51
|
Wang X, Ricciuti B, Alessi JV, Nguyen T, Awad MM, Lin X, Johnson BE, Christiani DC. Smoking History as a Potential Predictor of Immune Checkpoint Inhibitor Efficacy in Metastatic Non-Small Cell Lung Cancer. J Natl Cancer Inst 2021; 113:1761-1769. [PMID: 34115098 PMCID: PMC8634315 DOI: 10.1093/jnci/djab116] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/08/2021] [Accepted: 06/07/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Despite the therapeutic efficacy of immune checkpoint inhibitors (ICIs) in a subset of patients, consistent and easily obtainable predictors of efficacy remain elusive. METHODS This study was conducted on 644 advanced non-small cell lung cancer (NSCLC) patients treated with ICI monotherapy between April 2013 and September 2020 at the Dana-Farber Cancer Institute and Brigham and Women's Hospital. Patient smoking history, clinicopathological characteristics, tumor mutation burden (TMB) by clinical targeted next-generation sequencing, and programmed death ligand-1 (PD-L1) tumor proportion score (TPS) by immunohistochemistry were prospectively collected. The association of smoking history with clinical outcomes of ICI monotherapy in metastatic NSCLC patients was evaluated after adjusting for other potential predictors. All statistical tests were 2-sided. RESULTS Of 644 advanced NSCLC patients, 105 (16.3%) were never smokers, 375 (58.2%) were former smokers (median pack-years = 28), and 164 (25.4%) were current smokers (median pack-years = 40). Multivariable logistic and Cox proportional hazards regression analyses suggested that doubling of smoking pack-years is statistically significantly associated with improved clinical outcomes of patients treated with ICI monotherapy (objective response rate odds ratio = 1.21, 95% confidence interval [CI] = 1.09 to 1.36, P < .001; progression-free survival hazard ratio = 0.92, 95% CI = 0.88 to 0.95, P < .001; overall survival hazard ratio = 0.94, 95% CI = 0.90 to 0.99, P = .01). Predictive models incorporating pack-years and PD-L1 TPS yielded additional information and achieved similar model performance compared with using TMB and PD-L1 TPS. CONCLUSIONS Increased smoking exposure had a statistically significant association with improved clinical outcomes in metastatic NSCLC treated with ICI monotherapy independent of PD-L1 TPS. Pack-years may serve as a consistent and readily obtainable surrogate of ICI efficacy when TMB is not available to inform prompt clinical decisions and allow more patients to benefit from ICIs.
Collapse
Affiliation(s)
- Xinan Wang
- The Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, USA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology and Center for Cancer Genomics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Joao V Alessi
- Lowe Center for Thoracic Oncology and Center for Cancer Genomics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Tom Nguyen
- Lowe Center for Thoracic Oncology and Center for Cancer Genomics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Mark M Awad
- Lowe Center for Thoracic Oncology and Center for Cancer Genomics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Bruce E Johnson
- Lowe Center for Thoracic Oncology and Center for Cancer Genomics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA,Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Correspondence to: David C. Christiani, MD, MPH, MS, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, 667 Huntington Ave, Boston, MA 02115, USA (e-mail: )
| |
Collapse
|
52
|
Bychkovsky BL, Li T, Sotelo J, Tayob N, Mercado J, Gomy I, Chittenden AB, Kane SR, Stokes S, Hughes ME, Kim JS, Awad MM, Konstantinopoulos PA, Wolpin BM, Taplin ME, Johnson BE, Lindeman NI, MacConaill LE, Garber JE, Lin NU. Identification and management of pathogenic mutations in BRCA1, BRCA2, and PALB2 in a tumor-only genomic testing program. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.10528] [Citation(s) in RCA: 1] [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: 11/20/2022] Open
Abstract
10528 Background: Tumor-genomic testing is increasingly used to guide treatment decisions in cancer patients. Although tumor-only testing cannot definitively distinguish between germline versus somatic alterations, the identification of pathogenic or likely pathogenic (P/LP) variants in certain genes should prompt consideration of germline testing. Germline P/LPs in BRCA1, BRCA2 and PALB2 ( B1B2PAL) are associated with hereditary cancer syndromes. Methods: We reviewed tumor-only genomic data (Dana-Farber Oncopanel) between 10/2016 and 6/2018 to examine the prevalence of P/LPs in BRCA1, BRCA2, PALB2 among adult cancer patients at Dana-Farber Cancer Institute/Brigham and Women’s Hospital. We characterized the frequency of P/LPs by primary tumor type, confirmation by germline testing before or within 12 months after Oncopanel testing or not, and factors associated with germline testing. Results: Among 7,575 patients, the median age was 62 (range 18-99); 53.9% were female. A total of 272 (3.6%) had P/LPs in BRCA1 (n = 90), BRCA2 (n = 162) and/or PALB2 (n = 29). P/LPs in B1B2PAL were detected in 5.3% (38/712) of breast, 11.9% (34/285) of ovarian, 6.6% (18/272) of pancreatic, and 5.1% (12/234) of prostate cancers. P/LPs in B1B2PAL were also detected in other neoplasms (12.9% (8/62) of non-melanoma skin, 5.0% (43/855) of colorectal, 7.6% (20/264) of endometrial, and 4.6% (10/216) of head and neck cancers). Of 169 patients who had not had prior germline testing, 29/169 (17.2%) completed germline testing within 12 months after Oncopanel; 13 (7.7%) referred for testing declined or did not complete testing within 12 months, 14 (8.3%) died before or within 3 months of the Oncopanel results, and 113 (66.9%) had no documented germline testing within 12 months. Among 132 patients who had germline testing, 117 (88.6%) had a clinical indication based on personal or family history compared to 66/140 (47.1%) who did not undergo germline testing. Among 132/272 (48.5%) germline-tested patients, 70.5% were positive for a germline mutation in B1B2PAL; the remainder had somatic B1B2PAL mutations only. Germline testing was more often performed in patients with B1B2PAL-associated tumors (breast, ovarian, pancreatic and prostate cancers) or other clinical indications for germline testing. Conclusions: A low but clinically meaningful rate of P/LPs in BRCA1, BRCA2 and PALB2 was detected by tumor-only genomic testing in diverse malignancies. Given the implications of B1B2PAL alterations on treatment and familial cancer risk, our data support current NCCN guidelines recommending germline testing among patients with cancer and P/LPs in B1B2PAL detected on tumor-genomic testing and highlights the need for systems to ensure germline testing when indicated.
Collapse
Affiliation(s)
- Brittany L. Bychkovsky
- Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Tianyu Li
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | | | - Nabihah Tayob
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | | | - Israel Gomy
- Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA
| | - Anu B. Chittenden
- Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA
| | - Sarah R. Kane
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samantha Stokes
- Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA
| | - Melissa E Hughes
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Ji Seok Kim
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Mark M. Awad
- Lowe C, Dana-Farber Cancer Institute, Boston, MA
| | | | - Brian M. Wolpin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Mary-Ellen Taplin
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Bruce E. Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Laura E MacConaill
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, MA
| | - Judy Ellen Garber
- Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Nancy U. Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| |
Collapse
|
53
|
Mileham KF, Basu Roy UK, Bruinooge SS, Freeman-Daily J, Garon EB, Garrett-Mayer L, Jalal SI, Johnson BE, Moore A, Osarogiagbon RU, Rosenthal L, Schenkel C, Smith RA, Virani S, Redman MW, Silvestri GA. Physician concern about delaying lung cancer treatment while awaiting biomarker testing: Results of a survey of U.S. oncologists. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9067] [Citation(s) in RCA: 1] [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: 11/20/2022] Open
Abstract
9067 Background: With rapid advancements in biomarker testing informing lung cancer treatment decisions, clinicians are challenged to maintain knowledge of who, what and when to test and how to treat based on test results. An ASCO taskforce including representatives from the American Cancer Society National Lung Cancer Roundtable and patient advocates conducted a study to assess biomarker testing and treatment practices for patients with advanced non-small cell lung cancer (aNSCLC) among U.S. oncologists. Methods: A survey was sent to 2374 ASCO members – lung cancer specialists and general oncologists. Eligibility required treating ≥1 lung cancer patient/month. Proportions were estimated across groups and compared using chi-square tests. Results: 170 responses were analyzed. 59% of respondents work at an academic center (i.e., have a fellowship program), while 41% work at a community (non-academic hospital/health system/private practice). Nearly all (98%) believe biomarker results should be received within 1 or 2 weeks of ordering, yet 37% wait an average of 3 or 4 weeks for results. Of respondents who usually wait 3 or 4 weeks, 37% initiate a non-targeted systemic treatment while waiting. Respondents from community practices were more likely to initiate non-targeted systemic treatment if results were not available after 2 weeks (59% compared to 40% of academic respondents; p = 0.013). ). When asked about reasons for not testing, respondents <5 years since training were more likely to report that delaying treatment while waiting for results was always/often a concern compared to those >6 years from training (41% vs 19%). Respondents reported high testing rates in both non-squamous and squamous aNSCLC. Roughly equal representation of generalists/specialists and academic/community respondents helps mitigate potential concerns about external validity. Conclusions: Respondents indicated that treatment decisions are impacted by delays in biomarker test results. Clinicians should be informed about when it is safe and appropriate to defer treatment while biomarker testing is pending. Respondents suggest that diagnostic biomarker testing companies should strive to expedite results.[Table: see text]
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Amy Moore
- Bonnie J Addario Lung Cancer Foundation, San Carlos, CA
| | | | | | | | | | | | - Mary Weber Redman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | |
Collapse
|
54
|
Wang X, Ricciuti B, Nguyen T, Li X, Rabin MS, Awad MM, Lin X, Johnson BE, Christiani DC. Association between Smoking History and Tumor Mutation Burden in Advanced Non-Small Cell Lung Cancer. Cancer Res 2021; 81:2566-2573. [PMID: 33653773 DOI: 10.1158/0008-5472.can-20-3991] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/21/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022]
Abstract
Lung carcinogenesis is a complex and stepwise process involving accumulation of genetic mutations in signaling and oncogenic pathways via interactions with environmental factors and host susceptibility. Tobacco exposure is the leading cause of lung cancer, but its relationship to clinically relevant mutations and the composite tumor mutation burden (TMB) has not been fully elucidated. In this study, we investigated the dose-response relationship in a retrospective observational study of 931 patients treated for advanced-stage non-small cell lung cancer (NSCLC) between April 2013 and February 2020 at the Dana Farber Cancer Institute and Brigham and Women's Hospital. Doubling smoking pack-years was associated with increased KRASG12C and less frequent EGFRdel19 and EGFRL858R mutations, whereas doubling smoking-free months was associated with more frequent EGFRL858R . In advanced lung adenocarcinoma, doubling smoking pack-years was associated with an increase in TMB, whereas doubling smoking-free months was associated with a decrease in TMB, after controlling for age, gender, and stage. There is a significant dose-response association of smoking history with genetic alterations in cancer-related pathways and TMB in advanced lung adenocarcinoma. SIGNIFICANCE: This study clarifies the relationship between smoking history and clinically relevant mutations in non-small cell lung cancer, revealing the potential of smoking history as a surrogate for tumor mutation burden.
Collapse
Affiliation(s)
- Xinan Wang
- Harvard Graduate School of Arts and Sciences, Harvard University, Cambridge, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Tom Nguyen
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Xihao Li
- Harvard Graduate School of Arts and Sciences, Harvard University, Cambridge, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Michael S Rabin
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Bruce E Johnson
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
55
|
Frangieh CJ, Melms JC, Thakore PI, Geiger-Schuller KR, Ho P, Luoma AM, Cleary B, Jerby-Arnon L, Malu S, Cuoco MS, Zhao M, Ager CR, Rogava M, Hovey L, Rotem A, Bernatchez C, Wucherpfennig KW, Johnson BE, Rozenblatt-Rosen O, Schadendorf D, Regev A, Izar B. Multimodal pooled Perturb-CITE-seq screens in patient models define mechanisms of cancer immune evasion. Nat Genet 2021; 53:332-341. [PMID: 33649592 PMCID: PMC8376399 DOI: 10.1038/s41588-021-00779-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/04/2021] [Indexed: 01/05/2023]
Abstract
Resistance to immune checkpoint inhibitors (ICIs) is a key challenge in cancer therapy. To elucidate underlying mechanisms, we developed Perturb-CITE-sequencing (Perturb-CITE-seq), enabling pooled clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9 perturbations with single-cell transcriptome and protein readouts. In patient-derived melanoma cells and autologous tumor-infiltrating lymphocyte (TIL) co-cultures, we profiled transcriptomes and 20 proteins in ~218,000 cells under ~750 perturbations associated with cancer cell-intrinsic ICI resistance (ICR). We recover known mechanisms of resistance, including defects in the interferon-γ (IFN-γ)-JAK/STAT and antigen-presentation pathways in RNA, protein and perturbation space, and new ones, including loss/downregulation of CD58. Loss of CD58 conferred immune evasion in multiple co-culture models and was downregulated in tumors of melanoma patients with ICR. CD58 protein expression was not induced by IFN-γ signaling, and CD58 loss conferred immune evasion without compromising major histocompatibility complex (MHC) expression, suggesting that it acts orthogonally to known mechanisms of ICR. This work provides a framework for the deciphering of complex mechanisms by large-scale perturbation screens with multimodal, single-cell readouts, and discovers potentially clinically relevant mechanisms of immune evasion.
Collapse
Affiliation(s)
- Chris J Frangieh
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Johannes C Melms
- Columbia Center for Translational Immunology, New York, NY, USA
- Department of Medicine, Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA
| | - Pratiksha I Thakore
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kathryn R Geiger-Schuller
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Genentech, South San Francisco, CA, USA
| | - Patricia Ho
- Columbia Center for Translational Immunology, New York, NY, USA
- Department of Medicine, Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA
| | - Adrienne M Luoma
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Brian Cleary
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Livnat Jerby-Arnon
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Shruti Malu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Immunitas Therapeutics, Waltham, MA, USA
| | - Michael S Cuoco
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Maryann Zhao
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Casey R Ager
- Columbia Center for Translational Immunology, New York, NY, USA
| | - Meri Rogava
- Columbia Center for Translational Immunology, New York, NY, USA
- Department of Medicine, Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA
| | - Lila Hovey
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Asaf Rotem
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
- AstraZeneca, Waltham, MA, USA
| | - Chantale Bernatchez
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Kai W Wucherpfennig
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Orit Rozenblatt-Rosen
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Genentech, South San Francisco, CA, USA
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen and German Cancer Consortium, Partner Site, Essen, Germany
| | - Aviv Regev
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD, USA.
- Genentech, South San Francisco, CA, USA.
| | - Benjamin Izar
- Columbia Center for Translational Immunology, New York, NY, USA.
- Department of Medicine, Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA.
- Program for Mathematical Genomics, Columbia University, New York, NY, USA.
| |
Collapse
|
56
|
Alon S, Goodwin DR, Sinha A, Wassie AT, Chen F, Daugharthy ER, Bando Y, Kajita A, Xue AG, Marrett K, Prior R, Cui Y, Payne AC, Yao CC, Suk HJ, Wang R, Yu CCJ, Tillberg P, Reginato P, Pak N, Liu S, Punthambaker S, Iyer EPR, Kohman RE, Miller JA, Lein ES, Lako A, Cullen N, Rodig S, Helvie K, Abravanel DL, Wagle N, Johnson BE, Klughammer J, Slyper M, Waldman J, Jané-Valbuena J, Rozenblatt-Rosen O, Regev A, Church GM, Marblestone AH, Boyden ES. Expansion sequencing: Spatially precise in situ transcriptomics in intact biological systems. Science 2021; 371:eaax2656. [PMID: 33509999 PMCID: PMC7900882 DOI: 10.1126/science.aax2656] [Citation(s) in RCA: 157] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/13/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022]
Abstract
Methods for highly multiplexed RNA imaging are limited in spatial resolution and thus in their ability to localize transcripts to nanoscale and subcellular compartments. We adapt expansion microscopy, which physically expands biological specimens, for long-read untargeted and targeted in situ RNA sequencing. We applied untargeted expansion sequencing (ExSeq) to the mouse brain, which yielded the readout of thousands of genes, including splice variants. Targeted ExSeq yielded nanoscale-resolution maps of RNAs throughout dendrites and spines in the neurons of the mouse hippocampus, revealing patterns across multiple cell types, layer-specific cell types across the mouse visual cortex, and the organization and position-dependent states of tumor and immune cells in a human metastatic breast cancer biopsy. Thus, ExSeq enables highly multiplexed mapping of RNAs from nanoscale to system scale.
Collapse
Affiliation(s)
- Shahar Alon
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
- Faculty of Engineering, Gonda Brain Research Center and Institute of Nanotechnology, Bar-Ilan University, Ramat Gan, Israel
| | - Daniel R Goodwin
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
| | - Anubhav Sinha
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
- Harvard-MIT Program in Health Sciences and Technology, MIT, Cambridge, MA, USA
| | - Asmamaw T Wassie
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
- Department of Biological Engineering, MIT, Cambridge, MA, USA
| | - Fei Chen
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Evan R Daugharthy
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | - Yosuke Bando
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- Kioxia Corporation, Minato-ku, Tokyo, Japan
| | | | - Andrew G Xue
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
| | | | | | - Yi Cui
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
| | - Andrew C Payne
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Chun-Chen Yao
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ho-Jun Suk
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
- Harvard-MIT Program in Health Sciences and Technology, MIT, Cambridge, MA, USA
| | - Ru Wang
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
| | - Chih-Chieh Jay Yu
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
- Department of Biological Engineering, MIT, Cambridge, MA, USA
| | - Paul Tillberg
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
| | - Paul Reginato
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- Department of Biological Engineering, MIT, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | - Nikita Pak
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA
- McGovern Institute, MIT, Cambridge, MA, USA
- Department of Mechanical Engineering, MIT, Cambridge, MA, USA
| | - Songlei Liu
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | - Sukanya Punthambaker
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | - Eswar P R Iyer
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | - Richie E Kohman
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | | | - Ed S Lein
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Ana Lako
- Center for Immuno-Oncology (CIO), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicole Cullen
- Center for Immuno-Oncology (CIO), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Scott Rodig
- Center for Immuno-Oncology (CIO), Dana-Farber Cancer Institute, Boston, MA, USA
| | - Karla Helvie
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Daniel L Abravanel
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - Nikhil Wagle
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bruce E Johnson
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Michal Slyper
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Julia Waldman
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | | | - Aviv Regev
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Koch Institute for Integrative Cancer Research, Department of Biology, MIT, Cambridge, MA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - George M Church
- Department of Genetics, Harvard Medical School, Boston, MA, USA.
- Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA
| | | | - Edward S Boyden
- Department of Media Arts and Sciences, MIT, Cambridge, MA, USA.
- McGovern Institute, MIT, Cambridge, MA, USA
- Department of Biological Engineering, MIT, Cambridge, MA, USA
- Koch Institute for Integrative Cancer Research, Department of Biology, MIT, Cambridge, MA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA, USA
| |
Collapse
|
57
|
Garrido-Castro AC, Spurr LF, Hughes ME, Li YY, Cherniack AD, Kumari P, Lloyd MR, Bychkovsky B, Barroso-Sousa R, Di Lascio S, Jain E, Files J, Mohammed-Abreu A, Krevalin M, MacKichan C, Barry WT, Guo H, Xia D, Cerami E, Rollins BJ, MacConaill LE, Lindeman NI, Krop IE, Johnson BE, Wagle N, Winer EP, Dillon DA, Lin NU. Genomic Characterization of de novo Metastatic Breast Cancer. Clin Cancer Res 2020; 27:1105-1118. [PMID: 33293374 DOI: 10.1158/1078-0432.ccr-20-1720] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/05/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE In contrast to recurrence after initial diagnosis of stage I-III breast cancer [recurrent metastatic breast cancer (rMBC)], de novo metastatic breast cancer (dnMBC) represents a unique setting to elucidate metastatic drivers in the absence of treatment selection. We present the genomic landscape of dnMBC and association with overall survival (OS). EXPERIMENTAL DESIGN Targeted DNA sequencing (OncoPanel) was prospectively performed on either primary or metastatic tumors from 926 patients (212 dnMBC and 714 rMBC). Single-nucleotide variants, copy-number variations, and tumor mutational burden (TMB) in treatment-naïve dnMBC primary tumors were compared with primary tumors in patients who ultimately developed rMBC, and correlated with OS across all dnMBC. RESULTS When comparing primary tumors by subtype, MYB amplification was enriched in triple-negative dnMBC versus rMBC (21.1% vs. 0%, P = 0.0005, q = 0.111). Mutations in KMTD2, SETD2, and PIK3CA were more prevalent, and TP53 and BRCA1 less prevalent, in primary HR+/HER2- tumors of dnMBC versus rMBC, though not significant after multiple comparison adjustment. Alterations associated with shorter OS in dnMBC included TP53 (wild-type: 79.7 months; altered: 44.2 months; P = 0.008, q = 0.107), MYC (79.7 vs. 23.3 months; P = 0.0003, q = 0.011), and cell-cycle (122.7 vs. 54.9 months; P = 0.034, q = 0.245) pathway genes. High TMB correlated with better OS in triple-negative dnMBC (P = 0.041). CONCLUSIONS Genomic differences between treatment-naïve dnMBC and primary tumors of patients who developed rMBC may provide insight into mechanisms underlying metastatic potential and differential therapeutic sensitivity in dnMBC. Alterations associated with poor OS in dnMBC highlight the need for novel approaches to overcome potential intrinsic resistance to current treatments.
Collapse
Affiliation(s)
- Ana C Garrido-Castro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. .,Harvard Medical School, Boston, Massachusetts
| | - Liam F Spurr
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Melissa E Hughes
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Yvonne Y Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Andrew D Cherniack
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Priti Kumari
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Maxwell R Lloyd
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Brittany Bychkovsky
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | | | - Simona Di Lascio
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Esha Jain
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Janet Files
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Max Krevalin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Colin MacKichan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - William T Barry
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Hao Guo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Daniel Xia
- Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women' Hospital, Boston, Massachusetts
| | - Ethan Cerami
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Barrett J Rollins
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Laura E MacConaill
- Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women' Hospital, Boston, Massachusetts.,Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Neal I Lindeman
- Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women' Hospital, Boston, Massachusetts.,Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ian E Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Nikhil Wagle
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Eric P Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Deborah A Dillon
- Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women' Hospital, Boston, Massachusetts
| | - Nancy U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
58
|
Albayrak A, Garrido-Castro AC, Giannakis M, Umeton R, Manam MD, Stover EH, Porter RL, Johnson BE, Liaw KL, Amonkar M, Church AJ, Janeway KA, Nowak JA, Sholl L, Lin NU, Johnson JM. Clinical Pan-Cancer Assessment of Mismatch Repair Deficiency Using Tumor-Only, Targeted Next-Generation Sequencing. JCO Precis Oncol 2020; 4:1084-1097. [PMID: 35050773 PMCID: PMC10445788 DOI: 10.1200/po.20.00185] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Given regulatory approval of immune checkpoint inhibitors in patients with mismatch repair-deficient (MMR-D) cancers agnostic to tumor type, it has become important to characterize occurrence of MMR-D and develop cost-effective screening approaches. Using a next-generation sequencing (NGS) panel (OncoPanel), we developed an algorithm to identify MMR-D frequency in tumor samples and applied it in a clinical setting with pathologist review. METHODS To predict MMR-D, we adapted methods described previously for use in NGS panels, which assess patterns of single base-pair insertion or deletion events occurring in homopolymer regions. Tumors assayed with OncoPanel between July 2013 and July 2018 were included. For tumors tested after June 2017, sequencing results were presented to pathologists in real time for clinical MMR determination, in the context of tumor mutation burden, other mutational signatures, and clinical data. RESULTS Of 20,301 tumors sequenced, 2.7% (553) were retrospectively classified as MMR-D by the algorithm. Of 4,404 samples with pathologist sign-out of MMR status, the algorithm classified 147 (3.3%) as MMR-D: in 116 cases, MMR-D was confirmed by a pathologist, five cases were overruled by the pathologist, and 26 were assessed as indeterminate. Overall, the highest frequencies of OncoPanel-inferred MMR-D were in endometrial (21%; 152/723), colorectal (9.7%; 169/1,744), and small bowel (9.3%; 9/97) cancers. When algorithm predictions were compared with historical MMR immunohistochemistry or polymerase chain reaction results in a set of 325 tumors sequenced before initiation of pathologist assessment, the overall sensitivity and specificity of the algorithm were 91.1% and 98.2%, respectively. CONCLUSION We show that targeted, tumor-only NGS can be leveraged to determine MMR signatures across tumor types, suggesting that broader biomarker screening approaches may have clinical value.
Collapse
Affiliation(s)
- Adem Albayrak
- Informatics and Analytics Department, Dana-Farber Cancer Institute, Boston, MA
| | - Ana C. Garrido-Castro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Marios Giannakis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
| | - Renato Umeton
- Informatics and Analytics Department, Dana-Farber Cancer Institute, Boston, MA
- Massachusetts Institute of Technology, Cambridge, MA
| | | | - Elizabeth H. Stover
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Rebecca L. Porter
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Bruce E. Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | | | | | - Alanna J. Church
- Harvard Medical School, Boston, MA
- Department of Pathology, Boston Children’s Hospital, Boston, MA
| | | | - Jonathan A. Nowak
- Harvard Medical School, Boston, MA
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Lynette Sholl
- Harvard Medical School, Boston, MA
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Nancy U. Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Jason M. Johnson
- Informatics and Analytics Department, Dana-Farber Cancer Institute, Boston, MA
| |
Collapse
|
59
|
Shah P, Cuoco M, Su MJ, Melms J, Leeson R, Kanodia A, Mei S, Lin JR, Wang S, Rabasha B, Liu D, Shalek AK, Tirosh I, Sorger PK, Wucherpfennig K, Van Allen EM, Schadendorf D, Johnson BE, Rotem A, Rozenblatt-Rosen O, Garraway LA, Yoon CH, Izar B, Regev A, Jerby-Arnon L. Abstract PR01: A cancer cell program promotes T-cell exclusion and resistance to checkpoint blockade. Cancer Res 2020. [DOI: 10.1158/1538-7445.mel2019-pr01] [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
Immune checkpoint inhibitors (ICI) produce durable responses in some melanoma patients, but many patients derive no clinical benefit, and the molecular underpinnings of such resistance remain elusive. Here, we leveraged single-cell RNA-seq (scRNA-seq) from 33 melanoma tumors and computational analyses to interrogate malignant cell states that promote immune evasion. We identified a resistance program expressed by malignant cells that is associated with T-cell exclusion and immune evasion. The program is expressed prior to immunotherapy, characterizes cold niches in situ, and predicts clinical responses to anti-PD-1 therapy in an independent cohort of 112 melanoma patients. CDK4/6-inhibition represses this program in individual malignant cells, induces senescence, and reduces melanoma tumor outgrowth in mouse models in vivo when given in combination with immunotherapy. Our study provides a high-resolution landscape of ICI resistant cell states, identifies clinically predictive signatures, and suggests new therapeutic strategies to overcome immunotherapy resistance. This study will be published on Nov. 1st in Cell (Jerby-Arnon et al., Cell 2018).
This abstract is also being presented as Poster A25.
Citation Format: Parin Shah, Michael Cuoco, Mei-Ju Su, Johannes Melms, Rachel Leeson, Abhay Kanodia, Shaolin Mei, Jia-Ren Lin, Shu Wang, Bokang Rabasha, David Liu, Alex K. Shalek, Itay Tirosh, Peter K. Sorger, Kai Wucherpfennig, Eliezer M. Van Allen, Dirk Schadendorf, Bruce E. Johnson, Asaf Rotem, Orit Rozenblatt-Rosen, Levi A. Garraway, Charles H. Yoon, Benjamin Izar, Aviv Regev, Livnat Jerby-Arnon. A cancer cell program promotes T-cell exclusion and resistance to checkpoint blockade [abstract]. In: Proceedings of the AACR Special Conference on Melanoma: From Biology to Target; 2019 Jan 15-18; Houston, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(19 Suppl):Abstract nr PR01.
Collapse
Affiliation(s)
- Parin Shah
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | - Mei-Ju Su
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | | | | | - Shaolin Mei
- Broad Institute of MIT and Harvard, Cambridge, MA
| | - Jia-Ren Lin
- Broad Institute of MIT and Harvard, Cambridge, MA
| | - Shu Wang
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | - David Liu
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | - Itay Tirosh
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | | | | | | | | | - Asaf Rotem
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | | | | | | | - Aviv Regev
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | |
Collapse
|
60
|
Tolaney SM, Lydon CA, Li T, Dai J, Standring A, Legor KA, Caparrotta CM, Schenker MP, Glazer DI, Tayob N, DuBois SG, Meyerhardt JA, Taplin ME, Johnson BE. The Impact of COVID-19 on Clinical Trial Execution at the Dana-Farber Cancer Institute. J Natl Cancer Inst 2020; 113:1453-1459. [PMID: 32959883 PMCID: PMC7543498 DOI: 10.1093/jnci/djaa144] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/27/2020] [Accepted: 09/04/2020] [Indexed: 12/14/2022] Open
Abstract
Interventions designed to limit the spread of COVID-19 are having profound effects on the delivery of healthcare, but data showing the impact on oncology clinical trial enrollment, treatment, and monitoring are limited. We prospectively tracked relevant data from oncology clinical trials at Dana-Farber Cancer Institute (DFCI) from January 1, 2018 to June 30, 2020, including the number of open trials, new patient enrollments, in-person and virtual patient visits, dispensed investigational infusions, dispensed/shipped oral investigational agents, research biopsies, and blood samples. We ascertained why patients came off trials and determined on-site clinical research staffing levels. We used two-sided Wilcoxon rank sum tests to assess the statistical significance of the reported changes. Nearly all patients on interventional treatment trials were maintained, and new enrollments continued at just under half the pre-pandemic rate. The median number of investigational prescriptions shipped to patients increased from 0-74 (range: 22-107) per week from March-June 2020. The median number of telemedicine appointments increased from 0-107 (range: 33-267) per week from March-June 2020. Research biopsies and blood collections decreased dramatically after DFCI implemented COVID-19-related policies in March 2020. The number of research nurses and clinical research coordinators on-site also decreased after March 2020. Substantial changes were required to safely continue clinical research during the pandemic; yet, we observed no increases in serious adverse events or major violations related to drug dosing. Lessons learned from adapting research practices during COVID-19 can inform industry sponsors and governmental agencies to consider altering practices to increase operational efficiency and convenience for patients.
Collapse
Affiliation(s)
- Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Christine A Lydon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Tianyu Li
- Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Jiale Dai
- Pharmacy, Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | - Daniel I Glazer
- Department of Radiology, Brigham and Women's Hospital, Boston, MA
| | | | - Steven G DuBois
- Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| |
Collapse
|
61
|
Exman P, Garrido-Castro AC, Hughes ME, Freedman RA, Li T, Trippa L, Bychkovsky BL, Barroso-Sousa R, Di Lascio S, Mackichan C, Lloyd MR, Krevalin M, Cerami E, Merrill MS, Santiago R, Crowley L, Kuhnly N, Files J, Lindeman NI, MacConaill LE, Kumari P, Tolaney SM, Krop IE, Bose R, Johnson BE, Ma CX, Dillon DA, Winer EP, Wagle N, Lin NU. Identifying ERBB2 Activating Mutations in HER2-Negative Breast Cancer: Clinical Impact of Institute-Wide Genomic Testing and Enrollment in Matched Therapy Trials. JCO Precis Oncol 2020; 3:1900087. [PMID: 32923853 DOI: 10.1200/po.19.00087] [Citation(s) in RCA: 1] [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] [Accepted: 10/26/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The yield of comprehensive genomic profiling in recruiting patients to molecular-based trials designed for small subgroups has not been fully evaluated. We evaluated the likelihood of enrollment in a clinical trial that required the identification of a specific genomic change based on our institute-wide genomic tumor profiling. PATIENTS AND METHODS Using genomic profiling from archived tissue samples derived from patients with metastatic breast cancer treated between 2011 and 2017, we assessed the impact of systematic genomic characterization on enrollment in an ongoing phase II trial (ClinicalTrials.gov identifier: NCT01670877). Our primary aim was to describe the proportion of patients with a qualifying ERBB2 mutation identified by our institutional genomic panel (OncoMap or OncoPanel) who enrolled in the trial. Secondary objectives included median time from testing result to trial registration, description of the spectrum of ERBB2 mutations, and survival. Associations were calculated using Fisher's exact test. RESULTS We identified a total of 1,045 patients with metastatic breast cancer without ERBB2 amplification who had available genomic testing results. Of these, 42 patients were found to have ERBB2 mutation and 19 patients (1.8%) were eligible for the trial on the basis of the presence of an activating mutation, 18 of which were identified by OncoPanel testing. Fifty-eight percent of potentially eligible patients were approached, and 33.3% of eligible patients enrolled in the trial guided exclusively by OncoPanel testing. CONCLUSION More than one half of eligible patients were approached for trial participation and, significantly, one third of those were enrolled in NCT01670877. Our data illustrate the ability to enroll patients in trials of rare subsets in routine clinical practice and highlight the need for these broadly based approaches to effectively support the success of these studies.
Collapse
Affiliation(s)
| | | | | | | | - Tianyu Li
- Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ian E Krop
- Dana-Farber Cancer Institute, Boston, MA
| | - Ron Bose
- Washington University School of Medicine, St. Louis, MO
| | | | - Cynthia X Ma
- Washington University School of Medicine, St. Louis, MO
| | - Deborah A Dillon
- Dana-Farber Cancer Institute, Boston, MA.,Brigham and Women's Hospital, Boston, MA
| | | | | | | |
Collapse
|
62
|
Johnson BE, Kim TM, Hiltermann TJN, Barlesi F, Grohe C, Goto Y, Gunnarsson O, Overbeck T, Reguart N, Wermke M, Castro GC, Felip E, Greystoke A, Solomon BJ, Deudon S, Louveau AL, Passos V, Tan DSW. Abstract CT214: CANOPY-1: Safety run-in results from phase (ph) 3 study of canakinumab (CAN) or placebo (PBO) in combination (comb) with pembrolizumab (PEM) plus platinum-based doublet chemotherapy (Ctx) as 1st line therapy in patients (pts) with advanced or metastatic NSCLC. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cytokine interleukin-1β (IL-1β) has multiple pro-tumorogenic effects on tumor microenvironment, thereby promoting carcinogenesis, tumor invasiveness, and immunosuppression. CAN is a selective IL-1β inhibitor that aims to target tumor-promoting inflammation to reduce immune suppression, thereby potentiating effects of immunotherapy with PD-1 inhibitors such as PEM. Ph 3 CANTOS study has shown IL-1β inhibition with CAN was associated with reduced incidence of lung cancer (LC) and LC mortality in pts with atherosclerosis, providing a rationale to investigate therapeutic role of CAN in LC. CANOPY-1 (NCT03631199) is a PBO-controlled, double-blind, randomized, ph 3 trial designed to evaluate efficacy and safety of PEM + Ctx ± CAN in tx naive pts with stage IIIB/IIIC (not eligible for definitive chemo-radiation curative tx) or stage IV squamous and nonsquamous NSCLC. The study was divided into 2 parts: part 1 is open labelled, safety run-in part where pts received CAN 200 mg s.c Q3W + PEM 200 mg i.v Q3W + platinum-based Ctx (as induction during first 4 cycles only); Cohort A (A, non-squamous), carboplatin + pemetrexed; Cohort B (B, non-squamous), cisplatin + pemetrexed; Cohort C (C, squamous or non-squamous), carboplatin + paclitaxel. Part 2 is randomized and evaluates efficacy and safety of CAN comb regimen vs PBO comb regimen. Primary objective of safety run-in part: recommended ph 3 dose regimen (RP3R) of CAN comb. Secondary objectives: ORR, DCR, DOR, safety, PK, and immunogenicity. As of 14 May 2019 (follow-up of ≥42 days from C1D1 unless pt discontinued earlier), 10 pts in A, 11 pts in B, and 9 pts in C were treated, of which 73% were male, median age was 63 yrs. In total, 24/30 (80%) pts enrolled were still receiving tx; primary reason for tx discontinuation was progressive disease (3 pts in A and 1 pt each in B and C) and 1 pt died due to study indication. 1 pt reported DLT during first 42 days of study tx (C: grade 3 hepatitis, not related to CAN). RP3R of CAN in comb with standard dose PEM + Ctx was 200 mg SC Q3W based on Bayesian logistic regression model (BLRM). Serious AEs regardless of causality were reported in 8 (27%) pts (2 pts in A and 3 pts each in B and C), none of which were considered to be related to CAN. Most common AEs (≥20%, any grade) across all cohorts (n=30) were nausea (37%), vomiting (30%), constipation and fatigue (each 23%), and neutrophil count decrease (20%). 14 pts (47%) experienced grade 3 AEs and 1 pt experienced grade 4 AE (cardiac tamponade [unrelated]). No fatal serious AEs were reported. AEs leading to discontinuation of one of the study drugs were reported in 3 (10%) pts (hepatitis, peripheral neuropathy, and polyneuropathy) but none were CAN related. AEs leading to dose reduction and dose interruption of one of study drugs were reported in 3 (10%) pts and 5 (17%) pts, respectively. Only 1 DLT was reported with CAN + PEM + Ctx. Based on BLRM and all relevant clinical data, the RP3R of CAN as 200 mg SC Q3W comb was considered safe and well tolerated. Enrollment for the randomized part is completed.
