, Lemieux S, Breton D, Bouchard G, Drolet S, Melland-Smith M, Smith L, Tan J, Kahn U, McLean C, Mocanu V, Birch D, Karmali S, Switzer N, Fortin M, Paré X, Doyon A, Keshavjee S, Schwenger K, Yadav J, Fischer S, Jackson T, Allard J, Okrainec A, Lee Y, Anvari S, Chu M, Lovrics O, Aditya I, Malhan R, Khondker A, Walsh M, Doumouras A, Hong D, He W, Vergis A, Hardy K, Romanescu R, Deaninck F, Linton J, Fowler-Woods M, Fowler-Woods A, Shingoose G, Vergis A, Hardy K, Zmudzinski M, Cloutier Z, McKechnie T, Lee Y, Archer V, Doumouras A, Shiroky J, Abu Halimah J, Ramji K, Boudreau V, Mierzwa A, Mocanu V, Marcil G, Dang J, Switzer N, Birch D, Karmali S, Mierzwa A, Jarrar A, Hardy-Henry A, Kolozsvari N, Lin W, Hagen J, Connell M, Sun W, Dang J, Mocanu V, Kung J, Switzer N, Birch D, Karmali S. 2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Can J Surg 2021; 64:S80-S159. [PMID: 35483046 PMCID: PMC8677574 DOI: 10.1503/cjs.021321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- G Johnson
- From the University of Manitoba, Winnipeg, Man
| | - A Vergis
- From the University of Manitoba, Winnipeg, Man
| | - B Unger
- From the University of Manitoba, Winnipeg, Man
| | - J Park
- From the University of Manitoba, Winnipeg, Man
| | - L Gillman
- From the University of Manitoba, Winnipeg, Man
| | - K Hickey
- From Memorial University, St. John's, Nfld
| | - D Pace
- From Memorial University, St. John's, Nfld
| | - A Azin
- From the University of Toronto, Toronto, Ont
| | | | | | - S Chadi
- University Health Network, Toronto, Ont
| | | | | | - J Catton
- University Health Network, Toronto, Ont
| | - B Rubin
- University Health Network, Toronto, Ont
| | - J Bell
- University Health Network, Toronto, Ont
| | | | | | | | | | - F Shariff
- From the University of Toronto, Toronto, Ont
| | - F Wright
- From the University of Toronto, Toronto, Ont
| | - N Ahmed
- From the University of Toronto, Toronto, Ont
| | - A Nadler
- From the University of Toronto, Toronto, Ont
| | - J Hallet
- From the University of Toronto, Toronto, Ont
| | - J Gentles
- From the University of British Columbia, Vancouver, B.C
| | - L Chen
- From the University of British Columbia, Vancouver, B.C
| | - H Hwang
- From the University of British Columbia, Vancouver, B.C
| | - M Parapini
- University of British Columbia, Vancouver, B.C
| | | | - R Sidhu
- University of British Columbia, Vancouver, B.C
| | - T Scott
- University of British Columbia, Vancouver, B.C
| | | | - R Guo
- From the University of British Columbia, Vancouver, B.C
| | - A Nguyen
- From the University of British Columbia, Vancouver, B.C
| | - J Osborn
- From the University of British Columbia, Vancouver, B.C
| | - S Wiseman
- From the University of British Columbia, Vancouver, B.C
| | - K Nabata
- From the University of British Columbia, Vancouver, B.C
| | - E Ertel
- From the University of British Columbia, Vancouver, B.C
| | - H Hwang
- From the University of British Columbia, Vancouver, B.C
| | - T Lenet
- University of Ottawa, Ottawa, Ont
| | - L Baker
- University of Ottawa, Ottawa, Ont
| | - L Park
- University of Ottawa, Ottawa, Ont
| | - M Vered
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - A Zahrai
- University of Ottawa, Ottawa, Ont
| | - R Shorr
- The Ottawa Hospital, Ottawa, Ont
| | - A Davis
- The Ottawa Hospital, Ottawa, Ont
| | | | | | - D Fergusson
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - G Martel
- The Ottawa Hospital, Ottawa, Ont
| | - K Nabata
- From the University of British Columbia, Vancouver, B.C
| | - S Rummel
- From the University of British Columbia, Vancouver, B.C
| | | | - A Karimuddin
- From the University of British Columbia, Vancouver, B.C
| | - M Stewart
- From the University of British Columbia, Vancouver, B.C
| | - A Melck
- From the University of British Columbia, Vancouver, B.C
| | | | | | | | - Y Lee
- From McMaster University, Hamilton, Ont
| | - K Ramji
- From McMaster University, Hamilton, Ont
| | | | - A Zhu
- From the University of Toronto, Toronto, Ont
| | - S Deng
- From the University of Toronto, Toronto, Ont
| | - B Greene
- From the University of Toronto, Toronto, Ont
| | - M Tsang
- From the University of Toronto, Toronto, Ont
| | - V Palter
- From the University of Toronto, Toronto, Ont
| | - S Jayaraman
- From the University of Toronto, Toronto, Ont
| | | | - A Mann
- From McMaster University, Hamilton, Ont
| | - J Tittley
- From McMaster University, Hamilton, Ont
| | - M Cadeddu
- From McMaster University, Hamilton, Ont
| | - M Nguyen
- University of Toronto, Toronto, Ont
| | - A Madani
- University Health Network, Toronto, Ont
| | | | | | - K Ramji
- From McMaster University, Hamilton, Ont
| | - D Hong
- From McMaster University, Hamilton, Ont
| | - L Qu
- Western University, London, Ont
| | - A Istl
- Johns Hopkins Hospital, Baltimore, Md
| | - E Tang
- Western University, London, Ont
| | - D Gray
- Western University, London, Ont
| | | | - N Coburn
- University of Toronto, Toronto, Ont
| | - J Callum
- Queen's University, Kingston, Ont
| | - R McLeod
- University of Toronto, Toronto, Ont
| | | | - Y Lin
- University of Toronto, Toronto, Ont
| | | | - G Martel
- University of Ottawa, Ottawa, Ont
| | - J Hallet
- University of Toronto, Toronto, Ont
| | - A Mahar
- University of Manitoba, Winnipeg, Man
| | - A Kammili
- From the McGill University Health Centre, Montreal, Que
| | | | - L Lee
- From the McGill University Health Centre, Montreal, Que
| | | | - L Ferri
- From the McGill University Health Centre, Montreal, Que
| | - C Mueller
- From the McGill University Health Centre, Montreal, Que
| | | | - B Haas
- University of Toronto, Toronto, Ont
| | | | | | | | - V Zuk
- Sunnybrook Research Institute, Toronto, Ont
| | - A Mahar
- University of Manitoba, Winnipeg, Man
| | - A Hsu
- University of Ottawa, Ottawa, Ont
| | | | - R Vasdev
- Sunnybrook Research Institute, Toronto, Ont
| | - N Coburn
- University of Toronto, Toronto, Ont
| | - J Hallet
- University of Toronto, Toronto, Ont
| | - K D'Souza
- From the University of British Columbia, Vancouver, B.C
| | - C Huynh
- From the University of British Columbia, Vancouver, B.C
| | | | - R Warburton
- From the University of British Columbia, Vancouver, B.C
| | - H Hwang
- From the University of British Columbia, Vancouver, B.C
| | - M Hameed
- From the University of British Columbia, Vancouver, B.C
| | - L Glass
- Western University, London, Ont
| | | | - P Murphy
- Medical College of Wisconsin, Milwaukee, Wis
| | - E Tang
- Western University, London, Ont
| | | | - J Hawel
- Western University, London, Ont
| | - L Kerr
- From the Northern Ontario School of Medicine, Thunder Bay, Ont
| | - S Zablotny
- From the Northern Ontario School of Medicine, Thunder Bay, Ont
| | - H Roldan
- From the Northern Ontario School of Medicine, Thunder Bay, Ont
| | - W He
- University of Manitoba, Winnipeg, Man
| | - X Jiang
- Memorial University of Newfoundland, St. John's, Nfld
| | - B Zheng
- University of Alberta, Edmonton, Alta
| | - L Lee
- From McGill University, Montreal, Que
| | - J Fiore
- From McGill University, Montreal, Que
| | - L Feldman
- From McGill University, Montreal, Que
| | - G Fried
- From McGill University, Montreal, Que
| | - C Mueller
- From McGill University, Montreal, Que
| | - S Valanci
- From McGill University, Montreal, Que
| | | | - J Cipolla
- From McGill University, Montreal, Que
| | - P Kaneva
- From McGill University, Montreal, Que
| | | | - M Boutros
- From McGill University, Montreal, Que
| | - L Lee
- From McGill University, Montreal, Que
| | - L Feldman
- From McGill University, Montreal, Que
| | - J Fiore
- From McGill University, Montreal, Que
| | | | | | - J Cipolla
- From McGill University, Montreal, Que
| | - L Lee
- From McGill University, Montreal, Que
| | - J Fiore
- From McGill University, Montreal, Que
| | - L Feldman
- From McGill University, Montreal, Que
| | - A Miles
- From the University of Alberta, Edmonton, Alta
| | - K Purich
- From the University of Alberta, Edmonton, Alta
| | - K Verhoeff
- From the University of Alberta, Edmonton, Alta
| | - J Shapiro
- From the University of Alberta, Edmonton, Alta
| | - D Bigam
- From the University of Alberta, Edmonton, Alta
| | - J Kung
- From the University of Alberta, Edmonton, Alta
| | - A Fecso
- From the University of Toronto, Toronto, Ont
| | - T Chesney
- From the University of Toronto, Toronto, Ont
| | - J Mosko
- From the University of Toronto, Toronto, Ont
| | - D Skubleny
- From the University of Alberta, Edmonton, Alta
| | - P Hamilton
- From the University of Alberta, Edmonton, Alta
| | - S Ghosh
- From the University of Alberta, Edmonton, Alta
| | - S Widder
- From the University of Alberta, Edmonton, Alta
| | - D Schiller
- From the University of Alberta, Edmonton, Alta
| | - U Do
- McGill University, Montreal, Que
| | | | - M Pook
- McGill University, Montreal, Que
| | - N Barone
- McGill University, Montreal, Que
| | | | | | | | | | - H Elhaj
- McGill University Health Centre, Montreal, Que
| | | | - G Olleik
- McGill University, Montreal, Que
| | - P Kaneva
- McGill University Health Centre, Montreal, Que
| | - A Antoun
- McGill University, Montreal, Que
| | - N Safa
- McGill University, Montreal, Que
| | | | | | | | - G Fried
- McGill University Health Centre, Montreal, Que
| | - M Alhashemi
- McGill University Health Centre, Montreal, Que
| | - F Lee
- McGill University Health Centre, Montreal, Que
| | - G Baldini
- McGill University Health Centre, Montreal, Que
| | - L Feldman
- McGill University Health Centre, Montreal, Que
| | - J Fiore
- McGill University Health Centre, Montreal, Que
| | | | - S Parpia
- McMaster University, Hamilton, Ont
| | - L Ruo
- McMaster University, Hamilton, Ont
| | | | - S Lee
- McMaster University, Hamilton, Ont
| | | | - N Faisal
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - A Alfayyadh
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | - C Kruse
- McMaster University, Hamilton, Ont
| | | | - M Levin
- University of Toronto, Toronto, Ont
| | - K Aldrich
- Center for Medical Interoperability, Nashville, Tenn
| | - T Grantcharov
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont
| | - A Langerman
- Vanderbilt University Medical Center, Nashville, Tenn
| | - H Forbes
- From the University of Alberta, Edmonton, Alta
| | - R Anantha
- From the University of Alberta, Edmonton, Alta
| | - V Fawcett
- From the University of Alberta, Edmonton, Alta
| | | | - V Pravong
- University of Montreal, Montreal, Que
| | - M Gervais
- Maisonneuve-Rosemont Hospital, Montreal, Que
| | - G Rakovich
- Maisonneuve-Rosemont Hospital, Montreal, Que
| | - R Selvam
- From the University of Ottawa, Ottawa, Ont
| | - R Hu
- From the University of Ottawa, Ottawa, Ont
| | | | - I Raiche
- From the University of Ottawa, Ottawa, Ont
| | - H Moloo
- From the University of Ottawa, Ottawa, Ont
| | - R Liu
- Western University, London, Ont
| | - A Elnahas
- Western University, Canadian Surgical Technologies & Advanced Robotics, London Health Sciences Centre, London, Ont
| | - N Alkhamesi
- Western University, Canadian Surgical Technologies & Advanced Robotics, London Health Sciences Centre, London, Ont
| | - J Hawel
- Western University, Canadian Surgical Technologies & Advanced Robotics, London Health Sciences Centre, London, Ont
| | - E Tang
- Western University, Canadian Surgical Technologies & Advanced Robotics, London Health Sciences Centre, London, Ont
| | - A Alnumay
- Western University, Canadian Surgical Technologies & Advanced Robotics, London Health Sciences Centre, London, Ont
| | - C Schlachta
- Western University, Canadian Surgical Technologies & Advanced Robotics, London Health Sciences Centre, London, Ont
| | - E Walser
- From Western University, London, Ont
| | - C Zhang
- From Western University, London, Ont
| | | | - M Ott
- From Western University, London, Ont
| | - A Lee
- From the University of Ottawa, Ottawa, Ont
| | - B Niu
- From the University of Ottawa, Ottawa, Ont
| | - F Balaa
- From the University of Ottawa, Ottawa, Ont
| | - N Gawad
- From the University of Ottawa, Ottawa, Ont
| | - K Ren
- From McMaster University, Hamilton, Ont
| | - Y Qiu
- From McMaster University, Hamilton, Ont
| | - K Hamann
- From McMaster University, Hamilton, Ont
| | - N How
- From McMaster University, Hamilton, Ont
| | | | | | - A Eqbal
- From McMaster University, Hamilton, Ont
| | | | | | | | - E Lee
- From McMaster University, Hamilton, Ont
| | - I Yang
- From McMaster University, Hamilton, Ont
| | - K Ren
- From McMaster University, Hamilton, Ont
| | - H Muaddi
- University of Toronto, Toronto, Ont
| | - T Stukel
- ICES, University of Toronto, Toronto, Ont
| | - C de Mestral
- St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - A Nathens
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont
| | - P Karanicolas
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont
| | - J Frigault
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - S Lemieux
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - D Breton
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - P Bouchard
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - A Bouchard
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - R Grégoire
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - F Letarte
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - G Bouchard
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - S Drolet
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - J Frigault
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - S Avoine
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - S Drolet
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - F Letarte
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - A Bouchard
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - J Gagné
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - C Thibault
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - R Grégoire
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | | | - M Gosselin
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - P Bouchard
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | | | - T Stuleanu
- From the University of Ottawa, Ottawa, Ont
| | - A Jarrar
- From the University of Ottawa, Ottawa, Ont
| | | | | | - R Nenshi
- McMaster University, Hamilton, Ont
| | - A Jerath
- University of Toronto, Toronto, Ont
| | - D Gomez
- University of Toronto, Toronto, Ont
| | - K Singh
- University of Toronto, Toronto, Ont
| | - T Amir
- McMaster University, Hamilton, Ont
| | - E Liu
- McMaster University, Hamilton, Ont
| | | | - R Mao
- McMaster University, Hamilton, Ont
| | - L Lan
- McMaster University, Hamilton, Ont
| | - J Yan
- University of British Columbia, Vancouver, B.C
| | | | - A Mierzwa
- From the University of Alberta, Edmonton, Alta
| | - R Tin
- From the University of Alberta, Edmonton, Alta
| | - R Brisebois
- From the University of Alberta, Edmonton, Alta
| | - N Bradley
- From the University of Alberta, Edmonton, Alta
| | - R Wigen
- From Western University, London, Ont
| | - E Walser
- From Western University, London, Ont
| | | | | | - K Vogt
- From Western University, London, Ont
| | - R Hilsden
- From Western University, London, Ont
| | - N Parry
- From Western University, London, Ont
| | - L Allen
- From Western University, London, Ont
| | - K Leslie
- From Western University, London, Ont
| | - R Raskin
- From Dalhousie University, Halifax, N.S
| | - J Jones
- From Dalhousie University, Halifax, N.S
| | - K Neumann
- From Dalhousie University, Halifax, N.S
| | - C Dwyer
- University of Alberta, Edmonton, Alta
| | | | - N Bradley
- University of Alberta, Edmonton, Alta
| | | | - K Lobay
- University of Alberta, Edmonton, Alta
| | | | - E Chang
- University of Alberta, Edmonton, Alta
| | - S Widder
- University of Alberta, Edmonton, Alta
| | - R Anantha
- University of Alberta, Edmonton, Alta
| | - W Sun
- University of Alberta, Edmonton, Alta
| | - J Beck
- Royal Alexandra Hospital, Edmonton, Alta
| | - R Anantha
- University of Alberta, Edmonton, Alta
| | - R Liu
- From Western University, London, Ont
| | | | - S Jones
- From Western University, London, Ont
| | | | | | - M Ott
- From Western University, London, Ont
| | - E Schmitz
- From the University of Ottawa, Ottawa, Ont
| | - I Raiche
- From the University of Ottawa, Ottawa, Ont
| | - W Sun
- University of Alberta, Edmonton, Alta
| | | | - J Dang
- University of Alberta, Edmonton, Alta
| | - V Mocanu
- University of Alberta, Edmonton, Alta
| | - G Lutzak
- University of Alberta, Edmonton, Alta
| | | | - C Wong
- University of Alberta, Edmonton, Alta
| | - S Karmali
- University of Alberta, Edmonton, Alta
| | - E Schmitz
- From the University of Ottawa, Ottawa, Ont
| | - M Petrera
- From the University of Ottawa, Ottawa, Ont
| | - M Pickell
- From the University of Ottawa, Ottawa, Ont
| | - R Auer
- From the University of Ottawa, Ottawa, Ont
| | - N Patro
- From McMaster University, Hamilton, Ont
| | - B Li
- From McMaster University, Hamilton, Ont
| | - Y Lee
- From McMaster University, Hamilton, Ont
| | - H Wilson
- From the University of Alberta, Edmonton, Alta
| | - V Mocanu
- From the University of Alberta, Edmonton, Alta
| | - W Sun
- From the University of Alberta, Edmonton, Alta
| | - J Dang
- From the University of Alberta, Edmonton, Alta
| | - U Jogiat
- From the University of Alberta, Edmonton, Alta
| | - J Kung
- From the University of Alberta, Edmonton, Alta
| | - N Switzer
- From the University of Alberta, Edmonton, Alta
| | - S Karmali
- From the University of Alberta, Edmonton, Alta
| | - C Wong
- From the University of Alberta, Edmonton, Alta
| | - C Li
- University of Alberta, Edmonton, Alta
| | | | - A Cieply
- University of Alberta, Edmonton, Alta
| | - H Hawes
- University of British Columbia, Vancouver, B.C
| | - E Joos
- University of British Columbia, Vancouver, B.C
| | - A Saleh
- University of Alberta, Edmonton, Alta
| | - C Li
- University of Alberta, Edmonton, Alta
| | - A Saleh
- University of Alberta, Edmonton, Alta
| | - P Engels
- McMaster University, Hamilton, Ont
| | - J Drung
- From the University of Western Ontario, London, Ont
| | - L Allen
- From the University of Western Ontario, London, Ont
| | - K Leslie
- From the University of Western Ontario, London, Ont
| | - G Pang
- From Western University, London, Ont
| | - M Kwong
- From Western University, London, Ont
| | | | | | - J Hawel
- From Western University, London, Ont
| | - A Elnahas
- From Western University, London, Ont
| | | | | | - S Chadi
- University of Toronto, Toronto, Ont
| | | | - D Chang
- Harvard University, Cambridge, Mass
| | - M Hutter
- Harvard University, Cambridge, Mass
| | - R Spence
- Dalhousie University, Halifax, N.S
| | | | - M Boutros
- Jewish General Hospital, Montreal, Que
| | | | - N Morin
- Jewish General Hospital, Montreal, Que
| | - Y Longtin
- Jewish General Hospital, Montreal, Que
| | - S Liberman
- McGill University Health Centre, Montreal, Que
| | | | | | - M Poirier
- Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Que
| | | | - H Sebajang
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - R Younan
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - F Schwenter
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - E De Broux
- Centre hospitalier de l'Université de Montreal, Montreal, Que
| | - K Larsen
- University of Toronto, Toronto, Ont
| | | | | | - J Nantais
- University of Manitoba, Winnipeg, Man
| | - D Gomez
- University of Toronto, Toronto, Ont
| | - L Lan
- McMaster University, Hamilton, Ont
| | - R Mao
- McMaster University, Hamilton, Ont
| | - J Kay
- McMaster University, Hamilton, Ont
| | - R Lohre
- University of British Columbia, Vancouver, B.C
| | - O Ayeni
- McMaster University, Hamilton, Ont
| | - D Goel
- University of British Columbia, Vancouver, B.C
| | - D de Sa
- McMaster University, Hamilton, Ont
| | - R He
- University of Alberta, Edmonton, Alta
| | - D Hylton
- McMaster University, Hamilton, Ont
| | - E Bedard
- University of Alberta, Edmonton, Alta
| | - S Johnson
- University of Alberta, Edmonton, Alta
| | - B Laing
- University of Alberta, Edmonton, Alta
| | - A Valji
- University of Alberta, Edmonton, Alta
| | | | - S Turner
