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Ponde NF, Agbor-Tarh D, Dal Lago L, Korde LA, Hilbers F, Jackisch C, Werner O, Gelber RD, Jatoi A, Dueck AC, Moreno-Aspitia A, Sotiriou C, de Azambuja E, Piccart M. Treatment completion and toxicity of trastuzumab or trastuzumab + lapatinib in older patients (pts): BIG 2-06; NCCTG N063D (Alliance). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.11553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11553 Background: Little is known about the toxicity of trastuzumab (T) or of trastuzumab + lapatinib (T + L), approved in the advanced setting, in older pts. We have performed a sub-analysis of the Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation (ALTTO) trial focused on treatment completion and toxicity of T and T+L in older pts (aged ≥65 years (yr)). Methods: The ALTTO trial (NCT00490139, NCCTG N063D) randomised 8381 pts with early HER2+ BC into 4 arms and we included the T and T+L arms in our analysis. Eligible pts for our study were those having received at least one dose of assigned treatment. Treatment completion was evaluated through the rate of temporary treatment interruptions (TTI), permanent treatment discontinuations (PTD) and lapatinib dose reductions (LDR). Toxicity was evaluated via a selected set of adverse events of interest (AEIs). Risk factors for TTI, PTD, LDR and AEIs were assessed, including comorbidities and polypharmacy at baseline (defined as use 5 or more co-medications) and AEIs during treatment. Results: A total of 430 pts≥65-year-old were identified for this sub-analysis, out of a total of 4190 pts with a median age of 68 yrs (range 65-80). Older pts were more likely to have comorbidities (70% vs 38%). Treatment completion was worse among older pts in the T+L arm but not in the T arm (Table). AEIs were more common in the T+L arm in all patients, with older patients having higher AEI rates (78.04% in older vs 63.38% in younger), particularly diarrhea (60.75% vs 38.0%). Identified risk factors (multivariate) for worse treatment completion in the T and T+ L arms included concomitant use of chemotherapy and the occurrence of grade 3 adverse events, among others. Conclusions: T + L has worse treatment completion and is more toxic in older patients, while T was well tolerated. Identifiable risk factors at baseline and during the course of treatment could be used to aid in regimen selection and management for both T and T + L in their respective indications. Support: UG1CA189823, Novartis;https://acknowledgments.alliancefound.org. [Table: see text]
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Affiliation(s)
| | | | | | - Larissa A. Korde
- Head, Breast Cancer Therapeutics, Clinical Investigations Branch, National Cancer Institute, Bethesda, MD
| | | | | | | | - Richard D. Gelber
- Dana-Farber Cancer Institute, Harvard Medical School, Harvard TH Chan School of Public Health, and Frontier Science and Technology Research Foundation, Boston, MA
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Luen SJ, Griguolo G, Nuciforo P, Campbell C, Fasani R, Cortes J, Untch M, Lin SJ, Savas P, Fox SB, Di Cosimo S, Llombart Cussac A, de Azambuja E, Piccart-Gebhart MJ, Pusztai L, Sotiriou C, Salgado R, Prat A, Loi S. On-treatment changes in tumor-infiltrating lymphocytes (TIL) during neoadjuvant HER2 therapy (NAT) and clinical outcome. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
574 Background: Higher quantity of pretreatment TIL (PT) is associated with improved pCR and EFS in HER2+ early breast cancer (BC). The value of on-treatment TIL is unknown. Methods: The NeoALTTO trial randomized 455 women with HER2+ BC to 12 weeks NAT with trastuzumab, lapatinib or combination with paclitaxel, followed by FEC after surgery. In the PAMELA trial 151 women received 18 weeks NAT with lapatinib and trastuzumab (±hormonal therapy). TIL were quantified on PT and on-treatment (W2) biopsies using the published method on H&E slides, and tested for associations with pCR (logistic regression), EFS and OS (Cox models) in univariate (UV) and multivariate (MV) analyses. The likelihood ratio test assessed added prognostic value to clinicopathological (CP) variables. pCR associations were validated in PAMELA. We investigated enrichment of immune cell subsets using previously published RNAseq data from NeoALTTO. Results: In NeoALTTO, PT and W2 TIL were evaluable in 277/455 (61%). We defined two groups: immune-poor (L+F) and immune-enriched (II+P), see Table. Immune-enriched (41%; 134) vs poor (59%; 164) patients had significantly higher pCR rates (40% vs 21%; UV OR 2.24; 95%CI 1.31-3.85; P = .003; MV P = .009), and added significant value to CP + PT TIL for prediction of pCR (P = .003). This was further confirmed in PAMELA (N = 94/151) (26% vs 6%; UV P = .021; MV P = .028). In NeoALTTO, the immune-enriched vs poor patients had significantly improved EFS (5 yr est 85% vs 60%; UV HR 0.31; 95%CI 0.18-0.54; P < .001; MV P < .001) and OS (5 yr est 91% vs 77%; UV HR 0.40; 95%CI 0.20-0.82; P = .012; MV P = 0.026), and provided significant added prognostic value beyond CP + pCR + PT TIL (EFS P < .001) In NeoALTTO PT samples, II vs F patients had enrichment of DCs, NKs and CD8+ including tissue resident memory cells (P = .009) suggesting requirement of key immune subsets. Further validation by IHC is ongoing. Conclusions: On-treatment TIL identifies patients more likely to achieve pCR and have improved EFS in early-stage HER2+ BC, beyond CP + PT TIL. This information could aid future trial design. Clinical trial information: NCT00553358, NCT01973660. [Table: see text]
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Affiliation(s)
| | | | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Roberta Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Cortes
- IOB Institute of Oncology, Quironsalud Group, Madrid & Barcelona, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Peter Savas
- Peter Maccallum Cancer Centre, Melbourne, Australia
| | - Stephen B. Fox
- University of Newcastle/Australian New Zealand Breast Cancer Trials Group, Newcastle, Australia
| | - Serena Di Cosimo
- Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | | | | | - Roberto Salgado
- Center for Oncological Research (CORE) -Campus Sint-Augustinus-University of Antwerp, Antwerpen, Belgium
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Sherene Loi
- Peter MacCallum Cancer Centre, Melbourne, Australia
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Richard F, Bitton R, Sotiriou C, de Azambuja E. Prognostic and predictive significance of the expression of the beta-2 adrenergic receptor in HER2-positive breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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104
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Nederlof I, de Bortoli D, Bareche Y, Hooijer G, Sotiriou C, van de Vijver M, Horlings H, Salgado R, Biganzoli E, Desmedt C. Comprehensive evaluation of methodology to assess abundance of immune infiltrates in breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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105
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Rothé F, Silva MJ, Venet D, Campbell C, Bradburry I, Rouas G, de Azambuja E, Maetens M, Fumagalli D, Rodrik-Outmezguine V, Di Cosimo S, Rosa D, Chia S, Wardley A, Ueno T, Janni W, Huober J, Baselga J, Piccart M, Loi S, Sotiriou C, Dawson SJ, Ignatiadis M. Circulating Tumor DNA in HER2-Amplified Breast Cancer: A Translational Research Substudy of the NeoALTTO Phase III Trial. Clin Cancer Res 2019; 25:3581-3588. [PMID: 30862692 DOI: 10.1158/1078-0432.ccr-18-2521] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 01/04/2019] [Accepted: 03/06/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE In the neoadjuvant treatment (NAT) setting, dual HER2-targeted therapy is associated with increased pathologic complete response (pCR) rates compared with each therapy alone. Biomarkers allowing to predict treatment response during NAT are needed. We aim to evaluate whether circulating tumor DNA (ctDNA) is associated with response to anti-HER2-targeted therapy. EXPERIMENTAL DESIGN Plasma DNA collected before NAT, at week 2, and before surgery from patients enrolled in the NeoALTTO trial was assessed using digital PCR for PIK3CA and TP53 mutation detection. RESULTS A total of 69 of 455 (15.2%) patients had a PIK3CA and/or TP53 mutation detected in the baseline tumor sample and evaluable ctDNA results from baseline samples. CtDNA was detected in 41%, 20%, and 5% patients before NAT, at week 2, and before surgery, respectively. ctDNA detection before NAT was significantly associated with older age and ER-negative status. ctDNA detection before NAT was associated with decreased odds of achieving pCR (OR = 0.15; 95% CI, 0.034-0.7; P = 0.0089), but not with event-free survival (EFS). Analyses for EFS were underpowered. Interestingly, the patients with HER2-enriched subtype tumors and undetectable ctDNA at baseline had the highest pCR rates. In contrast, patients with persistent ctDNA detection at baseline and week 2 had the lowest rate of pCR. CONCLUSIONS ctDNA detection before neoadjuvant anti-HER2 therapies is associated with decreased pCR rates. Interestingly, patients with HER2-enriched tumors and undetectable ctDNA at baseline had the highest pCR rates, therefore appearing as the best candidates for treatment deescalation strategies.