Citation Format: Bruce E. Johnson, Tae Min Kim, T. Jeroen N. Hiltermann, Fabrice Barlesi, Christian Grohe, Yasushi Goto, Orvar Gunnarsson, Tobias Overbeck, Noemi Reguart, Martin Wermke, Gilberto Castro Castro, Enriqueta Felip, Alastair Greystoke, Benjamin J. Solomon, Stephanie Deudon, Anne-Laure Louveau, Vanessa Passos, Daniel SW Tan. CANOPY-1: Safety run-in results from phase (ph) 3 study of canakinumab (CAN) or placebo (PBO) in combination (comb) with pembrolizumab (PEM) plus platinum-based doublet chemotherapy (Ctx) as 1st line therapy in patients (pts) with advanced or metastatic NSCLC [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT214.
Collapse
Affiliation(s)
| | - Tae Min Kim
- 2Seoul National University Hospital, Seoul, Republic of Korea
| | | | | | | | | | | | - Tobias Overbeck
- 8University Hospital Göttingen - University Medical Centre Göttingen, Groningen, Germany
| | - Noemi Reguart
- 9Hospital Clinic i Provincial de Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | - Vanessa Passos
- 17Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | |
Collapse
|
63
|
Kehl KL, Xu W, Elmarakeby HA, Hassett MJ, Nyman J, Johnson BE, Van Allen EM, Schrag D. Abstract 2063: Deep natural language processing for automated ascertainment of cancer outcomes from clinician progress notes. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-2063] [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: Clinical research using genomic datasets, such as AACR Project GENIE, requires outcomes such as cancer progression and response to contextualize molecular information. We are developing the “PRISSMM” (Pathology, Radiology/Imaging, Signs/Symptoms, Medical oncologist assessment, and tumor Markers) framework for clinical curation of genomic data. Natural language processing (NLP) models based on this framework could accelerate curation of reproducible endpoints. However, the application of NLP at scale to extract outcomes from oncologist notes, which mix historical and current information, has been limited to date.
Methods: Medical oncologists' progress notes were reviewed for patients with lung cancer whose tumors were sequenced through an institutional precision medicine study from 2013-2018. For each note, curators recorded whether the assessment/plan indicated the presence of (a) any cancer, (b) progression/worsening of disease, and/or (c) response to therapy/improvement of disease. Next, a recurrent neural network was trained to extract the assessment/plan from each note. Finally, convolutional neural networks were trained on the assessments/plans to predict the probability that each curated outcome was present. Model performance was evaluated among a held-out 10% test subset of patients using the area under the receiver-operating characteristic curve (AUC) and area under the precision-recall curve (AUPRC). Associations between curated response or progression endpoints (generated using 10-fold cross-validation) and overall survival were measured using Cox models, treating the endpoints as time-varying covariates, among patients receiving palliative-intent systemic therapy.
Results: Results among 7,597 curated notes for 919 patients are indicated in the Table.
EndpointAUC of NLP models for identifying endpoint in the test setProportion of manually curated notes with endpointAUPRC of NLP models for identifying endpoint in the test setHR (95% CI) for mortality associated with endpoint, as manually curated, among patients receiving palliative- intent treatmentHR (95% CI) for mortality associated with endpoint, as predicted using NLP models using F1-optimal threshold probabilitiesAny evidence of lung cancer0.940.770.97N/AN/AProgression0.860.200.652.93 (2.33-3.67)2.49 (2.00-3.09)Response to treatment0.900.120.570.70 (0.47-1.03)0.45 (0.30-0.67)
Conclusion: Neural network NLP models can extract meaningful outcomes from oncologist notes for clinical curation of electronic health records at scale.
Citation Format: Kenneth L. Kehl, Wenxin Xu, Haitham A. Elmarakeby, Michael J. Hassett, Jackson Nyman, Bruce E. Johnson, Eliezer M. Van Allen, Deb Schrag. Deep natural language processing for automated ascertainment of cancer outcomes from clinician progress notes [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2063.
Collapse
Affiliation(s)
| | - Wenxin Xu
- 2Beth Israel Deaconess Medical Center, Boston, MA
| | | | | | | | | | | | - Deb Schrag
- 1Dana-Farber Cancer Institute, Boston, MA
| |
Collapse
|
64
|
Paz-Ares L, Garon EB, Mok T, Ardizzoni A, Barlesi F, Cho BC, de Castro G, De Marchi P, Felip E, Goto Y, Greystoke A, Lu S, Lim DWT, Reck M, Solomon BJ, Spigel DR, Tan DSW, Thomas M, Yang JCH, Lee JM, Garrido P, Kim E, Johnson BE. Abstract CT286: CANOPY program clinical trials: Canakinumab (Cana) in patients (pts) with non-small cell lung cancer (NSCLC). Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In the CANTOS study, treatment (tx) with Cana (selective IL-1β inhibitor) was associated with reduced incidence and mortality of NSCLC in stable post-myocardial infarction pts with elevated high-sensitivity C-reactive protein levels. The results provided a rationale to investigate the therapeutic role of Cana in NSCLC. Methods: The phase (ph) 2, open-label CANOPY-N study (NCT03968419) is evaluating Cana or pembrolizumab (pembro) alone or in combination as neoadjuvant tx in stage IB-IIIA, tx-naive NSCLC pts eligible for primary resection (except N2 and T4 tumors) with planned surgery in 4-6 weeks (wks) from the 1st dose of study tx. Pts (~110) are randomized 2:2:1 to Cana (2 doses 200 mg SC Q3W), Cana + pembro, or pembro (2 doses 200 mg iv Q3W) for 2 three-wk cycles. Randomization (R) stratification: histology (squamous [sq] vs non-sq). Primary endpoint: major pathological response rate at time of surgery.CANOPY-A (NCT03447769), CANOPY-1 (NCT03631199), and CANOPY-2 (NCT03626545) are ph 3, multicenter, double-blind studies. In CANOPY-A (Cana in adjuvant setting), pts (~1500) with stages IIA-IIIA and IIIB (T>5 cm N2), any histology, completely resected (R0) NSCLC post cisplatin-based chemotherapy (CTx) and radiation therapy (if applicable) are randomized 1:1 to Cana (200 mg SC Q3W)/placebo (PBO; SC Q3W) for 18 cycles. R stratification: AJCC/UICC v.8 stage (IIA vs IIB vs IIIA vs IIIB with T>5 cm, N2 disease), histology (sq vs non-sq), region (western Europe and North America vs eastern Asia vs rest of the world). Primary endpoint: disease-free survival. CANOPY-1 and CANOPY-2 consist of Part 1 (open-label, safety run-in; enrollment complete) and Part 2 (randomized 1:1, PBO-controlled, efficacy & safety; ongoing). CANOPY-1 eligibility: pts with previously untreated stages IIIB/IIIC or IV NSCLC and known PD-L1 status (for Part 2), without EGFR sensitizing mutations and/or ALK rearrangements. Part 1 (3 cohorts of ~9 pts each, based on different platinum-CTx): to confirm the recommended phase 3 regimen (RP3R) for Cana. In Part 2, pts (~600) are randomized to Cana (200 mg SC Q3W)/PBO + pembro + CTx for 4 cycles, followed by maintenance tx (Cana/PBO + pembro ± pemetrexed) until progressive disease (PD). R stratification: PD-L1 status (tumor proportion score <1% vs ≥1%), histology (sq vs non-sq), geographic region (eastern Asia vs North America + western Europe vs rest of the world). Screening has ceased as of Dec 9, 2019. In CANOPY-2, pts with stage IIIB-IV NSCLC, who received prior PD-(L)1 inhibitor therapy and platinum-based CTx, without EGFR sensitizing mutations and/or ALK rearrangements are eligible. Part 1 (~9 pts): to confirm the RP3R of Cana + docetaxel. In Part 2, pts (~226) are randomized to receive Cana (200 mg SC Q3W)/PBO + docetaxel (75 mg/m2 iv Q3W) until PD. R stratification: number of prior lines of therapy in advanced setting (1 vs 2 prior lines of therapy) and histology (sq vs non-sq). Primary endpoints: CANOPY-1 and CANOPY-2 Part 1: to confirm RP3R of the combination; CANOPY-1 Part 2: progression-free survival and overall survival (OS); CANOPY-2 Part 2: OS.
Citation Format: Luis Paz-Ares, Edward B. Garon, Tony Mok, Andrea Ardizzoni, Fabrice Barlesi, Byoung Chul Cho, Gilberto de Castro, Pedro De Marchi, Enriqueta Felip, Yasushi Goto, Alastair Greystoke, Shun Lu, Darren Wan-Teck Lim, Martin Reck, Benjamin J. Solomon, David R. Spigel, Daniel SW Tan, Michael Thomas, James Chih-Hsin Yang, Jay M. Lee, Pilar Garrido, Edward Kim, Bruce E. Johnson. CANOPY program clinical trials: Canakinumab (Cana) in patients (pts) with non-small cell lung cancer (NSCLC) [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT286.
Collapse
Affiliation(s)
| | - Edward B. Garon
- 2David Geffen School of Medicine at UCLA/TRIO-US Network, Los Angeles, CA
| | - Tony Mok
- 3Chinese University of Hong Kong, Shatin, Hong Kong
| | | | | | - Byoung Chul Cho
- 6Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | | | - Yasushi Goto
- 10National Cancer Center Hospital, Department of Thoracic Oncology, Tokyo, Japan
| | | | - Shun Lu
- 12Shanghai Chest Hospital, Jiaotong University, Shanghai, China
| | | | - Martin Reck
- 14LungenClinic, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | | | | | - Daniel SW Tan
- 13National Cancer Centre Singapore, Singapore, Singapore
| | - Michael Thomas
- 17Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany
| | - James Chih-Hsin Yang
- 18Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jay M. Lee
- 19University of California, Los Angeles, Los Angeles, CA
| | - Pilar Garrido
- 20Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Edward Kim
- 21Levine Cancer Institute, Charlotte, NC
| | | |
Collapse
|
65
|
Izar B, Tirosh I, Stover EH, Wakiro I, Cuoco MS, Alter I, Rodman C, Leeson R, Su MJ, Shah P, Iwanicki M, Walker SR, Kanodia A, Melms JC, Mei S, Lin JR, Porter CBM, Slyper M, Waldman J, Jerby-Arnon L, Ashenberg O, Brinker TJ, Mills C, Rogava M, Vigneau S, Sorger PK, Garraway LA, Konstantinopoulos PA, Liu JF, Matulonis U, Johnson BE, Rozenblatt-Rosen O, Rotem A, Regev A. A single-cell landscape of high-grade serous ovarian cancer. Nat Med 2020; 26:1271-1279. [PMID: 32572264 PMCID: PMC7723336 DOI: 10.1038/s41591-020-0926-0] [Citation(s) in RCA: 221] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 05/07/2020] [Indexed: 01/04/2023]
Abstract
Malignant abdominal fluid (ascites) frequently develops in women with advanced high-grade serous ovarian cancer (HGSOC) and is associated with drug resistance and a poor prognosis1. To comprehensively characterize the HGSOC ascites ecosystem, we used single-cell RNA sequencing to profile ~11,000 cells from 22 ascites specimens from 11 patients with HGSOC. We found significant inter-patient variability in the composition and functional programs of ascites cells, including immunomodulatory fibroblast sub-populations and dichotomous macrophage populations. We found that the previously described immunoreactive and mesenchymal subtypes of HGSOC, which have prognostic implications, reflect the abundance of immune infiltrates and fibroblasts rather than distinct subsets of malignant cells2. Malignant cell variability was partly explained by heterogeneous copy number alteration patterns or expression of a stemness program. Malignant cells shared expression of inflammatory programs that were largely recapitulated in single-cell RNA sequencing of ~35,000 cells from additionally collected samples, including three ascites, two primary HGSOC tumors and three patient ascites-derived xenograft models. Inhibition of the JAK/STAT pathway, which was expressed in both malignant cells and cancer-associated fibroblasts, had potent anti-tumor activity in primary short-term cultures and patient-derived xenograft models. Our work contributes to resolving the HSGOC landscape3-5 and provides a resource for the development of novel therapeutic approaches.
Collapse
Affiliation(s)
- Benjamin Izar
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Ludwig Center for Cancer Research at Harvard, Boston, MA, USA
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
- Columbia University Medical Center, Columbia Center for Translational Immunology, New York, NY, USA
| | - Itay Tirosh
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Elizabeth H Stover
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Isaac Wakiro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael S Cuoco
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Idan Alter
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Christopher Rodman
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Rachel Leeson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mei-Ju Su
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Parin Shah
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marcin Iwanicki
- Chemistry and Chemical Biology, Stevens Institute of Technology, Hoboken, NJ, USA
| | - Sarah R Walker
- Molecular, Cellular, and Biomedical Sciences, College of Life Sciences and Agriculture, University of New Hampshire, Durham, NH, USA
| | - Abhay Kanodia
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Johannes C Melms
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Shaolin Mei
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Jia-Ren Lin
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Caroline B M Porter
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Michal Slyper
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Julia Waldman
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Livnat Jerby-Arnon
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Orr Ashenberg
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Caitlin Mills
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Meri Rogava
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Sébastien Vigneau
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Peter K Sorger
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | | | | | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ursula Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Asaf Rotem
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA, USA
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Aviv Regev
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Ludwig Center for Cancer Research at MIT, Boston, MA, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD, USA.
| |
Collapse
|
66
|
Mulshine JL, Ujhazy P, Antman M, Burgess CM, Kuzmin I, Bunn PA, Johnson BE, Roth JA, Pass HI, Ross SM, Aldige CR, Wistuba II, Minna JD. From clinical specimens to human cancer preclinical models-a journey the NCI-cell line database-25 years later. J Cell Biochem 2020; 121:3986-3999. [PMID: 31803961 PMCID: PMC7496084 DOI: 10.1002/jcb.29564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/13/2019] [Indexed: 01/24/2023]
Abstract
The intramural the National Cancer Institute (NCI) and more recently the University of Texas Southwestern Medical Center with many different collaborators comprised a complex, multi-disciplinary team that collaborated to generated large, comprehensively annotated, cell-line related research resources which includes associated clinical, and molecular characterization data. This material has been shared in an anonymized fashion to accelerate progress in overcoming lung cancer, the leading cause of cancer death across the world. However, this cell line collection also includes a range of other cancers derived from patient-donated specimens that have been remarkably valuable for other types of cancer and disease research. A comprehensive analysis conducted by the NCI Center for Research Strategy of the 278 cell lines reported in the original Journal of Cellular Biochemistry Supplement, documents that these cell lines and related products have since been used in more than 14 000 grants, and 33 207 published scientific reports. This has resulted in over 1.2 million citations using at least one cell line. Many publications involve the use of more than one cell line, to understand the value of the resource collectively rather than individually; this method has resulted in 2.9 million citations. In addition, these cell lines have been linked to 422 clinical trials and cited by 4700 patents through publications. For lung cancer alone, the cell lines have been used in the research cited in the development of over 70 National Comprehensive Cancer Network clinical guidelines. Finally, it must be underscored again, that patient altruism enabled the availability of this invaluable research resource.