- University of Alberta, Edmonton, Alta
| | | | | | | | | | | | | | | | - V Gupta
- University of Toronto, Toronto, Ont
| | - B Kidane
- University of Manitoba, Winnipeg, Man
| | | | | | | | | | - Y Patel
- McMaster University, Hamilton, Ont
| | | | - D Hylton
- McMaster University, Hamilton, Ont
| | - F Xie
- McMaster University, Hamilton, Ont
| | - A Seely
- University of Ottawa, Ottawa, Ont
| | - J Spicer
- McGill University, Montreal, Que
| | - B Kidane
- University of Manitoba, Winnipeg, Man
| | - S Turner
- University of Alberta, Edmonton, Alta
| | | | - W Hanna
- McMaster University, Hamilton, Ont
| | - U Jogiat
- From the University of Alberta, Edmonton, Alta
| | - W Sun
- From the University of Alberta, Edmonton, Alta
| | - J Dang
- From the University of Alberta, Edmonton, Alta
| | - V Mocanu
- From the University of Alberta, Edmonton, Alta
| | - J Kung
- From the University of Alberta, Edmonton, Alta
| | - S Karmali
- From the University of Alberta, Edmonton, Alta
| | - S Turner
- From the University of Alberta, Edmonton, Alta
| | - N Switzer
- From the University of Alberta, Edmonton, Alta
| | - Y Patel
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - I Churchill
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - K Sullivan
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - M Beauchamp
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - J Wald
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - L Mbuagbaw
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - J Agzarian
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - Y Shargall
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - C Finley
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - C Fahim
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - W Hanna
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - M Abbas
- From McMaster University, Hamilton, Ont
| | - O Olaiya
- From McMaster University, Hamilton, Ont
| | - H Begum
- From McMaster University, Hamilton, Ont
| | | | - C Finley
- From McMaster University, Hamilton, Ont
| | - W Hanna
- From McMaster University, Hamilton, Ont
| | | | | | - A Ednie
- Western University, London, Ont
| | - D Palma
- Western University, London, Ont
| | | | | | | | - M Qiabi
- Western University, London, Ont
| | - R Nayak
- Western University, London, Ont
| | | | - A Louie
- Sunnybrook Health Sciences Centre
| | | | | | - J Laba
- Western University, London, Ont
| | | | - J Alaichi
- From McMaster University, Hamilton, Ont
| | - Y Patel
- From McMaster University, Hamilton, Ont
| | - W Hanna
- From McMaster University, Hamilton, Ont
| | - S Turner
- From the University of Alberta, Edmonton, Alta
| | - B Mador
- From the University of Alberta, Edmonton, Alta
| | - H Lai
- From the University of Alberta, Edmonton, Alta
| | - J White
- From the University of Alberta, Edmonton, Alta
| | - M Kim
- From the University of Alberta, Edmonton, Alta
| | | | - B Kidane
- University of Manitoba, Winnipeg, Man
| | - A Louie
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - V Zuk
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - G Darling
- Toronto General Hospital, Toronto, Ont
| | | | - T Chesney
- St. Michael's Hospital, Toronto, Ont
| | - N Coburn
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - J Hallet
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Y Lee
- McMaster University, Hamilton, Ont
| | | | - M Lee
- University of Toronto, Toronto, Ont
| | - L Thiru
- McMaster University, Hamilton, Ont
| | | | - C Finley
- McMaster University, Hamilton, Ont
| | - W Hanna
- McMaster University, Hamilton, Ont
| | - O Levine
- McMaster University, Hamilton, Ont
| | | | | | - R Nayak
- Western University, London, Ont
| | - S Brogly
- Queen's University, Kingston, Ont
| | - W Li
- ICES Queen's, Kingston, Ont
| | | | | | - N Mistry
- From McMaster University, Hamilton, Ont
| | - A Gatti
- From McMaster University, Hamilton, Ont
| | | | - Y Patel
- From McMaster University, Hamilton, Ont
| | - W Hanna
- From McMaster University, Hamilton, Ont
| | - S Abdul
- University of Ottawa, Ottawa, Ont
| | - C Anestee
- Ottawa Hospital Research Institute, Ottawa, Ont
| | | | | | - A Seely
- University of Ottawa, Ottawa, Ont
| | | | - D Maziak
- University of Ottawa, Ottawa, Ont
| | - R Razzak
- University of Manitoba, Winnipeg, Man
| | - A Ashrafi
- University of British Columbia, Vancouver, B.C
| | | | | | - S Stone
- University of British Columbia, Vancouver, B.C
| | | | - T Bong
- Fraser Health Authority, B.C
| | - R Bond
- University of British Columbia, Vancouver, B.C
| | - A Hafizi
- Surrey Thoracic Surgery Group, Surrey, B.C
| | - M De Meo
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - R Rayes
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - S Milette
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - M Vagai
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - M Usatii
- Research Institute of the McGill University Health Centre, Montreal, Que
| | | | - B Giannias
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - F Bourdeau
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - V Sangwan
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - N Bertos
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - C Moraes
- McGill University, Montreal, Que
| | - S Huang
- McGill University, Montreal, Que
| | - D Quail
- McGill University, Montreal, Que
| | - L Walsh
- McGill University, Montreal, Que
| | - S Camilleri-Broet
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - P Fiset
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - J Cools-Lartigue
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - L Ferri
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - J Spicer
- Research Institute of the McGill University Health Centre, Montreal, Que
| | - A Kammili
- McGill University Health Centre, Montreal, Que
| | - E Bilgic
- McGill University Health Centre, Montreal, Que
| | | | | | - S Najmeh
- McGill University Health Centre, Montreal, Que
| | - C Mueller
- McGill University Health Centre, Montreal, Que
| | - L Esther
- From McMaster University, Hamilton, Ont
| | - H Begum
- From McMaster University, Hamilton, Ont
| | | | - W Hanna
- From McMaster University, Hamilton, Ont
| | - C Finley
- From McMaster University, Hamilton, Ont
| | | | - Y Lee
- McMaster University, Hamilton, Ont
| | - J Lu
- University of Toronto, Toronto, Ont
| | - R Malhan
- McMaster University, Hamilton, Ont
| | | | - C Finley
- McMaster University, Hamilton, Ont
| | - W Hanna
- McMaster University, Hamilton, Ont
| | | | - S Brophy
- From Dalhousie University, Halifax, N.S
| | - K Brennan
- From Dalhousie University, Halifax, N.S
| | - D French
- From Dalhousie University, Halifax, N.S
| | - V Resende
- Ottawa Hospital Research Institute, Ottawa, Ont
| | | | - O Solaja
- The Ottawa Hospital, Ottawa, Ont
| | | | - D Maziak
- The Ottawa Hospital, Ottawa, Ont
| | - A Seely
- The Ottawa Hospital, Ottawa, Ont
| | | | | | - D Sisson
- From the University of Toronto, Toronto, Ont
| | - L Donahoe
- From the University of Toronto, Toronto, Ont
| | - P Bedard
- From the University of Toronto, Toronto, Ont
| | - A Hansen
- From the University of Toronto, Toronto, Ont
| | - M De Perrot
- From the University of Toronto, Toronto, Ont
| | | | - A Simone
- University of Ottawa, Ottawa, Ont
| | - H Begum
- McMaster University, Hamilton, Ont
| | - W Hanna
- McMaster University, Hamilton, Ont
| | | | - S Turner
- University of Alberta, Edmonton, Alta
| | - J Huang
- Memorial Sloan Kettering Cancer Center, New York, N.Y
| | - H Lai
- University of Alberta, Edmonton, Alta
| | - E Bedard
- University of Alberta, Edmonton, Alta
| | | | - S Murthy
- Cleveland Clinic, Cleveland, Ohio
| | - J Lin
- University of Michigan, Ann Arbor, Mich
| | | | | | - B Kidane
- University of Manitoba, Winnipeg, Man
| | - A Seely
- University of Ottawa, Ottawa, Ont
| | - H Li
- Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | | | | | - E Lau
- McMaster University, Hamilton, Ont
| | | | - W Hanna
- McMaster University, Hamilton, Ont
| | - C Finley
- McMaster University, Hamilton, Ont
| | | | | | | | - V Gupta
- University of Toronto, Toronto, Ont
| | | | - L Davis
- McGill University, Montreal, Que
| | | | - B Kidane
- University of Toronto, Toronto, Ont
| | - G Darling
- University Health Network, Toronto, Ont
| | - N Coburn
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - C Huynh
- From McGill University, Montreal, Que
| | | | - L Ferri
- From McGill University, Montreal, Que
| | - S Najmeh
- From McGill University, Montreal, Que
| | - C Sirois
- From McGill University, Montreal, Que
| | - D Mulder
- From McGill University, Montreal, Que
| | - J Spicer
- From McGill University, Montreal, Que
| | | | | | - D Nguyen
- From the University of Ottawa, Ottawa, Ont
| | - C Anstee
- From the University of Ottawa, Ottawa, Ont
| | - E Delic
- From the University of Ottawa, Ottawa, Ont
| | - S Gilbert
- From the University of Ottawa, Ottawa, Ont
| | - D Maziak
- From the University of Ottawa, Ottawa, Ont
| | | | - A Seely
- From the University of Ottawa, Ottawa, Ont
| | - D Sisson
- University of Toronto, Toronto, Ont
| | | | | | - D Low
- Virginia Mason Medical Center, Seattle, Wash
| | | | - S Turner
- University of Alberta, Edmonton, Alta
| | - M Humer
- From the University of British Columbia, Kelowna, B.C
| | - S Abdul
- University of Ottawa, Ottawa, Ont
| | - D Nguyen
- University of Ottawa, Ottawa, Ont
| | - A Al Rawahi
- Department of Surgery, University of Ottawa, Ottawa, Ont
| | - C Anstee
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - E Delic
- Ottawa Hospital Research Institute, Ottawa, Ont
| | | | | | - D Maziak
- University of Ottawa, Ottawa, Ont
| | - A Seely
- University of Ottawa, Ottawa, Ont
| | | | | | | | - C Anstee
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - E Delic
- Ottawa Hospital Research Institute, Ottawa, Ont
| | | | | | - D Maziak
- University of Ottawa, Ottawa, Ont
| | - A Seely
- University of Ottawa, Ottawa, Ont
| | - Y Patel
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - M Kay
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - I Churchill
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - K Sullivan
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - Y Shargall
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - B Shayegan
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - A Adili
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | - W Hanna
- From McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ont
| | | | - C Huynh
- From McGill University, Montreal, Que
| | | | | | - F Maleki
- From McGill University, Montreal, Que
| | - K Ovens
- From McGill University, Montreal, Que
| | - M Gold
- From McGill University, Montreal, Que
| | - M Sorin
- From McGill University, Montreal, Que
| | - R Falutz
- From McGill University, Montreal, Que
| | - R Rayes
- From McGill University, Montreal, Que
| | | | - J Spicer
- From McGill University, Montreal, Que
| | - N Hunka
- From the University of Saskatchewan, Saskatoon, Sask
| | - R Kennedy
- From the University of Saskatchewan, Saskatoon, Sask
| | - R Bigsby
- From the University of Saskatchewan, Saskatoon, Sask
| | - S Bharadwaj
- From the University of Saskatchewan, Saskatoon, Sask
| | - S Gowing
- From the University of Saskatchewan, Saskatoon, Sask
| | | | - A Gatti
- From McMaster University, Hamilton, Ont
| | - D Hylton
- From McMaster University, Hamilton, Ont
| | | | - Y Patel
- From McMaster University, Hamilton, Ont
| | | | | | - W Hanna
- From McMaster University, Hamilton, Ont
| | - C Finley
- From McMaster University, Hamilton, Ont
| | - H Begum
- From McMaster University, Hamilton, Ont
| | - K Pearce
- From McMaster University, Hamilton, Ont
| | | | - W Hanna
- From McMaster University, Hamilton, Ont
| | | | | | - D Jones
- From The Ottawa Hospital, Ottawa, Ont
| | - C Anstee
- From The Ottawa Hospital, Ottawa, Ont
| | - S Kumar
- From The Ottawa Hospital, Ottawa, Ont
| | | | - A Simone
- From The Ottawa Hospital, Ottawa, Ont
| | | | - K Thavorn
- From The Ottawa Hospital, Ottawa, Ont
| | - A Seely
- From The Ottawa Hospital, Ottawa, Ont
| | - V Gupta
- From the University of Toronto, Toronto, Ont
| | | | - A Mohammed
- From the University of Toronto, Toronto, Ont
| | - S Uddin
- From the University of Toronto, Toronto, Ont
| | - D Jones
- From the University of Toronto, Toronto, Ont
| | - A Behzadi
- From the University of Toronto, Toronto, Ont
| | - A Brar
- From the University of Toronto, Toronto, Ont
| | - L Qu
- From Western University, London, Ont
| | - M Qiabi
- From Western University, London, Ont
| | - R Nayak
- From Western University, London, Ont
| | | | - E Peters
- From the University of Manitoba, Winnipeg, Man
| | - G Buduhan
- From the University of Manitoba, Winnipeg, Man
| | - L Tan
- From the University of Manitoba, Winnipeg, Man
| | - R Liu
- From the University of Manitoba, Winnipeg, Man
| | - S Srinathan
- From the University of Manitoba, Winnipeg, Man
| | - B Kidane
- From the University of Manitoba, Winnipeg, Man
| | - V Gupta
- University of Toronto, Toronto, Ont
| | - J Levy
- University of Toronto, Toronto, Ont
| | - B Kidane
- University of Manitoba, Winnipeg, Man
| | - A Mahar
- University of Manitoba, Winnipeg, Man
| | | | | | | | - N Coburn
- University of Toronto, Toronto, Ont
| | - M Robinson
- From the University of Manitoba, Winnipeg, Man
| | - L Bednarek
- From the University of Manitoba, Winnipeg, Man
| | - G Buduhan
- From the University of Manitoba, Winnipeg, Man
| | - R Liu
- From the University of Manitoba, Winnipeg, Man
| | - L Tan
- From the University of Manitoba, Winnipeg, Man
| | - S Srinathan
- From the University of Manitoba, Winnipeg, Man
| | - B Kidane
- From the University of Manitoba, Winnipeg, Man
| | - H Wang
- From Dalhousie University, Halifax, N.S
| | - D French
- From Dalhousie University, Halifax, N.S
| | | | - K Graham
- From the University of Manitoba, Winnipeg, Man
| | - S Enns
- From the University of Manitoba, Winnipeg, Man
| | - G Buduhan
- From the University of Manitoba, Winnipeg, Man
| | - S Srinathan
- From the University of Manitoba, Winnipeg, Man
| | - R Liu
- From the University of Manitoba, Winnipeg, Man
| | - A Tan
- From the University of Manitoba, Winnipeg, Man
| | - B Kidane
- From the University of Manitoba, Winnipeg, Man
| | | | - E Poole
- University of Manitoba, Winnipeg, Man
| | - C Pascoe
- Children's Hospital Research Institute of Manitoba, Winnipeg, Man
| | - T Karakach
- Children's Hospital Research Institute of Manitoba, Winnipeg, Man
| | - G Buduhan
- University of Manitoba, Winnipeg, Man
| | - L Tan
- University of Manitoba, Winnipeg, Man
| | | | - A Halayko
- Children's Hospital Research Institute of Manitoba, Winnipeg, Man
| | - B Kidane
- University of Manitoba, Winnipeg, Man
| | - K Verhoeff
- From the University of Alberta, Edmonton, Alta
| | - V Mocanu
- From the University of Alberta, Edmonton, Alta
| | - B Fang
- From the University of Alberta, Edmonton, Alta
| | - J Dang
- From the University of Alberta, Edmonton, Alta
| | - J Kung
- From the University of Alberta, Edmonton, Alta
| | - N Switzer
- From the University of Alberta, Edmonton, Alta
| | - D Birch
- From the University of Alberta, Edmonton, Alta
| | - S Karmali
- From the University of Alberta, Edmonton, Alta
| | - G Johnson
- From the University of Manitoba, Winnipeg, Man
| | - H Singh
- From the University of Manitoba, Winnipeg, Man
| | - A Vergis
- From the University of Manitoba, Winnipeg, Man
| | - J Park
- From the University of Manitoba, Winnipeg, Man
| | - O Hershorn
- From the University of Manitoba, Winnipeg, Man
| | - D Hochman
- From the University of Manitoba, Winnipeg, Man
| | - R Helewa
- From the University of Manitoba, Winnipeg, Man
| | - G Johnson
- From the University of Manitoba, Winnipeg, Man
| | - R Robertson
- From the University of Manitoba, Winnipeg, Man
| | - A Vergis
- From the University of Manitoba, Winnipeg, Man
| | - G Johnson
- From the University of Manitoba, Winnipeg, Man
| | - A Vergis
- From the University of Manitoba, Winnipeg, Man
| | - H Singh
- From the University of Manitoba, Winnipeg, Man
| | - J Park
- From the University of Manitoba, Winnipeg, Man
| | - R Helewa
- From the University of Manitoba, Winnipeg, Man
| | - A Azin
- From the University of Toronto, Toronto, Ont
| | - C Cahill
- University of Calgary, Calgary, Alta
| | - M Lipson
- University of Calgary, Calgary, Alta
| | - A Afzal
- University of Calgary, Calgary, Alta
| | - A Maclean
- University of Calgary, Calgary, Alta
| | - C Wong
- University of Alberta, Edmonton, Alta
| | - S Roen
- University of Calgary, Calgary, Alta
| | - W Buie
- University of Calgary, Calgary, Alta
| | | | | | - M Chu
- From McMaster University, Hamilton, Ont
| | - Y Lee
- From McMaster University, Hamilton, Ont
| | - N Amin
- From McMaster University, Hamilton, Ont
| | - D Hong
- From McMaster University, Hamilton, Ont
| | | | | | - K Ramji
- McMaster University, Hamilton, Ont
| | - C Kruse
- McMaster University, Hamilton, Ont
| | - H Jaffer
- University of Toronto, Toronto, Ont
| | | | - N Amin
- McMaster University, Hamilton, Ont
| | | | - D Hong
- McMaster University, Hamilton, Ont
| | | | - R Hajjar
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - M Oliero
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - T Cuisiniere
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - G Fragoso
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - A Calvé
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - S Djediai
- Université du Québec à Montréal, Montreal, Que
| | - B Annabi
- Université du Québec à Montréal, Montreal, Que
| | - C Richard
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - M Santos
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - K Purich
- From the University of Alberta, Edmonton, Alta
| | - Y Zhou
- From the University of Alberta, Edmonton, Alta
| | - S Dodd
- From the University of Alberta, Edmonton, Alta
| | - B Ring
- From the University of Alberta, Edmonton, Alta
| | - Y Yuan
- From the University of Alberta, Edmonton, Alta
| | - J White
- From the University of Alberta, Edmonton, Alta
| | | | | | | | - N Morin
- Jewish General Hospital, Montreal, Que
| | | | - J Faria
- Jewish General Hospital, Montreal, Que
| | | | | | - M Boutros
- Jewish General Hospital, Montreal, Que
| | | | - E Salama
- Jewish General Hospital, Montreal, Que
| | | | - N Morin
- Jewish General Hospital, Montreal, Que
| | | | - J Faria
- Jewish General Hospital, Montreal, Que
| | | | - M Boutros
- Jewish General Hospital, Montreal, Que
| | - G Talwar
- McMaster University, Hamilton, Ont
| | - R Daniel
- University of Toronto, Toronto, Ont
| | | | - O Levine
- McMaster University, Hamilton, Ont
| | | | | | | | | | | | | | - N Morin
- From McGill University, Montreal, Que
| | - M Boutros
- From McGill University, Montreal, Que
| | | | - A Chen
- McMaster University, Hamilton, Ont
| | - A Patel
- Western University, London, Ont
| | - Y Lee
- McMaster University, Hamilton, Ont
| | | | - D Hong
- McMaster University, Hamilton, Ont
| | | | | | | | | | - J Moon
- Jewish General Hospital, Montreal, Que
| | - M Demian
- Jewish General Hospital, Montreal, Que
| | | | - N Morin
- Jewish General Hospital, Montreal, Que
| | - M Boutros
- Jewish General Hospital, Montreal, Que
| | - R Selvam
- University of Ottawa, Ottawa, Ont
| | - H Moloo
- University of Ottawa, Ottawa, Ont
| | - H MacRae
- University of Toronto, Toronto, Ont
| | - F Alam
- University of Toronto, Toronto, Ont
| | - I Raiche
- University of Ottawa, Ottawa, Ont
| | - J Holland
- From McGill University, Montreal, Que
| | - M Cwintal
- From McGill University, Montreal, Que
| | - G Rigas
- From McGill University, Montreal, Que
| | | | - N Morin
- From McGill University, Montreal, Que
| | | | - J Faria
- From McGill University, Montreal, Que
| | - A Pang
- From McGill University, Montreal, Que
| | - M Boutros
- From McGill University, Montreal, Que
| | - J Holland
- From McGill University, Montreal, Que
| | - J Moon
- From McGill University, Montreal, Que
| | | | - N Morin
- From McGill University, Montreal, Que
| | | | - A Pang
- From McGill University, Montreal, Que
