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Pitiyarachchi O, Lee YC, Sim HW, Srirangan S, Mapagu C, Kirk J, Harnett PR, Balleine RL, Bowtell DDL, Samimi G, Brand AH, Marsh DJ, Beale P, Anderson L, Bouantoun N, Provan P, Ramus SJ, DeFazio A, Friedlander M. Older age should not be a barrier to testing for somatic variants in homologous recombination DNA repair-related genes in patients with high-grade serous ovarian carcinoma. Transl Oncol 2023; 31:101638. [PMID: 36805919 PMCID: PMC9971549 DOI: 10.1016/j.tranon.2023.101638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Somatic pathogenic variants (PVs) in homologous recombination DNA repair (HR)-related genes found in high-grade serous ovarian carcinomas (HGSC) are not well-characterised in older patients (≥70 years). This may reflect low testing rates in older patients. METHODS Data from 1210 HGSC patients in AACR Project GENIE and 324 patients in an independent dataset INOVATe were analysed. Cases where somatic variants could be distinguished from germline variants were included, and analysis was restricted to those with a somatic TP53 variant, to ensure cases were HGSC. RESULTS Of 1210 patients in GENIE, 27% (n = 325) were aged ≥70 years at testing. Patients with somatic-only PVs in BRCA2 were older compared with BRCA1 (median 71 vs 60 years, p = 0.002). Median age for 21 patients with somatic-only PVs in 11 other HR-related genes ranged from 40 to 67 years. In older patients, 7% (n = 22) had somatic BRCA1/2 PVs, and 1% (n = 2) had PVs other HR-related genes; this rate was not significantly different to younger patients (<70 years), 7% (n = 62) BRCA1/2 and 2% (n = 19) other HR-related genes (p = 0.36). The overall frequency of somatic BRCA1/2 PVs was similar in INOVATe (n = 25; 7.7%) and somatic-only BRCA2 PVs were again found in older patients compared with BRCA1 (median age: at testing, 70 vs 63 years; at diagnosis, 68 vs 60 years). CONCLUSIONS The overall frequency of somatic-only PVs in HR-related genes was similar in older and younger patients with HGSC, highlighting the importance of somatic testing irrespective of age. Limiting somatic testing by age may exclude patients who could benefit from maintenance poly(ADP-ribose) polymerase (PARP) inhibitors.
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Affiliation(s)
- Omali Pitiyarachchi
- School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Yeh Chen Lee
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Randwick, NSW, Australia
| | - Hao-Wen Sim
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia; Department of Medical Oncology, The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Sivatharsny Srirangan
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Cristina Mapagu
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Illawarra and Shoalhaven Cancer Care Centres, Wollongong and Nowra, NSW, Australia
| | - Judy Kirk
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Paul R Harnett
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Rosemary L Balleine
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - David D L Bowtell
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Goli Samimi
- National Cancer Institute, Bethesda, Maryland, United States of America
| | - Alison H Brand
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Deborah J Marsh
- Translational Oncology Group, School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Philip Beale
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Lyndal Anderson
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; NSW Health Pathology, NSW, Australia; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Natalie Bouantoun
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Pamela Provan
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Susan J Ramus
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia; Adult Cancer Program, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Anna DeFazio
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Michael Friedlander
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Randwick, NSW, Australia
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Moujaber T, Balleine RL, Gao B, Madsen I, Harnett PR, DeFazio A. New therapeutic opportunities for women with low-grade serous ovarian cancer. Endocr Relat Cancer 2021; 29:R1-R16. [PMID: 34636747 DOI: 10.1530/erc-21-0191] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/12/2021] [Indexed: 11/08/2022]
Abstract
Low-grade serous ovarian cancer (LGSC) is a morphologically and molecularly distinct subtype of ovarian cancer, accounting for ~10% of serous carcinomas. Women typically present at a younger age and have a protracted clinical course compared with the more common, high-grade serous ovarian cancer. Currently, the primary treatment of LGSC is the same as other epithelial ovarian cancer subtypes, with treatment for most patients comprised of debulking surgery and platinum/taxane chemotherapy. Primary surgical cytoreduction to no visible residual disease remains a key prognostic factor; however, the use of platinum-based chemotherapy in both upfront and relapsed setting is being questioned due to low response rates in LGSC. Most LGSC expresses steroid hormone receptors, and selected patients may benefit from endocrine maintenance therapy following chemotherapy, in particular, those with evidence of residual disease at completion of surgery. In the recurrent setting, while hormonal therapies may offer disease stabilisation with relatively low toxicity, objective response rates remain low. Strategies to increase response rates, including combining with CDK4/6 inhibitors, are being investigated. LGSC has a high prevalence of activating somatic mutations in mitogen-activated protein kinase pathway genes, most commonly in KRAS, BRAF and NRAS. Trametinib, a MEK inhibitor, has shown efficacy over chemotherapy and endocrine therapy. The use of combination targeted therapies, immunotherapy and anti-angiogenic agents, remain active areas of investigation for the treatment of LGSC.
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Affiliation(s)
- Tania Moujaber
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Western Sydney Local Health District, New South Wales, Australia
- Blacktown Cancer and Haematology Centre, Blacktown Hospital, Western Sydney Local Health District, New South Wales, Australia
| | - Rosemary L Balleine
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Children's Medical Research Institute, Sydney, New South Wales, Australia
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Western Sydney Local Health District, New South Wales, Australia
- Blacktown Cancer and Haematology Centre, Blacktown Hospital, Western Sydney Local Health District, New South Wales, Australia
| | - Ida Madsen
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Western Sydney Local Health District, New South Wales, Australia
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Western Sydney Local Health District, New South Wales, Australia
| | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Western Sydney Local Health District, New South Wales, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, New South Wales, Australia
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Poulos RC, Hains PG, Shah R, Lucas N, Xavier D, Manda SS, Anees A, Koh JMS, Mahboob S, Wittman M, Williams SG, Sykes EK, Hecker M, Dausmann M, Wouters MA, Ashman K, Yang J, Wild PJ, deFazio A, Balleine RL, Tully B, Aebersold R, Speed TP, Liu Y, Reddel RR, Robinson PJ, Zhong Q. Strategies to enable large-scale proteomics for reproducible research. Nat Commun 2020; 11:3793. [PMID: 32732981 PMCID: PMC7393074 DOI: 10.1038/s41467-020-17641-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [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: 01/15/2020] [Accepted: 07/08/2020] [Indexed: 01/12/2023] Open
Abstract
Reproducible research is the bedrock of experimental science. To enable the deployment of large-scale proteomics, we assess the reproducibility of mass spectrometry (MS) over time and across instruments and develop computational methods for improving quantitative accuracy. We perform 1560 data independent acquisition (DIA)-MS runs of eight samples containing known proportions of ovarian and prostate cancer tissue and yeast, or control HEK293T cells. Replicates are run on six mass spectrometers operating continuously with varying maintenance schedules over four months, interspersed with ~5000 other runs. We utilise negative controls and replicates to remove unwanted variation and enhance biological signal, outperforming existing methods. We also design a method for reducing missing values. Integrating these computational modules into a pipeline (ProNorM), we mitigate variation among instruments over time and accurately predict tissue proportions. We demonstrate how to improve the quantitative analysis of large-scale DIA-MS data, providing a pathway toward clinical proteomics. Clinical proteomics critically depends on the ability to acquire highly reproducible data over an extended period of time. Here, the authors assess reproducibility over four months across different mass spectrometers and develop a computational approach to mitigate variation among instruments over time.
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Affiliation(s)
- Rebecca C Poulos
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Peter G Hains
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Rohan Shah
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Natasha Lucas
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Dylan Xavier
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Srikanth S Manda
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Asim Anees
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Jennifer M S Koh
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Sadia Mahboob
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Max Wittman
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Steven G Williams
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Erin K Sykes
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Michael Hecker
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Michael Dausmann
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Merridee A Wouters
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | | | - Jean Yang
- School of Mathematics and Statistics, The University of Sydney, Sydney, Australia
| | - Peter J Wild
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany.,Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Anna deFazio
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia
| | - Rosemary L Balleine
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Brett Tully
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Ruedi Aebersold
- Department of Biology, Institute of Molecular Systems Biology, ETH Zürich, Zürich, Switzerland.,Faculty of Science, University of Zürich, Zürich, Switzerland
| | - Terence P Speed
- Bioinformatics Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Mathematics and Statistics, University of Melbourne, Melbourne, VIC, Australia
| | - Yansheng Liu
- Department of Pharmacology, Yale University School of Medicine, New Haven, CT, USA.,Yale Cancer Biology Institute, Yale University, West Haven, CT, USA
| | - Roger R Reddel
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Phillip J Robinson
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Qing Zhong
- ProCan®, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.
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Tully B, Balleine RL, Hains PG, Zhong Q, Reddel RR, Robinson PJ. Addressing the Challenges of High-Throughput Cancer Tissue Proteomics for Clinical Application: ProCan. Proteomics 2019; 19:e1900109. [PMID: 31321850 DOI: 10.1002/pmic.201900109] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/11/2019] [Indexed: 11/09/2022]
Abstract
The cancer tissue proteome has enormous potential as a source of novel predictive biomarkers in oncology. Progress in the development of mass spectrometry (MS)-based tissue proteomics now presents an opportunity to exploit this by applying the strategies of comprehensive molecular profiling and big-data analytics that are refined in other fields of 'omics research. ProCan (ProCan is a registered trademark) is a program aiming to generate high-quality tissue proteomic data across a broad spectrum of cancer types. It is based on data-independent acquisition-MS proteomic analysis of annotated tissue samples sourced through collaboration with expert clinical and cancer research groups. The practical requirements of a high-throughput translational research program have shaped the approach that ProCan is taking to address challenges in study design, sample preparation, raw data acquisition, and data analysis. The ultimate goal is to establish a large proteomics knowledge-base that, in combination with other cancer 'omics data, will accelerate cancer research.
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Affiliation(s)
- Brett Tully
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Rosemary L Balleine
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Peter G Hains
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Qing Zhong
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Roger R Reddel
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Phillip J Robinson
- ProCan, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
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Lee CI, Fox P, Balakrishnar B, Balleine RL, Gao B, Provan P, Coulter S, Liddle C, Hui R, Wong M, Gurney H, Wilcken N. Tamoxifen-induced severe hot flashes and endoxifen levels: is dose reduction a safe and effective strategy? Breast 2019; 46:52-57. [PMID: 31082762 DOI: 10.1016/j.breast.2019.05.009] [Citation(s) in RCA: 5] [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: 11/26/2018] [Revised: 04/17/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Severe hot flash (HF) toxicity due to tamoxifen can compromise compliance. We previously found that HFs did not correlate with endoxifen level or CYP2D6 genotype. In this study, we reduced tamoxifen dose in patients with severe HFs to determine whether HFs were ameliorated whilst maintaining a purported therapeutic endoxifen level of >15 nM. MATERIALS AND METHODS Twenty patients with severe HFs on 20 mg TAM had CYP2D6genotype, trough level tamoxifen and metabolites measured with Loprinzi HF scores (HFS) derived before and after DR of tamoxifen to 10 mg. Other data collected included demographics, smoking, alcohol, menstrual and breast cancer history, previous chemotherapies, concurrent medications, BMI and other tamoxifen toxicities. RESULTS At the 20 mg tamoxifen dose, endoxifen levels were 25.6, 0-91.9 nM (median, range) with HFS 131, 22-1482 (median, range). Upon DR to 10 mg, median endoxifen level fell to 14.1, 0.6-71.9 nM (difference in means p = 0.11, two-tailed T test) with HFS 47, 5-864 (difference in means p = 0.24, two-tailed T test). Despite lacking statistical significance, 85% of patients reported subjective improvement of HFs with DR. After DR, the proportion of patients with endoxifen level <15 nM increased from 20% to 50%. HFS did not correlate with any other parameter. CONCLUSION DR of tamoxifen from 20 mg to 10 mg daily resulted in halving of endoxifen levels and subjective improvement of HF. While half the dose-reduced patients were below a potential therapeutic level of endoxifen, other recent studies suggest that low endoxifen levels may not indicate reduced effectiveness of tamoxifen.
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Affiliation(s)
- Clara I Lee
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Department of Medical Oncology, Bankstown-Lidcombe Hospital, Bankstown, Australia; Faculty of Medicine, University of New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
| | - Peter Fox
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | | | - Rosemary L Balleine
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Westmead Institute for Medical Research, Westmead, Australia
| | - Bo Gao
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | - Pamela Provan
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Sally Coulter
- Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Westmead Institute for Medical Research, Westmead, Australia
| | - Christopher Liddle
- Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Westmead Institute for Medical Research, Westmead, Australia
| | - Rina Hui
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Mark Wong
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; Macquarie University, Australia
| | - Nicholas Wilcken
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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Balleine RL, Reddel R, Robinson P, Zhong Q, Hains P, Tully B. Proteomics: Adding a dimension to cancer tissue pathology. Pathology 2019. [DOI: 10.1016/j.pathol.2018.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lucas N, Robinson AB, Marcker Espersen M, Mahboob S, Xavier D, Xue J, Balleine RL, deFazio A, Hains PG, Robinson PJ. Accelerated Barocycler Lysis and Extraction Sample Preparation for Clinical Proteomics by Mass Spectrometry. J Proteome Res 2018; 18:399-405. [DOI: 10.1021/acs.jproteome.8b00684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Natasha Lucas
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
| | - Andrew B. Robinson
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
| | - Maiken Marcker Espersen
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW 2145, Australia
| | - Sadia Mahboob
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
| | - Dylan Xavier
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
| | - Jing Xue
- Cell Signalling Unit, Children’s Medical Research Institute, The University of Sydney, Westmead, NSW 2145, Australia
| | - Rosemary L. Balleine
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
| | - Anna deFazio
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Peter G. Hains
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Cell Signalling Unit, Children’s Medical Research Institute, The University of Sydney, Westmead, NSW 2145, Australia
| | - Phillip J. Robinson
- ProCan, Children’s Medical Research Institute, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Cell Signalling Unit, Children’s Medical Research Institute, The University of Sydney, Westmead, NSW 2145, Australia
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Moujaber T, Etemadmoghadam D, Kennedy CJ, Chiew YE, Balleine RL, Saunders C, Wain GV, Gao B, Hogg R, Srirangan S, Kan C, Fereday S, Traficante N, Patch AM, Pearson JV, Waddell N, Grimmond SM, Dobrovic A, Bowtell DD, Harnett PR, deFazio A. BRAF Mutations in Low-Grade Serous Ovarian Cancer and Response to BRAF Inhibition. JCO Precis Oncol 2018; 2:1-14. [DOI: 10.1200/po.17.00221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Low-grade serous ovarian carcinoma (LGSC) responds poorly to chemotherapy and is characterized by activating mutations in the Ras sarcoma–mitogen-activated protein kinase (RAS-MAPK) pathway, including oncogenic BRAF. However, response to BRAF inhibitors is tumor-type specific. Significant improvement in survival is seen in patients with BRAF-mutant melanoma, but other cancer types, such as colorectal cancers, are generally less sensitive. We examined the frequency and characteristics of BRAF-mutated LGSC and described the response to treatment with BRAF inhibitors. Patients and Methods Mutations were assessed in LGSC (N = 65) by using targeted, exome, and whole-genome sequencing. Patient characteristics, treatment, and clinical outcome were assessed, and the median follow-up time was more than 5 years. BRAF inhibitors were trialed in two patients with a somatic BRAF V600E mutation: one patient received dabrafenib monotherapy and was monitored clinically, biochemically (cancer antigen [CA]-125 levels), and with positron emission tomography (PET) imaging. Expression of the BRAF V600E protein in this patient was assessed by immunohistochemistry. Results Among patients with LGSC, nine (13.8%) of 65 had a somatic BRAF mutation. Of the nine patients with BRAF mutation–positive LGSC, four experienced progressive disease that did not respond to conventional chemotherapy. Two of the patients experienced progression quickly and died as a result of disease progression, and two received targeted treatment. Two patients with BRAF V600E mutation received BRAF inhibitors at relapse and both achieved durable responses. Conclusion BRAF mutations are not uncommon in patients with LGSC and should be routinely tested, because BRAF inhibitors can be an effective treatment for these patients. The results highlight the need for targeted treatment in this rare tumor type, and a prospective study is needed to formally assess the response rate and clinical benefit.