Collapse
Affiliation(s)
- James L. Mulshine
- Center for Healthy Aging, Department of Internal MedicineRush UniversityChicagoIllinois
| | - Peter Ujhazy
- Translational Research Program, Division of Cancer Treatment and DiagnosisNational Cancer InstituteRockvilleMaryland
| | - Melissa Antman
- Center for Research StrategyNational Cancer InstituteBethesdaMaryland
| | | | - Igor Kuzmin
- Translational Research Program, Division of Cancer Treatment and DiagnosisNational Cancer InstituteRockvilleMaryland
| | - Paul A. Bunn
- University of Colorado Cancer CenterUniversity of Colorado Cancer CenterAuroraColorado
| | - Bruce E. Johnson
- Department of Medical OncologyDana‐Farber Cancer InstituteBostonMassachusetts
| | - Jack A. Roth
- Department of Thoracic and Cardiovascular Surgery, Division of SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTexas
| | - Harvey I. Pass
- Department of Cardiothoracic SurgeryNew York University Langone Medical CenterNew YorkNew York
| | - Sheila M. Ross
- AdvocacyLung Cancer AllianceAnnapolisMaryland,MemberIASLC Early Detection and Screening CommitteeAuroraColorado
| | | | - Ignacio I. Wistuba
- Department of Translational Molecular PathologyUT MD Anderson Cancer CenterHoustonTexas
| | - John D Minna
- Nancy B. and Jake L. Hamon Center for Therapeutic Oncology ResearchUT Southwestern Medical CenterDallasTexas
| |
Collapse
|
67
|
Mulshine JL, Ujhazy P, Antman M, Burgess CM, Kuzmin I, Bunn PA, Johnson BE, Roth JA, Pass HI, Ross SM, Aldige CR, Wistuba II, Minna JD. Cover Image, Volume 121, Number 8‐9, August 2020. J Cell Biochem 2020. [DOI: 10.1002/jcb.29829] [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: 11/09/2022]
Affiliation(s)
- James L. Mulshine
- Center for Healthy Aging, Department of Internal MedicineRush UniversityChicago Illinois
| | - Peter Ujhazy
- Translational Research Program, Division of Cancer Treatment and DiagnosisNational Cancer InstituteRockville Maryland
| | - Melissa Antman
- Center for Research StrategyNational Cancer InstituteBethesda Maryland
| | | | - Igor Kuzmin
- Translational Research Program, Division of Cancer Treatment and DiagnosisNational Cancer InstituteRockville Maryland
| | - Paul A. Bunn
- University of Colorado Cancer CenterUniversity of Colorado Cancer CenterAurora Colorado
| | - Bruce E. Johnson
- Department of Medical OncologyDana‐Farber Cancer InstituteBoston Massachusetts
| | - Jack A. Roth
- Department of Thoracic and Cardiovascular Surgery, Division of SurgeryThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Harvey I. Pass
- Department of Cardiothoracic SurgeryNew York University Langone Medical CenterNew York New York
| | - Sheila M. Ross
- AdvocacyLung Cancer AllianceAnnapolis Maryland
- MemberIASLC Early Detection and Screening CommitteeAurora Colorado
| | | | - Ignacio I. Wistuba
- Department of Translational Molecular PathologyUT MD Anderson Cancer CenterHouston Texas
| | - John D Minna
- Nancy B. and Jake L. Hamon Center for Therapeutic Oncology ResearchUT Southwestern Medical CenterDallas Texas
| |
Collapse
|
68
|
Slyper M, Porter CBM, Ashenberg O, Waldman J, Drokhlyansky E, Wakiro I, Smillie C, Smith-Rosario G, Wu J, Dionne D, Vigneau S, Jané-Valbuena J, Tickle TL, Napolitano S, Su MJ, Patel AG, Karlstrom A, Gritsch S, Nomura M, Waghray A, Gohil SH, Tsankov AM, Jerby-Arnon L, Cohen O, Klughammer J, Rosen Y, Gould J, Nguyen L, Hofree M, Tramontozzi PJ, Li B, Wu CJ, Izar B, Haq R, Hodi FS, Yoon CH, Hata AN, Baker SJ, Suvà ML, Bueno R, Stover EH, Clay MR, Dyer MA, Collins NB, Matulonis UA, Wagle N, Johnson BE, Rotem A, Rozenblatt-Rosen O, Regev A. Author Correction: A single-cell and single-nucleus RNA-Seq toolbox for fresh and frozen human tumors. Nat Med 2020; 26:1307. [PMID: 32587393 PMCID: PMC7417328 DOI: 10.1038/s41591-020-0976-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Collapse
Affiliation(s)
- Michal Slyper
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Caroline B M Porter
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Orr Ashenberg
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Julia Waldman
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Eugene Drokhlyansky
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Isaac Wakiro
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christopher Smillie
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | | | - Jingyi Wu
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Danielle Dionne
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Sébastien Vigneau
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Judit Jané-Valbuena
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Timothy L Tickle
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Sara Napolitano
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mei-Ju Su
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anand G Patel
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA.,Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Asa Karlstrom
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Simon Gritsch
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Masashi Nomura
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Avinash Waghray
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Satyen H Gohil
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alexander M Tsankov
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Livnat Jerby-Arnon
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Ofir Cohen
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Johanna Klughammer
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Yanay Rosen
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Joshua Gould
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Lan Nguyen
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Matan Hofree
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | | | - Bo Li
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Catherine J Wu
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Benjamin Izar
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA.,Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA.,Center for Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA.,Ludwig Center for Cancer Research at Harvard, Boston, MA, USA.,Melanoma Disease Center, Dana-Farber Cancer Institute, Boston, MA, USA.,Columbia Center for Translational Immunology and Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA
| | - Rizwan Haq
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Stephen Hodi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Melanoma Disease Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Charles H Yoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Surgical Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Aaron N Hata
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Suzanne J Baker
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Mario L Suvà
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Elizabeth H Stover
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael R Clay
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael A Dyer
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA.,Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Natalie B Collins
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Division of Pediatric Hematology and Oncology, Boston Children's Hospital, Boston, MA, USA
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nikhil Wagle
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Asaf Rotem
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Aviv Regev
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA. .,Howard Hughes Medical Institute, Chevy Chase, MD, USA. .,Koch Institute for Integrative Cancer Research, Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA.
| |
Collapse
|
69
|
Rotow JK, Costa DB, Paweletz CP, Awad MM, Marcoux P, Rangachari D, Barbie DA, Sands J, Cheng ML, Johnson BE, Oxnard GR, Jackman DM, Kwiatkowski DJ, Kehl KL, Izdebski MD, Lau CJ, Vasquez KA, Janne PA. Concurrent osimertinib plus gefitinib for first-line treatment of EGFR-mutated non-small cell lung cancer (NSCLC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9507] [Citation(s) in RCA: 14] [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: 11/20/2022] Open
Abstract
9507 Background: First-line treatment with an EGFR tyrosine kinase inhibitor (TKI) is standard of care for patients (pts) with EGFR-mutated NSCLC. The EGFR TKI osimertinib is active against the acquired gefitinib-resistant mutation EGFR T790M, as is gefitinib against the osimertinib-resistant EGFR C797S. Preclinical evidence suggests dual EGFR inhibition with gefitinib + osimertinib may delay emergence of acquired resistance. Methods: This ongoing phase I/II study enrolled pts with stage IV EGFR-mutated (L858R or del19) NSCLC, without prior therapy for metastatic disease. Treatment in dose escalation (n = 6): concurrent osimertinib 40 mg or 80 mg + gefitinib 250 mg daily. In dose expansion (n = 21): osimertinib + gefitinib at the maximum tolerated dose (MTD). Prior to protocol amendment 6 pts received alternating monthly cycles of TKI monotherapy and were excluded from this analysis. The primary endpoints in the dose escalation and expansion phases were, respectively, identification of the MTD and feasibility, defined as receipt of combination therapy for ≥ 6 four-week cycles. Secondary endpoints included overall response rate (ORR), survival outcomes, plasma EGFR mutation clearance (cell free DNA by droplet digital PCR (ddPCR)), and mechanisms of acquired resistance. Results: From May 2017 to July 2019 27 pts were enrolled and evaluable for the primary endpoints. The MTD was osimertinib 80 mg plus gefitinib 250 mg orally daily. In feasibility analysis, 81.5% completed ≥6 cycles combination therapy (1 pt discontinued for progression, 4 for toxicity). The ORR was 85.2% (95% CI 67.5%-94.1%). Best response: 85.2% partial response, 14.8% stable disease. The most common treatment-related adverse effects (TRAEs) (% any grade, % grade 3) were rash (96.3%, 3.7%), diarrhea (85.2%, 11.1%) and dry skin (70.4%, 0%). Plasma ddPCR (n = 25 pts) detected the driver EGFR mutation at baseline in 68% of pts. In these pts, plasma EGFR cleared to undetectable at 2 weeks treatment in 82.4%. At 14.8 months median follow up the median progression free survival was not yet reached. Conclusions: Combination therapy with osimertinib and gefitinib is tolerable for first-line treatment of EGFR-mutated NSCLC and resulted in rapid plasma clearance of the EGFR mutation. The observed ORR is consistent with previously reported first-line response rates to osimertinib. Analysis of survival outcomes and acquired resistance mechanisms are pending data maturity and will facilitate understanding of the role of first-line dual EGFR TKI therapy for this pt population. Clinical trial information: NCT03122717 .
Collapse
|
70
|
Kehl KL, Hassett MJ, Stafford KA, Xu W, Johnson BE, Schrag D. Development and validation of a novel EHR-based tumor progression outcome to support biomarker discovery. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e19297] [Citation(s) in RCA: 1] [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: 11/20/2022] Open
Abstract
e19297 Background: Obtaining clinical outcomes for analysis has historically been a critical barrier to cancer genomics research. EHRs could constitute an important data source to bridge this gap, but EHRs rarely capture structured outcomes such as cancer progression. Novel, robust methods are needed to capture clinically relevant outcomes from EHRs. Methods: Among patients with lung adenocarcinoma whose tumors were sequenced via the Dana Farber Cancer Institute/Brigham and Women’s PROFILE study from 2013-2018, imaging reports following first palliative-intent systemic therapy were annotated using natural language processing (NLP) models trained to capture cancer progression according to the structured “PRISSMM” framework. NLP-based cancer progression and imaging report frequency were jointly modeled using inverse-intensity weighted generalized estimated equations, censored at six months, to explore associations between alterations in lung cancer biomarkers (ALK, EGFR, ROS1, BRAF, KRAS, SMARCA4) and progression. Among patients with KRAS mutations who received immunotherapy, we also analyzed the association between STK11 mutations and progression. The novel outcome generated by the model – imaging report-based progression (iPROG) – corresponded to the difference in the mean log odds of progression per inverse-intensity weighted report associated with a given biomarker; it was reported as adjusted mean probability and in exponentiated form as an odds ratio (OR). Results: Among 690 patients with lung adenocarcinoma, associations between tumor mutations and the iPROG outcome are listed in the Table. Conclusions: A deep NLP model applied to EHR data can capture a novel cancer progression outcome, which is associated with known prognostic markers in lung cancer. Application of this method to large “real world” datasets, with attention to interactions between treatment and genomics, could speed biomarker discovery. [Table: see text]
Collapse
Affiliation(s)
| | | | | | - Wenxin Xu
- Beth Israel Deaconess Medical Center, Boston, MA
| | | | | |
Collapse
|
71
|
Planchard D, Besse B, Groen H, Hashemi SMS, Mazieres J, Kim TM, Quoix EA, Souquet PJ, Barlesi F, Baik CS, Villaruz LC, Kelly RJ, Zhang S, Tan M, Gasal E, Santarpia L, Johnson BE. Updated overall survival (OS) and genomic analysis from a single-arm phase II study of dabrafenib (D) + trametinib (T) in patients (pts) with BRAF V600E mutant (Mut) metastatic non-small cell lung cancer (NSCLC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9593] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9593 Background: The phase II multicenter, open label study, which evaluated efficacy and safety of D+T in pretreated (cohort B) and treatment (tx)-naive (cohort C) pts with BRAF V600E mut metastatic NSCLC. The results of the primary analysis have been reported. Here, we present an updated survival and genomic analysis data for cohorts B and C. Methods: Tx-naïve (n=36) and pretreated (n=57) pts received D 150 mg twice daily + T 2 mg daily. Primary objective: ORR, secondary objectives: PFS, DOR, OS, safety, tolerability and PK of D+T. Tumor samples were centrally tested using a NGS cancer targeted panel (Oncomine Dx Target test, ThermoFisher Scientific). KM curves and Cox regression models were used to evaluate potential associations between baseline genomic landscape and pt efficacy endpoints. Results: As of June 22, 2019, median (m) follow-up was 16.3 mo in tx-naïve pts and 16.6 mo in pretreated pts. mOS was 17.3 mo (95% CI: 12.3, 40.2; 3 yr OS: 40%) and 18.2 mo (95% CI: 14.3, 28.6; 3 yr OS: 33%) with 14/36 and 11/57 pts alive in tx naïve and pretreated pts respectively. Detailed efficacy results are presented in table. 57/62 tumor samples retrieved from 93 pts were centrally confirmed to have BRAF V600E mut; 5 non-confirmed BRAF tumors (3 pts had PR) were positive for c-MET T1010I, KRAS G12V, ALK fusion and 2 JAK3 S493C with mPFS of 13.8 mo while OS was NE due to limited data points. Eleven pts (18%) had concomitant somatic mutations and/or genetic alterations in addition to BRAF V600E mut: 4 had alterations within PI3K pathway4 had concomitant mutations at IDH1 R132X, and 3 pts had additional mutations at BRAF G466V, KRAS G13C and a cMET exon 14 skipping, respectively. Pts whose tumors had concomitant genetic alterations, particularly in PI3K pathway, showed a trend towards decreased PFS and OS. Safety profile was similar to previous reported results. Conclusions: This update of BRF113928 study reported improved and durable OS rates with combination D+T in BRAF V600E mut NSCLC pts. Co-occurring genetic alterations might influence clinical outcomes of such pts. Further validation is ongoing to corroborate current genomic findings. Clinical trial information: NCT01336634 . [Table: see text]
Collapse
Affiliation(s)
| | | | - Harry Groen
- University of Groningen and University Medical Centre Groningen, Groningen, Netherlands
| | | | | | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | | | | | - Fabrice Barlesi
- Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Liza C Villaruz
- University of Pittsburgh Medical Center-Hillman Cancer Center, Pittsburgh, PA
| | | | - Shirong Zhang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Monique Tan
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Eduard Gasal
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | | | |
Collapse
|
72
|
Kabraji SK, Spurr LF, Hughes ME, Li YY, Leone JP, Garrido-Castro AC, Barroso-Sousa R, Files J, Kirkner G, Johnson BE, Winer EP, Cherniack AD, Lin NU. Genomic profiling of breast cancer brain metastases reveals targetable alterations. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.2525] [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
2525 Background: Genomic characterization of breast cancer brain metastases (BCBMs) has thus far been limited. The objective of this study was to describe the landscape of genomic alterations in patients (pts) with BCBMs. Methods: Targeted next-generation DNA sequencing of > 300 cancer-related genes (OncoPanel) was prospectively performed on primary and metastatic (met) tumors in 321 pts with a diagnosis of BCBM between August 2016 and April 2019 at Dana-Farber Cancer Institute (table). Enrichment analysis of genomic alterations was performed using a two-sided Fisher exact test and differences in tumor mutation burden (TMB) between groups were assessed using two-sided Mann-Whitney U test. Multiple comparison correction was performed using the Benjamini-Hochberg procedure. Results: All subtypes were represented in BCBM (25 HR+/HER2-; 24 HR+/HER2+; 27 HR-/HER2+; 18 TNBC; 5 unknown; n = 99) and extracranial (EC) samples: (96 HR+/HER2-; 32 HR+/HER2+; 22 HR-/HER2+; 41 TNBC; 31 unknown; n = 222). BCBMs were found most commonly to have mutations or copy number alterations in TP53, ERBB2, PIK3CA, GATA3, PTEN, ESR1, CDH1, BRCA2, ARID1A, BRCA1 (>5% frequency, table). Two pts acquired ERBB2 amplification (amp) between the matched primary breast sample and brain met. In pair-wise comparisons of BCBMs to unmatched primaries or EC mets, only ERBB2 amp was significantly enriched (table, † = adjusted p < 0.05). There was no significant difference in TMB between BCBM and EC mets (median 9.12 vs 7.26, p = 0.15). In contrast, TMB was significantly higher in BCBMs compared to unmatched primaries (median 9.12 vs 7.26, p=0.005). Conclusions: BCBMs display similar mutations and copy number alterations compared to primary tumors and EC mets in pts with BCBM. These data suggest that BCBMs contain actionable genomic alterations that are most often also reflected in EC disease. Alterations in ERBB2, PIK3CA/PTEN, and BRCA1/2 represent potentially targetable alterations in pts with BCBM. [Table: see text]
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Eric P. Winer
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | | |
Collapse
|
73
|
Slyper M, Porter CBM, Ashenberg O, Waldman J, Drokhlyansky E, Wakiro I, Smillie C, Smith-Rosario G, Wu J, Dionne D, Vigneau S, Jané-Valbuena J, Tickle TL, Napolitano S, Su MJ, Patel AG, Karlstrom A, Gritsch S, Nomura M, Waghray A, Gohil SH, Tsankov AM, Jerby-Arnon L, Cohen O, Klughammer J, Rosen Y, Gould J, Nguyen L, Hofree M, Tramontozzi PJ, Li B, Wu CJ, Izar B, Haq R, Hodi FS, Yoon CH, Hata AN, Baker SJ, Suvà ML, Bueno R, Stover EH, Clay MR, Dyer MA, Collins NB, Matulonis UA, Wagle N, Johnson BE, Rotem A, Rozenblatt-Rosen O, Regev A. A single-cell and single-nucleus RNA-Seq toolbox for fresh and frozen human tumors. Nat Med 2020; 26:792-802. [PMID: 32405060 PMCID: PMC7220853 DOI: 10.1038/s41591-020-0844-1] [Citation(s) in RCA: 287] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/20/2020] [Indexed: 01/20/2023]
Abstract
Single-cell genomics is essential to chart tumor ecosystems. Although single-cell RNA-Seq (scRNA-Seq) profiles RNA from cells dissociated from fresh tumors, single-nucleus RNA-Seq (snRNA-Seq) is needed to profile frozen or hard-to-dissociate tumors. Each requires customization to different tissue and tumor types, posing a barrier to adoption. Here, we have developed a systematic toolbox for profiling fresh and frozen clinical tumor samples using scRNA-Seq and snRNA-Seq, respectively. We analyzed 216,490 cells and nuclei from 40 samples across 23 specimens spanning eight tumor types of varying tissue and sample characteristics. We evaluated protocols by cell and nucleus quality, recovery rate and cellular composition. scRNA-Seq and snRNA-Seq from matched samples recovered the same cell types, but at different proportions. Our work provides guidance for studies in a broad range of tumors, including criteria for testing and selecting methods from the toolbox for other tumors, thus paving the way for charting tumor atlases.