| | | | - M Boutros
- From McGill University, Montreal, Que
| | - C Brown
- From St. Paul's Hospital, Vancouver, B.C
| | | | - M Raval
- From St. Paul's Hospital, Vancouver, B.C
| | - P Phang
- From St. Paul's Hospital, Vancouver, B.C
| | - A Ghuman
- From St. Paul's Hospital, Vancouver, B.C
| | - M Li
- University of Calgary, Calgary, Alta
| | - S Muncner
- University of Alberta, Edmonton, Alta
| | | | - M Dykstra
- University of Alberta, Edmonton, Alta
| | | | - H Wang
- University of Alberta, Edmonton, Alta
| | - O Monton
- McMaster University, Hamilton, Ont
| | - A Smith
- Western University, London, Ont
| | - J Moon
- McGill University, Montreal, Que
| | - M Demian
- McGill University, Montreal, Que
| | | | | | | | | | - O AlAamer
- From King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - N AlSelaim
- From King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - M AlMalki
- From King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A Al-Osail
- From King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - R Ruxton
- From Southland Hospital, Invercargill, New Zealand
| | - P Manuel
- From Southland Hospital, Invercargill, New Zealand
| | - F Mohamed
- From Southland Hospital, Invercargill, New Zealand
| | | | - S Serahati
- University of Saskatchewan, Saskatoon, Saskatchewan
| | | | - C Brown
- Providence Health Care, Vancouver, B.C
| | - M Raval
- Providence Health Care, Vancouver, B.C
| | | | - A Ghuman
- Providence Health Care, Vancouver, B.C
| | - T Phang
- Providence Health Care, Vancouver, B.C
| | | | - J Moon
- McGill University, Montreal, Que
| | | | - S Chadi
- University Health Network, Toronto, Ont
| | - K Alavi
- University of Massachusetts, Amherst, Mass
| | - I Paquette
- University of Cincinnati, Cincinnati, Ohio
| | - T MacLean
- University of Calgary, Calgary, Alta
| | - S Wexner
- Cleveland Clinic Florida, Weston, Fla
| | | | - S Steele
- Cleveland Clinic, Cleveland, Ohio
| | - J Park
- University of Manitoba, Winnipeg, Man
| | - S Patel
- Queen's University, Kingston, Ont
| | | | - R Auer
- The Ottawa Hospital, Ottawa, Ont
| | - P Sylla
- Icahn School of Medicine at Mount Sinai, New York, N.Y
| | - N Morin
- McGill University, Montreal, Que
| | - A Ghuman
- McGill University, Montreal, Que
| | | | - Z Bayat
- From the University of Toronto, Toronto, Ont
| | - E Kennedy
- From the University of Toronto, Toronto, Ont
| | - C Victor
- From the University of Toronto, Toronto, Ont
| | | | - J Liang
- From McGill University, Montreal, Que
| | | | - A Pang
- From McGill University, Montreal, Que
| | | | - J Faria
- From McGill University, Montreal, Que
| | - N Morin
- From McGill University, Montreal, Que
| | - M Boutros
- From McGill University, Montreal, Que
| | | | - H Roy
- University of Saskatchewan, Saskatoon, Sask
| | - Z Baig
- University of Saskatchewan, Saskatoon, Sask
| | | | - M Raval
- University of British Columbia, Vancouver, B.C
| | - C Brown
- University of British Columbia, Vancouver, B.C
| | - T Phang
- University of British Columbia, Vancouver, B.C
| | - D Gill
- University of Saskatchewan, Saskatoon, Sask
| | - N Ginther
- University of Saskatchewan, Saskatoon, Sask
| | - J Moon
- From McGill University, Montreal, Que
| | | | - A Pang
- From McGill University, Montreal, Que
| | | | - J Faria
- From McGill University, Montreal, Que
| | - N Morin
- From McGill University, Montreal, Que
| | | | - M Boutros
- From McGill University, Montreal, Que
| | - J Moon
- From McGill University, Montreal, Que
| | - A Pang
- From McGill University, Montreal, Que
| | | | - J Faria
- From McGill University, Montreal, Que
| | - N Morin
- From McGill University, Montreal, Que
| | | | - M Boutros
- From McGill University, Montreal, Que
| | - E Salama
- From McGill University, Montreal, Que
| | | | | | | | - J Faria
- From McGill University, Montreal, Que
| | - N Morin
- From McGill University, Montreal, Que
| | - M Boutros
- From McGill University, Montreal, Que
| | - V Wiseman
- From Queen's University, Kingston, Ont
| | - L Zhang
- From Queen's University, Kingston, Ont
| | | | | | | | | | - S V Patel
- From Queen's University, Kingston, Ont
| | - Z Harra
- From McGill University, Montreal, Que
| | | | | | - N Morin
- From McGill University, Montreal, Que
| | - M Boutros
- From McGill University, Montreal, Que
| | - A Pang
- From McGill University, Montreal, Que
| | - M Hegagi
- From McGill University, Montreal, Que
| | | | - N Morin
- From McGill University, Montreal, Que
| | | | | | - M Boutros
- From McGill University, Montreal, Que
| | | | | | | | - A Pang
- From McGill University, Montreal, Que
| | | | - M Boutros
- From McGill University, Montreal, Que
| | | | - N Kasteel
- University of Calgary, Calgary, Alta
| | - G Kaur
- University of Calgary, Calgary, Alta
| | - S Bindra
- University of Calgary, Calgary, Alta
| | - A Malhotra
- Vardhman Mahavir Medical College, New Delhi, India
| | - C Graham
- University of Calgary, Calgary, Alta
| | - A MacLean
- University of Calgary, Calgary, Alta
| | - P Beck
- University of Calgary, Calgary, Alta
| | - H Jijon
- University of Calgary, Calgary, Alta
| | - J Ferraz
- University of Calgary, Calgary, Alta
| | - W Buie
- University of Calgary, Calgary, Alta
| | - R Szwimer
- From McGill University, Montreal, Que
| | - J Moon
- From McGill University, Montreal, Que
| | - M Demian
- From McGill University, Montreal, Que
| | - A Pang
- From McGill University, Montreal, Que
| | - N Morin
- From McGill University, Montreal, Que
| | | | | | - M Boutros
- From McGill University, Montreal, Que
| | - A Azin
- From the University of Toronto, Toronto, Ont
| | | | - W Kong
- Queen's Cancer Research Institute, Kingston, Ont
| | | | - T Hanna
- Queen's University, Kingston, Ont
| | - W Chung
- Queen's University, Kingston, Ont
| | - S Nanji
- Queen's University, Kingston, Ont
| | - S Patel
- Queen's University, Kingston, Ont
| | - C Booth
- Queen's University, Kingston, Ont
| | - V Li
- From McMaster University, Hamilton, Ont
| | - A Awan
- From McMaster University, Hamilton, Ont
| | - P Serrano
- From McMaster University, Hamilton, Ont
| | - M Jacobson
- From the University of Calgary, Calgary, Alta
| | - M Chanco
- From the University of Calgary, Calgary, Alta
| | - V Wen
- From the University of Calgary, Calgary, Alta
| | - N Singh
- From the University of Calgary, Calgary, Alta
| | - L Peiris
- From the University of Calgary, Calgary, Alta
| | - J Pasieka
- From the University of Calgary, Calgary, Alta
| | - P Ghatage
- From the University of Calgary, Calgary, Alta
| | - D Buie
- From the University of Calgary, Calgary, Alta
| | - T MacLean
- From the University of Calgary, Calgary, Alta
| | | | - L Mack
- From the University of Calgary, Calgary, Alta
| | - W Marini
- From the University of Toronto, Toronto, Ont
| | - W Zheng
- From the University of Toronto, Toronto, Ont
| | - C Swallow
- From the University of Toronto, Toronto, Ont
| | - M Reedijk
- From the University of Toronto, Toronto, Ont
| | | | - L Peiris
- From the University of Alberta, Edmonton, Alta
| | | | - L Delmar
- From the University of Alberta, Edmonton, Alta
| | - N Gagnon
- Université de Sherbrooke, Sherbrooke, Que
| | | | | | | | | | | | - S Mysuria
- From the University of British Columbia, Vancouver, B.C
| | - A Bazzarelli
- From the University of British Columbia, Vancouver, B.C
| | - J Pao
- From the University of British Columbia, Vancouver, B.C
| | - L Chen
- From the University of British Columbia, Vancouver, B.C
| | - M Zhang
- From the University of British Columbia, Vancouver, B.C
| | - E McKevitt
- From the University of British Columbia, Vancouver, B.C
| | - R Warburton
- From the University of British Columbia, Vancouver, B.C
| | - U Kuusk
- From the University of British Columbia, Vancouver, B.C
| | - N Van Laeken
- From the University of British Columbia, Vancouver, B.C
| | - E Bovill
- From the University of British Columbia, Vancouver, B.C
| | - K Isaac
- From the University of British Columbia, Vancouver, B.C
| | - C Dingee
- From the University of British Columbia, Vancouver, B.C
| | | | | | | | - L Barbera
- University of Calgary, Calgary, Alta
| | - Y Efegoma
- University of Calgary, Calgary, Alta
| | - D Howell
- Princess Margaret Research Institute, Toronto, Ont
| | | | | | - A Scheer
- St. Michael's Hospital, Toronto, Ont
| | - C Simmons
- University of British Columbia, Vancouver, B.C
| | | | | | - Y Xu
- University of Calgary, Calgary, Alta
| | | | - M Quan
- University of Calgary, Calgary, Alta
| | - A Alqaydi
- From Queen's University, Kingston, Ont
| | - J la
- From Queen's University, Kingston, Ont
| | | | - G Digby
- From Queen's University, Kingston, Ont
| | - V Pravong
- University of Montreal, Montreal, Que
| | | | - L Sidéris
- Maisonneuve-Rosemont Hospital, Montreal, Que
| | - P Dubé
- Maisonneuve-Rosemont Hospital, Montreal, Que
| | | | - S Fortin
- University of Montreal, Montreal, Que
| | - M Auclair
- University of Montreal, Montreal, Que
| | - B Trilling
- Maisonneuve-Rosemont Hospital, Montreal, Que
| | - J Tremblay
- Maisonneuve-Rosemont Hospital, Montreal, Que
| | - É Di Lena
- From McGill University, Montreal, Que
| | - B Hopkins
- From McGill University, Montreal, Que
| | - S Wong
- From McGill University, Montreal, Que
| | | | - É Di Lena
- From McGill University, Montreal, Que
| | - N Barone
- From McGill University, Montreal, Que
| | - B Hopkins
- From McGill University, Montreal, Que
| | - S Dumitra
- From McGill University, Montreal, Que
| | - P Kaneva
- From McGill University, Montreal, Que
| | - J Fiore
- From McGill University, Montreal, Que
| | | | - S Mysuria
- From the University of British Columbia, Vancouver, B.C
| | - E McKevitt
- From the University of British Columbia, Vancouver, B.C
| | - R Warburton
- From the University of British Columbia, Vancouver, B.C
| | - L Chen
- From the University of British Columbia, Vancouver, B.C
| | - A Bazzarelli
- From the University of British Columbia, Vancouver, B.C
| | - J Pao
- From the University of British Columbia, Vancouver, B.C
| | - E Bovill
- From the University of British Columbia, Vancouver, B.C
| | - M Zhang
- From the University of British Columbia, Vancouver, B.C
| | - U Kuusk
- From the University of British Columbia, Vancouver, B.C
| | - K Isaac
- From the University of British Columbia, Vancouver, B.C
| | - N Van Laeken
- From the University of British Columbia, Vancouver, B.C
| | - C Dingee
- From the University of British Columbia, Vancouver, B.C
| | - H Kapur
- From the University of British Columbia, Vancouver, B.C
| | - E McKevitt
- From the University of British Columbia, Vancouver, B.C
| | - R Warburton
- From the University of British Columbia, Vancouver, B.C
| | - J Pao
- From the University of British Columbia, Vancouver, B.C
| | - C Dingee
- From the University of British Columbia, Vancouver, B.C
| | - A Bazarelli
- From the University of British Columbia, Vancouver, B.C
| | - U Kuusk
- From the University of British Columbia, Vancouver, B.C
| | - L Chen
- From the University of British Columbia, Vancouver, B.C
| | - L Cadili
- From the University of British Columbia, Vancouver, B.C
| | - K DeGirolamo
- From the University of British Columbia, Vancouver, B.C
| | - E McKevitt
- From the University of British Columbia, Vancouver, B.C
| | - J Pao
- From the University of British Columbia, Vancouver, B.C
| | - C Dingee
- From the University of British Columbia, Vancouver, B.C
| | - A Bazzarelli
- From the University of British Columbia, Vancouver, B.C
| | - R Warburton
- From the University of British Columbia, Vancouver, B.C
| | - D Ng
- From the University of Toronto, Toronto, Ont
| | - A Ali
- From the University of Toronto, Toronto, Ont
| | - D Eymae
- From the University of Toronto, Toronto, Ont
| | - K Lee
- From the University of Toronto, Toronto, Ont
| | - S Brar
- From the University of Toronto, Toronto, Ont
| | - J Conner
- From the University of Toronto, Toronto, Ont
| | - M Magalhaes
- From the University of Toronto, Toronto, Ont
| | - C Swallow
- From the University of Toronto, Toronto, Ont
| | - K Allen
- From the University of British Columbia, Vancouver, B.C
| | - C Baliski
- From the University of British Columbia, Vancouver, B.C
| | - D Cyr
- University of Toronto, Toronto, Ont
| | - A Sari
- Sinai Health System, Toronto, Ont
| | | | - D Driman
- London Health Sciences Centre, London, Ont
| | | | - A Juda
- Sinai Health System, Toronto, Ont
| | | | | | - M Brar
- University of Toronto, Toronto, Ont
| | - J Conner
- Sinai Health System, Toronto, Ont
| | - R Kirsch
- Sinai Health System, Toronto, Ont
| | | | - K Singh
- University of Toronto, Toronto, Ont
| | | | - Y Gamache
- ASDevices, Spira Innovations, Thetford, Que
| | | | - C Mardinger
- From the University of Calgary, Calgary, Alta
| | - C Lee
- From the University of Calgary, Calgary, Alta
| | - R Duckworth
- From the University of Calgary, Calgary, Alta
| | - M Brindle
- From the University of Calgary, Calgary, Alta
| | - F Fraulin
- From the University of Calgary, Calgary, Alta
| | - L Austen
- From the University of Calgary, Calgary, Alta
| | - J Kortbeek
- From the University of Calgary, Calgary, Alta
| | - M Hyndman
- From the University of Calgary, Calgary, Alta
| | - D Nguyen
- From McGill University, Montreal, Que
| | - G Jamjoum
- From McGill University, Montreal, Que
| | | | - S Langer
- University of Calgary, Calgary, Alta
| | - Y Yuan Xu
- University of Calgary, Calgary, Alta
| | - S Kong
- Alberta Health Services, Calgary, Alta
| | - M Quan
- University of Calgary, Calgary, Alta
| | - D Lim
- Women's College Hospital, Toronto, Ont
| | | | | | - K Butler
- University Health Network, Toronto, Ont
| | | | - T Cil
- University of Toronto, Toronto, Ont
| | - T Zhong
- University of Toronto, Toronto, Ont
| | - S Hofer
- University of Toronto, Toronto, Ont
| | | | | | - D Lim
- Women's College Hospital, Toronto, Ont
| | - B Greene
- University of Toronto, Toronto, Ont
| | | | - M Parapini
- University of British Columbia, Vancouver, B.C
| | - J Skipworth
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, U.K
| | - A Mah
- University of British Columbia, Vancouver, B.C
| | - S Desai
- University of British Columbia, Vancouver, B.C
| | - S Chung
- University of British Columbia, Vancouver, B.C
| | - C Scudamore
- University of British Columbia, Vancouver, B.C
| | - M Segedi
- University of British Columbia, Vancouver, B.C
| | - E Vasilyeva
- University of British Columbia, Vancouver, B.C
| | - J Li
- University of British Columbia, Vancouver, B.C
| | - P Kim
- University of British Columbia, Vancouver, B.C
| | - K Verhoeff
- From the University of Alberta, Edmonton, Alta
| | - A Deprato
- From the University of Alberta, Edmonton, Alta
| | - K Purich
- From the University of Alberta, Edmonton, Alta
| | - J Kung
- From the University of Alberta, Edmonton, Alta
| | - D Bigam
- From the University of Alberta, Edmonton, Alta
| | - K Dajani
- From the University of Alberta, Edmonton, Alta
| | - T Lenet
- University of Ottawa, Ottawa, Ont
| | | | - R Smoot
- Mayo Clinic, Rochester, Minn
| | - G Martel
- The Ottawa Hospital, Ottawa, Ont
| | - C Tzeng
- MD Anderson Cancer Center, Houston, Tex
| | - F Rocha
- Oregon Health & Science University, Portland, Ore
| | | | | | | | | | | | | | - N Hanna
- Queen's University, Kingston, Ont
| | - S Brogly
- Queen's University, Kingston, Ont
| | | | - C Booth
- Queen's University, Kingston, Ont
| | - S Nanji
- Queen's University, Kingston, Ont
| | | | - N Coburn
- University of Toronto, Toronto, Ont
| | - A Mahar
- University of Manitoba, Winnipeg, Man
| | - J Callum
- Queen's University, Kingston, Ont
| | | | | | - A Wei
- Memorial Sloan Kettering Cancer Center, New York, N.Y
| | | | - J Hallet
- University of Toronto, Toronto, Ont
| | | | | | - A Wei
- Memorial Sloan Kettering Cancer Center, New York, N.Y
| | - A Mahar
- University of Manitoba, Winnipeg, Man
| | | | - G Martel
- University of Ottawa, Ottawa, Ont
| | - N Coburn
- University of Toronto, Toronto, Ont
| | - J Hallet
- University of Toronto, Toronto, Ont
| | - D Henault
- From the University of Montreal, Montreal, Que
| | - B Barrette
- From the University of Montreal, Montreal, Que
| | - S Pelletier
- From the University of Montreal, Montreal, Que
| | - P Thebault
- From the University of Montreal, Montreal, Que
| | | | - Z Rong
- From the University of Montreal, Montreal, Que
| | - M Plasse
- From the University of Montreal, Montreal, Que
| | | | | | - R Lapointe
- From the University of Montreal, Montreal, Que
| | | | - B Nguyen
- From the University of Montreal, Montreal, Que
| | - G Soucy
- From the University of Montreal, Montreal, Que
| | - S Turcotte
- From the University of Montreal, Montreal, Que
| | - M Lemke
- From Western University, London, Ont
| | - E Waugh
- From Western University, London, Ont
| | - K Leslie
- From Western University, London, Ont
| | - D Quan
- From Western University, London, Ont
| | - A Skaro
- From Western University, London, Ont
| | - E Tang
- From Western University, London, Ont
| | - M Lund
- From the University of Western Ontario, London, Ont
| | - L Allen
- From the University of Western Ontario, London, Ont
| | - J Glinka
- From the University of Western Ontario, London, Ont
| | - G Jada
- From the University of Western Ontario, London, Ont
| | - D Quan
- From the University of Western Ontario, London, Ont
| | - A Skaro
- From the University of Western Ontario, London, Ont
| | - E Tang
- From the University of Western Ontario, London, Ont
| | - L Park
- McMaster University, Hamilton, Ont
| | - J Daza
- University of Toronto, Toronto, Ont
| | - V Li
- McMaster University, Hamilton, Ont
| | | | - B Zhang
- McMaster University, Hamilton, Ont
| | | | - S Faisal
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - R Faisal
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M Fabbro
- University of Toronto, Toronto, Ont
| | - C Gu
- McMaster University, Hamilton, Ont
| | | | - V Zuk
- University of Toronto, Toronto, Ont
| | - J Hallet
- University of Toronto, Toronto, Ont
| | - G Martel
- University of Ottawa, Ottawa, Ont
| | | | | | - J Glinka
- From the Western University, London, Ont
| | - A Skaro
- From the Western University, London, Ont
| | - K Leslie
- From the Western University, London, Ont
| | - G Jada
- From the Western University, London, Ont
| | - D Quan
- From the Western University, London, Ont
| | - E Tang
- From the Western University, London, Ont
| | - E Waugh
- From Western University, London, Ont
| | - M Lemke
- From Western University, London, Ont
| | - J Glinka
- From Western University, London, Ont
| | - A Skaro
- From Western University, London, Ont
| | - K Leslie
- From Western University, London, Ont
| | - E Tang
- From Western University, London, Ont
| | - E Waugh
- From Western University, London, Ont
| | | | - R Liu
- From Western University, London, Ont
| | - E Tang
- From Western University, London, Ont
| | - L Allen
- From Western University, London, Ont
| | - S Welch
- From Western University, London, Ont
| | - A Skaro
- From Western University, London, Ont
| | - K Leslie
- From Western University, London, Ont
| | - J Glinka
- From Western University, London, Ont
| | - E Waugh
- From Western University, London, Ont
| | - E Tang
- From Western University, London, Ont
| | - G Jada
- From Western University, London, Ont
| | - D Quan
- From Western University, London, Ont
| | - A Skaro
- From Western University, London, Ont
| | - A Webb
- From the University of Alberta, Edmonton, Alta
| | - E Lester
- From the University of Alberta, Edmonton, Alta
| | - A Shapiro
- From the University of Alberta, Edmonton, Alta
| | - D Eurich
- From the University of Alberta, Edmonton, Alta
| | - D Bigam
- From the University of Alberta, Edmonton, Alta
| | - Y Essaji
- From Virginia Mason Medical Center, Seattle, Wash
| | - H Shrader
- From the University of Iowa, Iowa City, Iowa
| | - A Nayyar
- From the University of Iowa, Iowa City, Iowa
| | - M Suraju
- From the University of Iowa, Iowa City, Iowa
| | | | - P Ear
- From the University of Iowa, Iowa City, Iowa
| | - C Chan
- From the University of Iowa, Iowa City, Iowa
| | - V Smith
- From Dalhousie University, Halifax, N.S