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Affiliation(s)
- Tania Moujaber
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Dariush Etemadmoghadam
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Catherine J. Kennedy
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Yoke-Eng Chiew
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Rosemary L. Balleine
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Catherine Saunders
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Gerard V. Wain
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Bo Gao
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Russell Hogg
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Sivatharsny Srirangan
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Casina Kan
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Sian Fereday
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Nadia Traficante
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Ann-Marie Patch
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - John V. Pearson
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Nicola Waddell
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Sean M. Grimmond
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Alexander Dobrovic
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - David D.L. Bowtell
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Paul R. Harnett
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
| | - Anna deFazio
- Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Bo Gao, Sivatharsny Srirangan, Casina Kan, Paul R. Harnett, and Anna deFazio, Westmead Institute for Medical Research; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Russell Hogg, Paul R. Harnett, and Anna DeFazio, University of Sydney; Tania Moujaber, Catherine J. Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Bo Gao, Paul R. Harnett, and Anna
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9
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Gao B, Lu Y, Nieuweboer AJM, Xu H, Beesley J, Boere I, de Graan AJM, de Bruijn P, Gurney H, J Kennedy C, Chiew YE, Johnatty SE, Beale P, Harrison M, Luccarini C, Conroy D, Mathijssen RHJ, R Harnett P, Balleine RL, Chenevix-Trench G, Macgregor S, de Fazio A. Genome-wide association study of paclitaxel and carboplatin disposition in women with epithelial ovarian cancer. Sci Rep 2018; 8:1508. [PMID: 29367611 PMCID: PMC5784122 DOI: 10.1038/s41598-018-19590-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 09/26/2017] [Accepted: 01/04/2018] [Indexed: 12/12/2022] Open
Abstract
Identifying single nucleotide polymorphisms (SNPs) that influence chemotherapy disposition may help to personalize cancer treatment and limit toxicity. Genome-wide approaches are unbiased, compared with candidate gene studies, but usually require large cohorts. As most chemotherapy is given cyclically multiple blood sampling is required to adequately define drug disposition, limiting patient recruitment. We found that carboplatin and paclitaxel disposition are stable phenotypes in ovarian cancer patients and tested a genome-wide association study (GWAS) design to identify SNPs associated with chemotherapy disposition. We found highly significant SNPs in ABCC2, a known carboplatin transporter, associated with carboplatin clearance (asymptotic P = 5.2 × 106, empirical P = 1.4 × 10−5), indicating biological plausibility. We also identified novel SNPs associated with paclitaxel disposition, including rs17130142 with genome-wide significance (asymptotic P = 2.0 × 10−9, empirical P = 1.3 × 10−7). Although requiring further validation, our work demonstrated that GWAS of chemotherapeutic drug disposition can be effective, even in relatively small cohorts, and can be adopted in drug development and treatment programs.
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Affiliation(s)
- Bo Gao
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia.,The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Yi Lu
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | | | - Ingrid Boere
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Anne-Joy M de Graan
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Peter de Bruijn
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
| | - Catherine J Kennedy
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia.,The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Yoke-Eng Chiew
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia.,The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia
| | | | | | | | - Craig Luccarini
- Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge University, Cambridge, UK
| | - Don Conroy
- Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge University, Cambridge, UK
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Paul R Harnett
- The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia.,Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.,Sydney West Translational Cancer Research Centre, Sydney, Australia
| | - Rosemary L Balleine
- The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia.,Sydney West Translational Cancer Research Centre, Sydney, Australia.,Pathology West, Institute for Clinical Pathology and Medical Research (ICPMR), Westmead, Sydney, Australia
| | | | | | - Anna de Fazio
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia. .,The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia. .,Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia. .,Sydney West Translational Cancer Research Centre, Sydney, Australia.
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10
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Soon PS, Provan PJ, Kim E, Pathmanathan N, Graham D, Clarke CL, Balleine RL. Profiling differential microRNA expression between in situ, infiltrative and lympho-vascular space invasive breast cancer: a pilot study. Clin Exp Metastasis 2017; 35:3-13. [PMID: 29214365 DOI: 10.1007/s10585-017-9868-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/30/2017] [Indexed: 12/12/2022]
Abstract
Ductal carcinoma in situ (DCIS), invasive breast cancer (IBC) and lympho-vascular invasion (LVI) represent distinct stages in breast cancer progression with different clinical implications. Altered microRNA (miRNA) expression may play a role in mediating the progression of DCIS to IBC and LVI. The aim of this pilot study was to investigate whether differential miRNA expression could play a role in breast cancer progression. Cancer cells from DCIS, IBC and LVI were microdissected from formalin fixed paraffin embedded (FFPE) tissue of five breast cancer samples. MiRNA profiling of extracted RNA was performed using the TaqMan® Array Human MicroRNA Cards A and B v3.0. Candidate miRNAs and gene targets were validated by qPCR. 3D culture of MCF10A, MCF10DCIS.com and T47D cells were used as models for normal, DCIS and IBC. Immunohistochemistry of candidate genes was performed on FFPE 3D cell cultures as well as on tissue microarray which included cores of DCIS and IBC samples. MiR-150, miR-126 and miR-155 were found to be more highly expressed in IBC and LVI compared to DCIS. Gene targets of these miRNAs, RhoA, PEG10 and MYB, were found to be more highly expressed in DCIS compared to IBC by qPCR and in MCF10A and MCF10DCIS.com cells compared to T47D cells by immunohistochemistry. There was no difference in intensity of staining of RhoA by immunohistochemistry in DCIS versus IBC samples on tissue microarray. In this pilot study, we found evidence to support a potential role for variation in miRNA levels in the transition from DCIS to IBC.
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MESH Headings
- Adult
- Aged
- Axilla
- Blood Vessels/pathology
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Cell Line, Tumor
- Disease Progression
- Female
- Formaldehyde
- Gene Expression Profiling
- Humans
- Lymph Node Excision
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymph Nodes/surgery
- Lymphatic Metastasis/genetics
- MicroRNAs/genetics
- Middle Aged
- Neoplasm Invasiveness/genetics
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Paraffin Embedding
- Pilot Projects
- Reproducibility of Results
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- Patsy S Soon
- South Western Sydney Clinical School, Bankstown Hospital, University of New South Wales, Bankstown, NSW, 2200, Australia.
- Breast Cancer, Medical Oncology Group, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, NSW, 2170, Australia.
- Department of Surgery, Bankstown Hospital, Bankstown, NSW, 2200, Australia.
- Cancer Genetics, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
- Level 3, Staff Specialist Suite, Bankstown Hospital, Eldridge Rd, Bankstown, NSW, 2200, Australia.
| | - Pamela J Provan
- Translational Oncology, Sydney West Cancer Network, The Crown Princess Mary Cancer Centre Westmead Hospital, Westmead, NSW, 2145, Australia
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
| | - Edward Kim
- Cancer Genetics, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Nirmala Pathmanathan
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Dinny Graham
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
| | - Christine L Clarke
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
| | - Rosemary L Balleine
- Translational Oncology, Sydney West Cancer Network, The Crown Princess Mary Cancer Centre Westmead Hospital, Westmead, NSW, 2145, Australia
- Sydney Medical School, The University of Sydney, Westmead, NSW, 2145, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, Westmead, NSW, 2145, Australia
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11
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Gao B, Lindemann K, Anderson L, Fereday S, Hung J, Alsop K, Tothill RW, Gebski V, Kennedy C, Balleine RL, Harnett PR, Bowtell DDL, DeFazio A. Serous ovarian and primary peritoneal cancers: A comparative analysis of clinico-pathological features, molecular subtypes and treatment outcome. Gynecol Oncol 2016; 142:458-64. [PMID: 27444035 DOI: 10.1016/j.ygyno.2016.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 05/02/2016] [Revised: 06/23/2016] [Accepted: 06/30/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Primary peritoneal cancer is rare and considered equivalent to stage III/IV ovarian cancer, but questions remain concerning its underlying biology, prognosis and optimal management. METHODS Clinico-pathological and treatment details of primary peritoneal (n=120) and ovarian cancer (n=635) were obtained on women recruited to the Australian Ovarian Cancer Study. Log-rank test was used to compare survival and cox proportional hazards models were fitted to obtain hazard ratios and 95% confidence intervals, both unadjusted and adjusted for age, grade, FIGO stage, residual disease and treatment with neoadjuvant chemotherapy. Molecular subtype was determined by gene expression profiling using published data. RESULTS Compared with advanced serous ovarian cancer, primary peritoneal cancer patients were older (mean age 65.5 vs. 60.2years, p<0.001), more often treated with neoadjuvant chemotherapy (38.4% vs. 11.4%, p<0.001). Gene expression profiling classified a substantially higher proportion of primary peritoneal carcinomas as C1 (mesenchymal, reactive stromal infiltration) subtype (70.6% vs. 32.1%, p=0.029), which was associated with lower complete surgical resection rate. Women with primary peritoneal cancer had significantly shorter progression-free (11.6 vs. 13.6months, p=0.007) and overall survival (31.7 vs. 39.8months, p=0.012). In multivariate analysis, residual disease and neoadjuvant chemotherapy were both independently associated with increased risk of progression and death. CONCLUSIONS Primary peritoneal cancer patients were more frequently treated with neoadjuvant chemotherapy and had inferior survival. Different tumor biology characterized by activated stromal fibrosis in primary peritoneal cancer may underlie the differences in treatment and clinical outcome.
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Affiliation(s)
- Bo Gao
- Crown Princess Mary Cancer Care Centre, Westmead Hospital, Sydney, NSW, Australia; The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Kristina Lindemann
- Crown Princess Mary Cancer Care Centre, Westmead Hospital, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, Sydney, NSW, Australia; Department of Gynecological Cancer, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jillian Hung
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia; Department of Gynecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Kathryn Alsop
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Val Gebski
- NHMRC Clinical Trials Centre, Sydney, NSW, Australia
| | - Catherine Kennedy
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia; Department of Gynecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Rosemary L Balleine
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia; Pathology West ICPMR, Westmead, NSW, Australia
| | | | - Paul R Harnett
- Crown Princess Mary Cancer Care Centre, Westmead Hospital, Sydney, NSW, Australia; The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - David D L Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia; Department of Biochemistry and Molecular Biology, University of Melbourne, Melbourne, Victoria, Australia; Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, UK; The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Anna DeFazio
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia; Department of Gynecological Oncology, Westmead Hospital, Sydney, NSW, Australia.