Collapse
Affiliation(s)
- Michal Slyper
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Caroline B M Porter
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Orr Ashenberg
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Julia Waldman
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Eugene Drokhlyansky
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Isaac Wakiro
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christopher Smillie
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | | | - Jingyi Wu
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Danielle Dionne
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Sébastien Vigneau
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Judit Jané-Valbuena
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Timothy L Tickle
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Sara Napolitano
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mei-Ju Su
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anand G Patel
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Asa Karlstrom
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Simon Gritsch
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Masashi Nomura
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Avinash Waghray
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Satyen H Gohil
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alexander M Tsankov
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Livnat Jerby-Arnon
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Ofir Cohen
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Johanna Klughammer
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Yanay Rosen
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Joshua Gould
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Lan Nguyen
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Matan Hofree
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | | | - Bo Li
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Catherine J Wu
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Benjamin Izar
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
- Center for Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA
- Ludwig Center for Cancer Research at Harvard, Boston, MA, USA
- Melanoma Disease Center, Dana-Farber Cancer Institute, Boston, MA, USA
- Columbia Center for Translational Immunology and Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA
| | - Rizwan Haq
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Stephen Hodi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Melanoma Disease Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Charles H Yoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Surgical Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Aaron N Hata
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Suzanne J Baker
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Mario L Suvà
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Elizabeth H Stover
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael R Clay
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael A Dyer
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Natalie B Collins
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Division of Pediatric Hematology and Oncology, Boston Children's Hospital, Boston, MA, USA
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nikhil Wagle
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Asaf Rotem
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Aviv Regev
- Klarman Cell Observatory, Broad Institute of Harvard and MIT, Cambridge, MA, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD, USA.
- Koch Institute for Integrative Cancer Research, Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA.
| |
Collapse
|
74
|
Rozenblatt-Rosen O, Regev A, Oberdoerffer P, Nawy T, Hupalowska A, Rood JE, Ashenberg O, Cerami E, Coffey RJ, Demir E, Ding L, Esplin ED, Ford JM, Goecks J, Ghosh S, Gray JW, Guinney J, Hanlon SE, Hughes SK, Hwang ES, Iacobuzio-Donahue CA, Jané-Valbuena J, Johnson BE, Lau KS, Lively T, Mazzilli SA, Pe'er D, Santagata S, Shalek AK, Schapiro D, Snyder MP, Sorger PK, Spira AE, Srivastava S, Tan K, West RB, Williams EH. The Human Tumor Atlas Network: Charting Tumor Transitions across Space and Time at Single-Cell Resolution. Cell 2020; 181:236-249. [PMID: 32302568 PMCID: PMC7376497 DOI: 10.1016/j.cell.2020.03.053] [Citation(s) in RCA: 257] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 12/22/2022]
Abstract
Crucial transitions in cancer-including tumor initiation, local expansion, metastasis, and therapeutic resistance-involve complex interactions between cells within the dynamic tumor ecosystem. Transformative single-cell genomics technologies and spatial multiplex in situ methods now provide an opportunity to interrogate this complexity at unprecedented resolution. The Human Tumor Atlas Network (HTAN), part of the National Cancer Institute (NCI) Cancer Moonshot Initiative, will establish a clinical, experimental, computational, and organizational framework to generate informative and accessible three-dimensional atlases of cancer transitions for a diverse set of tumor types. This effort complements both ongoing efforts to map healthy organs and previous large-scale cancer genomics approaches focused on bulk sequencing at a single point in time. Generating single-cell, multiparametric, longitudinal atlases and integrating them with clinical outcomes should help identify novel predictive biomarkers and features as well as therapeutically relevant cell types, cell states, and cellular interactions across transitions. The resulting tumor atlases should have a profound impact on our understanding of cancer biology and have the potential to improve cancer detection, prevention, and therapeutic discovery for better precision-medicine treatments of cancer patients and those at risk for cancer.
Collapse
Affiliation(s)
| | - Aviv Regev
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Koch Institute for Integrative Cancer Research, Department of Biology, MIT, Cambridge, MA 02139, USA.
| | - Philipp Oberdoerffer
- Division of Cancer Biology, National Cancer Institute, NIH, Rockville, MD 20850, USA
| | - Tal Nawy
- Computational and Systems Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Anna Hupalowska
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Jennifer E Rood
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Orr Ashenberg
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Ethan Cerami
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Robert J Coffey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Emek Demir
- Department of Molecular and Medical Genetics, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Li Ding
- Department of Medicine, McDonnell Genome Institute, and Siteman Cancer Center, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Edward D Esplin
- Department of Genetics, Stanford School of Medicine, Stanford, CA 94305, USA
| | - James M Ford
- Department of Genetics, Stanford School of Medicine, Stanford, CA 94305, USA; Department of Medicine, Oncology Division, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jeremy Goecks
- Computational Biology Program, Oregon Health and Science University, OR 97201, USA
| | - Sharmistha Ghosh
- Division of Cancer Prevention, National Cancer Institute, NIH, Rockville, MD 20850, USA
| | - Joe W Gray
- Center for Spatial Systems Biomedicine, Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97201, USA
| | - Justin Guinney
- Sage Bionetworks, Seattle, WA 98121, USA; Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, USA
| | - Sean E Hanlon
- Center for Strategic Scientific Initiatives, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Shannon K Hughes
- Division of Cancer Biology, National Cancer Institute, NIH, Rockville, MD 20850, USA
| | - E Shelley Hwang
- Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA; Women's Cancer Program, Duke Cancer Institute, Duke University, Durham, NC 27710, USA
| | - Christine A Iacobuzio-Donahue
- David M. Rubenstein Center for Pancreatic Cancer Research, Human Oncology and Pathogenesis Program, and Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | - Bruce E Johnson
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450 Brookline Avenue, Boston, MA 02215, USA
| | - Ken S Lau
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Tracy Lively
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, Rockville, MD 20850, USA
| | - Sarah A Mazzilli
- Department of Medicine, Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Dana Pe'er
- Computational and Systems Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Sandro Santagata
- Ludwig Center for Cancer Research and Laboratory of Systems Pharmacology, Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alex K Shalek
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Institute for Medical Engineering and Science, Department of Chemistry, and Koch Institute for Integrative Cancer Research, MIT, Cambridge, MA 02139, USA; Ragon Institute of Massachusetts General Hospital, MIT and Harvard University, Cambridge, MA 02139, USA; Division of Health Sciences and Technology, Harvard Medical School, Boston, MA 02115, USA; Department of Immunology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Denis Schapiro
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Ludwig Center for Cancer Research and Laboratory of Systems Pharmacology, Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Michael P Snyder
- Department of Genetics, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Peter K Sorger
- Ludwig Center for Cancer Research and Laboratory of Systems Pharmacology, Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Avrum E Spira
- Department of Medicine, Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA 02118, USA; Johnson & Johnson, Cambridge, MA 02142, USA
| | - Sudhir Srivastava
- Division of Cancer Prevention, National Cancer Institute, NIH, Rockville, MD 20850, USA
| | - Kai Tan
- Division of Oncology and Center for Childhood Cancer Research, 4004 CTRB, Children's Hospital of Philadelphia, 3501 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Robert B West
- Department of Pathology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Elizabeth H Williams
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Present address: Foundation Medicine, Cambridge, MA 02141, USA
| |
Collapse
|
75
|
Shih DJH, Nayyar N, Bihun I, Dagogo-Jack I, Gill CM, Aquilanti E, Bertalan M, Kaplan A, D'Andrea MR, Chukwueke U, Ippen FM, Alvarez-Breckenridge C, Camarda ND, Lastrapes M, McCabe D, Kuter B, Kaufman B, Strickland MR, Martinez-Gutierrez JC, Nagabhushan D, De Sauvage M, White MD, Castro BA, Hoang K, Kaneb A, Batchelor ED, Paek SH, Park SH, Martinez-Lage M, Berghoff AS, Merrill P, Gerstner ER, Batchelor TT, Frosch MP, Frazier RP, Borger DR, Iafrate AJ, Johnson BE, Santagata S, Preusser M, Cahill DP, Carter SL, Brastianos PK. Genomic characterization of human brain metastases identifies drivers of metastatic lung adenocarcinoma. Nat Genet 2020; 52:371-377. [PMID: 32203465 PMCID: PMC7136154 DOI: 10.1038/s41588-020-0592-7] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 02/18/2020] [Indexed: 01/08/2023]
Abstract
Brain metastases from lung adenocarcinoma (BM-LUAD) frequently cause patient mortality. To identify genomic alterations that promote brain metastases, we performed whole-exome sequencing of 73 BM-LUAD cases. Using case-control analyses, we discovered candidate drivers of brain metastasis by identifying genes with more frequent copy-number aberrations in BM-LUAD compared to 503 primary LUADs. We identified three regions with significantly higher amplification frequencies in BM-LUAD, including MYC (12 versus 6%), YAP1 (7 versus 0.8%) and MMP13 (10 versus 0.6%), and significantly more frequent deletions in CDKN2A/B (27 versus 13%). We confirmed that the amplification frequencies of MYC, YAP1 and MMP13 were elevated in an independent cohort of 105 patients with BM-LUAD. Functional assessment in patient-derived xenograft mouse models validated the notion that MYC, YAP1 or MMP13 overexpression increased the incidence of brain metastasis. These results demonstrate that somatic alterations contribute to brain metastases and that genomic sequencing of a sufficient number of metastatic tumors can reveal previously unknown metastatic drivers.
Collapse
Affiliation(s)
- David J H Shih
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Naema Nayyar
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
- Program in Molecular Medicine, UMass Medical School, Worcester, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Ivanna Bihun
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Corey M Gill
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Elisa Aquilanti
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mia Bertalan
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Alexander Kaplan
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Megan R D'Andrea
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Ugonma Chukwueke
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Franziska Maria Ippen
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Nicholas D Camarda
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matthew Lastrapes
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Devin McCabe
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ben Kuter
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin Kaufman
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matthew R Strickland
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Juan Carlos Martinez-Gutierrez
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Deepika Nagabhushan
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Magali De Sauvage
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Michael D White
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Brandyn A Castro
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Kaitlin Hoang
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew Kaneb
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Emily D Batchelor
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Sun Ha Paek
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
- Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea
| | - Sun Hye Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
- Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Anna S Berghoff
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Center Vienna, Vienna, Austria
| | - Parker Merrill
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Tracy T Batchelor
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew P Frosch
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Ryan P Frazier
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Darrell R Borger
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - A John Iafrate
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sandro Santagata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
- Ludwig Center at Harvard Medical School, Boston, MA, USA
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Comprehensive Cancer Center Vienna, Vienna, Austria
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Scott L Carter
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA.
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Priscilla K Brastianos
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA.
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| |
Collapse
|
76
|
Kehl KL, Lathan CS, Johnson BE, Schrag D. Race, Poverty, and Initial Implementation of Precision Medicine for Lung Cancer. J Natl Cancer Inst 2020; 111:431-434. [PMID: 30576459 DOI: 10.1093/jnci/djy202] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/13/2018] [Accepted: 10/19/2018] [Indexed: 01/15/2023] Open
Abstract
Data are limited regarding whether the availability of biomarker-directed therapy for lung cancer exacerbates racial and socioeconomic disparities. Patients diagnosed with stage IV lung adenocarcinoma from 2008 to 2013 were identified using Surveillance, Epidemiology, and End Results Program-Medicare. The primary outcome was a Medicare claim for molecular testing within 60 days of diagnosis, analyzed using multivariable logistic regression; the secondary outcome was overall survival, analyzed using multivariable Cox proportional hazards models. All statistical tests were two-sided. Of 5556 patients, 1437 (25.9%) had molecular testing. Testing rates were 14.1% among black, 26.2% among white, and 32.8% among patients of Asian/other descent (adjusted P < .001); 20.6% among patients with Medicaid eligibility vs 28.4% among those without (adjusted P = .01); and 19.9% among patients in the highest census tract-level poverty rate quintile vs 30.7% among patients in the lowest quintile (for all quintiles, adjusted P = .18). Median survival from 60 days was 8.2 months among patients with molecular testing within 60 days of diagnosis and 6.1 months among those without (hazard ratio = 0.92, 95% confidence interval = 0.86 to 0.99; adjusted P = .02). Equitable precision medicine requires concerted implementation efforts.
Collapse
Affiliation(s)
- Kenneth L Kehl
- Division of Population Sciences.,Thoracic Oncology Program, Dana-Farber Cancer Institute, Boston, MA
| | - Christopher S Lathan
- Division of Population Sciences.,Thoracic Oncology Program, Dana-Farber Cancer Institute, Boston, MA
| | - Bruce E Johnson
- Thoracic Oncology Program, Dana-Farber Cancer Institute, Boston, MA
| | | |
Collapse
|
77
|
Kamran SC, Coroller T, Milani N, Agrawal V, Baldini EH, Chen AB, Johnson BE, Kozono D, Franco I, Chopra N, Zeleznik R, Aerts HJWL, Mak R. The impact of quantitative CT-based tumor volumetric features on the outcomes of patients with limited stage small cell lung cancer. Radiat Oncol 2020; 15:14. [PMID: 31937336 PMCID: PMC6961251 DOI: 10.1186/s13014-020-1460-4] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/06/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Limited stage small cell lung cancer (LS-SCLC) has a poor prognosis. Additional prognostic markers are needed for risk-stratification and treatment intensification. This study compares quantitative CT-based volumetric tumor measurements versus International Association for the Study of Lung Cancer (IASLC) TNM staging to predict outcomes. MATERIALS & METHODS A cohort of 105 patients diagnosed with LS-SCLC and treated with chemoradiation (CRT) from 2000 to 2013 were analyzed retrospectively. Patients were staged by the Union for International Cancer Control (UICC) TNM Classification, 8th edition. Tumor volumes and diameters were extracted from radiation planning CT imaging. Univariable and multivariable models were used to analyze relationships between CT features and overall survival (OS), locoregional recurrence (LRR), in-field LRR, any progression, and distant metastasis (DM). RESULTS Median follow-up was 21.3 months. Two-year outcomes were as follows: 38% LRR, 31% in-field LRR, 52% DM, 62% any progression, and 47% OS (median survival 16.5 months). On univariable analysis, UICC T-stage and N-stage were not associated with any clinical outcome. UICC overall stage was only statistically associated with in-field LRR. One imaging feature (3D maximum tumor diameter) was found to be significantly associated with LRR (HR 1.10, p = 0.003), in-field LRR (HR 1.10, p = 0.007), DM (HR 1.10, p = 0.02), any progression (HR 1.10, p = 0.008), and OS (HR 1.10, p = 0.03). On multivariable analysis, this feature remained significantly associated with all outcomes. CONCLUSION For LS-SCLC, quantitative CT-based volumetric tumor measurements were significantly associated with outcomes after CRT and may be better predictors of outcome than TNM stage.
Collapse
Affiliation(s)
- Sophia C Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Cox 3, Boston, MA, 02114, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Thibaud Coroller
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Nastaran Milani
- Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Vishesh Agrawal
- Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Elizabeth H Baldini
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | | | - Bruce E Johnson
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - David Kozono
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Idalid Franco
- Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Nitish Chopra
- Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Roman Zeleznik
- Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Hugo J W L Aerts
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Raymond Mak
- Harvard Medical School, Boston, MA, USA. .,Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.
| |
Collapse
|
78
|
Johnson BE, Kim TM, Hiltermann TJN, Barlesi F, Grohe C, Goto Y, Gunnarsson O, Overbeck T, Reguart N, Wermke M, Castro G, Felip E, Greystoke A, Solomon BJ, Nebot N, Deudon S, Louveau AL, Passos VQ, Tan DSW. Abstract C100: Safety run-in results from phase 3 study of canakinumab (CAN) or placebo in combination with pembrolizumab (PEM) plus platinum-based doublet chemotherapy (Ctx) as 1st line therapy in patients (pts) with advanced or metastatic NSCLC (CANOPY-1). Mol Cancer Ther 2019. [DOI: 10.1158/1535-7163.targ-19-c100] [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
Cytokine interleukin-1β (IL-1β) has multiple pro-tumorogenic effects on tumor microenvironment, thereby promoting carcinogenesis, tumor invasiveness, and immunosuppression. CAN is a selective IL-1β inhibitor that aims to target tumor-promoting inflammation to reduce immune suppression, thereby potentiating effects of immunotherapy with PD-1 inhibitors such as PEM. Results of phase 3 CANTOS study have shown that IL-1β inhibition with CAN was associated with reduced incidence of lung cancer and lung cancer mortality, thus providing a rationale to investigate therapeutic role of CAN in lung cancer. CANOPY-1 (NCT03631199) is a placebo-controlled, double-blind, randomized, phase 3 trial designed to evaluate efficacy and safety of PEM + Ctx ± CAN in previously untreated pts with stage IIIB/IIIC (not eligible for definitive chemo-radiation curative tx) or stage IV squamous and nonsquamous NSCLC. The study was divided into 2 parts: part 1 is non-randomized, safety run-in part where pts received CAN 200 mg s.c Q3W + PEM 200 mg i.v Q3W + platinum-based Ctx [Cohort A (non-squamous), carboplatin + pemetrexed; Cohort B (non-squamous), cisplatin + pemetrexed; Cohort C (squamous or non-squamous), carboplatin + paclitaxel]. Part 2 of the study randomizes pts to evaluate efficacy and safety of CAN combination regimen vs placebo combination regimen. Primary objective of safety run-in part: RP3R for CAN in combination with PEM + Ctx. Secondary objectives: ORR, DCR, DOR, safety, PK, and immunogenicity. As of 14 May 2019 (follow-up of ≥42 days from C1D1 unless pt discontinued earlier), 10 pts in cohort A (A), 11 pts in cohort B (B), and 9 pts in cohort C (C) were treated, of which 73% were male, median age was 63 yrs. In total, 24/30 (80%) pts enrolled were still receiving tx; primary reason for tx discontinuation was progressive disease (5 pts; 3 pts in A and 1 pt each in B and C) and 1 patient died due to study indication. Dose-limiting toxicity (DLT) occurring during first 42 days of study tx was reported only in 1 pt (cohort C: grade 3 hepatitis, not related to CAN). Recommended phase 3 regimen (RP3R) of CAN in combination with standard dose of PEM + Ctx was confirmed as 200 mg SC Q3W based on Bayesian logistic regression model (BLRM). Serious AEs regardless of study drug relationship were reported in 8 (27%) pts (2 pts in A and 3 pts each in B and C), none of which considered to be related to CAN. Most common AEs (≥20%, any grade) across all cohorts (n=30) were nausea (37%), vomiting (30%), constipation and fatigue (each 23%), and neutrophil count decrease (20%). Overall, 14 pts (47%) experienced grade 3 AEs and 1 pt experienced grade 4 AE (cardiac tamponade unrelated to study drugs). No fatal serious AEs were reported. AEs leading to discontinuation of one of the study drugs were reported in 3 (10%) pts (hepatitis, peripheral neuropathy, and polyneuropathy) but none were CAN related. AEs leading to dose reduction and dose interruption of one of study drugs were reported in 3 (10%) pts and 5 (17%) pts, respectively. Only 1 DLT was reported with this triplet combination of CAN + PEM + Ctx. Based on BLRM and all relevant data, the RP3R of CAN as 200 mg SC Q3W combination was considered safe and well tolerated. Enrolment is ongoing in randomized phase 3 part of study to evaluate efficacy and safety.