| | | | - A Costa
- From Dalhousie University, Halifax, N.S
| | - A Stueck
- From Dalhousie University, Halifax, N.S
| | | | - S Allen
- From Dalhousie University, Halifax, N.S
| | | | | | - T Lenet
- University of Ottawa, Ottawa, Ont
| | | | - R Smoot
- Mayo Clinic, Rochester, Minn
| | - C Tzeng
- MD Anderson Cancer Center, Houston, Tex
| | - F Rocha
- Oregon Health and Science University, Portland, Ore
| | - G Martel
- University of Ottawa, Ottawa, Ont
| | | | - Z Mir
- From Queen's University, Kingston, Ont
| | - H Golding
- From Queen's University, Kingston, Ont
| | - S McKeown
- From Queen's University, Kingston, Ont
| | - S Nanji
- From Queen's University, Kingston, Ont
| | | | - P Groome
- From Queen's University, Kingston, Ont
| | - Z Mir
- From Queen's University, Kingston, Ont
| | | | - S Nanji
- From Queen's University, Kingston, Ont
| | | | - P Groome
- From Queen's University, Kingston, Ont
| | - S Elbekri
- University of Sherbrooke, Sherbrooke, Que
| | - S Turcotte
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - E Girard
- Centre hospitalier universitaire de Grenoble Alpes, Grenoble, France
| | | | - R Lapointe
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | | | - M Dagenais
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - A Roy
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - R Letourneau
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - M Plasse
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - E Simoneau
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - Z Rong
- Centre hospitalier de l'Université de Montréal, Montreal, Que
| | - N Zuker
- From SUNY Upstate Medical University, Syracuse, N.Y
| | - M Oakley
- From SUNY Upstate Medical University, Syracuse, N.Y
| | - G Chartrand
- From the University of Montreal, Montreal, Que
| | - B Misheva
- From the University of Montreal, Montreal, Que
| | - Y Bendavid
- From the University of Montreal, Montreal, Que
| | - J Frigault
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - S Lemieux
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - D Breton
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - G Bouchard
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | - S Drolet
- From the Centre hospitalier universitaire de Québec - Université Laval, Québec, Que
| | | | - L Smith
- North York General Hospital, North York, Ont
| | - J Tan
- Humber River Hospital, North York, Ont
| | - U Kahn
- University of Toronto, Toronto, Ont
| | - C McLean
- From the University of Alberta, Edmonton, Alta
| | - V Mocanu
- From the University of Alberta, Edmonton, Alta
| | - D Birch
- From the University of Alberta, Edmonton, Alta
| | - S Karmali
- From the University of Alberta, Edmonton, Alta
| | - N Switzer
- From the University of Alberta, Edmonton, Alta
| | - M Fortin
- Centre hospitalier affilié universitaire régional de Trois-Rivières, Trois-Rivières, Que
| | - X Paré
- Centre hospitalier affilié universitaire régional de Trois-Rivières, Trois-Rivières, Que
| | - A Doyon
- Centre hospitalier affilié universitaire régional de Trois-Rivières, Trois-Rivières, Que
| | | | | | - J Yadav
- University of Toronto, Toronto, Ont
| | - S Fischer
- University Health Network, Toronto, Ont
| | - T Jackson
- University Health Network, Toronto, Ont
| | - J Allard
- University Health Network, Toronto, Ont
| | | | - Y Lee
- McMaster University, Hamilton, Ont
| | - S Anvari
- McMaster University, Hamilton, Ont
| | - M Chu
- McMaster University, Hamilton, Ont
| | | | - I Aditya
- University of Toronto, Toronto, Ont
| | - R Malhan
- McMaster University, Hamilton, Ont
| | | | - M Walsh
- McMaster University, Hamilton, Ont
| | | | - D Hong
- McMaster University, Hamilton, Ont
| | - W He
- From the University of Manitoba, Winnipeg, Man
| | - A Vergis
- From the University of Manitoba, Winnipeg, Man
| | - K Hardy
- From the University of Manitoba, Winnipeg, Man
| | - R Romanescu
- From the University of Manitoba, Winnipeg, Man
| | - F Deaninck
- From the University of Manitoba, Winnipeg, Man
| | - J Linton
- From the University of Manitoba, Winnipeg, Man
| | | | | | - G Shingoose
- From the University of Manitoba, Winnipeg, Man
| | - A Vergis
- From the University of Manitoba, Winnipeg, Man
| | - K Hardy
- From the University of Manitoba, Winnipeg, Man
| | | | | | | | - Y Lee
- From McMaster University, Hamilton, Ont
| | - V Archer
- From McMaster University, Hamilton, Ont
| | | | - J Shiroky
- From McMaster University, Hamilton, Ont
| | | | - K Ramji
- From McMaster University, Hamilton, Ont
| | | | - A Mierzwa
- From the University of Alberta, Edmonton, Alta
| | - V Mocanu
- From the University of Alberta, Edmonton, Alta
| | - G Marcil
- From the University of Alberta, Edmonton, Alta
| | - J Dang
- From the University of Alberta, Edmonton, Alta
| | - N Switzer
- From the University of Alberta, Edmonton, Alta
| | - D Birch
- From the University of Alberta, Edmonton, Alta
| | - S Karmali
- From the University of Alberta, Edmonton, Alta
| | - A Mierzwa
- From the University of Alberta, Edmonton, Alta
| | - A Jarrar
- The Ottawa Hospital, Ottawa, Ont
| | | | | | - W Lin
- University of Toronto, Toronto, Ont
| | - J Hagen
- Humber River Hospital, North York, Ont
| | - M Connell
- From the University of Alberta, Edmonton, Alta
| | - W Sun
- From the University of Alberta, Edmonton, Alta
| | - J Dang
- From the University of Alberta, Edmonton, Alta
| | - V Mocanu
- From the University of Alberta, Edmonton, Alta
| | - J Kung
- From the University of Alberta, Edmonton, Alta
| | - N Switzer
- From the University of Alberta, Edmonton, Alta
| | - D Birch
- From the University of Alberta, Edmonton, Alta
| | - S Karmali
- From the University of Alberta, Edmonton, Alta
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11
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Mohammad AH, Kim SH, Bertos N, El-Assaad W, Nandi I, Smith H, Yang J, Chen OJ, Gamache I, Rao T, Gagnon B, Gruosso T, Tremblay ML, Sonenberg N, Guiot MC, Muller W, Park M, Teodoro JG. Elevated V-ATPase Activity Following PTEN Loss Is Required for Enhanced Oncogenic Signaling in Breast Cancer. Mol Cancer Res 2020; 18:1477-1490. [PMID: 32587106 DOI: 10.1158/1541-7786.mcr-20-0088] [Citation(s) in RCA: 6] [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] [Received: 01/26/2020] [Revised: 04/30/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022]
Abstract
PTEN loss-of-function contributes to hyperactivation of the PI3K pathway and to drug resistance in breast cancer. Unchecked PI3K pathway signaling increases activation of the mechanistic target of rapamycin complex 1 (mTORC1), which promotes tumorigenicity. Several studies have suggested that vacuolar (H+)-ATPase (V-ATPase) complex activity is regulated by PI3K signaling. In this study, we showed that loss of PTEN elevated V-ATPase activity. Enhanced V-ATPase activity was mediated by increased expression of the ATPase H+ transporting accessory protein 2 (ATP6AP2), also known as the prorenin receptor (PRR). PRR is cleaved into a secreted extracellular fragment (sPRR) and an intracellular fragment (M8.9) that remains associated with the V-ATPase complex. Reduced PTEN expression increased V-ATPase complex activity in a PRR-dependent manner. Breast cancer cell lines with reduced PTEN expression demonstrated increased PRR expression. Similarly, PRR expression became elevated upon PTEN deletion in a mouse model of breast cancer. Interestingly, concentration of sPRR was elevated in the plasma of patients with breast cancer and correlated with tumor burden in HER2-enriched cancers. Moreover, PRR was essential for proper HER2 receptor expression, localization, and signaling. PRR knockdown attenuated HER2 signaling and resulted in reduced Akt and ERK 1/2 phosphorylation, and in lower mTORC1 activity. Overall, our study demonstrates a mechanism by which PTEN loss in breast cancer can potentiate multiple signaling pathways through upregulation of the V-ATPase complex. IMPLICATIONS: Our study contributed to the understanding of the role of the V-ATPase complex in breast cancer cell tumorigenesis and provided a potential biomarker in breast cancer.
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Affiliation(s)
- Amro H Mohammad
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Sung-Hoon Kim
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Nicholas Bertos
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Molecular Oncology Group, McGill University Health Centre, Montreal, Quebec, Canada
| | - Wissal El-Assaad
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Ipshita Nandi
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Harvey Smith
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Jieyi Yang
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Owen J Chen
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Isabelle Gamache
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Trisha Rao
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Bruno Gagnon
- Department of Family Medicine and Emergency Medicine, Laval University, Laval, Quebec, Canada
| | - Tina Gruosso
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Molecular Oncology Group, McGill University Health Centre, Montreal, Quebec, Canada
| | - Michel L Tremblay
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Nahum Sonenberg
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Marie-Christine Guiot
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - William Muller
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Morag Park
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada.,Molecular Oncology Group, McGill University Health Centre, Montreal, Quebec, Canada.,McGill University Health Centre, McGill University, Montreal, Quebec, Canada.,Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Jose G Teodoro
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada. .,Department of Biochemistry, McGill University, Montreal, Quebec, Canada
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12
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De Meo M, Rayes R, Milette S, Vagai M, Usatii M, Chandrasekaran A, Giannias B, Bourdeau F, Moraes C, Huang S, Quail D, Walsh L, Sangwan V, Bertos N, Camilleri-Broet S, Broet P, Fiset P, Cools-Lartigue J, Ferri L, Spicer J. MA04.07 Inhibition of CXCR2+ Neutrophil Migration as a Targeted Therapy in KRAS-Driven Lung Adenocarcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Dankner M, Senecal J, Neubarth NS, Bertos N, Park M, Issa-Chergui B, Asselah J, Siegel PM, Bouganim N. A survey of health care professionals and oncology patients at the McGill University Health Centre reveals enthusiasm for establishing a postmortem rapid tissue donation program. ACTA ACUST UNITED AC 2019; 26:e558-e570. [PMID: 31548825 DOI: 10.3747/co.26.4771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background In the early developmental phase of a postmortem rapid tissue donation (rtd) program for patients with metastatic cancer, we surveyed health care professionals (hcps) and oncology patients at the McGill University Health Centre (muhc) to assess their knowledge and attitudes pertaining to rtd from metastatic cancer patients for research purposes. Methods A 23-item survey was developed and distributed to hcps at tumour board meetings, and a related 26-item survey was developed and distributed to oncology patients at the muhc Cedars Cancer Centre. Results The survey attracted participation from 73 hcps, including 37 attending physicians, and 102 oncology patients. Despite the fact that 88% of hcps rated their knowledge of rtd as none or limited, 42% indicated that they would feel comfortable discussing rtd with their cancer patients. Of the responding hcps, 67% indicated that their current knowledge of rtd would affect their decision to discuss such a program with patients, which implies the importance of education for hcps to facilitate enrolment of patients into a rtd program. Of responding patients, 78% indicated that they would not be uncomfortable if their doctor discussed rtd with them, and 61% indicated that they would like it if their doctor were to discuss rtd with them. The hcps and patients felt that the best time for patients to be approached about consenting to a rtd program would be at the transition to palliative care when no treatment options remain. Conclusions At the muhc, hcps and patients are generally enthusiastic about adopting a rtd program for patients with metastatic cancer. Education of hcps and patients will be an important determinant of the program's success.
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Affiliation(s)
- M Dankner
- Goodman Cancer Research Centre, Montreal, QC.,Department of Experimental Medicine, McGill University, Montreal, QC
| | - J Senecal
- Goodman Cancer Research Centre, Montreal, QC.,Department of Experimental Medicine, McGill University, Montreal, QC
| | - N S Neubarth
- Goodman Cancer Research Centre, Montreal, QC.,Department of Anatomy and Cell Biology, McGill University, Montreal, QC
| | - N Bertos
- Research Institute of the McGill University Health Centre, Montreal, QC
| | - M Park
- Goodman Cancer Research Centre, Montreal, QC.,Research Institute of the McGill University Health Centre, Montreal, QC.,Department of Pathology, McGill University, Montreal, QC.,Department of Biochemistry, McGill University, Montreal, QC
| | - B Issa-Chergui
- Department of Pathology, McGill University, Montreal, QC.,Cedars Cancer Centre, Montreal, QC
| | - J Asselah
- Cedars Cancer Centre, Montreal, QC.,McGill University Health Centre, Montreal, QC
| | - P M Siegel
- Goodman Cancer Research Centre, Montreal, QC.,Department of Experimental Medicine, McGill University, Montreal, QC.,Department of Anatomy and Cell Biology, McGill University, Montreal, QC.,Research Institute of the McGill University Health Centre, Montreal, QC.,Department of Biochemistry, McGill University, Montreal, QC
| | - N Bouganim
- Cedars Cancer Centre, Montreal, QC.,McGill University Health Centre, Montreal, QC
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14
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Rayes RF, Mouhanna JG, Nicolau I, Bourdeau F, Giannias B, Rousseau S, Quail D, Walsh L, Sangwan V, Bertos N, Cools-Lartigue J, Ferri LE, Spicer JD. Primary tumors induce neutrophil extracellular traps with targetable metastasis promoting effects. JCI Insight 2019; 5:128008. [PMID: 31343990 DOI: 10.1172/jci.insight.128008] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Targeting the dynamic tumor immune microenvironment (TIME) can provide effective therapeutic strategies for cancer. Neutrophils are the predominant leukocyte population in mice and humans, and mounting evidence implicates these cells during tumor growth and metastasis. Neutrophil extracellular traps (NETs) are networks of extracellular neutrophil DNA fibers that are capable of binding tumor cells to support metastatic progression. Here we demonstrate for the first time that circulating NET levels are elevated in advanced esophageal, gastric and lung cancer patients compared to healthy controls. Using pre-clinical murine models of lung and colon cancer in combination with intravital video microscopy, we show that NETs functionally regulate disease progression and that blocking NETosis through multiple strategies significantly inhibits spontaneous metastasis to the lung and liver. Further, we visualize how inhibiting tumor-induced NETs decreases cancer cell adhesion to liver sinusoids following intrasplenic injection - a mechanism previously thought to be driven primarily by exogenous stimuli. Thus, in addition to neutrophil abundance, the functional contribution of NETosis within the TIME has critical translational relevance and represents a promising target to impede metastatic dissemination.
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Affiliation(s)
- Roni F Rayes
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Jack G Mouhanna
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Ioana Nicolau
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - France Bourdeau
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Betty Giannias
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Simon Rousseau
- Meakins-Christie Laboratories, Department of Medicine, McGill University and the MUHC, Montreal, Québec, Canada
| | - Daniela Quail
- Goodman Cancer Research Center, McGill University, Montreal, Québec, Canada
| | - Logan Walsh
- Goodman Cancer Research Center, McGill University, Montreal, Québec, Canada
| | - Veena Sangwan
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Nicholas Bertos
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Jonathan Cools-Lartigue
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Lorenzo E Ferri
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
| | - Jonathan D Spicer
- Cancer Research Program and the LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University Health Center (MUHC), Montreal, Québec, Canada
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15
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Rayes RF, Mouhanna JG, Wang C, Milette S, Wong C, Usatii M, Giannias B, Bourdeau F, Mot R, Chandrasekaran A, Moraes C, Huang S, Quail D, Walsh L, Sangwan V, Bertos N, Fiset PO, Cools-Lartigue J, Ferri LE, Spicer JD. Abstract 2799: Targeting CXCR2-mediated neutrophil recruitment to lung cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2799] [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
With recent advances in immunotherapy, it is evident that targeting the tumor microenvironment (TME) is an effective strategy to treat lung cancer (LC), however, more than half LC patients are still resistant to therapy. Limited attention was given to the relevance of the innate immune system despite its critical role in triggering adaptive responses. Neutrophils (PMNs) are the predominant circulating leukocyte in humans. PMNs are associated with developing lesions and are the main immune component of primary non-small cell LC (NSCLC). Multiple studies support the notion that PMNs promote tumor progression, however, the exact mechanisms in which these PMNs are recruited to the primary and metastatic lung TMEs remain unclear. To this end, we examined available genomic databases of > 1,000 NSCLC primary adenocarcinoma (ADC) patients and observed that high expression of all CXCR2 ligands (CXCL1-8 and MIF) correlate with poor survival in lung ADC. Lung ADC patients display one of the highest fold increases of these ligands as compared to all other cancers. We then performed shRNA knock down (KD) of CXCL1 and MIF in A549 and tested the migration of PMNs towards treated and control cell lines using the novel microfluidic device. We observe 3-fold increase of PMN migration towards A549 compared to control. This increase was significantly inhibited in MIF and CXCL1 KDs as well as using MIF and CXCL1 neutralizing antibodies (NA) as compared to controls. PMN migration was higher to A549 then to PC9EN, and treatment of PMNs with a CXCR2 NA led to a decrease in their migration to A549 while unaffecting their migration to PC9EN. Due to the lack of similar genomic databases on LC metastasis, we profiled liver homogenates of mice intrasplenically injected with liver-metastatic Lewis lung carcinoma (LLC) and observed that Cxcl1 was the most overexpressed gene as compared to non-tumor bearing mice (non-TBM). We then KD CXCL1 from the liver metastatic LLC cell line and compared its capacity to recruit PMNs in live mice using intravital microscopy. We observe a decrease in the number of PMNs around developing CXCL1 KD LLC tumors compared to control LLC. We also observe a decrease in PMN migration toward the CXCL1 KD LLC tumors as compared the control LLC. This resulted in a significant decrease in liver metastasis of the CXCL1 KD LLC as compared to control LLC injected mice. Altogether, our data highlight the importance of CXCR2-mediated PMN migration in primary LC and the establishment of liver metastasis from LC. Thus, inhibiting CXCR2 represents a promising strategy to impede primary tumor growth and metastatic dissemination of LC.