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12
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Lee CI, Low ASK, Fox P, Balakrishnar B, Balleine RL, Gao B, Provan P, Coulter S, Liddle C, Hui R, Wilcken N, Wong M, Gurney H. Simplified CYP2D6 metabolizer phenotype categorization of patients treated with tamoxifen: Role for endoxifen level monitoring? J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Peter Fox
- Royal Prince Alfred Hospital, Annandale, Australia
| | | | - Rosemary L Balleine
- Sydney West Cancer Network, Westmead Millennium Institute, Sydney Medical School-Westmead, Sydney, Australia
| | - Bo Gao
- Blacktown Hospital, Sydney, Australia
| | - Pamela Provan
- University of Sydney, Westmead Hospital, Sydney, Australia
| | | | - Christopher Liddle
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Sydney, Australia
| | - Rina Hui
- Westmead Cancer Care Center, Westmead, Australia
| | | | - Mark Wong
- Westmead Hospital, Westmead, Australia
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13
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Gao B, Lindemann K, Anderson L, Fereday S, Hung J, Alsop K, Tothill R, Gebski V, Kennedy C, Balleine RL, Harnett PR, Bowtell D, deFazio A. Serous ovarian and primary peritoneal cancers: A comparative analysis of clinico-pathological features, molecular subtypes and treatment outcome. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Bo Gao
- Blacktown Hospital, Sydney, Australia
| | | | | | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Jillian Hung
- Gynecological Oncology Department, Westmead Hospital, Sydney, Australia
| | | | | | - Val Gebski
- National Health and Medical Research Council Clinical Trials Centre, Sydney, Australia
| | - Catherine Kennedy
- Gynecological Oncology Department, Westmead Hospital, Sydney, Australia
| | - Rosemary L Balleine
- Sydney West Cancer Network, Westmead Millennium Institute, Sydney Medical School-Westmead, Sydney, Australia
| | - Paul R. Harnett
- Crown Princess Mary Cancer Centre Westmead, Sydney, Australia
| | - David Bowtell
- Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - Anna deFazio
- University of Sydney at Westmead Millennium Institute, Sydney, NSW, Australia
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Fox P, Balleine RL, Lee C, Gao B, Balakrishnar B, Menzies AM, Yeap SH, Ali SS, Gebski V, Provan P, Coulter S, Liddle C, Hui R, Kefford R, Lynch J, Wong M, Wilcken N, Gurney H. Dose Escalation of Tamoxifen in Patients with Low Endoxifen Level: Evidence for Therapeutic Drug Monitoring-The TADE Study. Clin Cancer Res 2016; 22:3164-71. [PMID: 26847054 DOI: 10.1158/1078-0432.ccr-15-1470] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 01/17/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE Endoxifen is the major mediator of tamoxifen effect and endoxifen levels <15 nmol/L may be associated with increased risk of breast cancer recurrence. We increased tamoxifen dose in breast cancer patients with low endoxifen levels and assessed the influence of various parameters on reaching 15 nmol/L and 30 nmol/L endoxifen levels. EXPERIMENTAL DESIGN Tamoxifen dose was increased in those with endoxifen levels below 30 nmol/L. Toxicity, including hot flash score, was measured. CYP2D6 metabolizer status was classified as ultra-rapid (UM), extensive (EM), intermediate (IM), or poor (PM) based genotype of somatic DNA. RESULTS Dosage was escalated in 68 of 122 participants. On 20 mg tamoxifen, 24% had endoxifen levels below 15 nmol/L and this reduced to 6% following dose escalation. In over 50% of cases, there was no identified cause for low endoxifen. Low baseline endoxifen level, and not CYP2D6 metabolizer status, independently predicted reaching threshold targets for both the 15 nmol/L and 30 nmol/L targets (P = 0.04 and 0.003 respectively). The 15 nmol/L target was reached in all UM/EM and IM patients, 63% of PM patients, and 58% of those with baseline endoxifen of <10 nmol/L. There was no correlation between hot flash score and genotype or any tamoxifen metabolite level including endoxifen (R = 0.07). CONCLUSIONS Low endoxifen on standard dose tamoxifen was the only independent predictor of failure to achieve potentially therapeutic levels. Trials examining tamoxifen dose escalation and breast cancer outcome should be guided by endoxifen levels alone, without reference to CYP2D6 genotype or presence of hot flashes. Clin Cancer Res; 22(13); 3164-71. ©2016 AACRSee related commentary by Hertz and Rae, p. 3121.
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Affiliation(s)
- Peter Fox
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | - Rosemary L Balleine
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Pathology West, Institute for Clinical Pathology and Medical Research, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia. Westmead Millennium Institute for Medical Research, Westmead, Australia
| | - Clara Lee
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | - Bo Gao
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia
| | | | | | - Shang Heng Yeap
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | | | - Val Gebski
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | - Pamela Provan
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia
| | - Sally Coulter
- Westmead Millennium Institute for Medical Research, Westmead, Australia
| | - Christopher Liddle
- Sydney Medical School - Westmead, University of Sydney, Sydney, Australia. Westmead Millennium Institute for Medical Research, Westmead, Australia. Storr Liver Centre, Westmead Hospital, Westmead, Australia
| | - Rina Hui
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia
| | - Richard Kefford
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia
| | | | - Mark Wong
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia
| | - Nicholas Wilcken
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia. Sydney Medical School - Westmead, University of Sydney, Sydney, Australia. Faculty of Medicine and Health Sciences, Macquarie University, Sydney Australia.
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15
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DeFazio A, Moujaber T, Etemadmoghadam D, Kennedy C, Chiew YE, Balleine RL, Saunders C, Wain GV, Dobrovic A, Bowtell DDL, Harnett PR. Abstract A25: BRAFV600E mutations in serous ovarian cancer and response to the BRAF inhibitor, dabrafenib. Clin Cancer Res 2016. [DOI: 10.1158/1557-3265.ovca15-a25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Low-grade serous ovarian cancer (LGSC) is a challenging disease to treat effectively. It often occurs in young women and it is well-recognized to be resistant to standard chemotherapy. The underlying molecular driver mutations are now beginning to be understood and they are distinctly different from the more common counterpart, high-grade serous ovarian cancer. LGSC are characterized by somatic mutations in RAS/RAF genes and a number of new agents have been developed that target these mutations, and related activated pathways. However, it is not yet known which pathway-targeted drugs, or combination of drugs, will be effective in the treatment of LGSC. BRAFV600E mutations have been reported in LGSC and BRAF inhibitors have demonstrated significant improvement in progression-free survival in patients with BRAF-mutant melanoma. However, limited response is seen in other cancer types, such as colorectal cancers harboring the same mutation, suggesting that clinical benefit is tumor-type specific. In this study we aimed to characterize BRAF mutations in LGSC and to determine whether BRAF inhibitors could demonstrate a clinical benefit in ovarian cancer patients.
Patients with LGSC were identified through the Australian Ovarian Cancer Study and the Westmead GynBiobank, Sydney, Australia. Tumor mutations were assessed using targeted and exome sequencing, and gene copy number was measured by whole genome SNP arrays. Tumor expression of BRAFV600E protein was also assessed by immunohistochemistry. Dabrafenib monotherapy was trialed in a patient with a somatic BRAFV600E mutation and progress was monitored clinically, biochemically using CA125 tumor marker levels and radiologically with PET imaging.
Amongst Grade 1 serous ovarian carcinoma cases, 5/40 (12.5%) were shown to have a BRAFV600E mutation. Tumors with a BRAFV600E mutation had a relatively low degree of gene copy number change and were TP53 wild-type. The BRAF-inhibitor, dabrafenib was trialed in a heavily pre-treated BRAFV600E mutation-positive LGSC patient with progressive chemotherapy-resistant disease (n=1). Whole exome sequencing confirmed the BRAFV600E mutation was the highest frequency variant allele present and also identified deleterious mutations in other cancer-associated genes including CSMD1, BMP1 and DNM1 at lower frequencies, suggestive of sub-clonal events. The patient received dabrafenib monotherapy for 11 months, and demonstrated a substantial clinical, radiological and biochemical response, with complete normalization of her CA125 levels for the first time in six years.
These results demonstrate that molecular analysis of low-grade serous ovarian carcinoma can identify targetable mutations and provide effective treatment options. The substantial response to dabrafenib suggests that BRAF inhibition represents a potential therapeutic option for ovarian cancer patients with somatic BRAFV600E mutations and should be tested in future trials. However, the results also highlight the need for novel clinical trial design, as traditional clinical trials are unlikely to be effective in such rare ovarian cancer sub-groups.
Citation Format: Anna DeFazio, Tania Moujaber, Dariush Etemadmoghadam, Catherine Kennedy, Yoke-Eng Chiew, Rosemary L. Balleine, Catherine Saunders, Gerard V. Wain, Alexander Dobrovic, Australian Ovarian Cancer Study Group (AOCS), David DL Bowtell, Paul R. Harnett. BRAFV600E mutations in serous ovarian cancer and response to the BRAF inhibitor, dabrafenib. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: Exploiting Vulnerabilities; Oct 17-20, 2015; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(2 Suppl):Abstract nr A25.
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Affiliation(s)
- Anna DeFazio
- 1The Westmead Millennium Institute; The University of Sydney; Westmead Hospital, Sydney, Australia,
| | - Tania Moujaber
- 1The Westmead Millennium Institute; The University of Sydney; Westmead Hospital, Sydney, Australia,
| | | | - Catherine Kennedy
- 1The Westmead Millennium Institute; The University of Sydney; Westmead Hospital, Sydney, Australia,
| | - Yoke-Eng Chiew
- 1The Westmead Millennium Institute; The University of Sydney; Westmead Hospital, Sydney, Australia,
| | - Rosemary L. Balleine
- 3The Westmead Millennium Institute;The University of Sydney; Pathology West ICPMR, Sydney, Australia,
| | | | - Gerard V. Wain
- 4The University of Sydney; Westmead Hospital, Sydney, Australia,
| | - Alexander Dobrovic
- 5LICR; Olivia Newton John Cancer and Wellness Centre; La Trobe University; University of Melbourne, Melbourne, Australia,
| | - David DL Bowtell
- 2Peter MacCallum Cancer Centre; University of Melbourne, Melbourne, Australia,
| | - Paul R. Harnett
- 4The University of Sydney; Westmead Hospital, Sydney, Australia,
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Gao B, Lu Y, Nieuweboer AJ, Xu H, Beesley J, Boere I, de Graan AJM, de Bruijn P, Gurney H, Kennedy C, Chiew YE, Johnatty SE, Beale P, Harrison M, Luccarini C, Dunning AM, Mathijssen RH, Harnett P, Balleine RL, Chenevix-Trench G, MacGregor S, deFazio A. Abstract 5493: Genome-wide study of carboplatin and paclitaxel disposition in ovarian cancer patients. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-5493] [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
Germline genetic variation can affect chemotherapeutic drug disposition, toxicity and efficacy. Identifying single nucleotide polymorphisms (SNPs) that influence chemotherapy disposition may help to personalize individual treatment. Compared to the traditional candidate gene approach, a genome-wide association study (GWAS) is unbiased but usually requires a large sample size. Since most cytotoxics have a short half-life and are given cyclically, multiple blood samples are therefore required to adequately define drug disposition and systemic exposure. This limits patient sample sizes in pharmacokinetic studies. The aim of this study was to identify SNPs that are associated with carboplatin and paclitaxel pharmacokinetic parameters using a GWAS approach in two small patient cohorts. Methods: Two independent pharmacokinetic cohorts were recruited in Australia (N = 61, both carboplatin and paclitaxel) and the Netherlands (N = 35, paclitaxel only). A total of 719,665 SNPs were genotyped using Illumina Human OmniExpress arrays. Linear regression was used to test the association between each SNP and the trait of interest, both unadjusted and adjusted for corresponding covariates using PLINK. We performed separate analysis within each population and then ran meta-analysis combining results from different populations weighted by sample sizes using METAL. Results: Carboplatin and paclitaxel disposition is a relative stable phenotype. The genomic control parameters in the test statistics for the adjusted carboplatin and paclitaxel analysis were 1.03 and 1.02 respectively, suggesting that there was little concern for population substructure or other artefacts. We identified highly significant SNPs in ABCC2 associated with carboplatin clearance (asymptotic p = 5.2 × 10−6, empirical p = 1.4 × 10−5 from 107 permutations) which are highly plausible pharmacogenomic markers given the known role of ABCC2 in carboplatin efflux. We also identified a novel SNP associated with paclitaxel disposition with genome wide significance in chromosome 1 (rs17130142, asymptotic p = 2.0 × 10−9, empirical p = 1.3× 10−7), in an intergenic region, neighboring PKN2. Conclusion: Although these findings requires a validation in a larger study, our work demonstrated that GWAS of chemotherapeutic drug disposition can be effective even when performed in a relative small sample number and can be adopted in drug development and treatment programs.
Citation Format: Bo Gao, Yi Lu, Annemieke J.M. Nieuweboer, Hongmei Xu, Jonathan Beesley, Ingrid Boere, Anne-Joy M. de Graan, Peter de Bruijn, Howard Gurney, Catherine Kennedy, Yoke-Eng Chiew, Sharon E. Johnatty, Philip Beale, Michelle Harrison, Craig Luccarini, Alison M. Dunning, Ron H.J. Mathijssen, Paul Harnett, Rosemary L. Balleine, Georgia Chenevix-Trench, Stuart MacGregor, Anna deFazio. Genome-wide study of carboplatin and paclitaxel disposition in ovarian cancer patients. [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 5493. doi:10.1158/1538-7445.AM2015-5493
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Affiliation(s)
- Bo Gao
- 1Center for Cancer Research, Sydney, Australia
| | - Yi Lu
- 2QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | | | - Ingrid Boere
- 3Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Anne-Joy M. de Graan
- 3Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Peter de Bruijn
- 3Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Howard Gurney
- 5Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
| | | | | | | | | | | | - Craig Luccarini
- 7Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge University, United Kingdom
| | - Alison M. Dunning
- 7Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge University, United Kingdom
| | - Ron H.J. Mathijssen
- 3Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Paul Harnett
- 5Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
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17
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Lee CI, Fox P, Balakrishnar B, Balleine RL, Gao B, Provan P, Coulter S, Tomlins M, Liddle C, Hui R, Wong M, Gurney H, Wilcken N. Tamoxifen (TAM)-induced severe hot flashes (HF): Is dose reduction (DR) a safe and effective strategy? J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Peter Fox
- Westmead Hospital, Sydney, Australia
| | | | - Rosemary L Balleine
- Sydney West Cancer Network, Westmead Millennium Institute, Sydney Medical School-Westmead, Sydney, Australia
| | - Bo Gao
- Westmead Hospital, Westmead, NSW, Australia
| | - Pamela Provan
- University of Sydney, Westmead Hospital, Sydney, Australia
| | | | - Mark Tomlins
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia
| | - Christopher Liddle
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Sydney, Australia
| | - Rina Hui
- Westmead Cancer Care Ctr, Westmead, Australia
| | - Mark Wong
- Westmead Hospital, Westmead, Australia
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18
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Gao B, Lu Y, Nieuweboer AJ, Xu H, Beesley J, Moghaddam-Helmantel IMG, de Graan AJM, de Bruijn P, Gurney H, Johnatty S, Beale PJ, Mathijssen RH, Harnett PR, Balleine RL, Chenevix-Trench G, MacGregor S, deFazio A. Genome-wide association study for identification of candidate SNPs associated with carboplatin and paclitaxel clearance in ovarian cancer patients. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Bo Gao
- Blacktown Hospital, Sydney, Australia
| | - Yi Lu
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Hongmei Xu
- Department of Quantitative Clinical Pharmacology, AstraZeneca Research and Development, Gaithersburg, MD
| | | | | | | | - Peter de Bruijn
- Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, Netherlands
| | - Howard Gurney
- Westmead Hospital, University of Sydney, Sydney, Australia
| | - Sharon Johnatty
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | - Paul R. Harnett
- Westmead Hospital, Sydney University Hospital, Sydney, Australia
| | - Rosemary L Balleine
- Sydney West Cancer Network, Westmead Millennium Institute, Sydney Medical School-Westmead, Sydney, Australia
| | | | | | - Anna deFazio
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Sydney, Australia
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19
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Pathmanathan N, Balleine RL, Jayasinghe UW, Bilinski KL, Provan PJ, Byth K, Bilous AM, Salisbury EL, Boyages J. The prognostic value of Ki67 in systemically untreated patients with node-negative breast cancer. J Clin Pathol 2014; 67:222-8. [PMID: 24403187 DOI: 10.1136/jclinpath-2013-201793] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIM To evaluate the utility of Ki67 as a prognostic marker in a series of patients with node-negative breast cancer untreated with adjuvant systemic therapy. METHODS The cohort consisted of 203 cases treated with breast conserving surgery and radiation only; median follow-up was 183 months (range 156-277 months). An immunohistochemical panel of oestrogen receptor (ER), progesterone receptor (PR), cytokeratin (CK)5/6 and Ki67 and human epidermal growth factor 2 in situ hybridization (HER2-ISH) was performed on the tumour samples. Ki67 scores were evaluable in 193/203 patients (95.1%). The primary outcome was breast cancer specific survival (BCSS). RESULTS Of the cohort, 29 (14.2%) died of breast cancer. A cut off of 10% separated tumours into a 'Ki67-low' (n=70) or 'Ki67-high' group (n=123). The breast cancer specific survival was 97.1% and 77.6% for Ki67-low and Ki67-high groups, respectively. Univariate analysis showed that in this lymph node-negative cohort, the predictors for BCSS were tumour size, Ki67, LVI, age and histological grade 3. Multivariable analysis showed that Ki67 index and lymphovascular space invasion were independent predictors of breast cancer death. To examine the utility of Ki67 in assignment of immunohistochemically molecular subtypes, cases were assigned into Luminal A (ER-positive, HER2-negative, Ki67 ≤14%), Luminal B (ER-positive, HER2-negative, Ki67 >14%) and triple negative (ER/PR-negative and HER2-negative, any Ki67). The 15-year breast cancer specific survival was 91.7%, 79.4% and 75.8%, respectively. CONCLUSIONS A statistically significant difference in breast cancer specific survival is seen in groups defined using Ki67 and receptor status, whereas histological grading was not a significant predictor of survival. Ki67 immunostaining provides prognostic information beyond traditionally assessed clinicopathological variables.