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Affiliation(s)
- Françoise Rothé
- Breast Cancer Translational Research Laboratory J.C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), U-CRC, Bruxelles, Belgium
| | | | - David Venet
- Breast Cancer Translational Research Laboratory J.C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), U-CRC, Bruxelles, Belgium
| | | | - Ian Bradburry
- Frontier Science (Scotland) Ltd, Kingussie, United Kingdom
| | - Ghizlane Rouas
- Breast Cancer Translational Research Laboratory J.C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), U-CRC, Bruxelles, Belgium
| | - Evandro de Azambuja
- Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Marion Maetens
- Breast Cancer Translational Research Laboratory J.C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), U-CRC, Bruxelles, Belgium
| | | | | | | | - Daniela Rosa
- Hospital Moinhos de Vento, Rio Grande do Sul, Brazil
| | - Stephen Chia
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Wardley
- The NIHR Manchester Clinical Research Facility at The Christie NHS Foundation Trust, School of Medical Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester, United Kingdom
| | | | | | | | - Jose Baselga
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martine Piccart
- Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Sherene Loi
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory J.C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), U-CRC, Bruxelles, Belgium
| | | | - Michail Ignatiadis
- Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium.
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Bareche Y, Buisseret L, Gruosso T, Girard E, Venet D, Dupont F, Desmedt C, Park M, Rothé F, Stagg J, Sotiriou C. Abstract P4-06-03: Unravelling triple-negative breast cancer tumor microenvironment heterogeneity using an integrative multiomic analysis. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-06-03] [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: Triple negative breast cancer (TNBC) constitute 10-20% of all breast cancers and is associated with a worse prognosis and limited treatment options. Recent trials evaluating immune checkpoint blockade in TNBC demonstrated encouraging results for a subset of patients. TNBC is highly heterogeneous and its tumour microenvironment (TME) has been recognized as a critical determinant of its behavior and clinical outcome. Genome-wide gene expression profiling analyses have already improved our understanding of the complexity of this disease and have defined 6 different molecular subtypes namely Basal-like 1 (BL1), basal-like 2 (BL2), immunomodulatory (IM), mesenchymal (M), mesenchymal stem-like (MSL) and luminal androgen receptor (LAR), exhibiting distinct biological and clinical characteristic.
In this study, we aim to dissect the molecular diversity of the TME and more specifically to assess the immune landscape according to TNBC molecular subtypes.
Methods: A cohort of 485 TNBC patient with publicly available data (RNA-Seq and Illumina HT-12 v3) from the METABRIC and the TCGA consortia were used in the gene expression analysis. Gene signatures reflecting different features or cellular components (immune, stromal, angiogenesis, lymphangiogenesis, hypoxia, metabolism) of the TME were used to evaluate multiple biological processes known to contribute to tumorogenesis. A compendium of 17 immune specific gene signatures and T cell localisation classification were used to evaluate the immune composition and spatial pattern of immune infiltrates. All parameters were compared using a logistic regression model to evaluate their relative contribution according to each molecular subtype.