Citation Format: Roni F. Rayes, Jack G. Mouhanna, Claire Wang, Simon Milette, Carson Wong, Mariana Usatii, Betty Giannias, France Bourdeau, Rachel Mot, Arvind Chandrasekaran, Christopher Moraes, Sidong Huang, Daniela Quail, Logan Walsh, Veena Sangwan, Nicholas Bertos, Pierre-Olivier Fiset, Jonathan Cools-Lartigue, Lorenzo E. Ferri, Jonathan D. Spicer. Targeting CXCR2-mediated neutrophil recruitment to lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2799.
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Affiliation(s)
- Roni F. Rayes
- 1McGill University Health Center, Montreal, Quebec, Canada
| | | | - Claire Wang
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Simon Milette
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Carson Wong
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Mariana Usatii
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Betty Giannias
- 1McGill University Health Center, Montreal, Quebec, Canada
| | | | - Rachel Mot
- 2McGill University, Montreal, Quebec, Canada
| | | | | | | | | | - Logan Walsh
- 2McGill University, Montreal, Quebec, Canada
| | - Veena Sangwan
- 1McGill University Health Center, Montreal, Quebec, Canada
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16
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Rayes RF, Mouhanna JG, Nicolau I, Vourtzoumis P, Wong C, Eustache J, Bourdeau F, Giannias B, Siblini A, Lee E, Sangwan V, Rousseau S, Quail D, Walsh L, Bertos N, Cools-Lartigue J, Ferri LE, Spicer JD. Abstract 1508: Primary tumors induce neutrophil extracellular traps with targetable metastasis promoting effects. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1508] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Targeting the dynamic tumor immune microenvironment can provide effective therapeutic strategies for cancer. Neutrophils (polymorphonuclear neutrophils, PMNs) are the predominant circulating leukocyte population in humans and are vital to fight infection. Despite mounting evidence that PMNs can promote tumor progression, depleting PMNs is not a viable therapeutic option. Neutrophil extracellular traps (NETs) are networks of extracellular neutrophil DNA fibers that are capable of trapping tumor cells and promoting their growth and their metastasis. Targeting NETs can therefore be a potentially successful therapeutic option to block the tumor promoting functions of PMNs. Here we demonstrate that circulating NET levels are elevated in esophageal, gastric and lung cancer patients compared to healthy controls. This increase correlates with disease stage and NET levels are independent predictors of advanced stage. Using pre-clinical murine models of lung and colon cancer, we observe elevated NET levels in tumor bearing mice compared to non-tumor bearing mice; these levels correlated with tumor size. NET levels significantly decrease following tumor resection or treatment with DNase1, a NET degrader, or neutrophil elastase inhibitor (NEi), a NET inhibitor. NET levels do not rise following tumor inoculation in peptidyl arginine deiminase-IV knock out (PAD4-/-) mice; PAD4 being an enzyme essential for citrullination of histones, a crucial step in NET release. Moreover, PMNs from tumor bearing mice are more primed for NETosis than PMNs from non-tumor bearing mice or NEi-treated or PAD4-/- tumor bearing mice. Finally, elevated in vivo hepatic adhesion and spontaneous liver and lung metastases are observed in tumor bearing mice compared to DNase1- or NEi-treated or PAD4-/- tumor bearing mice. Therefore, inhibiting NETs represents a promising strategy to impede metastatic dissemination in several types of cancer patients.
Citation Format: Roni F. Rayes, Jack G. Mouhanna, Ioana Nicolau, Phil Vourtzoumis, Carson Wong, Jules Eustache, France Bourdeau, Betty Giannias, Aya Siblini, Emma Lee, Veena Sangwan, Simon Rousseau, Daniela Quail, Logan Walsh, Nicholas Bertos, Jonathan Cools-Lartigue, Lorenzo E. Ferri, Jonathan D. Spicer. Primary tumors induce neutrophil extracellular traps with targetable metastasis promoting effects [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1508.
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Affiliation(s)
- Roni F. Rayes
- 1McGill University Health Center, Montreal, Quebec, Canada
| | | | | | | | - Carson Wong
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Jules Eustache
- 1McGill University Health Center, Montreal, Quebec, Canada
| | | | - Betty Giannias
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Aya Siblini
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Emma Lee
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Veena Sangwan
- 1McGill University Health Center, Montreal, Quebec, Canada
| | - Simon Rousseau
- 1McGill University Health Center, Montreal, Quebec, Canada
| | | | - Logan Walsh
- 3McGill University, Montreal, Quebec, Canada
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17
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Dankner M, Senecal J, Neubarth N, Bertos N, Park M, Issa-Chergui B, Asselah J, Siegel P, Bouganim N. A survey of healthcare professionals and oncology patients at the McGill University Health Centre reveals enthusiasm towards establishing a post-mortem rapid tissue donation program. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e23005] [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
e23005 Background: In the early developmental phase of a post-mortem Rapid Tissue Donation (RTD) program for metastatic cancer patients, we surveyed health care professionals (HCPs) and oncology patients at the McGill University Health Centre (MUHC) to assess their knowledge and attitudes pertaining to RTD from metastatic cancer patients for research purposes. Methods: A 23-item survey was developed and distributed to HCPs at tumour board meetings, and a related 26-item survey was developed and distributed to oncology patients at the MUHC Cedars Cancer Centre. Results: 73 HCPs, including 37 attending physicians, and 102 oncology patients participated in the study. Despite the fact that 88% of HCPs rated their knowledge of RTD as none or limited, 42% indicated that they would feel comfortable discussing RTD with their cancer patients. 67% of HCPs indicated that their current knowledge of RTD would impact their decision to discuss such a program with patients, implying the importance of educating HCPs to facilitate enrolment of patients into an RTD program. 78% of patients indicated that they would not be uncomfortable if their doctor discussed RTD with them, and 61% indicated that they would like for their doctor to discuss RTD with them. HCPs and patients felt that the best time for patients to be approached about consenting to an RTD program is in the transition to palliative care when there are no treatment options remaining. Conclusions: HCPs and patients at the MUHC are generally enthusiastic about adopting an RTD program for metastatic cancer patients. Education of HCPs and patients will be an important determinant of the program’s success.
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Affiliation(s)
| | - Julien Senecal
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada
| | | | | | | | | | - Jamil Asselah
- Department of Oncology, McGill University Health Center, Montreal, QC, Canada
| | - Peter Siegel
- Goodman Cancer Research Centre, Montreal, QC, Canada
| | - Nathaniel Bouganim
- Department of Oncology, McGill University Health Center, Montreal, QC, Canada
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18
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Gruosso T, Gigoux M, Manem VSK, Bertos N, Zuo D, Perlitch I, Saleh SMI, Zhao H, Souleimanova M, Johnson RM, Monette A, Ramos VM, Hallett MT, Stagg J, Lapointe R, Omeroglu A, Meterissian S, Buisseret L, Van den Eynden G, Salgado R, Guiot MC, Haibe-Kains B, Park M. Spatially distinct tumor immune microenvironments stratify triple-negative breast cancers. J Clin Invest 2019; 129:1785-1800. [PMID: 30753167 DOI: 10.1172/jci96313] [Citation(s) in RCA: 223] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/07/2019] [Indexed: 12/21/2022] Open
Abstract
Understanding the tumor immune microenvironment (TIME) promises to be key for optimal cancer therapy, especially in triple-negative breast cancer (TNBC). Integrating spatial resolution of immune cells with laser capture microdissection gene expression profiles, we defined distinct TIME stratification in TNBC, with implications for current therapies including immune checkpoint blockade. TNBCs with an immunoreactive microenvironment exhibited tumoral infiltration of granzyme B+CD8+ T cells (GzmB+CD8+ T cells), a type 1 IFN signature, and elevated expression of multiple immune inhibitory molecules including indoleamine 2,3-dioxygenase (IDO) and programmed cell death ligand 1 (PD-L1), and resulted in good outcomes. An "immune-cold" microenvironment with an absence of tumoral CD8+ T cells was defined by elevated expression of the immunosuppressive marker B7-H4, signatures of fibrotic stroma, and poor outcomes. A distinct poor-outcome immunomodulatory microenvironment, hitherto poorly characterized, exhibited stromal restriction of CD8+ T cells, stromal expression of PD-L1, and enrichment for signatures of cholesterol biosynthesis. Metasignatures defining these TIME subtypes allowed us to stratify TNBCs, predict outcomes, and identify potential therapeutic targets for TNBC.
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Affiliation(s)
- Tina Gruosso
- Goodman Cancer Research Centre and.,Department of Oncology, McGill University, Montreal, Quebec, Canada
| | | | - Venkata Satya Kumar Manem
- Princess Margaret Cancer Centre and.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Sadiq Mehdi Ismail Saleh
- Goodman Cancer Research Centre and.,Department of Biochemistry.,Centre for Bioinformatics, McGill University, Montreal, Quebec, Canada
| | | | | | | | - Anne Monette
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montréal, Canada
| | | | - Michael Trevor Hallett
- Department of Biochemistry.,Centre for Bioinformatics, McGill University, Montreal, Quebec, Canada.,School of Computer Science, McGill University, Montreal, Quebec, Canada
| | - John Stagg
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montréal, Canada
| | - Réjean Lapointe
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montréal, Canada
| | | | - Sarkis Meterissian
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Surgery, McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - Laurence Buisseret
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Roberto Salgado
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.,Departments of Pathology and Cytology, GZA Hospitals, Wilrijk, Belgium
| | - Marie-Christine Guiot
- Department of Pathology and.,Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre and.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Computer Science, University of Toronto, Toronto, Ontario, Canada.,Ontario Institute of Cancer Research, Toronto, Ontario, Canada
| | - Morag Park
- Goodman Cancer Research Centre and.,Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry.,Department of Pathology and
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19
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Xue Y, Meehan B, Macdonald E, Venneti S, Wang XQD, Witkowski L, Jelinic P, Kong T, Martinez D, Morin G, Firlit M, Abedini A, Johnson RM, Cencic R, Patibandla J, Chen H, Papadakis AI, Auguste A, de Rink I, Kerkhoven RM, Bertos N, Gotlieb WH, Clarke BA, Leary A, Witcher M, Guiot MC, Pelletier J, Dostie J, Park M, Judkins AR, Hass R, Levine DA, Rak J, Vanderhyden B, Foulkes WD, Huang S. CDK4/6 inhibitors target SMARCA4-determined cyclin D1 deficiency in hypercalcemic small cell carcinoma of the ovary. Nat Commun 2019; 10:558. [PMID: 30718512 PMCID: PMC6361890 DOI: 10.1038/s41467-018-06958-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/04/2018] [Indexed: 12/22/2022] Open
Abstract
Inactivating mutations in SMARCA4 (BRG1), a key SWI/SNF chromatin remodelling gene, underlie small cell carcinoma of the ovary, hypercalcemic type (SCCOHT). To reveal its druggable vulnerabilities, we perform kinase-focused RNAi screens and uncover that SMARCA4-deficient SCCOHT cells are highly sensitive to the inhibition of cyclin-dependent kinase 4/6 (CDK4/6). SMARCA4 loss causes profound downregulation of cyclin D1, which limits CDK4/6 kinase activity in SCCOHT cells and leads to in vitro and in vivo susceptibility to CDK4/6 inhibitors. SCCOHT patient tumors are deficient in cyclin D1 yet retain the retinoblastoma-proficient/p16INK4a-deficient profile associated with positive responses to CDK4/6 inhibitors. Thus, our findings indicate that CDK4/6 inhibitors, approved for a breast cancer subtype addicted to CDK4/6 activation, could be repurposed to treat SCCOHT. Moreover, our study suggests a novel paradigm whereby critically low oncogene levels, caused by loss of a driver tumor suppressor, may also be exploited therapeutically.
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Affiliation(s)
- Yibo Xue
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Brian Meehan
- Department of Pediatrics, McGill University, Montreal, QC, H4A 3J1, Canada
- Research Institute of McGill University Health Centre Montreal Children's Hospital, Montreal, QC, H4A 3J1, Canada
| | - Elizabeth Macdonald
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, K1Y 4E9, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Sriram Venneti
- Pathology and Neuropathology, University of Michigan Medical School, Ann Arbor, MI, 48109-0605, USA
| | - Xue Qing D Wang
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Leora Witkowski
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada
- Department of Medical Genetics, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada
- Lady Davis Institute, McGill University, Montreal, QC, H3T 1E2, Canada
- Department of Medical Genetics and Cancer Research Program, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3JI, Canada
| | - Petar Jelinic
- Gynecologic Oncology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, 10016, USA
| | - Tim Kong
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Daniel Martinez
- Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, 19104, USA
| | - Geneviève Morin
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Michelle Firlit
- Gynecologic Oncology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, 10016, USA
| | - Atefeh Abedini
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, K1Y 4E9, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Radia M Johnson
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Regina Cencic
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Jay Patibandla
- Gynecologic Oncology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, 10016, USA
| | - Hongbo Chen
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sat University, 510275, Guangzhou, China
| | - Andreas I Papadakis
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Aurelie Auguste
- Department of Cancer Medicine, Gustave Roussy, INSERM U981, 94800, Villejuif, France
| | - Iris de Rink
- Genomics Core Facility, The Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
| | - Ron M Kerkhoven
- Genomics Core Facility, The Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
| | - Nicholas Bertos
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Walter H Gotlieb
- Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada
| | - Blaise A Clarke
- Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network, Toronto, ON, M5G 2C4, Canada
| | - Alexandra Leary
- Department of Cancer Medicine, Gustave Roussy, INSERM U981, 94800, Villejuif, France
| | - Michael Witcher
- Department of Oncology, McGill University, Montreal, QC, H3T 1E2, Canada
- Department of Experimental Medicine, McGill University, Montreal, QC, H3T 1E2, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, H3T 1E2, Canada
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC, H3T 1E2, Canada
| | - Marie-Christine Guiot
- Department of Pathology, Montreal Neurological Hospital/Institute, McGill University Health Centre, Montreal, QC, H3A 2B4, Canada
| | - Jerry Pelletier
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Josée Dostie
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Morag Park
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada
| | - Alexander R Judkins
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, 90027, USA
| | - Ralf Hass
- Biochemistry and Tumor Biology Laboratory, Department of Gynecology and Obstetrics, Medical University Hannover, 30625, Hannover, Germany
| | - Douglas A Levine
- Gynecologic Oncology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, 10016, USA
| | - Janusz Rak
- Department of Pediatrics, McGill University, Montreal, QC, H4A 3J1, Canada
- Research Institute of McGill University Health Centre Montreal Children's Hospital, Montreal, QC, H4A 3J1, Canada
| | - Barbara Vanderhyden
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, K1Y 4E9, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, H3A 0C7, Canada.
- Department of Medical Genetics, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
- Lady Davis Institute, McGill University, Montreal, QC, H3T 1E2, Canada.
- Department of Medical Genetics and Cancer Research Program, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3JI, Canada.
| | - Sidong Huang
- Department of Biochemistry, McGill University, Montreal, QC, H3G 1Y6, Canada.
- The Rosalind & Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, H3A 1A3, Canada.
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20
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Kuasne H, Savage P, Ramirez CM, Liu L, Muñoz-Ramos V, Pilon V, Monast A, Johnson R, Bertos N, Asselah J, Bouganim N, Petrecca K, Meterissian S, Omeroglu A, Basik M, Park M. Abstract 1044: Establishment and characterization of rare breast patient-derived xenograft models as a potential resource for personalized medicine. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer (BC) exhibits a wide range of morphologic phenotypes and gene expression profiles. Most of the studies that led to the identification of intrinsic molecular subtypes in BC were limited to invasive ductal carcinomas of the breast and did not take rare histopathologic subtypes into account. Rare histopathologic BC subtypes (collectively less than 2% of all breast cancer) have particular prognostic and clinical characteristics. There is no current established treatment that takes into account the specificity of rare BC subtypes. This is mainly due to the absence of clinical trials to determine the optimal management of these rare pathologies. The establishment of relevant preclinical models and molecular characterization of rare BC subtypes is essential for identifying directed and suitable therapeutic regimens for BC patients diagnosed with these rare histopathologic variants. Patient-derived xenograft (PDX) has been recognized as a valuable method to evaluate the clinical diversity of breast cancer. These models were shown to be predictive of clinical outcomes and are being used for preclinical drug evaluation, biomarker identification, and personalized medicine strategies. We developed a cohort of eight BC rare histopathologic subtypes, including four metaplastic, one adenoid cystic, one IDC pleomorphic, one neuroendocrine, and one mucinous BC subtype. These PDXs and their primary tumors were submitted to whole-genome sequencing (WGS) and RNA sequencing. We also evaluated a total of 255 proteins by reverse phase protein array (RPPA) in these PDX samples. We are currently performing conditional reprogramming experiments to generate cell lines from these rare BC PDXs. Our preliminary results indicate that pathways related to PI3K/AKT, ERK/MAPK, mTOR, HGF, ERBB, AMPK and IL3 signaling are disrupted in rare BC subtypes. Several genes belonging to these pathways are dysregulated in rare BC tumors, and therefore represent potential therapeutic targets for personalized treatment.
Citation Format: Hellen Kuasne, Paul Savage, Constanza Martinez Ramirez, Leah Liu, Valentina Muñoz-Ramos, Virginie Pilon, Anie Monast, Radia Johnson, Nicholas Bertos, Jamil Asselah, Nathaniel Bouganim, Kevin Petrecca, Sarkis Meterissian, Atilla Omeroglu, Mark Basik, Morag Park. Establishment and characterization of rare breast patient-derived xenograft models as a potential resource for personalized medicine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1044.
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Affiliation(s)
| | | | | | - Leah Liu
- 1McGill, Montreal, Quebec, Canada
| | | | | | | | | | | | | | | | | | | | | | - Mark Basik
- 2Jewish General Hospital, Montreal, Quebec, Canada
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21
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Janeiro CA, Stavrakos V, Alzahrani M, Rayes RF, Bourdeau F, Giannias B, Bertos N, Sangwan V, Cools-Lartigue J, Spicer JD, Ferri LE. Abstract 5176: Cell free malignant ascites fluid facilitates gastric adenocarcinoma peritoneal metastasis. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5176] [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
Gastric adenocarcinoma is the fastest rising malignancy in North America. It is commonly associated with malignant ascites (MA), the pathological accumulation of fluid containing cancer cells in the peritoneum. Peritoneal metastasis is the most common site of gastric cancer (GC) progression after curative intent surgery and is the leading cause of death. Upon peritoneal dissemination, the malignant process is deemed non-curative as it is rarely amenable to surgical resection and chemotherapeutic regimens are simply palliative. We hypothesize that cell-free MA increases the potential of GC cells to worsen peritoneal metastasis. Gastric adenocarcinoma cell lines (human: MKN-45, SNU-5, KATO III, OKAJIMA; murine NCC-S1, NCC-S1M) were incubated with cell-free MA and their metastatic ability assessed with static in vitro adhesion assays, as well as migration assays. A novel ex vivo peritoneal metastasis model further corroborated the in vitro results, where cancer cell adhesion to stripped human peritoneum was assessed by co-incubation with non- and pre-stimulated cancer cells. Gross liver metastasis was monitored over several weeks after in vivo intra-peritoneal and intra-splenic injections, whereby C57BL/6 mice were inoculated with control media or stimulated NCC-S1M cells. Incubation of human GC cells and/or human peritoneal mesothelial cells (HPMC) with cell-free MA resulted in a significant three to five-fold increase of GC cell adhesion to HPMC compared to non-stimulated condition (P<0.05), as measured by inverted fluorescent microscopy. In addition, the murine GC cells incubated with MA showed a significant eight-fold increase on average (P<0.05) in GC cell adhesion to HPMC compared to non-stimulated condition. Cell-free MA was shown to significantly enhance ex vivo SNU-5 cell adhesion to stripped human peritoneum by a two to four-fold increase (P<0.05) compared to non-stimulated condition. Liver metastases were visible in mice that received in vivo injections of ascites-stimulated NCC-S1M cancer cells by day 25, yet not in mice inoculated with control media. Several factors (ANG-2, HGF, ICAM-1, IL-8, TIMP-2, uPAR, VEGF, NAP-2, MIF) were shown to be upregulated in MA samples compared to a cirrhotic ascites control, using a multiplex ELISA. In particular, VEGF was upregulated 11 to 25-fold, and MIF two to 12-fold. The results demonstrated that MA plays a significant role in facilitating GC cell adhesion to peritoneal mesothelia, an important early step in the peritoneal metastatic cascade. MA must therefore provide an environment that supports tumour growth and spread. A more comprehensive understanding of the molecular network is essential to determine the role of cell free MA fluid in GC progression, allowing for the identification of potential therapeutic targets for this aggressive malignancy.