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Affiliation(s)
- Nirmala Pathmanathan
- Westmead Breast Cancer Institute, Westmead Hospital, , Westmead, New South Wales, Australia
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20
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Gao B, Nieuweboer AJ, Xu H, Beesley J, Moghaddam-Helmantel IMG, Graan AJMD, Bruijn PD, Gurney H, Johnatty SE, Beale P, Chenevix-Trench G, Balleine RL, Mathijssen RHRH, Harnett PR. Abstract A55: Influence of ABCB1 polymorphisms on paclitaxel pharmacokinetics in ovarian cancer patients. Clin Cancer Res 2013. [DOI: 10.1158/1078-0432.ovca13-a55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Epithelial ovarian cancer is generally treated by cytoreductive surgery followed by paclitaxel and carboplatin combination chemotherapy. Despite the high initial response rate, most patients with advanced disease will relapse and eventually succumb to illness due to intrinsic or acquired chemotherapy resistance. ABCB1 (ATP–binding cassette, sub-family B, member 1) mediates cellular elimination of many chemotherapeutic drugs, including paclitaxel. We previously reported a significant association between ABCB1 SNPs (single nucleotide polymorphisms) and PFS (progression-free survival) in ovarian cancer patients (Johnatty et al Clin Cancer Res 2008; 14: 5594-601). In patients with ≥1 cm residual disease, PFS was significantly shorter in homozygote GG carriers compared with patients who carried the minor T/A alleles at the G2677T/A locus (median PFS, 18 months compared with 32 months; p = 0.002). We hypothesized that variability in paclitaxel clearance (CL) resulting from genotypic differences in ABCB1 may underlie the impact of ABCB1 SNPs on clinical outcome.
Methods: Pharmacokinetic sampling was performed during the first cycle of paclitaxel (175 mg/m2) and carboplatin (AUC5 or 6) combination chemotherapy treatment in two independent patient cohorts. These included 39 patients in a hospital based series in the Netherlands and 55 patients recruited prospectively in Australia. Paclitaxel levels were measured using liquid chromatography - tandem mass spectrometry (LC-MS/MS). The individual posterior Bayesian estimates of paclitaxel CL and model-based estimate of AUC (area-under-curve) were determined by using population pharmacokinetics with the NONMEM software. Common ABCB1 SNPs in exon 12 (C1236T), 21 (G2677T/A) and 26 (C3435T) were examined by iPLEX genotyping on Sequenom's MassARRAY platform. Nonparametric Jonckheere-Terpstra tests were used to compare the distribution of paclitaxel CL and AUC between patients of different genotypes.
Results: In the Netherlands cohort, there were statistically significant associations observed between ABCB1 SNPs at exon 12 (C1236T), 21 (G2677T/A) and 26 (C3435T) and paclitaxel CL and AUC. Homozygote GG carriers at the G2677T/A locus had higher paclitaxel CL and lower AUC compared with minor T/A allele carriers. Similar findings were found for C1236T and C3435T. These findings were consistent with our previous clinical observations that patients with homozygote GG at exon 21 (G2677T/A), or homozygote CC at exon 12 (C1236T) or 26 (C3435T), had shorter PFS. The paclitaxel pharmacokinetic modeling results in the Australian cohort will be available for analysis shortly.
Conclusion: The results to date suggest that common ABCB1 SNPs may contribute to chemotherapy resistance in women with ovarian cancer through their effects on paclitaxel drug disposition.
Citation Format: Bo Gao, Annemieke J.M. Nieuweboer, Hongmei Xu, Jonathan Beesley, Inge M. Ghobadi Moghaddam-Helmantel, Anne-Joy M. de Graan, Peter de Bruijn, Howard Gurney, Sharon E. Johnatty, Philip Beale, Georgia Chenevix-Trench, Rosemary L. Balleine, Ron H.J. Ron H.J. Mathijssen, Paul R. Harnett. Influence of ABCB1 polymorphisms on paclitaxel pharmacokinetics in ovarian cancer patients. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A55.
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Affiliation(s)
- Bo Gao
- 1Department of Gynaecological Oncology, Westmead Hospital, Sydney, Nsw, Australia,
| | | | - Hongmei Xu
- 3Department of Clinical Pharmacology and Pharmacometrics, AstraZeneca Research and Development, Wilmington, DE,
| | | | | | - Anne-Joy M. de Graan
- 2Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands,
| | - Peter de Bruijn
- 2Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands,
| | - Howard Gurney
- 5Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia,
| | | | | | | | - Rosemary L. Balleine
- 7Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Sydney, Australia
| | | | - Paul R. Harnett
- 5Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia,
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21
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Fox P, Gao B, Balakrishnar B, Menzies AM, Yeap SH, Ali SS, Gebski V, Provan P, Coulter S, Liddle C, Hui R, Kefford R, Lynch J, Wilcken N, Balleine RL, Gurney H. Factors predicting endoxifen levels in breast cancer patients taking standard-dose tamoxifen and following dose escalation. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.543] [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
543 Background: Tamoxifen (TAM) is transformed via CYP2D6 to its major active metabolite endoxifen (Endox). Recent data suggest that 15nM Endox may be a therapeutic threshold for breast cancer . This study identified predictors of achieving specified Endox target levels (15nM and 30nM) on standard dose TAM, and following dose escalation. Methods: Baseline Endox was measured in 122 breast cancer pts on TAM 20mg pd. Pts with baseline Endox <30nM underwent incremental dose escalation to a maximum of 60mg pd until Endox reached 30nM or dose limiting toxicity. Clinical data were collected and CYP2D6 genotype was used to specify extensive, intermediate or poor metabolizer categories (EM, IM, PM). Multiple regression analyses examined associations between Endox and potential predictive factors. Results: Baseline Endox ranged from 3.1-72.2nM (mean 27.6nM). In 19% (n=23), baseline Endox was below 15nM and 62% (n=76) were below 30nM. Low baseline Endox was associated with CYP2D6 genotype (IM or PM, p<0.001) and younger age (p=0.02). Following dose escalation, 96% (n=117) attained an Endox level of 15nM and 76% (n=93) reached 30nM. Baseline Endox level was the only variable independently associated with achieving both targets (p=0.02, p<0.001 respectively). CYP2D6 genotype did not independently predict attainment of Endox targets following dose escalation (p>0.4). The ratio of Endox to its precursor N-desmethylTAM, an indicator of CYP2D6 activity, was stable with dose escalation, suggesting that CYP2D6 was not saturated. Conclusions: Although IM/PM predict for low Endox on 20mg TAM, only low baseline Endox predicted failure to achieve both 15nM and 30nM targets following dose escalation. These results suggest a role for Endox level monitoring to determine optimal TAM dose. Clinical trial information: NCT01075802. [Table: see text]
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Affiliation(s)
- Peter Fox
- Westmead Hospital, Sydney, Australia
| | - Bo Gao
- Westmead Hospital, Sydney, Australia
| | | | - Alexander M Menzies
- Melanoma Institute Australia, Westmead Hospital, University of Sydney, Sydney, Australia
| | - Shang Heng Yeap
- Johns Hopkins Singapore International Medical Centre, Tan Tock Seng, Singapore
| | | | - Val Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Pamela Provan
- University of Sydney, Westmead Hospital, Sydney, Australia
| | | | - Christopher Liddle
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Sydney, Australia
| | - Rina Hui
- Westmead Hospital, University of Sydney, Sydney, Australia
| | - Richard Kefford
- Westmead Hospital and Melanoma Institute Australia, Westmead, Australia
| | | | | | - Rosemary L Balleine
- Sydney West Cancer Network, Westmead Millennium Institute, Sydney Medical School-Westmead, Sydney, Australia
| | - Howard Gurney
- Westmead Hospital, University of Sydney, Sydney, Australia
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22
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Abstract
New approaches to the prognostic assessment of breast cancer have come from molecular profiling studies. A major feature of this work has been to emphasise the importance of cancer cell proliferation as a key discriminative indicator of recurrence risk for oestrogen receptor positive breast cancer in particular. Mitotic count scoring, as a component of histopathological grade, has long formed part of a routine evaluation of breast cancer biology. However, there is an increasingly compelling case to include a specific proliferation score in breast cancer pathology reports based on expression of the cell cycle regulated protein Ki67. Immunohistochemical staining for Ki67 is a widely available and economical test with good tolerance of pre-analytical variations and staining conditions. However, there is currently no evidence based protocol established to derive a reliable and informative Ki67 score for routine clinical use. In this circumstance, pathologists must establish a standardised framework for scoring Ki67 and communicating results to a multidisciplinary team.
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Affiliation(s)
- Nirmala Pathmanathan
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, New South Wales, Australia.
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23
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Abstract
The estrogen receptor (ER) has long been recognized as a key discriminative feature of breast cancer, which carries profound implications for management. However, recent advances in the understanding of breast cancer heterogeneity have demonstrated the importance of biologic context to the interpretation of ER as a prognostic and predictive factor. The use of tumor subtyping methods and prognostic indicators based on molecular profiling of tumor tissue is now helping to delineate high-risk ER-positive cancer types that have distinct risk and treatment response profiles. These new approaches to breast cancer classification will have a major impact on the conduct of clinical trials and individual patient assessment in the future.
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Affiliation(s)
- Rosemary L Balleine
- Translational Oncology, Sydney West Cancer Network, Western Sydney and Nepean Blue Mountains Local Health Districts, Sydney, NSW, Australia.
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24
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Pathmanathan N, Provan PJ, Mahajan H, Hall G, Byth K, Bilous AM, Balleine RL. Characteristics of HER2-positive breast cancer diagnosed following the introduction of universal HER2 testing. Breast 2012; 21:724-9. [PMID: 23099207 DOI: 10.1016/j.breast.2012.09.001] [Citation(s) in RCA: 18] [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: 04/06/2012] [Revised: 08/17/2012] [Accepted: 09/05/2012] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to determine the impact of universal HER2 testing on the clinico-pathologic profile of HER2+ breast cancer. Data were extracted from breast cancer pathology reports spanning two periods: before (2003/4, n = 379), and after (2008/9, n = 560) the introduction of universal testing. In 2003/4, 43.3% of breast cancers were tested for HER2 with 16% of tested cases HER2+. In 2008/9, 98.4% of cases were tested with 14.7% HER2+. In 2008/9, HER2+ status was associated with younger age, higher grade, increased tumour size, lymph node involvement, negative oestrogen and/or progesterone receptor status. HER2+ cases diagnosed in 2003/4 were not significantly different in respect of these features. The rate of HER2+ breast cancer amongst screen detected cases in 2008/9 was 8.3%. The phenotype of HER2+ breast cancer was stable following the introduction of universal testing. The overall rate of HER2+ breast cancer was influenced by screen detection.
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Affiliation(s)
- Nirmala Pathmanathan
- Department of Tissue Pathology and Diagnostic Oncology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia.
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25
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Balakrishnar B, Menzies AM, Ali SS, Yeap SH, Gao B, Liddle C, Coulter S, Provan P, Gebski V, Hui R, Kefford R, Wilcken N, Balleine RL, Gurney H. CYP2D6 genotype and adverse effects as indicators of plasma endoxifen in breast cancer patients taking tamoxifen. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.550] [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
550 Background: Tamoxifen is a prodrug. Its principal active metabolite endoxifen is a product of cytochrome P450 2D6 (CYP2D6) metabolism. The CYP2D6 gene is highly polymorphic with a number of relatively common reduced function alleles. The aim of this study was to determine whether plasma endoxifen levels were reflected by CYP2D6 genotype or adverse effects in individuals taking tamoxifen. Methods: Plasma endoxifen was measured by High Performance Liquid Chromatography / Mass Spectroscopy in 90 breast cancer patients taking 20mg tamoxifen per day. Ten CYP2D6 single nucleotide polymorphisms were assessed to designate four putative CYP2D6 functional categories: ultra-rapid (UM), extensive (EM), intermediate (IM) and poor (PM) metabolizers. CYP2D6 inhibitor use and adverse effects were documented. The study was part of an ongoing Australian trial of tamoxifen dose escalation. Results: There was marked variation in plasma endoxifen levels across the cohort (mean 27.6 nM, SD 14.3). Endoxifen levels were significantly associated with metabolizer categories (p<0.001, r= -0.44), but were not distinctive between categories. For example, in the EM category (n=46) endoxifen levels ranged from 3.8-72.2 nM (mean 32.6 nM) with levels in the lowest quartile (3.8-19.7 nM) substantially overlapping the PM category (n=11); 6.1-24.7 nM. Consistent with an impact of non-CYP2D6 genotype related factors on endoxifen levels, endoxifen was significantly lower in 18 patients taking CYP2D6 inhibitor medications (p=0.005). There was no association between endoxifen levels and vasomotor symptoms or other adverse effects of tamoxifen. Conclusions: Endoxifen levels were highly variable in patients taking standard dose tamoxifen, and not predicted by CYP2D6 genotype or adverse effects. Therapeutic monitoring of endoxifen levels may be a useful approach to assess tamoxifen activity.