Citation Format: Bruce E. Johnson, Tae Min Kim, T. Jeroen N. Hiltermann, Fabrice Barlesi, Christian Grohe, Yasushi Goto, Orvar Gunnarsson, Tobias Overbeck, Noemi Reguart, Martin Wermke, Gilberto Castro, Enriqueta Felip, Alastair Greystoke, Benjamin J. Solomon, Noelia Nebot, Stephanie Deudon, Anne-Laure Louveau, Vanessa Q. Passos, Daniel SW Tan. Safety run-in results from phase 3 study of canakinumab (CAN) or placebo in combination with pembrolizumab (PEM) plus platinum-based doublet chemotherapy (Ctx) as 1st line therapy in patients (pts) with advanced or metastatic NSCLC (CANOPY-1) [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr C100. doi:10.1158/1535-7163.TARG-19-C100
Collapse
Affiliation(s)
| | | | | | - Fabrice Barlesi
- 4Aix-Marseille University, CNRS, INSERM, CNRS, Assistance Publique Hôpitaux de Marseille, Marseille
| | | | | | | | - Tobias Overbeck
- 8University Hospital Göttingen - University Medical Centre Göttingen, Göttingen
| | - Noemi Reguart
- 9Hospital Clinic i Provincial de Barcelona, Barcelona
| | | | | | | | | | | | - Noelia Nebot
- 15Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | | | | | | | |
Collapse
|
79
|
Kehl KL, Elmarakeby H, Nishino M, Van Allen EM, Lepisto EM, Hassett MJ, Johnson BE, Schrag D. Assessment of Deep Natural Language Processing in Ascertaining Oncologic Outcomes From Radiology Reports. JAMA Oncol 2019; 5:1421-1429. [PMID: 31343664 DOI: 10.1001/jamaoncol.2019.1800] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance A rapid learning health care system for oncology will require scalable methods for extracting clinical end points from electronic health records (EHRs). Outside of clinical trials, end points such as cancer progression and response are not routinely encoded into structured data. Objective To determine whether deep natural language processing can extract relevant cancer outcomes from radiologic reports, a ubiquitous but unstructured EHR data source. Design, Setting, and Participants A retrospective cohort study evaluated 1112 patients who underwent tumor genotyping for a diagnosis of lung cancer and participated in the Dana-Farber Cancer Institute PROFILE study from June 26, 2013, to July 2, 2018. Exposures Patients were divided into curation and reserve sets. Human abstractors applied a structured framework to radiologic reports for the curation set to ascertain the presence of cancer and changes in cancer status over time (ie, worsening/progressing vs improving/responding). Deep learning models were then trained to capture these outcomes from report text and subsequently evaluated in a 10% held-out test subset of curation patients. Cox proportional hazards regression models compared human and machine curations of disease-free survival, progression-free survival, and time to improvement/response in the curation set, and measured associations between report classification and overall survival in the curation and reserve sets. Main Outcomes and Measures The primary outcome was area under the receiver operating characteristic curve (AUC) for deep learning models; secondary outcomes were time to improvement/response, disease-free survival, progression-free survival, and overall survival. Results A total of 2406 patients were included (mean [SD] age, 66.5 [10.8] years; 1428 female [59.7%]; 2170 [90.2%] white). Radiologic reports (n = 14 230) were manually reviewed for 1112 patients in the curation set. In the test subset (n = 109), deep learning models identified the presence of cancer, improvement/response, and worsening/progression with accurate discrimination (AUC >0.90). Machine and human curation yielded similar measurements of disease-free survival (hazard ratio [HR] for machine vs human curation, 1.18; 95% CI, 0.71-1.95); progression-free survival (HR, 1.11; 95% CI, 0.71-1.71); and time to improvement/response (HR, 1.03; 95% CI, 0.65-1.64). Among 15 000 additional reports for 1294 reserve set patients, algorithm-detected cancer worsening/progression was associated with decreased overall survival (HR for mortality, 4.04; 95% CI, 2.78-5.85), and improvement/response was associated with increased overall survival (HR, 0.41; 95% CI, 0.22-0.77). Conclusions and Relevance Deep natural language processing appears to speed curation of relevant cancer outcomes and facilitate rapid learning from EHR data.
Collapse
Affiliation(s)
- Kenneth L Kehl
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Thoracic Oncology Program, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Haitham Elmarakeby
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Eva M Lepisto
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Informatics, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Michael J Hassett
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Bruce E Johnson
- Thoracic Oncology Program, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Deborah Schrag
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| |
Collapse
|
80
|
Guo R, Berry LD, Aisner DL, Sheren J, Boyle T, Bunn PA, Johnson BE, Kwiatkowski DJ, Drilon A, Sholl LM, Kris MG. MET IHC Is a Poor Screen for MET Amplification or MET Exon 14 Mutations in Lung Adenocarcinomas: Data from a Tri-Institutional Cohort of the Lung Cancer Mutation Consortium. J Thorac Oncol 2019; 14:1666-1671. [PMID: 31228623 DOI: 10.1016/j.jtho.2019.06.009] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [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: 04/26/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION MNNG HOS Transforming gene (MET) amplification and MET exon 14 (METex14) alterations in lung cancers affect sensitivity to MET proto-oncogene, receptor tyrosine kinase (MET [also known by the alias hepatocyte growth factor receptor]) inhibitors. Fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), and immunohistochemistry (IHC) have been used to evaluate MET dependency. Here, we have determined the association of MET IHC with METex14 mutations and MET amplification. METHODS We collected data on a tri-institutional cohort from the Lung Cancer Mutation Consortium. All patients had metastatic lung adenocarcinomas and no prior targeted therapies. MET IHC positivity was defined by an H-score of 200 or higher using SP44 antibody. MET amplification was defined by copy number fold change of 1.8x or more with use of NGS or a MET-to-centromere of chromosome 7 ratio greater than 2.2 with use of FISH. RESULTS We tested tissue from 181 patients for MET IHC, MET amplification, and METex14 mutations. Overall, 71 of 181 patients (39%) were MET IHC-positive, three of 181 (2%) were MET-amplified, and two of 181 (1%) harbored METex14 mutations. Of the MET-amplified cases, two were FISH positive with MET-to-centromere of chromosome 7 ratios of 3.1 and 3.3, one case was NGS positive with a fold change of 4.4x, and one of the three cases was MET IHC-positive. Of the 71 IHC-positive cases, one (1%) was MET-amplified and two (3%) were METex14-mutated. Of the MET IHC-negative cases, two of 110 (2%) were MET-amplified. CONCLUSIONS In this study, nearly all MET IHC-positive cases were negative for MET amplification or METex14 mutations. MET IHC can also miss patients with MET amplification. The limited number of MET-amplified cases in this cohort makes it challenging to demonstrate an association between MET IHC and MET amplification. Nevertheless, IHC appears to be an inefficient screen for these genomic changes. MET amplification or METex14 mutations can best be detected by FISH and a multiplex NGS panel.
Collapse
Affiliation(s)
- Robin Guo
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Lynne D Berry
- Center for Quantitative Sciences, Vanderbilt University, Nashville, Tennessee
| | - Dara L Aisner
- Department of Pathology, University of Colorado, Aurora, Colorado
| | - Jamie Sheren
- Department of Pathology, University of Colorado, Aurora, Colorado
| | - Theresa Boyle
- Department of Molecular Pathology, Moffitt Cancer Center, Tampa, Florida
| | - Paul A Bunn
- Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado
| | - Bruce E Johnson
- Department of Medical Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Alexander Drilon
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
| |
Collapse
|
81
|
Garrido-Castro AC, Spurr L, Hughes ME, Li YY, Cherniack AD, Bychkovsky BL, Barroso-Sousa R, Di Lascio S, Files J, Kumari P, Cerami E, Krop IE, MacConaill LE, Lindeman NI, Rollins BJ, Johnson BE, Wagle N, Winer EP, Dillon D, Lin NU. Genomic landscape of de novo stage IV breast cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1022 Background: Genomic profiling of primary and recurrent metastatic breast cancer (rMBC) has revealed potential resistance mechanisms to therapy. In contrast, de novo stage IV breast cancer (DNIV) represents an opportunity to elucidate metastatic drivers in the absence of treatment selection. Methods: Targeted NGS (Oncopanel, OP) using multiplexed copy number variation (CNV) and mutation (mut) detection across the full coding regions of 300 genes and selected intronic regions of 35 genes was performed on either primary or metastatic samples collected in patients (pts) with DNIV or rMBC. Mut/CNV in primary and metastatic tumors were compared per subtype between DNIV and rMBC using Fisher´s exact test (significant p<0.05). FDR were computed ( q<0.25). Results: Between 8/2013-9/2016, of 929 pts who underwent OP testing 212 presented with DNIV; 136 HR+/HER2- (64%); 35 HR+/HER2+ (17%); 25 TNBC (12%); 16 HR-/HER2+ (8%). In 168 (79%) pts, the primary was tested; 44 had a metastatic site tested. Comparison of primary HR+/HER2- tumors showed that DNIV pts were more likely to harbor mut in CDKN1B, SETD2 and PMS2 and less likely to have TP53 mut than rMBC (Table). Metastases in HR+/HER2- DNIV (n=29) had higher mut in CDH1, PTCH1 and CTNNB1 and fewer CCND1 amplification (amp) than rMBC (n=121), albeit these findings lost significance after FDR correction. DNIV primary TNBC (n=19) was significantly enriched for CIITA mut (26% vs. 0%; q=0.046) and MYB amp (21% vs. 0%, q=0.098) compared to rMBC (n=101). TP53 mut, amp in RAD21, MYC, MYB, PTK2 and EGFR, and deletions in CDKN2A/2B and MAP2K4 significantly predicted poorer overall survival in DNIV. Conclusions: DNIV primary and metastatic tumors have distinct genomic profiles compared to rMBC. Alterations in genes involved in epigenetic modulation ( KMT2D, SETD2) and epithelial-mesenchymal transition ( CDH1, PTCH1, CTNNB1) are more prevalent in HR+/HER2- DNIV. DNIV TNBC is enriched for CIITA mut, described to promote immune escape via reduced MHC class II expression. If validated, these findings may provide insight into mechanisms underlying metastatic potential. [Table: see text]
Collapse
Affiliation(s)
| | - Liam Spurr
- Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | - Simona Di Lascio
- Oncological Institute Of Southern Switzerland, Bellinzona, Switzerland
| | | | | | | | | | - Laura E MacConaill
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | | | | |
Collapse
|
82
|
Kwiatkowski DJ, Rusch VW, Chaft JE, Johnson BE, Nicholas A, Wistuba II, Merritt R, Lee JM, Bunn PA, Tang Y, Phan SC, Waqar SN, Patterson A, Haura EB, Toloza EM, Reckamp KL, Raz D, Schulze K, Johnson A, Carbone DP. Neoadjuvant atezolizumab in resectable non-small cell lung cancer (NSCLC): Interim analysis and biomarker data from a multicenter study (LCMC3). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.8503] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
8503 Background: Small pilot studies (e.g., N Engl J Med. 2018;378:1976) have shown that preoperative immune checkpoint inhibitor therapy may be of benefit in early-stage NSCLC. This large multicenter trial assesses the benefit of neoadjuvant treatment with atezolizumab (atezo; NCT02927301). Methods: Patients (pts) with stages IB to selected IIIB resectable NSCLC receive 2 cycles of atezo 1200 mg (days 1, 22) then undergo resection (day 40 ± 10). Primary tumor +/- node biopsies and blood samples are obtained before atezo and at surgery for biomarker studies. The primary endpoint is major pathological response (MPR), defined as ≤ 10% viable tumor cells in the resection specimen. Secondary endpoints include safety and correlation of response with PD-L1 expression, tumor mutation burden (TMB) and gene expression signatures. Results: For this interim efficacy analysis (5 Sep 2018 data cut), we report on the first 101 of 180 planned pts: 47 males, median age, 64 y; all ECOG PS 0-1; 23 current and 68 former smokers; 66 non-squamous NSCLC; clinical stages IB/IIA/IIB/IIIA/IIIB n = 11/16/28/39/7. There were 2 treatment-unrelated Gr 5 AEs (cardiac death post surgical resection; death due to disease progression), 29 Gr 3-4 AEs (6 [6%] treatment related). 90 pts had surgery. Excluding 8 pts who had driver mutations (7 EGFR, 1 ALK, no MPR), MPR rate was 15/82 (18%, 95% CI 11%-28%), 4 pts had pathological complete response (pCR). By RECIST, 6/82 pts had PR, 72 had SD and 4 had PD. Two of 26 (8%) PD-L1− (TC0 and IC0, clone SP142) and 10 of 35 (29%) PD-L1+ had MPR ( P= 0.055). Five of 44 (11%) TPS < 50 (PD-L1 clone 22C3) and 7 of 20 (35%) TPS > 50 had MPR ( P= 0.040). Exome sequencing data was available for 47/101 pts. Median TMB was 10.4 (range, 1.5-46.5) mutations per Mb and was not different in those with MPR compared with those without MPR. Further analysis of TMB, mutation signatures, and gene expression profiling is ongoing. Conclusions: Atezo in the neoadjuvant setting was well tolerated, and pCR and MPR rates are encouraging in this large multicenter trial. Efficacy interim analysis passed its futility boundary, and study enrollment continues. Safety, efficacy results and ongoing correlative analyses will be presented. Clinical trial information: NCT02927301.
Collapse
Affiliation(s)
| | | | - Jamie E. Chaft
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | | | | | - Ignacio Ivan Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Robert Merritt
- The Ohio State University Comprehensive Cancer Center, James Cancer Hospital, Solove Research Institute, Columbus, OH
| | - Jay M. Lee
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | | | - Yan Tang
- Brigham and Women’s Hospital, Boston, MA
| | | | | | | | - Eric B. Haura
- Department of Thoracic Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | | | - Dan Raz
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | | | | |
Collapse
|
83
|
Paz-Ares LG, Garon EB, Ardizzoni A, Barlesi F, Cho BC, Castro G, De Marchi P, Felip E, Goto Y, Greystoke A, Lu S, Lim DWT, Papadimitrakopoulou V, Reck M, Solomon BJ, Spigel DR, Tan DSW, Thomas M, Yang JCH, Johnson BE. The CANOPY program: Canakinumab in patients (pts) with non-small cell lung cancer (NSCLC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps9124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS9124 Background: Inflammatory pathways can be pro-tumorigenic or anti-tumorigenic. The cytokine interleukin-1β (IL-1β) can promote the infiltration of immunosuppressive cells into the tumor microenvironment leading to a pro-tumorigenic microenvironment that promotes carcinogenesis, tumor invasiveness, and immunosuppression. Canakinumab is a human monoclonal antibody that binds and neutralizes IL-1β. Previous clinical data (CANTOS study) has shown that canakinumab could significantly reduce lung cancer incidence and mortality. This data along with the preclinical results that IL-1β does support tumorigenic inflammation provide the rationale to investigate the therapeutic role of canakinumab in lung cancer. Methods: Three Phase 3 trials have been designed in parallel to evaluate canakinumab in NSCLC (Table). Clinical trial information: NCT03447769, NCT03631199, NCT03626545. [Table: see text]
Collapse
Affiliation(s)
| | - Edward B. Garon
- David Geffen School of Medicine, University of California/TRIO-US Network, Los Angeles, CA
| | | | | | | | - Gilberto Castro
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | | | - Yasushi Goto
- National Cancer Center Hospital, Department of Thoracic Oncology, Tokyo, Japan
| | | | - Shun Lu
- Shanghai Chest Hospital, Jiao Tong University, Shanghai, China
| | | | | | - Martin Reck
- LungenClinic, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | | | - David R. Spigel
- Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN
| | | | - Michael Thomas
- Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - James Chih-Hsin Yang
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | | |
Collapse
|
84
|
Pal SK, Miller MJ, Agarwal N, Chang SM, Chavez-MacGregor M, Cohen E, Cole S, Dale W, Magid Diefenbach CS, Disis ML, Dreicer R, Graham DL, Henry NL, Jones J, Keedy V, Klepin HD, Markham MJ, Mittendorf EA, Rodriguez-Galindo C, Sabel MS, Schilsky RL, Sznol M, Tap WD, Westin SN, Johnson BE. Clinical Cancer Advances 2019: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology. J Clin Oncol 2019; 37:834-849. [DOI: 10.1200/jco.18.02037] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
| | | | | | | | | | - Ezra Cohen
- University of California, San Diego, San Diego, CA
| | - Suzanne Cole
- Mercy Clinic Oncology and Hematology, Oklahoma City, OK
| | - William Dale
- City of Hope National Medical Center, Duarte, CA
| | | | | | - Robert Dreicer
- University of Virginia Cancer Center, Charlottesville, VA
| | | | | | - Joshua Jones
- University of Pennsylvania Health System, Philadelphia, PA
| | - Vicki Keedy
- Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
85
|
Araki T, Dahlberg SE, Hida T, Lydon CA, Rabin MS, Hatabu H, Johnson BE, Nishino M. Interstitial lung abnormality in stage IV non-small cell lung cancer: A validation study for the association with poor clinical outcome. Eur J Radiol Open 2019; 6:128-131. [PMID: 30984804 PMCID: PMC6444119 DOI: 10.1016/j.ejro.2019.03.003] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/17/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose The presence of interstitial lung abnormality (ILA) at diagnosis of stage IV non-small cell lung cancer (NSCLC) patients has previously shown to be associated with shorter overall survival (OS). The present study aimed to validate the association between ILA and shorter OS in a larger cohort of treatment-naïve stage IV NSCLC patients. Materials and methods This study includes 484 patients (205 men and 279 women) with a pathological diagnosis of stage IV NSCLC with pretreatment baseline CT available for review. ILA was visually scored on the baseline chest CT with a 3-point scale (0=no ILA, 1=indeterminate for ILA, 2 = ILA) as published previously. Clinical characteristics and overall survival (OS) were compared in patients with ILA score 2 vs. those with ILA score 0 or 1. Results ILA was present (score 2) on baseline CT in 19 of 484 patients (3.9%, 95%CI2.4-6.1%). Patients with ILA were significantly older (p = 0.0008) and more commonly male (p = 0.03) compared to those with ILA score 0 or 1. Patients with ILA score 2 showed significantly shorter OS compared to those with ILA score 0 or 1 (median OS 9.95 months vs. 16.95 months; p = 0.0002). In multivariate analyses, baseline ILA score 2 remained significant as a marker for shorter OS (HR = 2.09, p = 0.004) after adjustments for age (HR = 1.48; p = 0.001), gender (HR = 1.22, p = 0.06), and smoking (HR = 0.79; p = 0.051). Conclusions ILA on baseline CT at diagnosis of stage IV NSCLC patients was associated with shorter OS (HR = 2.09, p = 0.004), validating ILA as an independent marker for poor clinical outcome.