Citation Format: Chantelle A. Janeiro, Vivian Stavrakos, Malak Alzahrani, Roni F. Rayes, France Bourdeau, Betty Giannias, Nicholas Bertos, Veena Sangwan, Jonathan Cools-Lartigue, Jonathan D. Spicer, Lorenzo E. Ferri. Cell free malignant ascites fluid facilitates gastric adenocarcinoma peritoneal metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5176.
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Affiliation(s)
| | | | | | - Roni F. Rayes
- 2McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Betty Giannias
- 2McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Veena Sangwan
- 2McGill University Health Centre, Montreal, Quebec, Canada
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22
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Manem V, Adam GA, Gruosso T, Gigoux M, Bertos N, Park M, Haibe-Kains B. CrosstalkNet: A Visualization Tool for Differential Co-expression Networks and Communities. Cancer Res 2018; 78:2140-2143. [PMID: 29459407 DOI: 10.1158/0008-5472.can-17-1383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/23/2017] [Accepted: 02/13/2018] [Indexed: 11/16/2022]
Abstract
Variations in physiological conditions can rewire molecular interactions between biological compartments, which can yield novel insights into gain or loss of interactions specific to perturbations of interest. Networks are a promising tool to elucidate intercellular interactions, yet exploration of these large-scale networks remains a challenge due to their high dimensionality. To retrieve and mine interactions, we developed CrosstalkNet, a user friendly, web-based network visualization tool that provides a statistical framework to infer condition-specific interactions coupled with a community detection algorithm for bipartite graphs to identify significantly dense subnetworks. As a case study, we used CrosstalkNet to mine a set of 54 and 22 gene-expression profiles from breast tumor and normal samples, respectively, with epithelial and stromal compartments extracted via laser microdissection. We show how CrosstalkNet can be used to explore large-scale co-expression networks and to obtain insights into the biological processes that govern cross-talk between different tumor compartments.Significance: This web application enables researchers to mine complex networks and to decipher novel biological processes in tumor epithelial-stroma cross-talk as well as in other studies of intercompartmental interactions. Cancer Res; 78(8); 2140-3. ©2018 AACR.
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Affiliation(s)
- Venkata Manem
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - George Alexandru Adam
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Tina Gruosso
- Goodman Cancer Research Centre, McGill University, Montreal, Canada
| | - Mathieu Gigoux
- Goodman Cancer Research Centre, McGill University, Montreal, Canada
| | - Nicholas Bertos
- Goodman Cancer Research Centre, McGill University, Montreal, Canada
| | - Morag Park
- Goodman Cancer Research Centre, McGill University, Montreal, Canada
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. .,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Computer Science, University of Toronto, Toronto, Ontario, Canada.,Ontario Institute of Cancer Research, Toronto, Ontario, Canada
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23
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Gruosso T, Gigoux M, Bertos N, Manem VS, Zuo D, Saleg SM, Souleimanova M, Zhao H, Johnson RM, Monette A, Muñoz Ramos V, Hallett MT, Stagg J, Lapointe R, Omeroglu A, Meterissian S, Buisseret L, Van den Eyden G, Salgado R, Guiot MC, Haibe-Kains B, Park M. Abstract PD6-05: Distinct tumor microenvironments stratify triple negative breast cancer into immune subtypes. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Triple negative breast cancer (TNBC) are especially difficult to treat effectively. While only 20-30% of TNBC patients respond to chemotherapy in the neoadjuvant setting, overall outcome remains poor for non-responding patients. Engaging the immune system promises optimal personalized cancer therapy as mounting evidence suggests that immune-checkpoint inhibitor immunotherapies may become a therapeutic option for TNBC patients. The presence of CD8+ T cells, a crucial component of the cytotoxic arm of the adaptive immune response, is associated with good clinical outcome in TNBC patients. Specifically, it is the efficient CD8+ T cell invasion and infiltration in the tumor that is associated with good outcome. On the other hand, some tumors accumulate CD8+ T cells in the tumor-associated stroma with poor infiltration in the tumor epithelium. These patients show poor outcome. As CD8+ T cell infiltration in the tumor is a crucial step to mount an efficient anti-tumor response, we thus wondered how the tumor microenvironment affects CD8+ T cell invasion into the tumor epithelial compartment of the TNBC tumors.
Methods:
To identify potential stroma-dependent mechanisms that potentiate or inhibit CD8+ T cells invasion into the tumor epithelium, we coupled analysis of spatial patterns of CD8+ T cell localization by Immunohistochemistry (IHC) andperformed gene expression profiling of laser-capture microdissected tumor-associated stroma (as well as matched epithelium and bulk tumor) from 38 TNBC chemotherapy-naive primary cases. GSEA-based Metasignatures were derived from bulk tumor gene expression data from our cohort. To investigate the compartment of origin of the pathways identified via the Metasignatures, the (LCM)-derived tumor stromal and epithelial gene expression were analyzed.
Results:
CD8+ T cell quantification in different compartments of the tumor identify 3 main subgroups of TNBC based on CD8+ T cell localization. Importantly we developed a 2-step classification scheme based on CD8+ T cell localization. We developed metasignatures following our 2 steps classification and identified key bulk tumor metasignatures that showed prognostic value in an independent cohort. In addition the matched LCM gene expression from the tumor epithelium and stromal compartments allowed us to identify the compartment of origin.
Importantly, while 1 group of TNBC tumor was showing a significant anti-tumor response, the 2 other groups showed absence of such environment. The 2 non inflamed immune subtypes showed distinct phenotypes and biologies associated with poor anti-tumor response that we validated by immunohistochemistry and fluorescence. These results highlight different potential mecanisms that lead to immune evasion and allow us to stratify TNBC into immune subgroups.
Citation Format: Gruosso T, Gigoux M, Bertos N, Manem VS, Zuo D, Saleg SM, Souleimanova M, Zhao H, Johnson RM, Monette A, Muñoz Ramos V, Hallett MT, Stagg J, Lapointe R, Omeroglu A, Meterissian S, Buisseret L, Van den Eyden G, Salgado R, Guiot M-C, Haibe-Kains B, Park M. Distinct tumor microenvironments stratify triple negative breast cancer into immune subtypes [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD6-05.
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Affiliation(s)
- T Gruosso
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Gigoux
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - N Bertos
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - VS Manem
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - D Zuo
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - SM Saleg
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Souleimanova
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - H Zhao
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - RM Johnson
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Monette
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - V Muñoz Ramos
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - MT Hallett
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J Stagg
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - R Lapointe
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Omeroglu
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Meterissian
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - L Buisseret
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - G Van den Eyden
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - R Salgado
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M-C Guiot
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - B Haibe-Kains
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Park
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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24
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Liu H, Dowdle JA, Khurshid S, Sullivan NJ, Bertos N, Rambani K, Mair M, Daniel P, Wheeler E, Tang X, Toth K, Lause M, Harrigan ME, Eiring K, Sullivan C, Sullivan MJ, Chang SW, Srivastava S, Conway JS, Kladney R, McElroy J, Bae S, Lu Y, Tofigh A, Saleh SMI, Fernandez SA, Parvin JD, Coppola V, Macrae ER, Majumder S, Shapiro CL, Yee LD, Ramaswamy B, Hallett M, Ostrowski MC, Park M, Chamberlin HM, Leone G. Discovery of Stromal Regulatory Networks that Suppress Ras-Sensitized Epithelial Cell Proliferation. Dev Cell 2017; 41:392-407.e6. [PMID: 28535374 DOI: 10.1016/j.devcel.2017.04.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 10/19/2016] [Revised: 03/20/2017] [Accepted: 04/26/2017] [Indexed: 01/09/2023]
Abstract
Mesodermal cells signal to neighboring epithelial cells to modulate their proliferation in both normal and disease states. We adapted a Caenorhabditis elegans organogenesis model to enable a genome-wide mesodermal-specific RNAi screen and discovered 39 factors in mesodermal cells that suppress the proliferation of adjacent Ras pathway-sensitized epithelial cells. These candidates encode components of protein complexes and signaling pathways that converge on the control of chromatin dynamics, cytoplasmic polyadenylation, and translation. Stromal fibroblast-specific deletion of mouse orthologs of several candidates resulted in the hyper-proliferation of mammary gland epithelium. Furthermore, a 33-gene signature of human orthologs was selectively enriched in the tumor stroma of breast cancer patients, and depletion of these factors from normal human breast fibroblasts increased proliferation of co-cultured breast cancer cells. This cross-species approach identified unanticipated regulatory networks in mesodermal cells with growth-suppressive function, exposing the conserved and selective nature of mesodermal-epithelial communication in development and cancer.
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Affiliation(s)
- Huayang Liu
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - James A Dowdle
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Safiya Khurshid
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Nicholas J Sullivan
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Nicholas Bertos
- Department of Biochemistry, Rosalind and Morris Goodman Cancer Center, McGill University, Montreal, QC H3A 1A1, Canada; Department of Oncology, McGill University, Montreal, QC H3A 1A1, Canada
| | - Komal Rambani
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Markus Mair
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Piotr Daniel
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Esther Wheeler
- Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA
| | - Xing Tang
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Kyle Toth
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Michael Lause
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Markus E Harrigan
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Karl Eiring
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Connor Sullivan
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Matthew J Sullivan
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Serena W Chang
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Siddhant Srivastava
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Joseph S Conway
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Raleigh Kladney
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Joseph McElroy
- Center for Biostatistics, Office of Health Sciences, McGill University, Montreal, QC H3A 1A1, Canada; Department of Biomedical Informatics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Sooin Bae
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Yuanzhi Lu
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Ali Tofigh
- Department of Biochemistry, Rosalind and Morris Goodman Cancer Center, McGill University, Montreal, QC H3A 1A1, Canada; McGill Centre for Bioinformatics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Sadiq M I Saleh
- Department of Biochemistry, Rosalind and Morris Goodman Cancer Center, McGill University, Montreal, QC H3A 1A1, Canada; McGill Centre for Bioinformatics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Soledad A Fernandez
- Center for Biostatistics, Office of Health Sciences, McGill University, Montreal, QC H3A 1A1, Canada; Department of Biomedical Informatics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Jeffrey D Parvin
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Biomedical Informatics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Vincenzo Coppola
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Erin R Macrae
- Division of Medical Oncology, Department of Internal Medicine, McGill University, Montreal, QC H3A 1A1, Canada
| | - Sarmila Majumder
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Charles L Shapiro
- Division of Medical Oncology, Department of Internal Medicine, McGill University, Montreal, QC H3A 1A1, Canada
| | - Lisa D Yee
- Department of Surgery, The Ohio State University, Columbus, OH 43210, USA
| | - Bhuvaneswari Ramaswamy
- Division of Medical Oncology, Department of Internal Medicine, McGill University, Montreal, QC H3A 1A1, Canada
| | - Michael Hallett
- Department of Biochemistry, Rosalind and Morris Goodman Cancer Center, McGill University, Montreal, QC H3A 1A1, Canada; McGill Centre for Bioinformatics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Michael C Ostrowski
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada
| | - Morag Park
- Department of Biochemistry, Rosalind and Morris Goodman Cancer Center, McGill University, Montreal, QC H3A 1A1, Canada; Department of Oncology, McGill University, Montreal, QC H3A 1A1, Canada
| | - Helen M Chamberlin
- Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA.
| | - Gustavo Leone
- Solid Tumor Biology Program, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA; Department of Cancer Biology and Genetics, McGill University, Montreal, QC H3A 1A1, Canada; Hollings Cancer Center, Medical University of South Carolina, Hollings Cancer Center 124J, 86 Jonathan Lucas Street, Charleston, SC 29425, USA.
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Saleh SMI, Bertos N, Gruosso T, Gigoux M, Souleimanova M, Zhao H, Omeroglu A, Hallett MT, Park M. Identification of Interacting Stromal Axes in Triple-Negative Breast Cancer. Cancer Res 2017; 77:4673-4683. [PMID: 28652250 DOI: 10.1158/0008-5472.can-16-3427] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/30/2017] [Accepted: 06/20/2017] [Indexed: 11/16/2022]
Abstract
Triple-negative breast cancer (TNBC) is a molecularly heterogeneous cancer that is difficult to treat. Despite the role it may play in tumor progression and response to therapy, microenvironmental (stromal) heterogeneity in TNBC has not been well characterized. To address this challenge, we investigated the transcriptome of tumor-associated stroma isolated from TNBC (n = 57). We identified four stromal axes enriched for T cells (T), B cells (B), epithelial markers (E), or desmoplasia (D). Our analysis method (STROMA4) assigns a score along each stromal axis for each patient and then combined the axis scores to subtype patients. Analysis of these subtypes revealed that prognostic capacity of the B, T, and E scores was governed by the D score. When compared with a previously published TNBC subtyping scheme, the STROMA4 method better captured tumor heterogeneity and predicted patient benefit from therapy with increased sensitivity. This approach produces a simple ontology that captures TNBC heterogeneity and informs how tumor-associated properties interact to affect prognosis. Cancer Res; 77(17); 4673-83. ©2017 AACR.
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Affiliation(s)
- Sadiq M I Saleh
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada.,Centre for Bioinformatics, McGill University, Montreal, Quebec, Canada
| | - Nicholas Bertos
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Tina Gruosso
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Mathieu Gigoux
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Hong Zhao
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Atilla Omeroglu
- Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - Michael T Hallett
- Department of Biochemistry, McGill University, Montreal, Quebec, Canada. .,Centre for Bioinformatics, McGill University, Montreal, Quebec, Canada.,School of Computer Science, McGill University, Montreal, Quebec, Canada
| | - Morag Park
- Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Biochemistry, McGill University, Montreal, Quebec, Canada.,Department of Pathology, McGill University, Montreal, Quebec, Canada.,Department of Oncology, McGill University, Montreal, Quebec, Canada
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26
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Gruosso T, Gigoux M, Bertos N, Manem V, Guiot MC, Buisseret L, Salgado R, Van den Eyden G, Haibe-Kains B, Park M. Distinct immune microenvironments stratify triple-negative breast cancer and predict outcome. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx140.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Gruosso T, Gigoux M, Bertos N, Zuo D, Manem V, Monette A, Lapointe R, Haibe-Kains B, Park M. Abstract P4-03-08: Mechanisms of CD8+ T cell immunosuppression in triple negative breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-03-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Triple negative breast cancer (TNBC), defined as tumors lacking expression of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), are especially difficult to treat effectively. While ER+ and HER2+ breast cancer subtypes can be treated with Tamoxifen and Herceptin, respectively, there are no targeted therapies for TNBC patients. Furthermore, while only 20-30% of TNBC patients respond to chemotherapy in the neoadjuvant setting, overall outcome remains poor for non-responding patients. However, mounting evidence suggests that immune-checkpoint inhibitor immunotherapies may be especially promising for TNBC patients. We and others have shown that the presence of CD8+ T cells, a crucial component of the cytotoxic arm of the adaptive immune response, is a sign of good clinical outcome in TNBC patients. However, good outcome only correlates with CD8 +T cell invasion of the tumor parenchyma. Some patients had an accumulation of CD8+ T cells in the surrounding tumor-associated stroma, but not the tumor epithelia, and these patients responded as poorly as patients with no CD8 T cells at all. Yet how cancer associated fibroblasts (CAFs), the dominant cell type of the tumor-associated stroma, affects CD8+ T cell invasion into the tumor epithelia is still poorly understood. To identify potential stroma-dependent mechanisms which potentiate or inhibit CD8+ T cells invasion into the tumor epithelia, we performed gene expression profiling of laser-capture microdissected tumor-associated stroma (and matched epithelia) from 38 TNBC cases. Here we identify several stromal and epithelial canonical pathways as well as biomarkers that are associated with and may explain the accumulation of CD8 T cells outside of the tumor epithelia.
Citation Format: Gruosso T, Gigoux M, Bertos N, Zuo D, Manem V, Monette A, Lapointe R, Haibe-Kains B, Park M. Mechanisms of CD8+ T cell immunosuppression in triple negative breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-03-08.
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Affiliation(s)
- T Gruosso
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - M Gigoux
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - N Bertos
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - D Zuo
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - V Manem
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - A Monette
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - R Lapointe
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - B Haibe-Kains
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
| | - M Park
- Goodman Cancer Research Center, McGill University; Princess Margaret Cancer Centre, University Health Network; Laboratoire d'Immuno-Oncologie, ICM, Université de Montréal/CHUM Research Center (CRCHUM)
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Savage P, Saleh SMI, Wang YC, Revil T, Badescu D, Liu L, Iacucci E, Zuo D, Bertos N, Munoz-Ramos V, Asselah J, Meterissian S, Omeroglu A, Hébert S, Kleinman C, Park M, Ragoussis J. Abstract P1-06-11: A targetable EGFR-driven tumor-initiating program in breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-06-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inter- and intra-tumour heterogeneity underlies variability in therapeutic response. Although targeting of the epidermal growth factor receptor (EGFR) in breast cancer has failed to demonstrate clinical efficacy at the population level, complete and durable responses have been reported at low frequencies. The molecular determinants of these responses are unknown, but are of importance in the era of precision medicine.
Results: We performed a patient-derived xenograft (PDX) clinical trial with gefitinib in a breast cancer PDX cohort. Consistent with clinical trial data, gefitinib exhibited limited efficacy across most models. One PDX, however, demonstrated a complete and durable (>6 months) clinical response, and was subject to deep molecular profiling to identify determinants of response. Exome sequencing revealed no single nucleotide variants or copy number alterations in EGFR pathway members. EGFR was differentially expressed between the two major cellular subpopulations identified by single-cell RNAseq and this cellular heterogeneity in EGFR expression was validated immunohistochemically. Fluorescence-activated cell sorting of the EGFRhi subpopulation revealed cells with enhanced stem-like properties, including ALDH activity, sphere-forming capacity in vitro, ability to form tumours in vivo and seeding lung micrometastases from orthotopically transplanted tumours. Tumourspheres derived from EGFRhi cells developed into mixed EGFRhi and EGFRlo subpopulations, as did macrometastases, supporting that EGFRhi subpopulation can self-renew and re-populate. Analysis of expressed SNVs in the single-cell RNAseq data, filtered by variants identified from exome sequencing, showed no clonal segregation, supporting a non-clonal origin of the functionally distinct EGFRhi and EGFRlo subpopulations. This EGFR-driven tumour initiating cell program was observed in independent PDX models, some which showed growth inhibition in response to gefitinib.
Conclusions: Using bulk and single-cell genomic profiling, we identified and functionally validated an EGFR-driven tumour-initiating program in a subset of aggressive breast tumours, which may be predictive of gefitinib sensitivity. This contradicts traditional beliefs that good therapeutic targets are homogenously expressed, in that we show that a target displaying intra-tumour heterogeneity can be effective so long that it is expressed in the tumour-initiating population.