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Affiliation(s)
| | - Alexander M. Menzies
- Melanoma Institute Australia; Westmead Hospital, University of Sydney, Sydney, Australia
| | | | | | - Bo Gao
- Westmead Hospital, Sydney, Australia
| | - Chris Liddle
- Storr Liver Unit, Westmead Millenium Institute, University of Sydney, Westmead Hospital, Westmead, Australia
| | | | - Pamela Provan
- University of Sydney, Westmead Hospital, Sydney, Australia
| | - Val Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Rina Hui
- Westmead Hospital, Sydney University Hospital, Sydney, Australia
| | | | - Nicholas Wilcken
- Westmead Hospital, Sydney University Hospital, Sydney, Australia
| | - Rosemary L Balleine
- Sydney West Cancer Network, Westmead Millenium Institute, Sydney Medical School-Westmead, Sydney, Australia
| | - Howard Gurney
- Westmead Hospital, University of Sydney, Sydney, Australia
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26
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Khushi M, Carpenter JE, Balleine RL, Clarke CL. Electronic biorepository application system: web-based software to manage receipt, peer review, and approval of researcher applications to a biobank. Biopreserv Biobank 2012; 10:37-44. [PMID: 24849752 DOI: 10.1089/bio.2011.0038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The importance of suitably characterized and preserved biospecimens for research is acknowledged, yet providing information about the availability of biospecimens and associated data, responding to enquiries from researchers, processing applications for material, and seeking independent scientific review of proposed projects are complex and time-consuming processes. Most biorepositories operate as not-for-profit entities; therefore, cost containment is a major consideration. We identified that online systematizing and automation of all of the tasks associated with application management could reduce the administrative workload and therefore reduce costs and improve the efficiency of a biobank. Accordingly, we have developed a Web-based electronic Biorepository Application System (eBAS) that allows researchers to search for suitable material from the biobank database, submit an online expression of interest, and complete all the information required for a full application. Peer review is also managed through eBAS. Implementation of eBAS has streamlined application management and external peer review of researcher applications, and has facilitated automated record storage and management. This approach has potential to reduce the costs and complexities of administering researcher applications. We have also linked eBAS to an open-source clinical research and specimen management database, Caisis.
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Affiliation(s)
- Matloob Khushi
- 1 Breast Cancer Tissue Bank, Westmead Millennium Institute, Sydney Medical School-Westmead, University of Sydney , Westmead, Australia
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27
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Houssami N, Macaskill P, Balleine RL, Bilous M, Pegram MD. HER2 discordance between primary breast cancer and its paired metastasis: tumor biology or test artefact? Insights through meta-analysis. Breast Cancer Res Treat 2011; 129:659-74. [PMID: 21698410 DOI: 10.1007/s10549-011-1632-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 06/03/2011] [Indexed: 12/31/2022]
Abstract
The proto-oncogene, HER2, has prognostic and predictive relevance in invasive breast cancer (IBC). HER2 testing of primary IBC guides treatment selection and is assumed to reflect HER2 status of associated metastases, although HER2 discordance between IBC and metastasis has been reported. Systematic review and meta-analysis of HER2 status in IBC and its paired loco-regional or distant metastasis were done. Quality appraisal considered whether (within-subject) testing conditions were maintained for paired primary and metastasis. Random effects logistic regression models were used to estimate pooled within-subject HER2 discordant proportions and to examine study-level covariates, including tumor-related and testing-related variables, potentially associated with HER2 discordance differences across (between) studies. Modelled paired HER2 data for primary and metastatic cancer (2520 subjects, 26 studies) showed a pooled HER2 discordance of 5.5% (3.6-8.5%). Sensitivity analysis, excluding the only study not maintaining same conditions for paired testing, gave a pooled estimate of 5.2% (3.5-7.8%). Pooled discordant proportion was not associated with differences between studies in test type, test scoring or interpretation criteria, subjects' median age, study time-frame, or HER2 positivity in primary cancer (all P > 0.05). However, type of metastasis was significantly associated with estimated HER2 discordance (P = 0.0017): studies of primary tumor paired with distant metastases had higher discordance [11.5% (6.9-18.6%)] than studies of primary paired with lymph node metastases only [4.1% (2.4-7.2%)], or those paired with nodal or various metastases [3.3% (2.0-5.6%)]; P < 0.01. HER2 discordant proportion was higher where paired metastases were metachronous relative to synchronous to primary IBC (P = 0.0024). Sensitivity analysis provided weak evidence (P = 0.074) that discordance in the direction of change from HER2-negative primary cancer to HER2-positive paired metastasis was more likely than the reverse. Study-level meta-analysis suggests factors associated with the type of metastasis as underlying mechanisms for observed HER2 discordance between primary IBC and paired metastasis. Test-related factors did not account for differences across studies in the HER2 discordant proportion.
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Affiliation(s)
- Nehmat Houssami
- Screening and Test Evaluation Program, School of Public Health (A27), Sydney Medical School, University of Sydney, Sydney 2006, Australia.
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28
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Emmanuel C, Gava N, Chenevix-Trench G, Balleine RL, George J, Bowtell DDL, Clarke CL, deFazio A. Abstract 3875: NUAK2, a gene with a putative driver mutation in ovarian cancer, is regulated through the murine estrus cycle and loss is associated with worse outcome in ovarian cancer. Cancer Res 2011. [DOI: 10.1158/1538-7445.am2011-3875] [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
Molecular events leading to ovarian cancer are poorly understood but ovulatory hormones and a high number of lifetime ovulations increase risk. The most common histotype, serous ovarian cancer, is thought to arise from ovarian surface epithelium or inclusion cysts although recent evidence has implicated fallopian tube epithelium and other Müllerian tissues as potential sites of origin. The aim of this study was to identify genes that may play a critical role in the pathogenesis of ovarian cancer from candidates that we have previously identified as regulated during the murine estrus cycle in microdissected ovarian surface epithelium and matched oviduct.
We examined estrus regulated gene profiles in normal mouse ovarian and oviduct epithelium for genes (i) differentially expressed in ovarian cancer compared to normal controls; (ii) with copy number aberration in ovarian cancer; and (iii) with reported mutation in solid tumors. We identified over 350 genes that are regulated in the normal mouse ovarian epithelium during the estrus cycle and dysregulated in cancer including four genes found to be mutated in various tumour types (Catalogue Of Somatic Mutations In Cancer) and around 50 genes that have copy number aberration in ovarian cancer (The Cancer Genome Atlas). A similar number of genes were regulated in the normal mouse oviduct epithelium during the estrus cycle and dysregulated in ovarian cancer including six that are mutated in various tumor types and around 35 with copy number aberration in ovarian cancer. Interestingly, there was very little similarity between the ovarian and oviduct epithelium gene lists with only 19 genes in common, however, pathway analysis revealed over-representation of genes involved in cell cycle, particularly the spindle assembly checkpoint, and extracellular matrix/cell adhesion in both lists.
We identified NUAK family, SNF1-like kinase, 2 (NUAK2) as upregulated in ovarian epithelium during the proestrus phase of the murine estrus cycle, upregulated in ovarian cancer and with a candidate driver mutation for breast and ovarian cancer. Expression of NUAK2 was examined by immunohistochemistry in human ovary (n=10), fallopian tube (n=9), and ovarian cancer (n=119). This showed that NUAK2 expression was highest in fallopian tube, intermediate in OSE and lost in ∼20% of ovarian cancer cases. Kaplan-Meier curves with log-rank test revealed reduced expression of NUAK2 was significantly associated with reduced overall survival in ovarian cancer (p<0.04).
Future work involves functional analysis of key genes, including NUAK2, in human cell lines. Defining genes that are activated in normal ovarian and oviduct epithelial cells in the course of ovulation that are also dysregulated in cancer has identified a number of molecular pathways and novel candidate genes that may contribute to the development of ovarian cancer.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3875. doi:10.1158/1538-7445.AM2011-3875
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Affiliation(s)
- Catherine Emmanuel
- 1University of Sydney at Westmead Millennium Institute, Westmead, Australia
| | - Natalie Gava
- 1University of Sydney at Westmead Millennium Institute, Westmead, Australia
| | | | | | - Joshy George
- 3Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | - Anna deFazio
- 1University of Sydney at Westmead Millennium Institute, Westmead, Australia
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29
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Emmanuel C, Gava N, Kennedy C, Balleine RL, Sharma R, Wain G, Brand A, Hogg R, Etemadmoghadam D, George J, Birrer MJ, Clarke CL, Chenevix-Trench G, Bowtell DDL, Harnett PR, deFazio A. Comparison of expression profiles in ovarian epithelium in vivo and ovarian cancer identifies novel candidate genes involved in disease pathogenesis. PLoS One 2011; 6:e17617. [PMID: 21423607 PMCID: PMC3057977 DOI: 10.1371/journal.pone.0017617] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 02/02/2011] [Indexed: 12/30/2022] Open
Abstract
Molecular events leading to epithelial ovarian cancer are poorly understood but
ovulatory hormones and a high number of life-time ovulations with concomitant
proliferation, apoptosis, and inflammation, increases risk. We identified genes
that are regulated during the estrous cycle in murine ovarian surface epithelium
and analysed these profiles to identify genes dysregulated in human ovarian
cancer, using publically available datasets. We identified 338 genes that are
regulated in murine ovarian surface epithelium during the estrous cycle and
dysregulated in ovarian cancer. Six of seven candidates selected for
immunohistochemical validation were expressed in serous ovarian cancer,
inclusion cysts, ovarian surface epithelium and in fallopian tube epithelium.
Most were overexpressed in ovarian cancer compared with ovarian surface
epithelium and/or inclusion cysts (EpCAM, EZH2, BIRC5) although BIRC5 and EZH2
were expressed as highly in fallopian tube epithelium as in ovarian cancer. We
prioritised the 338 genes for those likely to be important for ovarian cancer
development by in silico analyses of copy number aberration and
mutation using publically available datasets and identified genes with
established roles in ovarian cancer as well as novel genes for which we have
evidence for involvement in ovarian cancer. Chromosome segregation emerged as an
important process in which genes from our list of 338 were over-represented
including two (BUB1, NCAPD2) for which there
is evidence of amplification and mutation. NUAK2, upregulated in ovarian surface
epithelium in proestrus and predicted to have a driver mutation in ovarian
cancer, was examined in a larger cohort of serous ovarian cancer where patients
with lower NUAK2 expression had shorter overall survival. In conclusion,
defining genes that are activated in normal epithelium in the course of
ovulation that are also dysregulated in cancer has identified a number of
pathways and novel candidate genes that may contribute to the development of
ovarian cancer.
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Affiliation(s)
- Catherine Emmanuel
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia.
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30
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Khushi M, Carpenter JE, Balleine RL, Clarke CL. Development of a data entry auditing protocol and quality assurance for a tissue bank database. Cell Tissue Bank 2011; 13:9-13. [PMID: 21331789 DOI: 10.1007/s10561-011-9240-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 01/31/2011] [Indexed: 10/18/2022]
Abstract
Human transcription error is an acknowledged risk when extracting information from paper records for entry into a database. For a tissue bank, it is critical that accurate data are provided to researchers with approved access to tissue bank material. The challenges of tissue bank data collection include manual extraction of data from complex medical reports that are accessed from a number of sources and that differ in style and layout. As a quality assurance measure, the Breast Cancer Tissue Bank (http:\\www.abctb.org.au) has implemented an auditing protocol and in order to efficiently execute the process, has developed an open source database plug-in tool (eAuditor) to assist in auditing of data held in our tissue bank database. Using eAuditor, we have identified that human entry errors range from 0.01% when entering donor's clinical follow-up details, to 0.53% when entering pathological details, highlighting the importance of an audit protocol tool such as eAuditor in a tissue bank database. eAuditor was developed and tested on the Caisis open source clinical-research database; however, it can be integrated in other databases where similar functionality is required.
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Affiliation(s)
- Matloob Khushi
- Breast Cancer Tissue Bank, The University of Sydney at the Westmead Millennium Institute, Darcy Road, Westmead, NSW 2145, Australia.
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31
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Balleine RL, Provan PJ, Pupo GM, Pathmanathan N, Cummings M, Farshid G, Salisbury EL, Bilous AM, Byth K, Mann GJ. Familial concordance of breast cancer pathology as an indicator of genotype in multiple-case families. Genes Chromosomes Cancer 2011; 49:1082-94. [PMID: 20815029 DOI: 10.1002/gcc.20816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The heterogeneity of multiple case breast cancer families that do not carry mutations in BRCA1 or BRCA2 (non-BRCA1/2 families) poses a challenge to the identification of breast cancer susceptibility genes. The aim of this study was to determine whether intrafamilial concordance in breast cancer pathology could identify subgroups of non-BRCA1/2 families with consistent genotypic features. Invasive breast cancers were reviewed from 84 individuals belonging to 30 multiple-case families; BRCA1 (n = 9), BRCA2 (n = 10), and non-BRCA1/2 (n = 11). Hierarchical cluster analysis based on histopathology and age at first diagnosis was then used to specify three subgroups designated Clusters 1-3. The genomic features of non-BRCA1/2 families were examined by genome wide linkage and FGFR2 SNP genotyping, according to whether they showed cluster-concordant or cluster-mixed familial pathology. The majority of pathogenic BRCA1 mutation carriers (80%) fell into a single cluster. In contrast pathogenic BRCA2 mutation carriers were distributed across all three clusters and within families, cluster groups were also generally mixed. Most non-BRCA1/2 mutation carriers belonged to Cluster 3 (71%). Genome wide linkage data from five non-BRCA1/2 Cluster 3-concordant families were compared with four mixed cluster non-BRCA1/2 families. This revealed a number of distinct linkage peaks, including some regions previously associated with breast cancer susceptibility. The distribution of low risk alleles in FGFR2 was not different between these two subgroups (P = 0.237). The pattern of breast cancer pathology concordance amongst family members may assist the investigation of breast cancer susceptibility in multiple case families.