Collapse
Affiliation(s)
- Tetsuro Araki
- Department of Radiology, Brigham and Women's Hospital, 73 Francis St., Boston, MA, 02115 USA.,Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Suzanne E Dahlberg
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Tomoyuki Hida
- Department of Radiology, Brigham and Women's Hospital, 73 Francis St., Boston, MA, 02115 USA
| | - Christine A Lydon
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Michael S Rabin
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, 73 Francis St., Boston, MA, 02115 USA
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, 73 Francis St., Boston, MA, 02115 USA.,Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
| |
Collapse
|
86
|
Ricciuti B, Kravets S, Dahlberg SE, Umeton R, Albayrak A, Subegdjo SJ, Johnson BE, Nishino M, Sholl LM, Awad MM. Use of targeted next generation sequencing to characterize tumor mutational burden and efficacy of immune checkpoint inhibition in small cell lung cancer. J Immunother Cancer 2019; 7:87. [PMID: 30922388 PMCID: PMC6437848 DOI: 10.1186/s40425-019-0572-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Clinically-available biomarkers to identify the fraction of patients with small cell lung cancer (SCLC) who respond to immune-checkpoint inhibitors (ICIs) are lacking. High nonsynonymous tumor mutational burden (TMB), as assessed by whole exome sequencing, correlates with improved clinical outcomes for patients with SCLC treated with ICIs. Whether TMB as assessed by targeted next generation sequencing (NGS) is associated with improved efficacy of ICIs in patients with SCLC is currently unknown. Here we determined whether TMB by targeted NGS is associated with efficacy of ICIs in patients with SCLC. METHODS We collected clinicopathologic data from patients with relapsed or refractory SCLC which underwent targeted NGS with TMB assessment by the Dana-Farber Cancer Institute OncoPanel platform. The relationship between TMB and clinical outcomes after treatment with ICIs was investigated. RESULTS Among the 52 patients treated with ICIs, we found no significant difference in the objective response rate (ORR) between patients with a TMB above the 50th percentile ("TMB high") and those with a TMB at or below the 50th percentile ("TMB low"). The median progression-free survival (mPFS) and median overall survival (mOS) were significantly longer in patients with a high TMB compared to those with a low TMB (mPFS: 3.3 versus 1.2 months, HR: 0.37 [95% CI: 0.20-0.69], P < 0.01; mOS: 10.4 versus 2.5 months, HR: 0.38 [95% CI: 0.19-0.77], P < 0.01). The one-year PFS and OS rates improved with increasing mutational load when TMB was divided into tertiles. CONCLUSIONS These findings show that targeted NGS, a readily available clinical diagnostic test, can be used to identify patients with SCLC who are most likely to benefit from treatment with immune checkpoint inhibitors.
Collapse
Affiliation(s)
- Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Sasha Kravets
- Department of Data Sciences, Division of Biostatistics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Suzanne E Dahlberg
- Department of Data Sciences, Division of Biostatistics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Renato Umeton
- Department of Informatics, Dana-Farber Cancer Institute, Boston, MA, USA.,Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Adem Albayrak
- Department of Informatics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Safiya J Subegdjo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Bruce E Johnson
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, Harvard Medical School, Boston, MA, USA
| | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.
| |
Collapse
|
87
|
Oezkan F, He K, Owen DH, Pietrzak M, Rusch VW, Chaft JE, Kitzler R, Nicholas A, Schulze K, Johnson A, Phan S, Bunn PA, Kris MG, Kwiatkowski DJ, Johnson BE, Wistuba II, Lee JM, Hirsch FR, Lozanski G, Carbone DP. Neoadjuvant atezolizumab in resectable NSCLC patients: Updated clinical and immunophenotyping results from a multicenter trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.8_suppl.99] [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
99 Background: Targeting PD-L1/PD-1 to activate anti-tumor immunity is associated with improved response and survival compared to chemo in NSCLC pts. We present a preliminary analysis of the clinical efficacy, safety and peripheral blood (PB) immunophenotyping from an ongoing multicenter atezolizumab (atezo) neoadjuvant immunotherapy study in resectable NSCLC. Methods: Pts received 2 cycles of atezo, 1200mg, days 1, 22 before resection. Tumor biopsies and PB were obtained pre-atezo & pre-surgery. The biomarker evaluable population (BEP) included pts with paired PB analyzed within 72 hrs by 10-color flow cytometry (IMMUNOME) and major pathological response (MPR) assessment (defined as ≤ 10% residual tumor). The primary endpoint was MPR. Secondary endpoints included safety, MPR by PD-L1, OS, and DFS. Immunophenotypic analyses were correlated with treatment, MPR and PD-L1 expression. Results: 116 patients have been enrolled as of October 31, 2018 and here we report on 54 of 180 planned pts with follow-up through surgery. 15 pts had Gr 3-4 AEs (3 treatment related), one Gr 5 AE (sudden death) was unrelated. By RECIST there were 3 PR, 49 SD, and 2 PD. 50/54 pts underwent the planned surgery, 47 pts had MPR assessment: 4 pts discontinued study preop (2 radiographic PD, 2 other reasons); 3 were unresectable. Excluding 5 pts with EGFR or ALK mutations, MPR rate was 10/45 (22%, 95% CI 11-37%). Baseline PD-L1 status was evaluable in 44/54 pts; BEP included 31 pts, 23 had tissue PD-L1 status: 16 PD-L1+. We observed significant increases in natural killer (NK) cells, CD8+ T-cells, Th1-response related dendritic cells (DC), and decreases in B-cells after atezo. Non-MPR pts showed significant increases in late activated NK cells, monocytic myeloid cells and Th2 and Th17-response–related DCs. PD-L1+ pts showed significant decreases of senescent T cells, monocytic myeloid cells, and increases of Th1-response–related DCs. We analyzed 22/54 tumor pairs, PD-L1+ cells increased in most pts after atezo treatment. Conclusions: Neoadjuvant atezo was well tolerated and the MPR rate is encouraging. Preliminary immunophenotyping data showed significant changes in PB with immunotherapy. Clinical trial information: NCT02927301.
Collapse
Affiliation(s)
- Filiz Oezkan
- The Ohio State University, Arthur G. James Thoracic Cancer Center, Columbus, OH
| | - Kai He
- Johns Hopkins Kimmel Cancer Center, Baltimore, MD
| | - Dwight Hall Owen
- Division of Medical Oncology, Department of Internal Medicine, Ohio State University, Columbus, OH
| | | | | | | | | | | | | | | | - See Phan
- Genentech, Inc., San Francisco, CA
| | | | - Mark G. Kris
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | - Jay M. Lee
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | | | | | | |
Collapse
|
88
|
Johnson BE. Review: Thyroid hormone therapy does not improve QoL or symptoms in subclinical hypothyroidism. Ann Intern Med 2019; 170:JC17. [PMID: 30776806 DOI: 10.7326/acpj201902190-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
89
|
Jerby L, Shah P, Cuoco MS, Rodman C, Su MJ, Melms JM, Leeson R, Kanodia A, Mei S, Lin JR, Wang S, Rabasha B, Liu D, Zhang G, Margolais C, Ashenberg O, Ott PA, Buchbinder EI, Haq R, Hodi S, Boland GM, Sullivan RJ, Frederick D, Miao B, Moll T, Flaherty K, Herlyn M, Jenkins RS, Thummalapalli R, Kowalczyk MS, Canadas I, Schilling B, Cartwright AN, Luoma AM, Malu S, Hwu P, Bernatchez C, Forget MA, Barbie DA, Shalek AK, Tirosh I, Sorger PK, Wucherpfennig KW, Allen EMV, Schadendorf D, Johnson BE, Rotem A, Rosenblatt-Rozen O, Garraway LA, Yoon CH, Izar B, Regev A. Abstract A082: Single-cell RNA-sequencing of metastatic melanoma identifies a cancer cell-intrinsic program associated with immune checkpoint inhibitor resistance. Cancer Immunol Res 2019. [DOI: 10.1158/2326-6074.cricimteatiaacr18-a082] [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
Immune checkpoint inhibitors (ICI) produce durable responses in some melanoma patients, but many patients derive no clinical benefit. The molecular underpinnings of ICI resistance involve intricate cell-cell interactions that are yet elusive. To systematically map the interactions between malignant and immune cells in the tumor ecosystem, we applied single-cell RNA sequencing to 31 human melanoma tumors, profiling thousands of malignant, immune, and stromal cells. We identified a transcriptional program in malignanT-cells that is strongly associated with T-cell exclusion and immunotherapy resistance. Using highly multiplexed in situ imaging we first demonstrated that this program characterizes malignanT-cells in “cold” niches. Next, we showed that the program predicts clinical responses to ICI according to multiple independent validation cohorts, including a new cohort that we obtained from 112 melanoma patients treated with anti-PD-1 therapy. We then identified CDK4/6 as master regulators of this resistance program, and found that CDK4/6 inhibitors repress the program and shift melanoma cells into a senescence-associated secretory phenotype. Lastly, we showed that CDK4/6-inhibition leads to a substantial reduction in melanoma tumor outgrowth in a B16 mouse model when given in combination with immunotherapy. Taken together, our study provides a high-resolution landscape of ICI-resistant cell states, identifies clinically predictive signatures, and forms a basis for the development of novel therapeutic strategies that could overcome immunotherapy resistance.
Citation Format: Livnat Jerby, Parin Shah, Michael S. Cuoco, Christopher Rodman, Mei-Ju Su, Johannes M. Melms, Rachel Leeson, Abhay Kanodia, Shaolin Mei, Jia-Ren Lin, Shu Wang, Bokang Rabasha, David Liu, Gao Zhang, Claire Margolais, Orr Ashenberg, Patrick A. Ott, Elizabeth I. Buchbinder, Riz Haq, Stephen Hodi, Genevieve M. Boland, Ryan J. Sullivan, Dennie Frederick, Benchun Miao, Tabea Moll, Keith Flaherty, Meenhard Herlyn, Russell S. Jenkins, Rohit Thummalapalli, Monika S. Kowalczyk, Israel Canadas, Bastian Schilling, Adam N.R Cartwright, Adrienne M. Luoma, Shruti Malu, Patrick Hwu, Chantale Bernatchez, Marie-Andree Forget, David A. Barbie, Alex K. Shalek, Itay Tirosh, Peter K. Sorger, Kai W. Wucherpfennig, Eliezer M. Van Allen, Dirk Schadendorf, Bruce E. Johnson, Asaf Rotem, Orit Rosenblatt-Rozen, Levi A. Garraway, Charles H. Yoon, Benjamin Izar, Aviv Regev. Single-cell RNA-sequencing of metastatic melanoma identifies a cancer cell-intrinsic program associated with immune checkpoint inhibitor resistance [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr A082.
Collapse
Affiliation(s)
- Livnat Jerby
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Parin Shah
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Michael S. Cuoco
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Christopher Rodman
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Mei-Ju Su
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Johannes M. Melms
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Rachel Leeson
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Abhay Kanodia
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Shaolin Mei
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Jia-Ren Lin
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Shu Wang
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Bokang Rabasha
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - David Liu
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Gao Zhang
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Claire Margolais
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Orr Ashenberg
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Patrick A. Ott
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Elizabeth I. Buchbinder
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Riz Haq
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Stephen Hodi
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Genevieve M. Boland
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Ryan J. Sullivan
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Dennie Frederick
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Benchun Miao
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Tabea Moll
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Keith Flaherty
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Meenhard Herlyn
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Russell S. Jenkins
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Rohit Thummalapalli
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Monika S. Kowalczyk
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Israel Canadas
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Bastian Schilling
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Adam N.R Cartwright
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Adrienne M. Luoma
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Shruti Malu
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Patrick Hwu
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Chantale Bernatchez
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Marie-Andree Forget
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - David A. Barbie
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Alex K. Shalek
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Itay Tirosh
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Peter K. Sorger
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Kai W. Wucherpfennig
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Eliezer M. Van Allen
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Dirk Schadendorf
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Bruce E. Johnson
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Asaf Rotem
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Orit Rosenblatt-Rozen
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Levi A. Garraway
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Charles H. Yoon
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Benjamin Izar
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| | - Aviv Regev
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; The Wistar Institute, Philadelphia, PA; Massachusetts General Hospital Cancer Center, Boston, MA; The University of Texas MD Anderson Cancer Center, Houston, TX; University Duisburg-Essen and the German Cancer Consortium (DKTK) , Essen, Germany; Brigham and Women’s Hospital, Boston, MA
| |
Collapse
|
90
|
Park H, Dahlberg SE, Lydon CA, Araki T, Hatabu H, Rabin MS, Johnson BE, Nishino M. M1b Disease in the 8th Edition of TNM Staging of Lung Cancer: Pattern of Single Extrathoracic Metastasis and Clinical Outcome. Oncologist 2019; 24:e749-e754. [PMID: 30696724 PMCID: PMC6693709 DOI: 10.1634/theoncologist.2018-0596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/28/2018] [Indexed: 02/07/2023] Open
Abstract
The 8th edition of TNM staging of lung cancer revised M staging and defined M1b disease with single extrathoracic metastasis, to be distinguished from M1c with multiple extrathoracic metastases in one or more organs. This new distinct category of M1b disease consists of patients with a single extrathoracic metastasis, thus consisting of a strictly defined oligometastatic disease. This article reports the prevalence of M1b disease among patients with stage IV non‐small cell lung cancer, focusing on the clinical characteristics and patterns of single extrathoracic metastasis and relationships with overall survival. Background. The 8th edition of TNM staging of non‐small cell lung cancer (NSCLC) has revised M classification and defined M1b disease with single extrathoracic metastasis, which is distinguished from M1c with multiple extrathoracic metastases. We investigated the prevalence, characteristics, and overall survival (OS) of M1b disease in patients with stage IV NSCLC. Methods. The study reviewed the medical records and imaging studies of 567 patients with stage IV NSCLC to determine M stage using the 8th edition of TNM staging. Clinical characteristics and OS were compared according to M stages. Results. Among 567 patients, 57 patients (10%) had M1b disease, whereas 119 patients (21%) had M1a disease and 391 patients (69%) had M1c disease. Squamous histology was more common in M1b (16%) than in M1a (6%) and M1c (6%; p = .03). The median OS of patients with M1b disease was 14.8 months, compared with 22.6 months for patients with M1a and 13.4 months for those with M1c disease (p < .0001). Significant OS differences of M1b compared with single‐organ M1c and multiorgan M1c groups were noted (single‐organ M1c vs. M1b: hazard ratio [HR], 1.49; p = .02; multiorgan M1c vs. M1b: HR, 1.57; p = .01) in multivariable analyses adjusting for smoking and systemic therapy types. Among patients with M1b disease, the brain was the most common site of single metastasis (28/57; 49%), followed by bone (16/57; 28%). Single brain metastasis was more frequently treated with local treatment (p < .0001). Conclusion. M1b disease was noted in 10% of patients with stage IV NSCLC. Squamous histology was more common in M1b group than others. The brain was the most common site of single metastasis and was often treated locally. Implications for Practice. The newly defined group of M stage consists of a unique subset among patients with stage IV non‐small cell lung cancer that can be studied further to optimize treatment approaches.