Citation Format: Savage P, Saleh SMI, Wang Y-C, Revil T, Badescu D, Liu L, Iacucci E, Zuo D, Bertos N, Munoz-Ramos V, Asselah J, Meterissian S, Omeroglu A, Hébert S, Kleinman C, Park M, Ragoussis J. A targetable EGFR-driven tumor-initiating program in breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-06-11.
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Affiliation(s)
- P Savage
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - SMI Saleh
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Y-C Wang
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - T Revil
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - D Badescu
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - L Liu
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - E Iacucci
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - D Zuo
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - N Bertos
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - V Munoz-Ramos
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - J Asselah
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - S Meterissian
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - A Omeroglu
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - S Hébert
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - C Kleinman
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - M Park
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - J Ragoussis
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada; Genome Québec Innovation Centre, McGill University, Montreal, QC, Canada; McGill University Health Centre, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
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Saleh S, Gruosso T, Gigoux M, Bertos N, Omeroglu A, Zuo D, Meterissian S, Hallett M, Park M. Abstract IA23: Deconvolution of the triple-negative breast cancer microenvironment. Cancer Res 2016. [DOI: 10.1158/1538-7445.tme16-ia23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer heterogeneity is one of the principal obstacles both to predicting outcome and to determining an effective course of treatment for this disease. Although genomic technologies have been used to gain a better understanding, by identifying gene expression signatures associated with clinical outcome and breast cancer subtypes, relatively little is known about heterogeneity in the tumor microenvironment. It is now accepted that changes in the normal cells that constitute the tumor microenvironment (TME) play important roles in determining cancer progression and ultimate outcome. We and others have established that an immune gene expression signature correlates with good outcome in triple negative breast cancer (TNBC), yet fails to accurately predict outcome in all patients. Examining stromal heterogeneity in TNBC has identified four distinct stromal clusters, three of which are prognostic, contain distinct immune signatures and a signature of fibrosis. Lymphocytic infiltration and access to tumor parenchyma is not well understood due to high levels of spatial heterogeneity within tumors. We show that location of CD8+T cells is strongly influenced by TME subtypes and identify gene expression signatures predictive of distinct CD8+T cell localization and patient outcome. Since mounting evidence suggests that immune-checkpoint inhibitor immunotherapies may be promising for only a subset of TNBC patients, highlights the importance of understanding how the TME influences CD8+T cell location.
Citation Format: Sadiq Saleh, Tina Gruosso, Mathieu Gigoux, Nicholas Bertos, Atilla Omeroglu, Dongmei Zuo, Sarkis Meterissian, Michael Hallett, Morag Park. Deconvolution of the triple-negative breast cancer microenvironment. [abstract]. In: Proceedings of the AACR Special Conference: Function of Tumor Microenvironment in Cancer Progression; 2016 Jan 7–10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2016;76(15 Suppl):Abstract nr IA23.
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Affiliation(s)
- Sadiq Saleh
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
| | - Tina Gruosso
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
| | | | | | | | - Dongmei Zuo
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
| | - Sarkis Meterissian
- 2McGill Centre for Bioinformatics, McGill University, Montreal, QC, Canada,
| | | | - Morag Park
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
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Gruosso T, Gigoux M, Bertos N, Saleh S, Omeroglu A, Zuo D, Zhao H, Souleimanova M, Weaver V, Meterissian S, Hallett M, Park M. Abstract A15: Mechanisms of CD8+ T cell immunosuppression in triple negative breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.tme16-a15] [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
Triple negative breast cancer (TNBC), defined as tumors lacking expression of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), are especially difficult to treat effectively. While ER+ and HER2+ breast cancer subtypes can be treated with Tamoxifen and Herceptin, respectively, there are no targeted therapies for TNBC patients. Furthermore, while only 20-30% of TNBC patients respond to chemotherapy in the neoadjuvant setting, overall outcome remains poor for non-responding patients. However, mounting evidence suggests that immune-checkpoint inhibitor immunotherapies may be especially promising for TNBC patients. We and others have shown that the presence of CD8+ T cells, a crucial component of the cytotoxic arm of the adaptive immune response, is a sign of good clinical outcome in TNBC patients. However, good outcome only correlates with CD8+ T cell invasion of the tumor parenchyma. Here we show that some patients have an accumulation of CD8+ T cells in the surrounding tumor-associated stroma, but not the tumor epithelium, and these patients responded as poorly as patients with no CD8+ T cells at all. Yet how cancer associated fibroblasts (CAFs), a dominant cell type of the tumor-associated stroma, affects CD8+ T cell invasion into the tumor epithelium is still poorly understood.
To identify potential stroma-dependent mechanisms that potentiate or inhibit CD8+ T cells invasion into the tumor epithelium, we performed gene expression profiling of laser-capture microdissected tumor-associated stroma (and matched epithelium) from 56 TNBC cases. Here we identify several key stromal features that may explain the accumulation of CD8+ T cells outside of the tumor epithelium. Preliminary data by immunohistochemistry and immunofluorescence validate some key stromal features and decipher the implication of other immune cell types in CD8+ T cells lack of tumor epithelium infiltration. These key stromal features that impair CD8+ T cell infiltration into the tumor in some patients might explain the relative low efficiency of immunotherapies in TNBC patients (20% of patients respond). One could speculate that targeting these key stromal features would allow a significant CD8+ T cell infiltration into the tumor and thus sensitize patients to immunotherapies.
Citation Format: Tina Gruosso, Mathieu Gigoux, Nicholas Bertos, Sadiq Saleh, Atilla Omeroglu, Dongmei Zuo, Hong Zhao, Margarita Souleimanova, Valerie Weaver, Sarkis Meterissian, Michael Hallett, Morag Park. Mechanisms of CD8+ T cell immunosuppression in triple negative breast cancer. [abstract]. In: Proceedings of the AACR Special Conference: Function of Tumor Microenvironment in Cancer Progression; 2016 Jan 7–10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2016;76(15 Suppl):Abstract nr A15.
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Affiliation(s)
- Tina Gruosso
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
| | - Mathieu Gigoux
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
| | - Nicholas Bertos
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
| | - Sadiq Saleh
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
| | - Atilla Omeroglu
- 2Dept. of Pathology, McGill University, Montreal, QC, Canada,
| | - Dongmei Zuo
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
| | - Hong Zhao
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
| | | | - Valerie Weaver
- 3Center for Bioengineering, Tissue Regeneration, Department of Surgery, UCSF, San Francisco, CA,
| | | | | | - Morag Park
- 1Goodman Cancer Research Center, McGill University, Montreal, QC, Canada,
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Thompson C, Saleh SM, Bertos N, Gigoux M, Gruosso T, Souleimanova M, Zhao H, Hallett MT, Park M. Abstract 720: Novel prognostic stromal subtypes in triple-negative breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer is a heterogeneous disease in terms of presentation, morphology, molecular profile and response to therapy. Gene expression profiling has identified intrinsic molecular subtypes that are associated with clinical markers (ER, PR, HER2) as well as prognosis and survival. However, it is well established that the intrinsic molecular profiles of breast tumors are not sufficient to perfectly predict disease outcome. Increasing evidence indicates that characteristics of the breast stroma influence tumor progression and response to therapy. Previous work in our lab has demonstrated that gene expression signatures in human stroma can predict outcome of breast cancer patients independently of clinical parameters and molecular subtypes. In this study, we expand our findings by focusing on a previously underrepresented subset of breast tumors that have no detectable ER, PR or HER2 (termed Triple-Negative, TN). TN tumors, which represent approximately 15% of all breast cancers, are typically associated with poor outcome. However, the contribution of the stroma to the underlying heterogeneity of TN breast cancer and its corresponding influence on therapeutic response is not well understood. To address this, we isolated TN tumor epithelial and stromal tissues by laser capture microdissection and subjected them to gene expression profiling. Class discovery revealed distinct gene-clusters (stromal properties) which are associated with prognosis in TNBC whole tumor samples. Analysis of the genes comprising each stromal property suggests that the properties primarily represent the prevalence of distinct cell types, namely T cells, B cells, activated fibroblasts, and myoepithelial cells. Importantly, these properties are not mutually exclusive, i.e. some tumors are associated with multiple stromal properties. While confirming the heterogeneity of TN-associated stroma, this also indicates that a multi-parameter classification better reflects the true nature of the tumor microenvironment. This project provides the first integrated in-depth analysis of the contribution of tumor stromal processes to TN disease heterogeneity, and positions the tumor microenvironment for therapeutic intervention.
Citation Format: Crista Thompson, Sadiq M. Saleh, Nicholas Bertos, Mathieu Gigoux, Tina Gruosso, Margarita Souleimanova, Hong Zhao, Michael T. Hallett, Morag Park. Novel prognostic stromal subtypes in triple-negative breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 720.
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Affiliation(s)
- Crista Thompson
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
| | - Sadiq M. Saleh
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
| | - Nicholas Bertos
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
| | - Mathieu Gigoux
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
| | - Tina Gruosso
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
| | | | - Hong Zhao
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
| | - Michael T. Hallett
- 2McGill Centre for Bioinformatics, McGill University, Montreal, Quebec, Canada
| | - Morag Park
- 1Goodman Cancer Centre, McGill University, Montreal, Quebec, Canada
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Gigoux M, Gruosso T, Bertos N, Saleh S, Omeroglu A, Zhao H, Souleimanova M, Meterissian S, Hallett M, Park M. Abstract A69: The immunological environment in triple negative breast cancer; impact on clinical outcomes towards a prognostic clinical test. Cancer Immunol Res 2015. [DOI: 10.1158/2326-6074.tumimm14-a69] [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
It is now accepted that changes in the normal cells that constitute the tumor microenvironment (TME) play important roles in determining cancer progression and ultimate outcome. We and others have established that an immune signature, and more recently that the ability of CD8+ T cells to infiltrate the tumor bed, are correlated with good outcome in triple negative breast cancer. Importantly, since the cytotoxic effector functions of CD8+ T cells are mainly contact-dependent, the tumor microenvironment may act to inhibit access to the epithelial tumor bed, leading to uncontrolled tumor growth. Therefore, in order to determine the role that the TME plays on mediating the entry of CD8+ T cells into the epithelial tumor bed, our group performed laser-capture microdissection to separate the tumor epithelial compartment from the surrounding tumor-associated stroma from the primary tumor of 56 triple negative breast cancer patients and followed by gene expression profiling. Our aims are to provide clinical validation of predicted CD8+ T cell localisation based on our bioinformatic analysis, test our predictions that the identified stroma signature correlates with CD8+ T cell retention in other cohort of TN breast cancer patients and develop suitable markers of this stroma, and develop a muliplex based assay integrating CD8+ T cell localisation with stromal markers suitable for a retrospective study to validate predictions with outcome. Using gene expression profiling, our data have identified a canonical gene expression signature which correlates with retention of CD8+ T cells in the stroma and poor outcome. Thus, our results demonstrate that gene expression analysis of clinical triple negative breast cancer samples can predict the location of CD8+ T cells within the tumor and in turn the outcome.
Citation Format: Mathieu Gigoux, Tina Gruosso, Nicholas Bertos, Sadiq Saleh, Atilla Omeroglu, Hong Zhao, Margarita Souleimanova, Sarkis Meterissian, Michael Hallett, Morag Park. The immunological environment in triple negative breast cancer; impact on clinical outcomes towards a prognostic clinical test. [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy: A New Chapter; December 1-4, 2014; Orlando, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2015;3(10 Suppl):Abstract nr A69.
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Affiliation(s)
| | - Tina Gruosso
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
| | | | - Sadiq Saleh
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
| | | | - Hong Zhao
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
| | | | | | | | - Morag Park
- 1Goodman Cancer Research Center, Montreal, QC, Canada,
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Savage P, Saleh SM, Iacucci E, Revil T, Wang YC, Bertos N, Monast A, Zhao H, Souleimanova M, Szulwach K, Batchu C, Omeroglu A, Park M, Ragoussis I. Abstract LB-129: Identifying tumor subpopulations and the functional consequences of intratumor heterogeneity using single-cell profiling of breast cancer patient-derived xenografts. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-lb-129] [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
Human breast tumors have been shown to exhibit extensive inter- and intra-tumor heterogeneity. While recent advances in genomic technologies have allowed us to deconvolute this heterogeneity, few studies have addressed the functional consequences of diversity within tumor populations. Here, we identified an index case for which we have derived a patient-derived xenograft (PDX) as a renewable tissue source to identify subpopulations and perform functional assays. On pathology, the tumor was an invasive ductal carcinoma which was hormone receptor-negative, HER2-positive (IHC 2+, FISH average HER2/CEP17 2.4), though the FISH signal was noted to be heterogeneous. On gene expression profiling of bulk samples, the primary tumor and PDX were classified as basal-like. We performed single cell RNA and exome sequencing of the PDX to identify population structure. Using a single sample predictor of breast cancer subtype, we have identified single basal-like, HER2-enriched and normal-like cells co-existing within the PDX tumor. Genes differentially expressed between these subpopulations are involved in proliferation and differentiation. Functional studies distinguishing these subpopulations are ongoing. Microfluidic whole genome amplification followed by whole exome capture of 81 single cells showed high and homogeneous target enrichment with >75% of reads mapping uniquely on target. Variant calling using GATK and Samtools revealed founder mutations in key genes as BRCA1 and TP53, as well as subclonal mutations that are being investigated further. Loss of heterozygocity was observed in 16 TCGA cancer driver genes and novel mutations in 7 cancer driver genes. These findings may be important in understanding the functional consequences of intra-tumor heterogeneity with respect to clinically important phenotypes such as invasion, metastasis and drug-resistance.
Citation Format: Paul Savage, Sadiq M. Saleh, Ernesto Iacucci, Timothe Revil, Yu-Chang Wang, Nicholas Bertos, Anie Monast, Hong Zhao, Margarita Souleimanova, Keith Szulwach, Chandana Batchu, Atilla Omeroglu, Morag Park, Ioannis Ragoussis. Identifying tumor subpopulations and the functional consequences of intratumor heterogeneity using single-cell profiling of breast cancer patient-derived xenografts. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-129. doi:10.1158/1538-7445.AM2015-LB-129
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Affiliation(s)
- Paul Savage
- 1McGill University, Montreal, Quebec, Canada
| | | | | | | | | | | | - Anie Monast
- 1McGill University, Montreal, Quebec, Canada
| | - Hong Zhao
- 1McGill University, Montreal, Quebec, Canada
| | | | | | | | | | - Morag Park
- 1McGill University, Montreal, Quebec, Canada
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Oh EY, Christensen SM, Ghanta S, Jeong JC, Bucur O, Glass B, Montaser-Kouhsari L, Knoblauch NW, Bertos N, Saleh SM, Haibe-Kains B, Park M, Beck AH. Extensive rewiring of epithelial-stromal co-expression networks in breast cancer. Genome Biol 2015; 16:128. [PMID: 26087699 PMCID: PMC4471934 DOI: 10.1186/s13059-015-0675-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/13/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Epithelial-stromal crosstalk plays a critical role in invasive breast cancer pathogenesis; however, little is known on a systems level about how epithelial-stromal interactions evolve during carcinogenesis. RESULTS We develop a framework for building genome-wide epithelial-stromal co-expression networks composed of pairwise co-expression relationships between mRNA levels of genes expressed in the epithelium and stroma across a population of patients. We apply this method to laser capture micro-dissection expression profiling datasets in the setting of breast carcinogenesis. Our analysis shows that epithelial-stromal co-expression networks undergo extensive rewiring during carcinogenesis, with the emergence of distinct network hubs in normal breast, and estrogen receptor-positive and estrogen receptor-negative invasive breast cancer, and the emergence of distinct patterns of functional network enrichment. In contrast to normal breast, the strongest epithelial-stromal co-expression relationships in invasive breast cancer mostly represent self-loops, in which the same gene is co-expressed in epithelial and stromal regions. We validate this observation using an independent laser capture micro-dissection dataset and confirm that self-loop interactions are significantly increased in cancer by performing computational image analysis of epithelial and stromal protein expression using images from the Human Protein Atlas. CONCLUSIONS Epithelial-stromal co-expression network analysis represents a new approach for systems-level analyses of spatially localized transcriptomic data. The analysis provides new biological insights into the rewiring of epithelial-stromal co-expression networks and the emergence of epithelial-stromal co-expression self-loops in breast cancer. The approach may facilitate the development of new diagnostics and therapeutics targeting epithelial-stromal interactions in cancer.
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Affiliation(s)
- Eun-Yeong Oh
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Stephen M Christensen
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Sindhu Ghanta
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Jong Cheol Jeong
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Octavian Bucur
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Benjamin Glass
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Laleh Montaser-Kouhsari
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Nicholas W Knoblauch
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
| | - Nicholas Bertos
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada.
| | - Sadiq Mi Saleh
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada.
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, M5G 1L7, Canada. .,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, M5G 1L7, Canada.
| | - Morag Park
- Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada.
| | - Andrew H Beck
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, 02215, USA. .,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, 02215, USA.
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Saleh SM, Savage P, Laferrière J, Cory S, Bertos N, Souleimanova M, Zhao H, Zacksenhaus E, Muller W, Hallett M, Park M. Abstract A79: Mouse models of breast cancer identify oncogene-associated stroma subtypes. Cancer Res 2015. [DOI: 10.1158/1538-7445.chtme14-a79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast Cancer is a highly heterogeneous disease involving complex crosstalk between tumor cells and their surrounding microenvironment (stroma). Previous work in our lab utilized laser capture microdissection and gene expression analysis to separate Breast Cancer stromal samples into distinct subtypes. Although this and other data demonstrate the importance of the stroma in tumor progression, the cause of these stromal changes are still poorly understood. We hypothesize that changes within stroma are related to individual oncogenic events within the tumor epithelium. Analyzing human data does not allow us to draw causative conclusions due to the presence of compounding factors such as genetic variance and living conditions. In an attempt to circumvent this challenge we used transgenic mouse models of breast cancer in the same strain of mice (FVB) with oncogenes driven by a mammary specific promoter (MMTV). By keeping these variables constant and only varying the oncogene: using either Neu-NDL-2-5, PyVMT or Wnt1 - allowed us to test the aforementioned hypothesis.
Class discovery and distinction confirmed that the epithelial and stromal samples from each mouse model were distinct, which validated our hypothesis. Pathway analysis of the genes that distinguish the stroma of the mouse models identifies genes linked to recruitment and activation of different stromal cells. Interestingly our findings corroborate with results from other labs using these mouse models.
Citation Format: Sadiq M. Saleh, Paul Savage, Julie Laferrière, Sean Cory, Nicholas Bertos, Margarita Souleimanova, Hong Zhao, Eldad Zacksenhaus, William Muller, Michael Hallett, Morag Park. Mouse models of breast cancer identify oncogene-associated stroma subtypes. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr A79. doi:10.1158/1538-7445.CHTME14-A79
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Affiliation(s)
- Sadiq M. Saleh
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Paul Savage
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Julie Laferrière
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Sean Cory
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Nicholas Bertos
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | | | - Hong Zhao
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Eldad Zacksenhaus
- 2Toronto General Research Institute (TGRI), University of Toronto, Toronto, ON, Canada
| | - William Muller
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Michael Hallett
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
| | - Morag Park
- 1Goodman Cancer Center, McGill University, Montreal, QC, Canada,
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Tofigh A, Suderman M, Paquet ER, Livingstone J, Bertos N, Saleh SM, Zhao H, Souleimanova M, Cory S, Lesurf R, Shahalizadeh S, Garcia Lopez N, Riazalhosseini Y, Omeroglu A, Ursini-Siegel J, Park M, Dumeaux V, Hallett M. The prognostic ease and difficulty of invasive breast carcinoma. Cell Rep 2014; 9:129-142. [PMID: 25284793 DOI: 10.1016/j.celrep.2014.08.073] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/18/2014] [Accepted: 08/27/2014] [Indexed: 11/26/2022] Open
Abstract
Breast carcinoma (BC) has been extensively profiled by high-throughput technologies for over a decade, and broadly speaking, these studies can be grouped into those that seek to identify patient subtypes (studies of heterogeneity) or those that seek to identify gene signatures with prognostic or predictive capacity. The sheer number of reported signatures has led to speculation that everything is prognostic in BC. Here, we show that this ubiquity is an apparition caused by a poor understanding of the interrelatedness between subtype and the molecular determinants of prognosis. Our approach constructively shows how to avoid confounding due to a patient's subtype, clinicopathological profile, or treatment profile. The approach identifies patients who are predicted to have good outcome at time of diagnosis by all available clinical and molecular markers but who experience a distant metastasis within 5 years. These inherently difficult patients (~7% of BC) are prioritized for investigations of intratumoral heterogeneity.