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32
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Da Silva L, Simpson PT, Smart CE, Cocciardi S, Waddell N, Lane A, Morrison BJ, Vargas AC, Healey S, Beesley J, Pakkiri P, Parry S, Kurniawan N, Reid L, Keith P, Faria P, Pereira E, Skalova A, Bilous M, Balleine RL, Do H, Dobrovic A, Fox S, Franco M, Reynolds B, Khanna KK, Cummings M, Chenevix-Trench G, Lakhani SR. HER3 and downstream pathways are involved in colonization of brain metastases from breast cancer. Breast Cancer Res 2010; 12:R46. [PMID: 20604919 PMCID: PMC2949633 DOI: 10.1186/bcr2603] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [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] [Received: 03/14/2010] [Revised: 06/15/2010] [Accepted: 07/06/2010] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Metastases to the brain from breast cancer have a high mortality, and basal-like breast cancers have a propensity for brain metastases. However, the mechanisms that allow cells to colonize the brain are unclear. METHODS We used morphology, immunohistochemistry, gene expression and somatic mutation profiling to analyze 39 matched pairs of primary breast cancers and brain metastases, 22 unmatched brain metastases of breast cancer, 11 non-breast brain metastases and 6 autopsy cases of patients with breast cancer metastases to multiple sites, including the brain. RESULTS Most brain metastases were triple negative and basal-like. The brain metastases over-expressed one or more members of the HER family and in particular HER3 was significantly over-expressed relative to matched primary tumors. Brain metastases from breast and other primary sites, and metastases to multiple organs in the autopsied cases, also contained somatic mutations in EGFR, HRAS, KRAS, NRAS or PIK3CA. This paralleled the frequent activation of AKT and MAPK pathways. In particular, activation of the MAPK pathway was increased in the brain metastases compared to the primary tumors. CONCLUSIONS Deregulated HER family receptors, particularly HER3, and their downstream pathways are implicated in colonization of brain metastasis. The need for HER family receptors to dimerize for activation suggests that tumors may be susceptible to combinations of anti-HER family inhibitors, and may even be effective in the absence of HER2 amplification (that is, in triple negative/basal cancers). However, the presence of activating mutations in PIK3CA, HRAS, KRAS and NRAS suggests the necessity for also specifically targeting downstream molecules.
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Affiliation(s)
- Leonard Da Silva
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
- Departamento de Anatomia Patológica, Universidade Federal de São Paulo, EPM, 754 Rua Napoleão de Barros, São Paulo, 04024-000, Brazil
| | - Peter T Simpson
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Chanel E Smart
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Sibylle Cocciardi
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Nic Waddell
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Annette Lane
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
| | - Brian J Morrison
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
- Biomolecular and Biomedical Science, Griffith University, 170 Kessels Road, Brisbane, 4011, Australia
| | - Ana Cristina Vargas
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
| | - Sue Healey
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Jonathan Beesley
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Pria Pakkiri
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
| | - Suzanne Parry
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Nyoman Kurniawan
- Centre for Magnetic Resonance, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Lynne Reid
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Patricia Keith
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Paulo Faria
- Lembaga Eijkman, Eijkman Institute, Diponegoro 69, Jakarta, 10430, Indonesia
- Departamento de Patologia, Instituto Nacional de Câncer, 23 Praça Cruz Vermelha, Rio de Janeiro, 20230-130, Brazil
| | - Emilio Pereira
- Departamento de Patologia, Laboratório Salomão & Zoppi, 48 Rua Correia Dias, São Paulo, 04104-000, Brazil
| | - Alena Skalova
- Department of Pathology, Medical Faculty of Charles University in Plzen, Husova 3, 306 05, Czech Republic
| | - Michael Bilous
- Sydney West Area Health Service, Institute of Clinical Pathology and Medical Research, University of Sydney, Darcy Road, Sydney, 2145, Australia
| | - Rosemary L Balleine
- Translational Oncology, Sydney West Area Health Service, Westmead Millennium Institute, University of Sydney, Darcy Road, Sydney, 2145, Australia
| | - Hongdo Do
- Department of Pathology, Peter MacCallum Cancer Centre, St Andrews Pl, East Melbourne, 3002, Australia
| | - Alexander Dobrovic
- Department of Pathology, Peter MacCallum Cancer Centre, St Andrews Pl, East Melbourne, 3002, Australia
| | - Stephen Fox
- Department of Pathology, Peter MacCallum Cancer Centre, St Andrews Pl, East Melbourne, 3002, Australia
| | - Marcello Franco
- Departamento de Anatomia Patológica, Universidade Federal de São Paulo, EPM, 754 Rua Napoleão de Barros, São Paulo, 04024-000, Brazil
| | - Brent Reynolds
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia
- Current address - University of Florida, McKnight Brain Institute,100 S. Newell Drive, Gainesville, 32611, USA
| | - Kum Kum Khanna
- Signal Transduction, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Margaret Cummings
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Signal Transduction, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Georgia Chenevix-Trench
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
| | - Sunil R Lakhani
- Molecular & Cellular Pathology, The University of Queensland Centre for Clinical Research, & School of Medicine, Building 918/B71, RBWH complex, Brisbane, 4029, Australia
- Cancer Genetics and Molecular Pathology, The Queensland Institute of Medical Research, 300 Herston Road, Brisbane, 4006, Australia
- Pathology Queensland: The Royal Brisbane & Women's Hospital, Herston Road, Brisbane, 4029, Australia
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Pathmanathan N, Albertini AF, Provan PJ, Milliken JS, Salisbury EL, Bilous AM, Byth K, Balleine RL. Diagnostic evaluation of papillary lesions of the breast on core biopsy. Mod Pathol 2010; 23:1021-8. [PMID: 20473278 DOI: 10.1038/modpathol.2010.81] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The management of asymptomatic intraductal papillary lesions of the breast diagnosed on core biopsy poses a challenge for patients and clinicians, as the distinction between common benign lesions and atypical or malignant varieties may be difficult without formal excision. The aim of this study was to determine whether a combination of histopathologic and biomarker features could be used to accurately identify benign papillary lesions on core biopsy. An inclusive group of 127 excised papillary lesions was characterized by detailed histopathologic review and immunohistochemical staining for the basal markers cytokeratin 5/6 (CK5/6) and P63 and the proliferation marker Ki67. Comparison of benign, atypical, and malignant lesions revealed that the combination of broad, sclerotic fibrovascular cores, and epithelial CK5/6 staining was most commonly seen in benign papillomas. Ki67 staining revealed striking intralesional heterogeneity, but there was no difference between the high scores of benign, atypical, or malignant lesions (P=0.173). In a non-overlapping set of 42 cases, a binary classifier specifying benign lesions on the basis of thick fibrovascular cores and epithelial CK5/6 staining on core biopsy gave an overall misclassification rate of 4/42 (10%) when compared with the final excision diagnosis. Misclassified cases included 2/27 lesions ultimately diagnosed as benign and 2/2 atypical papillomas. All malignant lesions (n=13) were correctly assigned. The combined assessment of fibrovascular core thickness and CK5/6 staining on core biopsy distinguished benign from malignant papillary lesions, but did not separate benign from atypical cases. This approach may form a useful addition to the clinicopathologic evaluation of papillary lesions of the breast.
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Affiliation(s)
- Nirmala Pathmanathan
- Department of Tissue Pathology, Institute of Clinical Pathology and Medical Research, Sydney West Area Health Service, Westmead, NSW, Australia.
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Spurdle AB, Lakhani SR, Da Silva LM, Balleine RL, Goldgar DE. Bayes analysis provides evidence of pathogenicity for the BRCA1 c.135-1G>T (IVS3-1) and BRCA2 c.7977-1G>C (IVS17-1) variants displaying in vitro splicing results of equivocal clinical significance. Hum Mutat 2010; 31:E1141-5. [PMID: 20020529 DOI: 10.1002/humu.21181] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although in vitro splicing assays can provide useful information about the clinical interpretation of sequence variants in high-risk cancer genes such as BRCA1 and BRCA2, results can sometimes be difficult to interpret. The BRCA1 c.135-1G>T (IVS3-1G>T) variant has been shown to give rise to an in-frame deletion of exon 5 (BRCA1 c.135_212del) that is predicted to encode 26 amino acids. BRCA2 c.7977-1G>C (IVS17-1G>C) was shown to increase the expression of two naturally occurring transcripts that contain frameshifts (BRCA2, c.7977_8311del (exon 18 deletion); BRCA2, c.7806_8331del (exon 17&18 deletion)). In this study we conducted multifactorial likelihood analysis to evaluate the clinical significance of these two variants, including assessing variant segregation in families by Bayes analysis, and breast tumor pathology features suggestive of positive mutation status. Multifactorial analysis provided strong evidence for causality for both of these variants. The Bayes scores from a single family with BRCA1 c.135-1G>T was 9528:1, and incorporation of pathology features gave an overall likelihood of causality of 28108:1. The Bayes scores from five informative families with BRCA2 c.7977-1G>C was 47401:1, and the combined Bayes-pathology odds of causality was 29389:1. Multifactorial likelihood analysis indicates that the BRCA1 c.135-1G>T and BRCA2 c.7977-1G>C variants are disease-associated mutations which should be managed clinically in the same fashion as classical truncating mutations.
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Pathmanathan N, Salisbury EL, Provan PJ, Bilous AM, Byth K, S. Milliken J, L. Clarke C, L. Balleine R. A class discovery and class prediction approach to histopathological classification of mammographic screen detected columnar cell lesions of the breast. Pathology 2010; 42:28-36. [DOI: 10.3109/00313020903434355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Graham JD, Mote PA, Salagame U, Balleine RL, Huschtscha LI, Clarke CL. Hormone-responsive model of primary human breast epithelium. J Mammary Gland Biol Neoplasia 2009; 14:367-79. [PMID: 19936891 DOI: 10.1007/s10911-009-9160-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 11/06/2009] [Indexed: 01/19/2023] Open
Abstract
Retention of hormone responsiveness in primary culture models of human breast is essential for studies aimed at understanding the mechanisms of action of the ovarian hormones in the human breast. In this chapter we describe the development of a culture model of primary human breast that retains critical features of the tissue in vivo. We find that primary normal human breast tissue in embedded culture recapitulates the morphology, cell lineages, functional gene expression characteristics and estrogen and progesterone receptor responsiveness of the breast in vivo. The ratio of luminal to myoepithelial cells after culture recapitulates that observed in the uncultured tissue, highlighting the fact that progenitor cells capable of giving rise to both epithelial cell lineages are retained in this model system. By contrast, primary cells placed into monolayer culture, even for a single passage, lose bipotent progenitors, and the myoepithelial lineage predominates, demonstrating the rapidity with which phenotypic changes and selection occur in normal breast cells, unless cultured under conditions that prevent this outcome. Primary matrix-embedded culture of normal human breast cells provides researchers with a new opportunity to understand ovarian hormone action in the human breast.
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Affiliation(s)
- J Dinny Graham
- Westmead Institute for Cancer Research, Westmead Millennium Institute, Westmead, New South Wales, 2145, Australia
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Graham JD, Mote PA, Salagame U, van Dijk JH, Balleine RL, Huschtscha LI, Reddel RR, Clarke CL. DNA replication licensing and progenitor numbers are increased by progesterone in normal human breast. Endocrinology 2009; 150:3318-26. [PMID: 19342456 PMCID: PMC2703536 DOI: 10.1210/en.2008-1630] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Proliferation in the nonpregnant human breast is highest in the luteal phase of the menstrual cycle when serum progesterone levels are high, and exposure to progesterone analogues in hormone replacement therapy is known to elevate breast cancer risk, yet the proliferative effects of progesterone in the human breast are poorly understood. In a model of normal human breast, we have shown that progesterone increased incorporation of 5-bromo-2'-deoxyuridine and increased cell numbers by activation of pathways involved in DNA replication licensing, including E2F transcription factors, chromatin licensing and DNA replication factor 1 (Cdt1), and the minichromosome maintenance proteins and by increased expression of proteins involved in kinetochore formation including Ras-related nuclear protein (Ran) and regulation of chromosome condensation 1 (RCC1). Progenitor cells competent to give rise to both myoepithelial and luminal epithelial cells were increased by progesterone, showing that progesterone influences epithelial cell lineage differentiation. Therefore, we have demonstrated that progesterone augments proliferation of normal human breast cells by both activating DNA replication licensing and kinetochore formation and increasing bipotent progenitor numbers.
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Affiliation(s)
- J Dinny Graham
- Westmead Institute for Cancer Research, Westmead Hospital, Westmead, New South Wales 2145, Australia
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Balleine RL, Webster LR, Davis S, Salisbury EL, Palazzo JP, Schwartz GF, Cornfield DB, Walker RL, Byth K, Clarke CL, Meltzer PS. Molecular grading of ductal carcinoma in situ of the breast. Clin Cancer Res 2009; 14:8244-52. [PMID: 19088042 DOI: 10.1158/1078-0432.ccr-08-0939] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Increased incidence of ductal carcinoma in situ (DCIS) associated with mammographic screening for breast cancer has emphasized the challenges of managing this condition. The aim of this study was to identify informative clinical indicators of DCIS biology by molecular profiling. EXPERIMENTAL DESIGN Areas of in situ carcinoma, atypical ductal hyperplasia, and benign epithelium were microdissected from 46 invasive breast cancers. Oligonucleotide probes showing differential expression between DCIS associated with grade 1 and 3 invasive cancer were identified by microarray-based gene expression profiling. Expression at these probes was used to define a "molecular grade" subcategorization of all samples. The genomic basis of molecular grade was examined by array-based comparative genomic hybridization. Clinical course was examined in a cohort of 134 patients with DCIS treated by surgery alone. RESULTS DCIS samples were designated as low or high molecular grade based on expression at 173 probes. The low molecular grade subgroup included low (n = 10) and intermediate (n = 11) nuclear grade DCIS as well as all samples of atypical ductal hyperplasia (n = 4) and benign epithelium (n = 7). The high molecular grade subgroup included DCIS of intermediate (n = 7) and high (n = 19) nuclear grade. The character and degree of genomic aberration were distinct between molecular grade subgroups. A classification tree model including nuclear grade and Ki67 score accurately predicted molecular grade for 95.7% of samples. In an independent cohort, this showed a pattern of rapid disease recurrence for high molecular grade DCIS. CONCLUSIONS Molecular profiling indicates a binary grading scheme for DCIS. This practical approach has potential to improve clinical evaluation of DCIS.