Results: Our analyses demonstrated that each molecular subtype exhibits different TME profiles, as well as specific immune composition and localisation. IM tumors were associated with the highest expression of immune-related gene signatures, enriched with adaptive immune cells and with a fully inflamed spatial pattern. MSL tumors were mostly associated with the expression of Lymphangiogenesis and Stromal TME signatures. They also exhibited some immune activity through the expression of immune gene signatures capturing innate immune and adaptive immunosuppressive cells. This subtype was mainly associated with margin restricted and to some extent with fully inflamed spatial pattern. BL1 tumors were associated with the expression of Metabolism TME signatures, along with fully inflamed and stroma restricted spatial pattern. To a lesser extent, this subtype was also associated with activated DC and CD4 Tem cells. LAR and M tumors exhibited an immune cold phenotype. They were associated with Stromal and Metabolism TME signatures, enriched in margin restricted spatial pattern and negatively associated with every immune cells.
Conclusions: Our results demonstrate for the first time the huge heterogeneity that characterizes the TME of TNBCs. Identification of specific TME profiles could help to design more rationale and appropriate synergistic therapeutic combinations targeting TME elements in this high-risk disease.
Citation Format: Bareche Y, Buisseret L, Gruosso T, Girard E, Venet D, Dupont F, Desmedt C, Park M, Rothé F, Stagg J, Sotiriou C. Unravelling triple-negative breast cancer tumor microenvironment heterogeneity using an integrative multiomic analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-06-03.
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Affiliation(s)
- Y Bareche
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - L Buisseret
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - T Gruosso
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - E Girard
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - D Venet
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - F Dupont
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - C Desmedt
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - M Park
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - F Rothé
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - J Stagg
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Goodman Cancer Research Center, McGill University, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
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Hanker AB, Garrett JT, Estrada MV, Moore PD, Ericsson PG, Koch JP, Langley E, Singh S, Kim PS, Frampton GM, Sanford E, Owens P, Becker J, Groseclose MR, Castellino S, Joensuu H, Huober J, Brase JC, Majjaj S, Brohée S, Venet D, Brown D, Baselga J, Piccart M, Sotiriou C, Arteaga CL. Correction: HER2-Overexpressing Breast Cancers Amplify FGFR Signaling upon Acquisition of Resistance to Dual Therapeutic Blockade of HER2. Clin Cancer Res 2019; 25:1434. [DOI: 10.1158/1078-0432.ccr-18-4267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Szekely B, Bareche Y, Van den Eynden G, Salgado R, Buisseret L, Garaud S, Willard-Gallo K, Hatzis C, Szasz M, Kulka J, Larsimont D, Sotiriou C, Pusztai L, Desmedt C. Abstract PD5-10: Immune characterization of matched primary and multiple metastatic samples issued from an institutional autopsy cohort. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-10] [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
While immune infiltrates have already been extensively characterized in primary tumors (P), data on breast cancer metastases (M) remains limited. To this end we quantified and qualified the immune cells in a unique cohort of multiple matched P and M samples selected from an institutional breast cancer autopsy cohort.
Patients and methods
Twenty-three patients were selected from an institutional autopsy program (Semmelweis University, Budapest, Hungary) based on matched P and M sample availability (124 samples). All samples were centrally characterized for estrogen (ER), progesterone (PR) and HER2 receptors. The primary molecular subtypes were as follows: 9 ER+/PR+/HER2-, 8 triple negative and 6 HER2+. Ten patients relapsed ≤1 year after diagnosis and were further referred to as “early relapsers”, as opposed to the remaining qualified as “late relapsers”. Immunohistochemistry (IHC) was carried out against CD3/CD20 and CD4/CD8 in 21 patients (119 samples). Tumor infiltrating lymphocytes (TILs) were assessed on hematoxylin and eosin (H&E) and CD3-stained slides. Gene expression data were generated using the NanoString nCounter assay (PanCancer Immune Profiling Panel) for 11 patients (35 samples) and analyzedusing the R package NanoStringQCPro. The scores from published immune gene signatures were calculated as a weighted sum of the expressions of their genes. All samples were analyzed for 22 immune cell subtypes relative abundance using CIBERSORT.