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Affiliation(s)
- Ali Tofigh
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada
| | - Matthew Suderman
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada
| | - Eric R Paquet
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada
| | - Julie Livingstone
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada
| | - Nicholas Bertos
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada
| | - Sadiq M Saleh
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada; Department of Biochemistry, McGill University, Montreal, QC H3G1Y6, Canada
| | - Hong Zhao
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada
| | - Margarita Souleimanova
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada
| | - Sean Cory
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada
| | - Robert Lesurf
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada; Department of Biochemistry, McGill University, Montreal, QC H3G1Y6, Canada
| | | | - Norberto Garcia Lopez
- Department of Human Genetics, McGill University, Montreal, QC H3A 1B1, Canada; McGill University Health Centre, McGill University, Montreal, QC H3A 1A1, Canada
| | - Yasser Riazalhosseini
- Department of Human Genetics, McGill University, Montreal, QC H3A 1B1, Canada; McGill University and Génome Québec Innovation Centre, Montreal, QC H3A 0G1, Canada
| | - Atilla Omeroglu
- Department of Pathology, McGill University, Montreal, QC H3A 2B4, Canada; McGill University Health Centre, McGill University, Montreal, QC H3A 1A1, Canada
| | - Josie Ursini-Siegel
- Lady Davis Institute for Medical Research, McGill University, Montreal, QC H3T1E2, Canada; Department of Oncology, McGill University, Montreal, QC H2W1S6, Canada
| | - Morag Park
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Department of Biochemistry, McGill University, Montreal, QC H3G1Y6, Canada; Department of Oncology, McGill University, Montreal, QC H2W1S6, Canada
| | - Vanessa Dumeaux
- Department of Oncology, McGill University, Montreal, QC H2W1S6, Canada; Institute of Community Medicine, UiT the Arctic University of Norway, Tromso 9037, Norway
| | - Michael Hallett
- The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A1A3, Canada; Centre for Bioinformatics, McGill University, Montreal, QC H3G0B1, Canada; Department of Biochemistry, McGill University, Montreal, QC H3G1Y6, Canada.
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Lai AZ, Cory S, Zhao H, Gigoux M, Monast A, Guiot MC, Huang S, Tofigh A, Thompson C, Naujokas M, Marcus VA, Bertos N, Sehat B, Perera RM, Bell ES, Page BDG, Gunning PT, Ferri LE, Hallett M, Park M. Dynamic reprogramming of signaling upon met inhibition reveals a mechanism of drug resistance in gastric cancer. Sci Signal 2014; 7:ra38. [PMID: 24757178 DOI: 10.1126/scisignal.2004839] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Met receptor tyrosine kinase is activated or genetically amplified in some gastric cancers, but resistance to small-molecule inhibitors of Met often emerges in patients. We found that Met abundance correlated with a proliferation marker in patient gastric tumor sections, and gastric cancer cell lines that have MET amplifications depended on Met for proliferation and anchorage-independent growth in culture. Inhibition of Met induced temporal changes in gene expression in the cell lines, initiated by a rapid decrease in the expression of genes encoding transcription factors, followed by those encoding proteins involved in epithelial-mesenchymal transition, and finally those encoding cell cycle-related proteins. In the gastric cancer cell lines, microarray and chromatin immunoprecipitation analysis revealed considerable overlap between genes regulated in response to Met stimulation and those regulated by signal transducer and activator of transcription 3 (STAT3). The activity of STAT3, extracellular signal-regulated kinase (ERK), and the kinase Akt was decreased by Met inhibition, but only inhibitors of STAT3 were as effective as the Met inhibitor in decreasing tumor cell proliferation in culture and in xenografts, suggesting that STAT3 mediates the pro-proliferative program induced by Met. However, the phosphorylation of ERK increased after prolonged Met inhibition in culture, correlating with decreased abundance of the phosphatases DUSP4 and DUSP6, which inhibit ERK. Combined inhibition of Met and the mitogen-activated protein kinase kinase (MEK)-ERK pathway induced greater cell death in cultured gastric cancer cells than did either inhibitor alone. These findings indicate combination therapies that may counteract resistance to Met inhibitors.
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Affiliation(s)
- Andrea Z Lai
- 1Department of Biochemistry, McGill University, Montréal, Québec H3A 0G4, Canada
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Lai A, Cory S, Zhao H, Sehat B, Tofigh A, Guiot MC, Thompson C, Bell ES, Bertos N, Ferri LE, Hallett M, Park M. Abstract B69: Dynamic reprogramming of signaling following Met inhibition reveals pathways for cell proliferation and negative feedback in gastric cancer. Mol Cancer Ther 2013. [DOI: 10.1158/1535-7163.targ-13-b69] [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 Met receptor tyrosine kinase activates multiple signalling pathways in response to stimulation by ligand. However, the signalling events that occur under chronic Met activation in cancer cells are poorly understood. Utilizing a pharmacological small-molecule inhibitor of Met, we demonstrate that the gastric cancer cell lines, Okajima, MKN45, Snu-5 and KATO II are dependent on Met signalling for proliferation and anchorage-independent growth. We show that short-term inhibition of Met leads to waves of changes in gene expression such as a rapid loss of immediate-early genes, negative regulators, and a more delayed decrease in genes involved in the cell-cycle and proliferation. At the post-translational level, the Ras-Erk, PI3K-Akt and STAT3 pathways were all found to be dependent on Met signalling in these cells, though STAT3 signalling was the key requirement for proliferation, downstream from Met. We also observed the loss of negative regulators of Erk signalling, such as DUSP4 and DUSP6, which allowed for Mek-dependent reactivation of Erk, in the presence of Met inhibitor. As Met inhibitors are currently in clinical trials, it is essential to understand the molecular events that occur upon treatment, such that we can more effectively target sensitive tumours and avoid resistance.
Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B69.
Citation Format: Andrea Lai, Sean Cory, Hong Zhao, Bita Sehat, Ali Tofigh, Marie-Christine Guiot, Crista Thompson, Emily S. Bell, Nicholas Bertos, Lorenzo E. Ferri, Michael Hallett, Morag Park. Dynamic reprogramming of signaling following Met inhibition reveals pathways for cell proliferation and negative feedback in gastric cancer. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B69.
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Affiliation(s)
- Andrea Lai
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
| | - Sean Cory
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
| | - Hong Zhao
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
| | - Bita Sehat
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
| | - Ali Tofigh
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
| | | | | | - Emily S. Bell
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
| | | | | | | | - Morag Park
- 1McGill Univ. Goodman Cancer Ctr., Montreal, Quebec, Canada
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Bertos N, Finak G, Lesurf R, Saleh SM, Zhao H, Souleimanova M, Meterrisian S, Omeroglu A, Hallett M, Park M. Abstract ES8-2: Breast Cancer Stroma: A Predictor of Clinical Outcome and Tumour Heterogeneity. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-es8-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer heterogeneity is one of the principal obstacles both to predicting outcome and to determining an effective course of treatment for this disease. Individual cases demonstrate heterogeneity at multiple levels, including those parameters assessed by studies of gene expression, chromosomal aberrations, and classical and immuno-pathology. Although genomic technologies have been used to gain a better understanding of the impact of gene expression heterogeneity on breast cancer outcome by identifying gene expression signatures associated with clinical outcome, histopathological breast cancer subtypes, and a variety of cancer–related pathways and processes, relatively little is known about the effects of heterogeneity in the tumor microenvironment. We have addressed changes in stroma by analyzing changes in gene expression in stromal tissue associated with breast tumors when compared to normal breast tissue. We have integrated gene expression data from laser capture microdissected breast tumor stroma with matched normal stroma. Using this approach we have identified that the microenvironment of a breast tumor can be classified into one of six distinct molecular phenotypes exhibiting distinct biological functions and carrying prognostic information independent of existing therapeutic biomarkers and tumor subtypes. A trained predictor of 23 genes was developed and contains new information to stratify breast cancer subtypes. This is independent of clinical parameters and published predictors of outcome and identifies patients with poor outcome in multiple breast cancer expression data generated using using whole tissue. The stromal predictor selects poor outcome patients from multiple clinical subtypes of breast cancer and contains genes representing distinct biological features, including differential immune response, angiogenic response, as well as a hypoxic response. Elements of this signature are present in murine models of breast cancer. These results highlight the complex relationship between the tumor and its microenvironment, and underline the role that the stroma plays in tumor progression.
These results demonstrate an important role for the tumor microenvironment in defining breast cancer heterogeneity, with a consequent impact upon clinical outcome. Novel therapies could be targeted at the processes that define the stroma classes, suggesting new avenues for the development of individualized treatment regimens.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr ES8-2.
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Affiliation(s)
- N Bertos
- McGill University, Montreal, QC, Canada
| | - G Finak
- McGill University, Montreal, QC, Canada
| | - R Lesurf
- McGill University, Montreal, QC, Canada
| | - SM Saleh
- McGill University, Montreal, QC, Canada
| | - H Zhao
- McGill University, Montreal, QC, Canada
| | | | | | | | - M Hallett
- McGill University, Montreal, QC, Canada
| | - M Park
- McGill University, Montreal, QC, Canada
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Mourskaia AA, Amir E, Dong Z, Tiedemann K, Cory S, Omeroglu A, Bertos N, Ouellet V, Clemons M, Scheffer GL, Park M, Hallett M, Komarova SV, Siegel PM. ABCC5 supports osteoclast formation and promotes breast cancer metastasis to bone. Breast Cancer Res 2012; 14:R149. [PMID: 23174366 PMCID: PMC4053136 DOI: 10.1186/bcr3361] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 11/12/2012] [Indexed: 12/12/2022] Open
Abstract
Introduction Bone is the most common site of breast cancer metastasis, and complications associated with bone metastases can lead to a significantly decreased patient quality of life. Thus, it is essential to gain a better understanding of the molecular mechanisms that underlie the emergence and growth of breast cancer skeletal metastases. Methods To search for novel molecular mediators that influence breast cancer bone metastasis, we generated gene-expression profiles from laser-capture microdissected trephine biopsies of both breast cancer bone metastases and independent primary breast tumors that metastasized to bone. Bioinformatics analysis identified genes that are differentially expressed in breast cancer bone metastases compared with primary, bone-metastatic breast tumors. Results ABCC5, an ATP-dependent transporter, was found to be overexpressed in breast cancer osseous metastases relative to primary breast tumors. In addition, ABCC5 was significantly upregulated in human and mouse breast cancer cell lines with high bone-metastatic potential. Stable knockdown of ABCC5 substantially reduced bone metastatic burden and osteolytic bone destruction in mice. The decrease in osteolysis was further associated with diminished osteoclast numbers in vivo. Finally, conditioned media from breast cancer cells with reduced ABCC5 expression failed to induce in vitro osteoclastogenesis to the same extent as conditioned media from breast cancer cells expressing ABCC5. Conclusions Our data suggest that ABCC5 functions as a mediator of breast cancer skeletal metastasis. ABCC5 expression in breast cancer cells is important for efficient osteoclast-mediated bone resorption. Hence, ABCC5 may be a potential therapeutic target for breast cancer bone metastasis.
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Mihalcioiu C, Lian J, Bertos N, Omeroglu A, Sebag M, DiBattista J, Li J, Chughtai N, Park M, Kremer R. P4-07-02: Detection, Enrichment, Characterization and Propagation of Circulating Tumour Cells from Patients with Advanced Metastatic Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-07-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Circulating tumour cells (CTCs) have attracted much attention lately due to their potential utility in diagnostic, therapeutic and prognostic applications. Characterization of these cells may indeed permit more targeted and individualized therapeutic approaches, as well as provide a means to monitor treatment response. Although detection of CTCs in peripheral blood (PB) is relatively easy using current methodologies, characterization of the CTC pool has proven more challenging due to their low abundance. Furthermore, in-vitro expansion of this elusive cell pool in mammosphere cultures has not yet been reported. In order to achieve a more complete characterization of CTCs and attempt to obtain live cells in sufficient quantity for in vitro expansion, we have used aphaeresis as a means to collect a large initial cell fraction from which to enrich CTCs from peripheral blood.
Methods: A cohort (n=17) of late stage breast cancer patients were first screened using 10ml PB. Peripheral blood mononuclear cells (PBMCs) were isolated using a Ficoll gradient and then enriched for CTCs by anti-CD45 negative selection using an automated system (RoboSep) based on magnetic bead separation. CTCs were detected by immunocytochemistry (ICC) for cytokeratin expression and patients classified as CTC-positive were selected for the aphaeresis procedure. Following collection of aphaeresis material (APM), PBMCs were isolated using a Ficoll gradient, enriched by automated anti-CD45 negative selection and characterized for a variety of markers by ICC, immunofluorescence and flow cytometry. CTCs were then cultured in serum-free medium as monolayers and suspensions. Recovery at the various steps of the isolation process was determined using PB from healthy subjects spiked with MCF-7 breast cancer cells and processed using the same approach.
Results: Recovery of spiked MCF-7 cells was about 40% after Ficoll and magnetic bead separation. Using this negative selection procedure 17/17 (100%) of subjects tested were positive at screening. Most patients (14/17) underwent aphaeresis and a large number (9,600 to 108,000) of enriched CTCs was recovered from APM in all patients tested, either as individual cells or as CTC clusters. Using dual immunofluorescence labelling, co-localization of the epithelial cell marker CK8 and the chemokine receptor CXCR4 was observed within CTCs. Furthermore, over 20% of CTCs were positive for both CK8 and ALDH1, indicative of a stem-like phenotype. APM-derived CTCs from all patients (14/14) could be propagated, both as attached cells and in suspension culture. They formed colonies in monolayer culture, and clusters in mammosphere culture, indicating stem cell-like properties. They replicated for at least three passages in mammosphere culture.
Conclusion: Our CTC detection and enrichment method using negative selection offers a distinct advantage over current methodologies, including collection of clusters, and the ability to grow and expand CTCs in serum-free culture conditions. Furthermore, these cells demonstrate breast cancer stem cell-like characteristics, the ability to replicate for multiple passages as mammospheres in suspensions and a metastatic signature.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-07-02.
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Affiliation(s)
- C Mihalcioiu
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - J Lian
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - N Bertos
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - A Omeroglu
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - M Sebag
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - J DiBattista
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - J Li
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - N Chughtai
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - M Park
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
| | - R Kremer
- 1Royal Victoria Hospital/McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
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Pla-Roca M, Leulmi RF, Tourekhanova S, Bergeron S, Laforte V, Moreau E, Gosline SJC, Bertos N, Hallett M, Park M, Juncker D. Antibody colocalization microarray: a scalable technology for multiplex protein analysis in complex samples. Mol Cell Proteomics 2011; 11:M111.011460. [PMID: 22171321 PMCID: PMC3322566 DOI: 10.1074/mcp.m111.011460] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
DNA microarrays were rapidly scaled up from 256 to 6.5 million targets, and although antibody microarrays were proposed earlier, sensitive multiplex sandwich assays have only been scaled up to a few tens of targets. Cross-reactivity, arising because detection antibodies are mixed, is a known weakness of multiplex sandwich assays that is mitigated by lengthy optimization. Here, we introduce (1) vulnerability as a metric for assays. The vulnerability of multiplex sandwich assays to cross-reactivity increases quadratically with the number of targets, and together with experimental results, substantiates that scaling up of multiplex sandwich assays is unfeasible. We propose (2) a novel concept for multiplexing without mixing named antibody colocalization microarray (ACM). In ACMs, both capture and detection antibodies are physically colocalized by spotting to the same two-dimensional coordinate. Following spotting of the capture antibodies, the chip is removed from the arrayer, incubated with the sample, placed back onto the arrayer and then spotted with the detection antibodies. ACMs with up to 50 targets were produced, along with a binding curve for each protein. The ACM was validated by comparing it to ELISA and to a small-scale, conventional multiplex sandwich assay (MSA). Using ACMs, proteins in the serum of breast cancer patients and healthy controls were quantified, and six candidate biomarkers identified. Our results indicate that ACMs are sensitive, robust, and scalable.
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Affiliation(s)
- M Pla-Roca
- Biomedical Engineering Department, McGill University, Montreal, Quebec, Canada
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Sangwan V, Abella J, Lai A, Bertos N, Stuible M, Tremblay ML, Park M. Protein-tyrosine phosphatase 1B modulates early endosome fusion and trafficking of Met and epidermal growth factor receptors. J Biol Chem 2011; 286:45000-13. [PMID: 22045810 DOI: 10.1074/jbc.m111.270934] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The endoplasmic reticulum-localized non-receptor protein-tyrosine phosphatase 1B (PTP1B) is associated with oncogenic, metabolic, and cytokine-related signaling and functionally targets multiple receptor tyrosine kinases (RTKs) for dephosphorylation. Loss of PTP1B activity leads to enhanced ligand-dependent biological activity of the Met RTK among others. Here, we demonstrate that knockdown of PTP1B or expression of a PTP1B trapping aspartic acid-to-alanine substitution (D/A) mutant delayed ligand-induced degradation of the Met and EGF RTKs. Loss of PTP1B function abrogated trafficking of Met and EGF receptor to Rab5- and phosphatidylinositol 3-phosphate (Pl3P)-positive early endosomes and subsequent trafficking through the degradative pathway. Under these conditions, internalization of the Met and EGF receptors was unaltered, suggesting a block at the level of early endosome formation. We show that the N-ethylmaleimide-sensitive factor (NSF), an essential component of the vesicle fusion machinery, was hyperphosphorylated in PTP1B knockdown or PTP1B D/A-expressing cells and was a target for PTP1B. NSF knockdown phenocopied PTP1B knockdown, demonstrating a mechanism through which PTP1B regulates endocytic trafficking. Finally, we show that PTP1B dephosphorylated NSF and that this interaction was required for physiological RTK trafficking and appropriate attenuation of downstream signaling.
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Affiliation(s)
- Veena Sangwan
- Department of Biochemistry, McGill University, Montréal, Québec H3A 1A1, Canada
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Rose A, Grosset AA, Dong Z, Bertos N, Simantov R, Park M, Gaboury L, Siegel P. Abstract A8: GPNMB is an independent prognostic indicator of recurrence and a therapeutic target in triple negative breast cancer. Clin Cancer Res 2010. [DOI: 10.1158/1078-0432.tcme10-a8] [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
Purpose: While the murine orthologue of GPNMB (Glycoprotein non-metastatic B, DC-HIL, HGFIN), Osteoactivin, has been shown to promote breast cancer metastasis in an in vivo mouse model, its importance in human breast cancer is unknown. We have examined the significance of GPNMB expression as a prognostic indicator of recurrence and assessed its potential as a novel therapeutic target in breast cancer.
Experimental Design: The clinical significance of GPNMB expression in breast cancer was addressed by analyzing GPNMB mRNA levels in several published gene expression datasets and by determining GPNMB protein expression in two independent tissue microarrays derived from human breast tumors. Human breast cancer cell lines endogenously or exogenously expressing GPNMB were further used to validate a toxin-conjugated anti-GPNMB antibody as a novel therapeutic agent.
Results: GPNMB expression correlates with shorter times to recurrence and reduced overall survival of breast cancer patients. Epithelial-specific staining of GPNMB serves as an independent prognostic indicator for breast cancer recurrence. GPNMB is highly expressed in basal and triple-negative (TN) breast cancers and is associated with increased risk of recurrence within this subtype. GPNMB expression confers a more migratory and invasive phenotype on breast cancer cells. Treatment of mice harbouring endogenous GPNMB-expressing human breast cancer xenografts with CDX-011 (glembatumumab vedotin, CR011-vcMMAE), a GPNMB-targeted antibody-drug conjugate, induces and sustains tumor regression in vivo.
Conclusions: GPNMB expression is associated with the basal/TN subtype and is a prognostic marker of poor outcome in patients with breast cancer. CDX-011 (glembatumumab vedotin) is a promising new targeted therapy for patients with metastatic TN breast cancers, a patient population that currently lacks targeted-therapy options.
Citation Information: Clin Cancer Res 2010;16(7 Suppl):A8
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Affiliation(s)
- April Rose
- 1McGill University, Montreal, QC, Canada
| | | | | | | | | | - Morag Park
- 1McGill University, Montreal, QC, Canada
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