Collapse
Affiliation(s)
- Hyesun Park
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Suzanne E Dahlberg
- Department of Biostatistics and Computational Biology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Christine A Lydon
- Department of Medical Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tetsuro Araki
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michael S Rabin
- Department of Medical Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Bruce E Johnson
- Department of Medical Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| |
Collapse
|
91
|
Jerby-Arnon L, Shah P, Cuoco MS, Rodman C, Su MJ, Melms JC, Leeson R, Kanodia A, Mei S, Lin JR, Wang S, Rabasha B, Liu D, Zhang G, Margolais C, Ashenberg O, Ott PA, Buchbinder EI, Haq R, Hodi FS, Boland GM, Sullivan RJ, Frederick DT, Miao B, Moll T, Flaherty KT, Herlyn M, Jenkins RW, Thummalapalli R, Kowalczyk MS, Cañadas I, Schilling B, Cartwright ANR, Luoma AM, Malu S, Hwu P, Bernatchez C, Forget MA, Barbie DA, Shalek AK, Tirosh I, Sorger PK, Wucherpfennig K, Van Allen EM, Schadendorf D, Johnson BE, Rotem A, Rozenblatt-Rosen O, Garraway LA, Yoon CH, Izar B, Regev A. A Cancer Cell Program Promotes T Cell Exclusion and Resistance to Checkpoint Blockade. Cell 2018; 175:984-997.e24. [PMID: 30388455 PMCID: PMC6410377 DOI: 10.1016/j.cell.2018.09.006] [Citation(s) in RCA: 720] [Impact Index Per Article: 120.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/18/2018] [Accepted: 09/05/2018] [Indexed: 12/12/2022]
Abstract
Immune checkpoint inhibitors (ICIs) produce durable responses in some melanoma patients, but many patients derive no clinical benefit, and the molecular underpinnings of such resistance remain elusive. Here, we leveraged single-cell RNA sequencing (scRNA-seq) from 33 melanoma tumors and computational analyses to interrogate malignant cell states that promote immune evasion. We identified a resistance program expressed by malignant cells that is associated with T cell exclusion and immune evasion. The program is expressed prior to immunotherapy, characterizes cold niches in situ, and predicts clinical responses to anti-PD-1 therapy in an independent cohort of 112 melanoma patients. CDK4/6-inhibition represses this program in individual malignant cells, induces senescence, and reduces melanoma tumor outgrowth in mouse models in vivo when given in combination with immunotherapy. Our study provides a high-resolution landscape of ICI-resistant cell states, identifies clinically predictive signatures, and suggests new therapeutic strategies to overcome immunotherapy resistance.
Collapse
Affiliation(s)
| | - Parin Shah
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | - Mei-Ju Su
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Johannes C Melms
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rachel Leeson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Abhay Kanodia
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Shaolin Mei
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Jia-Ren Lin
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Shu Wang
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Bokang Rabasha
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gao Zhang
- Molecular & Cellular Oncogenesis Program and Melanoma Research Center, The Wistar Institute, Philadelphia, PA, USA
| | - Claire Margolais
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Orr Ashenberg
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Patrick A Ott
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Rizwan Haq
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Stephen Hodi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Ryan J Sullivan
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | | | - Benchun Miao
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Tabea Moll
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | | | - Meenhard Herlyn
- Molecular & Cellular Oncogenesis Program and Melanoma Research Center, The Wistar Institute, Philadelphia, PA, USA
| | - Russell W Jenkins
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Rohit Thummalapalli
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Monika S Kowalczyk
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Celsius Therapeutics, Cambridge, MA, USA
| | - Israel Cañadas
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bastian Schilling
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium, Essen, Germany; Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Adam N R Cartwright
- Center for Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Adrienne M Luoma
- Center for Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Shruti Malu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chantale Bernatchez
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marie-Andrée Forget
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David A Barbie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alex K Shalek
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Itay Tirosh
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Peter K Sorger
- Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Kai Wucherpfennig
- Center for Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium, Essen, Germany
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | - Asaf Rotem
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Levi A Garraway
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA; Ludwig Center for Cancer Research at Harvard, Boston, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Charles H Yoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital, Department of Surgical Oncology, Boston, MA, USA
| | - Benjamin Izar
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Cancer Precision Medicine of Dana-Farber Cancer Institute, Boston, MA, USA; Laboratory for Systems Pharmacology, Harvard Medical School, Boston, MA, USA; Center for Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA; Ludwig Center for Cancer Research at Harvard, Boston, MA, USA.
| | - Aviv Regev
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA; Ludwig Center for Cancer Research at MIT, Boston, MA, USA; Massachusetts Institute of Technology, Department of Biology, Cambridge, MA, USA
| |
Collapse
|
92
|
Mak RH, Hermann G, Aerts HJ, Baldini EH, Chen AB, Kozono D, Rabin MS, Swanson SJ, Chen YH, Catalano P, Johnson BE, Jänne PA. Outcomes by EGFR, KRAS, and ALK Genotype After Combined Modality Therapy for Locally Advanced Non–Small-Cell Lung Cancer. JCO Precis Oncol 2018; 2:1-18. [DOI: 10.1200/po.17.00219] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose In 699 patients with locally advanced non–small-cell lung cancer (NSCLC) treated with radiation therapy as part of combined modality therapy, we compared outcomes among genotyped and ungenotyped patients and by tumor genotype status ( EGFR, KRAS, and ALK). Patients and Methods Genotyping was performed in 250 patients: EGFR+ (19%), KRAS+ (32%), ALK+ (9%), and wild type (WT−/−/−; 40%). Outcomes were analyzed using the Kaplan-Meier method and Cox regression. Results With a median follow-up of 48.2 months among genotyped patients, median overall survival (OS) was significantly longer for EGFR+ and ALK+ compared with KRAS+ and WT−/−/− (55.8 months v not reached v 28.0 v 33.2 months; P = .02). There was no difference in progression-free survival (median, 15.3 v 13.7 v 13.0 v 14.5 months; P = .47) or in freedom from distant metastases by genotype (3-year estimates: 42% v 49% v 27% v 25%; P = .25). There was higher freedom from locoregional recurrence (LRR) for EGFR+ tumors and lower freedom from LRR in ALK+ tumors, compared with KRAS+ and WT−/−/− tumors (3-year: 77% v 38% v 49% v 46%). In multivariable analysis, ALK+ remained associated with increased OS (HR, 0.32; 95% CI, 0.12 to 0.87; P = .03), and EGFR+ was associated with decreased LRR (HR, 0.47; 95% CI, 0.24 to 0.92; P = .03). Analysis of post-recurrence survival demonstrated that EGFR+/ ALK+ patients treated with appropriate tyrosine kinase inhibitors had higher OS compared with other groups. Conclusion In this series of locally advanced NSCLC treated with combined modality therapy, EGFR+ and ALK+ were associated with higher OS, whereas LRR was lower in EGFR+ patients, and the risk of distant metastases was high in all subgroups. The outcomes and patterns of failure in genotypic subgroups of NSCLC from this study can inform the design of future trials integrating targeted therapies.
Collapse
Affiliation(s)
- Raymond H. Mak
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Gretchen Hermann
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Hugo J. Aerts
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Elizabeth H. Baldini
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Aileen B. Chen
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - David Kozono
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Michael S. Rabin
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Scott J. Swanson
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Yu-Hui Chen
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Paul Catalano
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Bruce E. Johnson
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| | - Pasi A. Jänne
- Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Yu-Hui Chen, Paul Catalano, Bruce E. Johnson, and Pasi A. Jänne, Dana-Farber Cancer Institute; Raymond H. Mak, Gretchen Hermann, Hugo J. Aerts, Elizabeth H. Baldin, Aileen B. Chen, David Kozono, and Scott J. Swanson, Brigham and Women's Hospital; Raymond H. Mak, Hugo J. Aerts, Elizabeth H. Baldini, Aileen B. Chen, David Kozono, Michael S. Rabin, Scott J. Swanson, Bruce E. Johnson, and
| |
Collapse
|
93
|
|
94
|
Johnson BE. The impact of 15 years of precision medicine innovation on the treatment of lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
95
|
Dagogo-Jack I, Martinez P, Yeap BY, Ambrogio C, Ferris LA, Lydon C, Nguyen T, Jessop NA, Iafrate AJ, Johnson BE, Lennerz JK, Shaw AT, Awad MM. Impact of BRAF Mutation Class on Disease Characteristics and Clinical Outcomes in BRAF-mutant Lung Cancer. Clin Cancer Res 2018; 25:158-165. [DOI: 10.1158/1078-0432.ccr-18-2062] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/14/2018] [Accepted: 09/11/2018] [Indexed: 11/16/2022]
|
96
|
Aguirre AJ, Nowak JA, Camarda ND, Moffitt RA, Ghazani AA, Hazar-Rethinam M, Raghavan S, Kim J, Brais LK, Ragon D, Welch MW, Reilly E, McCabe D, Marini L, Anderka K, Helvie K, Oliver N, Babic A, Da Silva A, Nadres B, Van Seventer EE, Shahzade HA, St Pierre JP, Burke KP, Clancy T, Cleary JM, Doyle LA, Jajoo K, McCleary NJ, Meyerhardt JA, Murphy JE, Ng K, Patel AK, Perez K, Rosenthal MH, Rubinson DA, Ryou M, Shapiro GI, Sicinska E, Silverman SG, Nagy RJ, Lanman RB, Knoerzer D, Welsch DJ, Yurgelun MB, Fuchs CS, Garraway LA, Getz G, Hornick JL, Johnson BE, Kulke MH, Mayer RJ, Miller JW, Shyn PB, Tuveson DA, Wagle N, Yeh JJ, Hahn WC, Corcoran RB, Carter SL, Wolpin BM. Real-time Genomic Characterization of Advanced Pancreatic Cancer to Enable Precision Medicine. Cancer Discov 2018; 8:1096-1111. [PMID: 29903880 DOI: 10.1158/2159-8290.cd-18-0275] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/17/2018] [Accepted: 06/13/2018] [Indexed: 12/28/2022]
Abstract
Clinically relevant subtypes exist for pancreatic ductal adenocarcinoma (PDAC), but molecular characterization is not yet standard in clinical care. We implemented a biopsy protocol to perform time-sensitive whole-exome sequencing and RNA sequencing for patients with advanced PDAC. Therapeutically relevant genomic alterations were identified in 48% (34/71) and pathogenic/likely pathogenic germline alterations in 18% (13/71) of patients. Overall, 30% (21/71) of enrolled patients experienced a change in clinical management as a result of genomic data. Twenty-six patients had germline and/or somatic alterations in DNA-damage repair genes, and 5 additional patients had mutational signatures of homologous recombination deficiency but no identified causal genomic alteration. Two patients had oncogenic in-frame BRAF deletions, and we report the first clinical evidence that this alteration confers sensitivity to MAPK pathway inhibition. Moreover, we identified tumor/stroma gene expression signatures with clinical relevance. Collectively, these data demonstrate the feasibility and value of real-time genomic characterization of advanced PDAC.Significance: Molecular analyses of metastatic PDAC tumors are challenging due to the heterogeneous cellular composition of biopsy specimens and rapid progression of the disease. Using an integrated multidisciplinary biopsy program, we demonstrate that real-time genomic characterization of advanced PDAC can identify clinically relevant alterations that inform management of this difficult disease. Cancer Discov; 8(9); 1096-111. ©2018 AACR.See related commentary by Collisson, p. 1062This article is highlighted in the In This Issue feature, p. 1047.
Collapse
Affiliation(s)
- Andrew J Aguirre
- Dana-Farber Cancer Institute, Boston, Massachusetts. .,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Jonathan A Nowak
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Nicholas D Camarda
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Richard A Moffitt
- Department of Biomedical Informatics, Department of Pathology, Stony Brook University, Stony Brook, New York
| | - Arezou A Ghazani
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Srivatsan Raghavan
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Jaegil Kim
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | | | | | | | - Emma Reilly
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Devin McCabe
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lori Marini
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Kristin Anderka
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Karla Helvie
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Nelly Oliver
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Ana Babic
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Annacarolina Da Silva
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Brandon Nadres
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | | | | | | | - Kelly P Burke
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Thomas Clancy
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - James M Cleary
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Leona A Doyle
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kunal Jajoo
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Nadine J McCleary
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Meyerhardt
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Janet E Murphy
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Kimmie Ng
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Anuj K Patel
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Kimberly Perez
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Michael H Rosenthal
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Douglas A Rubinson
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Marvin Ryou
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Geoffrey I Shapiro
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Ewa Sicinska
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Stuart G Silverman
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rebecca J Nagy
- Department of Medical Affairs, Guardant Health, Inc., Redwood City, California
| | - Richard B Lanman
- Department of Medical Affairs, Guardant Health, Inc., Redwood City, California
| | | | | | - Matthew B Yurgelun
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Charles S Fuchs
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Levi A Garraway
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Gad Getz
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Jason L Hornick
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Bruce E Johnson
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Matthew H Kulke
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Robert J Mayer
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Jeffrey W Miller
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Paul B Shyn
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - David A Tuveson
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York; Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
| | - Nikhil Wagle
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts
| | - Jen Jen Yeh
- Departments of Surgery and Pharmacology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - William C Hahn
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Ryan B Corcoran
- Harvard Medical School, Boston, Massachusetts.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Scott L Carter
- Dana-Farber Cancer Institute, Boston, Massachusetts. .,Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Joint Center for Cancer Precision Medicine, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brian M Wolpin
- Dana-Farber Cancer Institute, Boston, Massachusetts. .,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
97
|
Horn L, Bauml J, Forde PM, Davis KL, Myall NJ, Sasane M, Dalal A, Culver KW, Wozniak AJ, Baik CS, Mutebi A, Zhang P, Wakelee HA, Johnson BE. Real-world treatment patterns and survival of BRAF V600-mutated metastatic non-small cell lung cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.9096] [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)
- Leora Horn
- Vanderbilt University Medical Center, Nashville, TN
| | | | - Patrick M. Forde
- Johns Hopkins Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, MD
| | | | | | - Medha Sasane
- Fromerly at Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Anand Dalal
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, US
| | | | | | | | - Alex Mutebi
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Pingkuan Zhang
- Formerly at Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | | | |
Collapse
|
98
|
Dagogo-Jack I, Martinez P, Yeap BY, Ambrogio C, Lydon CA, Nguyen T, Iafrate AJ, Lennerz JK, Johnson BE, Shaw AT, Awad MM. BRAF-mutant non-small cell lung cancer (NSCLC): Patient (pt) characteristics and outcomes by class of mutation. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.9045] [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)
| | | | | | | | | | - Tom Nguyen
- Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | |
Collapse
|
99
|
Izar B, Jerby-Arnon L, Rotem A, Shah P, Liu D, Zhang G, Schilling B, Rozenblatt-Rosen O, Boland GM, Hodi FS, Flaherty K, Van Allen EM, Johnson BE, Schadendorf D, Yoon C, Garraway LA, Regev A. Single-cell RNA-sequencing and -imaging of melanoma ecosystems reveals sources of resistance to immune checkpoint blockade. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Asaf Rotem
- Dana-Farber Cancer Institute, Boston, MA
| | - Parin Shah
- Dana-Farber Cancer Institute, Boston, MA
| | - David Liu
- Dana-Farber Cancer Institute, Boston, MA
| | | | - Bastian Schilling
- Department of Dermatology, University Hospital Wurzburg, Wurzburg, Germany
| | | | | | | | | | | | | | - Dirk Schadendorf
- Department of Dermatology, University of Duisburg-Essen, Essen, Germany
| | | | | | | |
Collapse
|
100
|
Burt BM, Richards WG, Lee HS, Bartel S, Dasilva MC, Gill RR, Jaklitsch MT, Johnson BE, Swanson SJ, Bueno R, Sugarbaker DJ. A Phase I Trial of Surgical Resection and Intraoperative Hyperthermic Cisplatin and Gemcitabine for Pleural Mesothelioma. J Thorac Oncol 2018; 13:1400-1409. [PMID: 29753120 DOI: 10.1016/j.jtho.2018.04.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/11/2018] [Accepted: 04/27/2018] [Indexed: 10/16/2022]
Abstract
INTRODUCTION The primary objective of this single-institution phase I clinical trial was to establish the maximum tolerated dose of gemcitabine added to cisplatin and delivered as heated intraoperative chemotherapy after resection of malignant pleural mesothelioma. METHODS The extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) treatment arms were based on investigators' assessment of patient fitness and potential for macroscopic complete resection. Previously established intracavitary dosing of cisplatin (range 175-225 mg/m2) with systemic cytoprotection was used in combination with escalating doses of gemcitabine, following a 3-plus-3 design from 100 mg/m2 in 100-mg increments. RESULTS From 2007 to 2011, 141 patients were enrolled and 104 completed treatment. The median age of those completing treatment was 65 years (range 43-85 years), and 22 (21%) were female. In the EPP arm (n = 59), 31 patients (53%) had the epithelioid histologic type and the median radiographic tumor volume was 236 cm3 (range 16-4285 cm3). In the P/D arm (n = 41), 29 patients (71%) had the epithelioid histologic type and the median tumor volume was 79 cm3 (range 6-1107 cm3). The operative mortality rate was 2%, and 35 and 22 serious adverse events were encountered among 27 patients (46%) and 16 patients (39%) in the EPP and P/D arms, respectively. Dose-limiting toxicity (grade 3 leukopenia) was observed in two patients who were receiving 1100 mg/m2 of gemcitabine, thus establishing the maximum tolerated dose at 1000 mg/m2, in combination with 175 mg/m2 of cisplatin. The median overall and recurrence-free survival times in treated patients were 20.3 and 10.7 months, respectively. CONCLUSIONS Combination cisplatin and gemcitabine heated intraoperative chemotherapy can be administered safely and feasibly in the context of complete surgical resection of malignant pleural mesothelioma by EPP or P/D.
Collapse
Affiliation(s)
- Bryan M Burt
- Department of Surgery, Division of General Thoracic Surgery, Baylor College of Medicine, Houston, Texas
| | - William G Richards
- Department of Surgery, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Hyun-Sung Lee
- Department of Surgery, Division of General Thoracic Surgery, Baylor College of Medicine, Houston, Texas
| | - Sylvia Bartel
- Research Pharmacy Core, Pharmacy and Clinical Support, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Marcelo C Dasilva
- Department of Surgery, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ritu R Gill
- Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michael T Jaklitsch
- Department of Surgery, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Bruce E Johnson
- Cancer Center, Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Scott J Swanson
- Department of Surgery, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Raphael Bueno
- Department of Surgery, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - David J Sugarbaker
- Department of Surgery, Division of General Thoracic Surgery, Baylor College of Medicine, Houston, Texas.
| |
Collapse
|