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Scurr LL, Guminski AD, Chiew YE, Balleine RL, Sharma R, Lei Y, Pryor K, Wain GV, Brand A, Byth K, Kennedy C, Rizos H, Harnett PR, deFazio A. Ankyrin repeat domain 1, ANKRD1, a novel determinant of cisplatin sensitivity expressed in ovarian cancer. Clin Cancer Res 2008; 14:6924-32. [PMID: 18980987 DOI: 10.1158/1078-0432.ccr-07-5189] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [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
PURPOSE The standard of care for ovarian cancer includes platinum-based chemotherapy. It is not possible, however, to predict clinical platinum sensitivity or to design rational strategies to overcome resistance. We used a novel approach to identify altered gene expression associated with high sensitivity to cisplatin, to define novel targets to sensitize tumor cells to platins and ultimately improve the effectiveness of this widely used class of chemotherapeutics. EXPERIMENTAL DESIGN Using differential display PCR, we identified genes differentially expressed in a mutagenized cell line with unusual sensitivity to cisplatin. The most highly differentially expressed gene was selected, and its role in determining cisplatin sensitivity was validated by gene transfection and small interfering RNA (siRNA) approaches, by association of expression levels with cisplatin sensitivity in cell lines, and by association of tumor expression levels with survival in a retrospective cohort of 71 patients with serous ovarian adenocarcinoma. RESULTS The most highly differently expressed gene identified was ANKRD1, ankyrin repeat domain 1 (cardiac muscle). ANKRD1 mRNA levels were correlated with platinum sensitivity in cell lines, and most significantly, decreasing ANKRD1 using siRNA increased cisplatin sensitivity >2-fold. ANKRD1 was expressed in the majority of ovarian adenocarcinomas tested (62/71, 87%), and higher tumor levels of ANKRD1 were found in patients with worse outcome (overall survival, P=0.013). CONCLUSIONS These findings suggest that ANKRD1, a gene not previously associated with ovarian cancer or with response to chemotherapy, is associated with treatment outcome, and decreasing ANKRD1 expression, or function, is a potential strategy to sensitize tumors to platinum-based drugs.
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Affiliation(s)
- Lyndee L Scurr
- Westmead Institute for Cancer Research, University of Sydney at the Westmead Millennium Institute, Westmead Hospital, Westmead, NSW, Australia
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40
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Webster LR, Lee SF, Ringland C, Morey AL, Hanby AM, Morgan G, Byth K, Mote PA, Provan PJ, Ellis IO, Green AR, Lamoury G, Ravdin P, Clarke CL, Ward RL, Balleine RL, Hawkins NJ. Poor-Prognosis Estrogen Receptor–Positive Breast Cancer Identified by Histopathologic Subclassification. Clin Cancer Res 2008; 14:6625-33. [PMID: 18927304 DOI: 10.1158/1078-0432.ccr-08-0701] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/classification
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/classification
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/classification
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Cluster Analysis
- Cohort Studies
- Female
- Gene Amplification
- Gene Expression Profiling
- Humans
- Immunoenzyme Techniques
- In Situ Hybridization, Fluorescence
- Keratin-14/metabolism
- Keratin-5/metabolism
- Keratin-6/metabolism
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/classification
- Neoplasms, Hormone-Dependent/metabolism
- Neoplasms, Hormone-Dependent/pathology
- Oligonucleotide Array Sequence Analysis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Survival Rate
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Affiliation(s)
- Lucy R Webster
- Translational Oncology, Sydney West Area Health Service, Westmead, NSW, Australia
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Abstract
AIMS In recent years histopathology has made an important contribution to the study of familial breast cancer, largely on the basis of the distinctive cancer phenotype commonly identified in BRCA1-mutation carriers. The aim of this study was to identify this phenotype amongst index cases from families in the kConFab familial breast cancer resource with no known pathogenic mutation ('BRCAX' families). METHODS The histopathology of breast cancer from 180 individuals was reviewed: 132 members of individual BRCAX families, 26 BRCA1 and 15 BRCA2 mutation carriers and seven mutation negative individuals from families with a known pathogenic mutation. RESULTS BRCAX breast cancers were a heterogeneous group with 25.8% grade 1, 37.9% grade 2 and 36.4% grade 3. Overall, 45/180 (25%) cases were designated 'BRCA1-phenotype' including 22/132 (16.7%) BRCAX cases, 18/26 (69.2%) BRCA1 and 5/15 (33.3%) BRCA2 mutation carriers. For BRCAX cases, a BRCA1 phenotype designation was negatively correlated with age. CONCLUSIONS Characteristic breast cancer pathology is not diagnostic of a germline BRCA1 mutation, but it does indicate a pathogenic mechanism that occurs with increased frequency in BRCA1 mutation carriers. In BRCAX families, BRCA1 tumour phenotype may signal the presence of an unidentified BRCA1 mutation. However, this finding must be interpreted with regard to limits of the association between histopathology and genotype, and the importance of clinical context.
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42
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Gurney H, Wong M, Balleine RL, Rivory LP, McLachlan AJ, Hoskins JM, Wilcken N, Clarke CL, Mann GJ, Collins M, Delforce SE, Lynch K, Schran H. Imatinib disposition and ABCB1 (MDR1, P-glycoprotein) genotype. Clin Pharmacol Ther 2007; 82:33-40. [PMID: 17495881 DOI: 10.1038/sj.clpt.6100201] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The aim of this study was to explore the impact of individual variation in drug elimination on imatinib disposition. Twenty-two patients with gastrointestinal stromal tumor or chronic myeloid leukemia initially received imatinib 600 mg daily with dosage subsequently toxicity adjusted. Pharmacokinetic parameters on day 1 and at steady-state were compared with elimination phenotype and single-nucleotide polymorphisms of CYP3A5 and ABCB1. A fivefold variation in estimated imatinib clearance (CL/F) was present on day 1 and mean CL/F had fallen by 26% at steady state. This reduction in imatinib CL/F was associated with ABCB1 genotype, being least apparent in thymidine homozygotes at the 1236T>C, 2677G>T/A and 3435C>T loci. Toxicity-related dose reduction also tended to be less common in these individuals. ABCB1 genotype was associated with steady-state CL/F due to an apparent genotype-specific influence of imatinib on elimination. Further evaluation of ABCB1 genotype and imatinib dosage is warranted.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B
- ATP Binding Cassette Transporter, Subfamily B, Member 1
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/pharmacokinetics
- Benzamides
- Cohort Studies
- Cytochrome P-450 CYP3A
- Cytochrome P-450 Enzyme System/genetics
- Cytochrome P-450 Enzyme System/metabolism
- Drug Monitoring
- Female
- Gastrointestinal Stromal Tumors/drug therapy
- Gastrointestinal Stromal Tumors/genetics
- Gastrointestinal Stromal Tumors/metabolism
- Genotype
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Male
- Metabolic Clearance Rate
- Middle Aged
- Organic Anion Transporters/antagonists & inhibitors
- Organic Anion Transporters/genetics
- Organic Anion Transporters/metabolism
- Phenotype
- Piperazines/administration & dosage
- Piperazines/adverse effects
- Piperazines/pharmacokinetics
- Polymorphism, Single Nucleotide
- Protein Kinase Inhibitors/administration & dosage
- Protein Kinase Inhibitors/adverse effects
- Protein Kinase Inhibitors/pharmacokinetics
- Pyrimidines/administration & dosage
- Pyrimidines/adverse effects
- Pyrimidines/pharmacokinetics
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Affiliation(s)
- H Gurney
- Department of Medical Oncology, Westmead Hospital Sydney West Area Health Service, Westmead, New South Wales, Australia.
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Abstract
BACKGROUND Women who have germline mutations in the BRCA1 gene are at substantially increased lifetime risk of developing breast and ovarian cancer but are otherwise normal. Currently, early age of onset of cancer and a strong family history are relied upon as the chief clues as to who should be offered genetic testing. Certain morphologic and immunohistochemical features are overrepresented in BRCA1-associated breast cancers but these differences have not been incorporated into the current selection criteria for genetic testing. DESIGN Each of the 4 pathologists studied 30 known cases of BRCA1- and BRCA2-associated breast cancer from kConFab families. After reviewing the literature, we agreed on a semiquantitative scoring system for estimating the chances of presence of an underlying BRCA1 mutation, based on the number of the reported prototypic features present. After a time lag of 12 months, we each examined a series of 62 deidentified cases of breast cancer, inclusive of cases of BRCA1-associated breast cancer and controls. The controls included cases of BRCA2-associated breast cancer and sporadic cases. RESULTS Our predictions had a sensitivity of 92%, specificity of 86%, positive predictive value of 61%, and negative predictive value of 98%. For comparison the sensitivity of currently used selection criteria are in the range of 25% to 30%. CONCLUSION The inclusion of morphologic and immunohistochemical features of breast cancers in algorithms to predict the likelihood of presence of germline mutations in the BRCA1 gene improves the accuracy of the selection process.
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Affiliation(s)
- Gelareh Farshid
- Division of Tissue Pathology, Institute of Medical and Veterinary Science, Adelaide, South Australia.
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Balleine RL, Murali R, Bilous AM, Farshid G, Waring P, Provan P, Byth K, Thorne H, Kirk JA. Histopathological features of breast cancer in carriers of ATM gene variants. Histopathology 2006; 49:523-32. [PMID: 17064299 DOI: 10.1111/j.1365-2559.2006.02538.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Germline variants in the ataxia telangiectasia mutated (ATM) gene have been implicated in increased breast cancer risk. The aim of this study was to determine whether the histopathology of breast cancers occurring in ATM variant carriers is distinctive or resembles the described BRCA1 mutation-associated phenotype. METHODS The histopathological features of breast cancers occurring in ATM variant carriers from multiple-case breast cancer families were compared with matched controls. The test group included 21 cases of in situ and/or invasive cancer from carriers of either the IVS10-6T-->G, 2424V-->G or 1420L-->F ATM variants in the absence of BRCA1 or BRCA2 mutations. An additional four invasive cancers from carriers of a pathogenic BRCA1 mutation in the context of a familial ATM variant were also examined. RESULTS The histopathology of breast cancers in ATM variant-only carriers was not significantly different from controls and known features of BRCA1 mutation-associated cancer were rarely seen. In contrast, these features were prominent in the small group of cases with a pathogenic BRCA1 mutation. CONCLUSIONS Breast cancer occurring in carriers of ATM variants is not associated with distinctive histopathological features and does not resemble the tumour phenotype commonly observed in BRCA1 mutation carriers.
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MESH Headings
- Adult
- Aged
- Ataxia Telangiectasia Mutated Proteins
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cell Cycle Proteins/genetics
- Cohort Studies
- DNA-Binding Proteins/genetics
- Female
- Genes, BRCA1
- Genes, BRCA2
- Genetic Carrier Screening
- Genetic Predisposition to Disease
- Germ-Line Mutation/genetics
- Humans
- Middle Aged
- Protein Serine-Threonine Kinases/genetics
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Tumor Suppressor Proteins/genetics
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Affiliation(s)
- R L Balleine
- Translational Oncology, Sydney West Area Health Service, Sydney, Australia.
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45
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Wong M, Balleine RL, Blair EYL, McLachlan AJ, Ackland SP, Garg MB, Evans S, Farlow D, Collins M, Rivory LP, Hoskins JM, Mann GJ, Clarke CL, Gurney H. Predictors of Vinorelbine Pharmacokinetics and Pharmacodynamics in Patients With Cancer. J Clin Oncol 2006; 24:2448-55. [PMID: 16651648 DOI: 10.1200/jco.2005.02.1295] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Marked interindividual variation in drug disposition and toxicity pose an ongoing challenge to chemotherapy dosage individualization. The aim of this study was to evaluate pretreatment clinical features, genotype and functional indicators of drug clearance as predictors of vinorelbine clearance, and myelotoxicity that could inform dosage optimization. Patients and Methods Forty-one patients with cancer received a 60 mg intravenous dose of vinorelbine. Pretreatment routine body size measurements and blood tests were performed. Midazolam clearance and hepatic technetium labeled sestamibi (99mTc-MIBI) clearance were used to investigate CYP3A and ABCB1 (MDR1, P-glycoprotein) phenotype respectively and selected single nucleotide polymorphisms in CYP3A and ABCB1 were documented. A limited blood sampling strategy was employed and vinorelbine concentrations were determined by high-performance liquid chromatography. Posterior Bayesian estimates of vinorelbine clearance were obtained for each patient using population pharmacokinetic modeling. Myelotoxicity was estimated from the fractional survival of neutrophils post-treatment. Results There was 4.3-fold variation in vinorelbine clearance across the cohort. In a multivariable analysis, pretreatment estimated creatinine clearance (P < .01) and hepatic 99mTc-MIBI clearance (P = .01) were independent predictors of vinorelbine clearance. Fractional survival of neutrophils ranged from 1.3% to 100% and was significantly correlated with vinorelbine clearance (P < .01). Body-surface area was the only pretreatment predictor of fractional survival of neutrophils independent of vinorelbine clearance (P = .02). Conclusion Specific indicators of drug clearance provide predictive information about vinorelbine pharmacokinetics, and body-surface area, probably reflecting normal bone marrow reserve, provides an additional pharmacodynamic indicator. Use of a fixed dose of vinorelbine with modifications guided by pretreatment measures is worthy of prospective evaluation.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Phytogenic/administration & dosage
- Antineoplastic Agents, Phytogenic/adverse effects
- Antineoplastic Agents, Phytogenic/pharmacokinetics
- Antineoplastic Agents, Phytogenic/pharmacology
- Body Size
- Body Surface Area
- Bone Marrow/drug effects
- Chromatography, High Pressure Liquid
- Cytochrome P-450 CYP3A
- Cytochrome P-450 Enzyme System/metabolism
- Feasibility Studies
- Female
- Genotype
- Humans
- Male
- Midazolam/pharmacokinetics
- Middle Aged
- Multivariate Analysis
- Neoplasms/drug therapy
- Phenotype
- Polymorphism, Single Nucleotide
- Predictive Value of Tests
- Technetium Tc 99m Sestamibi/metabolism
- Vinblastine/administration & dosage
- Vinblastine/adverse effects
- Vinblastine/analogs & derivatives
- Vinblastine/pharmacokinetics
- Vinblastine/pharmacology
- Vinorelbine
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Affiliation(s)
- Mark Wong
- Westmead Institute for Cancer Research Westmead Millennium Institute, Department of Translational Oncology, Westmead, Australia
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Mann GJ, Thorne H, Balleine RL, Butow PN, Clarke CL, Edkins E, Evans GM, Fereday S, Haan E, Gattas M, Giles GG, Goldblatt J, Hopper JL, Kirk J, Leary JA, Lindeman G, Niedermayr E, Phillips KA, Picken S, Pupo GM, Saunders C, Scott CL, Spurdle AB, Suthers G, Tucker K, Chenevix-Trench G. Analysis of cancer risk and BRCA1 and BRCA2 mutation prevalence in the kConFab familial breast cancer resource. Breast Cancer Res 2006; 8:R12. [PMID: 16507150 PMCID: PMC1413975 DOI: 10.1186/bcr1377] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 12/20/2005] [Accepted: 01/06/2006] [Indexed: 02/06/2023] Open
Abstract
Introduction The Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab) is a multidisciplinary, collaborative framework for the investigation of familial breast cancer. Based in Australia, the primary aim of kConFab is to facilitate high-quality research by amassing a large and comprehensive resource of epidemiological and clinical data with biospecimens from individuals at high risk of breast and/or ovarian cancer, and from their close relatives. Methods Epidemiological, family history and lifestyle data, as well as biospecimens, are collected from multiple-case breast cancer families ascertained through family cancer clinics in Australia and New Zealand. We used the Tyrer-Cuzick algorithms to assess the prospective risk of breast cancer in women in the kConFab cohort who were unaffected with breast cancer at the time of enrolment in the study. Results Of kConFab's first 822 families, 518 families had multiple cases of female breast cancer alone, 239 had cases of female breast and ovarian cancer, 37 had cases of female and male breast cancer, and 14 had both ovarian cancer as well as male and female breast cancer. Data are currently held for 11,422 people and germline DNAs for 7,389. Among the 812 families with at least one germline sample collected, the mean number of germline DNA samples collected per family is nine. Of the 747 families that have undergone some form of mutation screening, 229 (31%) carry a pathogenic or splice-site mutation in BRCA1 or BRCA2. Germline DNAs and data are stored from 773 proven carriers of BRCA1 or BRCA1 mutations. kConFab's fresh tissue bank includes 253 specimens of breast or ovarian tissue – both normal and malignant – including 126 from carriers of BRCA1 or BRCA2 mutations. Conclusion These kConFab resources are available to researchers anywhere in the world, who may apply to kConFab for biospecimens and data for use in ethically approved, peer-reviewed projects. A high calculated risk from the Tyrer-Cuzick algorithms correlated closely with the subsequent occurrence of breast cancer in BRCA1 and BRCA2 mutation positive families, but this was less evident in families in which no pathogenic BRCA1 or BRCA2 mutation has been detected.
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Affiliation(s)
- Graham J Mann
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | - Heather Thorne
- Research Division, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Rosemary L Balleine
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | | | - Christine L Clarke
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | - Edward Edkins
- Women's and Children's Health Service, Subiaco and Centre for Human Genetics, Edith Cowen University, Joondalup, Western Australia, Australia
| | - Gerda M Evans
- Breast Cancer Network Australia, Camberwell, Victoria, Australia
| | - Sián Fereday
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Eric Haan
- SA Clinical Genetics Service, Department of Genetic Medicine, Women's and Children's Hospital, North Adelaide, Australia, and Department of Paediatrics, University of Adelaide, Australia
| | - Michael Gattas
- Queensland Clinical Genetics Service, Royal Children's Hospital, Brisbane, Herston, Australia
| | - Graham G Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jack Goldblatt
- Genetic Services of Western Australia, King Edward's Memorial Hospital, School of Paediatrics and Child Health, University of Western Australia, Perth, Subiaco, Australia
| | - John L Hopper
- Centre for Genetic Epidemiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Judy Kirk
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | - Jennifer A Leary
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | - Geoffrey Lindeman
- Familial Cancer Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Eveline Niedermayr
- Research Division, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Kelly-Anne Phillips
- Division of Hematology and Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Sandra Picken
- Research Division, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Gulietta M Pupo
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Westmead Hospital, Westmead, New South Wales, Australia
| | - Christobel Saunders
- School of Surgery and Pathology, University of Western Australia, Perth, Western Australia, Australia
| | - Clare L Scott
- Walter and Eliza Hall Institute of Medical Research, Royal Parade, Parkville, Victoria, Australia
| | - Amanda B Spurdle
- The Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Graeme Suthers
- SA Clinical Genetics Service, Department of Genetic Medicine, Women's and Children's Hospital, North Adelaide, Australia, and Department of Paediatrics, University of Adelaide, Australia
| | - Kathy Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, Australia
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Guminski AD, Balleine RL, Chiew YE, Webster LR, Tapner M, Farrell GC, Harnett PR, Defazio A. MRP2 (ABCC2) and cisplatin sensitivity in hepatocytes and human ovarian carcinoma. Gynecol Oncol 2006; 100:239-46. [PMID: 16213010 DOI: 10.1016/j.ygyno.2005.08.046] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 08/26/2005] [Accepted: 08/26/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The ABC transporter MRP2 (ABCC2) can mediate cisplatin efflux, and over-expression of MRP2 has been associated with cisplatin resistance in cancer cell lines. The aim of this study was to determine the role of MRP2 in modulating cisplatin cytotoxicity in normal cells as well as the relationship between MRP2 expression and clinical response to platinum-based agents in ovarian cancer. METHODS The effect of absence of MRP2 expression on cisplatin sensitivity was investigated using primary hepatocyte cultures from the TR- rat strain, which is deficient in Mrp2. We also examined MRP2 expression immunohistochemically in human ovarian tumors exhibiting extremes of clinical response to platinum-based chemotherapy, either absolute platin resistance or patients with residual disease after surgery who experienced extremely long complete response to primary platinum-based chemotherapy. RESULTS Primary hepatocyte cultures from Mrp2-deficient TR- rats were over threefold more sensitive to cisplatin and accumulated a twofold greater amount of platinum on DNA that wild-type rat hepatocytes. In human ovarian carcinomas, MRP2 was detected by immunohistochemistry in 3/13 (23%) tumors from patients with absolute platin resistance compared with 5/9 (56%) tumors from patients with prolonged survival following treatment including a platinum-based agent. CONCLUSION These studies indicate that MRP2 may play an important role in modulating normal tissue response to cisplatin. However, MRP2 expression occurred only in a subset of primary ovarian cancers, was frequently aberrant in location and was not correlated with clinical response to platinum-based chemotherapy.
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Affiliation(s)
- Alexander D Guminski
- Department of Gynaecological Oncology, Westmead Hospital, University of Sydney at Westmead Millennium Institute, WESTMEAD, NSW 2145, Australia
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Byrne JA, Balleine RL, Schoenberg Fejzo M, Mercieca J, Chiew YE, Livnat Y, St Heaps L, Peters GB, Byth K, Karlan BY, Slamon DJ, Harnett P, Defazio A. Tumor protein D52 (TPD52) is overexpressed and a gene amplification target in ovarian cancer. Int J Cancer 2005; 117:1049-54. [PMID: 15986428 DOI: 10.1002/ijc.21250] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recurrent chromosome 8q gain in ovarian carcinoma is likely to reflect the existence of multiple target loci, as the separate gain of chromosome bands 8q21 and 8q24 has been reported in independent studies. Since tumor protein D52 (TPD52) has been identified as a chromosome 8q21 amplification target in breast and prostate carcinoma, we compared TPD52 expression in normal ovarian epithelium (n = 9), benign serous adenomas (n = 11), serous borderline tumors (n = 6) and invasive carcinomas of the major histologic subtypes (n = 57) using immunohistochemistry. These analyses revealed that all normal ovarian epithelium samples and benign serous tumors were predominantly TPD52-negative, whereas TPD52 was overexpressed in most (44/57; 77%) ovarian carcinomas regardless of histologic subtype. TPD52 subcellular localization was predominantly cytoplasmic, although nuclear localization was also frequently observed in mucinous and clear cell carcinomas. In an independent cohort of stage III serous carcinomas (n = 18), we also directly compared in situ TPD52 expression using immunohistochemistry and TPD52 copy number using interphase FISH analyses. This revealed that TPD52 dosage and TPD52 expression were significantly positively correlated. TPD52 therefore represents a novel molecular marker in ovarian cancer, which is broadly expressed across the different histologic subtypes and whose upregulation frequently reflects increased TPD52 copy number.
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Affiliation(s)
- Jennifer A Byrne
- Molecular Oncology Laboratory, Oncology Research Unit, The University of Sydney Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, New South Wales, Australia.
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Webster LR, Bilous AM, Willis L, Byth K, Burgemeister FC, Salisbury ELC, Clarke CL, Balleine RL. Histopathologic indicators of breast cancer biology: insights from population mammographic screening. Br J Cancer 2005; 92:1366-71. [PMID: 15812557 PMCID: PMC2362010 DOI: 10.1038/sj.bjc.6602501] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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] [Indexed: 11/09/2022] Open
Abstract
Histopathologic features of breast cancer such as tumour size, grade and axillary lymph node (LN) status variably reflect tumour biology and time. Recent evidence suggests that the biological character of breast cancer is established at an early stage and has a major impact on clinical course. The aim of this study was to distinguish the impact of biology on breast cancer histopathology by comparing features of breast cancers diagnosed following population mammographic screening with prevalent vs incident detection and screening interval. Central histopathology review data from 1147 cases of ductal in situ and/or invasive breast cancer were examined. Size, grade and LN status of invasive cancers were positively correlated (P<0.001). Prevalent invasive cancers were larger (P<0.001) and more likely to be LN positive (P=0.02) than incident cases, but grade was not associated with screening episode (P=0.7). Screening interval for incident cancers was positively associated with invasive cancer size (P=0.05) and LN status (P=0.002) but not grade (P=0.1). Together, these data indicate that biology and time both impact on size and LN status of invasive breast cancer, but grade reflects biology alone. In view of the clinical importance of breast cancer biology, grade as its most direct indicator assumes particular significance.
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Affiliation(s)
- L R Webster
- Translational Oncology Westmead and Nepean Hospitals, Westmead, NSW 2145, Australia
- Westmead Institute for Cancer Research, Westmead Millennium Institute, Westmead, NSW 2145, Australia
- University of Sydney, Camperdown, NSW 2006, Australia
| | - A M Bilous
- Department of Tissue Pathology, Institute of Clinical Pathology and Medical Research Westmead Hospital, Westmead, NSW 2145, Australia
| | - L Willis
- BreastScreen Greater Western Sydney, Parramatta, NSW 2150, Australia
| | - K Byth
- Division of Medicine, Westmead Hospital, Westmead, NSW 2145, Australia
| | - F C Burgemeister
- BreastScreen Greater Western Sydney, Parramatta, NSW 2150, Australia
| | - E L C Salisbury
- Department of Tissue Pathology, Institute of Clinical Pathology and Medical Research Westmead Hospital, Westmead, NSW 2145, Australia
| | - C L Clarke
- Translational Oncology Westmead and Nepean Hospitals, Westmead, NSW 2145, Australia
- Westmead Institute for Cancer Research, Westmead Millennium Institute, Westmead, NSW 2145, Australia
- University of Sydney, Camperdown, NSW 2006, Australia
| | - R L Balleine
- Translational Oncology Westmead and Nepean Hospitals, Westmead, NSW 2145, Australia
- Westmead Institute for Cancer Research, Westmead Millennium Institute, Westmead, NSW 2145, Australia
- Department of Medical Oncology, Westmead Hospital, PO Box 533, Wentworthville, NSW 2145, Australia. E-mail:
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50
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Wong M, Evans S, Rivory LP, Hoskins JM, Mann GJ, Farlow D, Clarke CL, Balleine RL, Gurney H. Hepatic technetium Tc 99m?labeled sestamibi elimination rate and () genotype as indicators of ABCB1 (P-glycoprotein) activity in patients with cancer. Clin Pharmacol Ther 2005; 77:33-42. [PMID: 15637529 DOI: 10.1016/j.clpt.2004.09.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE The adenosine triphosphate-binding cassette transporter ABCB1 (P-glycoprotein) mediates terminal excretion of many chemotherapeutic agents, and variable ABCB1 activity may be an important contributor to interpatient variability in the clearance of chemotherapeutic agents. Our objective was to determine the elimination constant (kH) for hepatic elimination of technetium Tc 99m-labeled sestamibi (99mTc-MIBI) in patients with cancer and to compare this putative indicator of ABCB1 phenotype with clinical features and common ABCB1 genetic variants. METHODS 99mTc-MIBI kH was determined from the time-dependent elimination profile of 99mTc-MIBI over a 90-minute hepatic scanning period in 66 patients with cancer. Single nucleotide polymorphisms (SNPs) in ABCB1 exons 12 (C1236T), 21 (G2677T/A), and 26 (C3435T) were documented by polymerase chain reaction-restriction fragment length polymorphism analysis. RESULTS There was a 12-fold variation in 99mTc-MIBI kH across the cohort, which was not correlated with sex, age, conventional liver function test results, previous chemotherapy treatment, or history of liver metastasis. Mean 99mTc-MIBI kH was significantly reduced in patients with SNPs in exons 21 and 26 such that mean 99mTc-MIBI kH was 1.90 times (95% confidence interval, 1.14-2.66; P = .02) and 2.21 times (95% confidence interval, 1.47-2.97; P < .01) higher in subjects homozygous for the wild-type alleles than in those homozygous for these SNPs, respectively. CONCLUSION Hepatic elimination of 99mTc-MIBI is a potential in vivo probe of hepatic ABCB1 activity that is significantly associated with the presence of common SNPs in ABCB1. 99mTc-MIBI hepatic scanning may provide a useful pretreatment indicator of ABCB1-mediated drug clearance in cancer patients.
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Affiliation(s)
- Mark Wong
- Westmead Institute for Cancer Research, Department of Nuclear Medicine, Westmead Hospital, University of Sydney, Camperdown, Australia
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