Results
TILs assessed on H&E and CD3-stained slides were weakly correlated (Rho= 0.38, p<.001). TIL levels as well as the number of tertiary lymphoid structures (TLS) were significantly lower in Ms as compared to Ps (p<.001). Among the different metastatic sites, the lung was more infiltrated when considering CD3+ and CD4+ cells (p=.01 and .02, respectively). We further observed significantly higher levels of TILs, CD3+, CD4+ and CD8+ cells in the Ms but not in the Ps from late relapsers as opposed to those from early relapsers. Gene expression analyses further confirmed these observations as several immune gene signatures displayed significantly higher scores in the Ms from late compared to early relapsers. An unsupervised analysis identified 13 genes significantly differentially expressed between Ps and Ms: CSF1R, CXCL14, CYBB, IL21R, IL2RB, TNF and TNFSF15 were upregulated in Ps while BCL2L1, C7, HSD11B1, and PSMB7 were upregulated in Ms. The matched P/M CIBERSORT analyses revealed a distinct composition of immune cell types between P and M of a same patient. Apart from a potential increase in M0 macrophages, no common trait was observed in immune cell composition between the Ms from the different patients.
Conclusion
This is to the best of our knowledge the first study characterizing the immune infiltration in patients with multiple matched P and M samples. The results suggest that Ms have not only a globally lower immune infiltration as compared to Ps, but also a different immune composition. Additionally, Ms from late relapsers are more infiltrated as compared to early relapsers. The present data also uncovers not only important inter-patient but also intra-patient immune heterogeneity, which should be taken into consideration for optimal treatment decision.
Citation Format: Szekely B, Bareche Y, Van den Eynden G, Salgado R, Buisseret L, Garaud S, Willard-Gallo K, Hatzis C, Szasz M, Kulka J, Larsimont D, Sotiriou C, Pusztai L, Desmedt C. Immune characterization of matched primary and multiple metastatic samples issued from an institutional autopsy cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-10.
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Affiliation(s)
- B Szekely
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - Y Bareche
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - G Van den Eynden
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - R Salgado
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - L Buisseret
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - S Garaud
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - K Willard-Gallo
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - C Hatzis
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - M Szasz
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - J Kulka
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - D Larsimont
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - C Sotiriou
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - L Pusztai
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - C Desmedt
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
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Nguyen B, Marion M, Salgado R, Venet D, Vuylsteke P, Polastro L, Wieldiers H, Simon P, Lindeman G, Larsimont D, Van den Eynden G, Velghe C, Rothe F, Garaud S, Michiels S, Willard-Gallo K, Azim Jr HA, Loi S, Piccart M, Sotiriou C. Abstract PD5-06: The immunomodulatory potential of denosumab in breast cancer: results from D-BEYOND, a window of opportunity trial evaluating a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Breast cancer (BC) in young women has unique biology and poor prognosis. Previous reports suggest that they often express RANKL, which was also shown to play a role in mammary tumorigenesis and various immune processes. Here, we present the primary results of D-BEYOND, a window study investigating the biological activity of the RANKL inhibitor; denosumab in pre-menopausal BC patients.
Methods
D-BEYOND is a prospective, phase Iia, single-arm, multicenter study assessing the effect of denosumab on BC biology in premenopausal women with early BC (NCT01864798). Patients received two subcutaneous injections of denosumab (120mg), one week apart, followed by breast surgery. The primary endpoint was geometric mean change in tumor Ki67 assessed by immunohistochemistry (IHC). Blood, tumor and normal adjacent breast tissue were collected pre- and post-treatment. Serum levels of RANKL, OPG and CTX were assessed by ELISA. RNA was extracted from fresh-frozen tissue and RNAseq was performed. DESeq2 was used for differential expression analysis, GAGE was used for pathway analysis and CIBERSORT was used to infer immune cell subsets between pre- and post-treatment. Ki67, CD4/Foxp3 and CD4/CD8 IHC were performed on FFPE tissue to further assess the immune microenvironment. The percentage of TILs was independently evaluated by two pathologists on H&E slides. Pre- and post-treatment values were compared using a paired t-test.
Results
A total of 27 patients were enrolled in the study between October 2013 and July 2016. The median age was 45 years (range 35-51 years). Tumors of 21 patients were hormone receptor positive (77.8%), 4 were HER2 positive (14.8%) and 2 were triple negative (7.4%). No serious adverse events were reported, the most frequent non-serious adverse event being arthralgia (14.8%). After treatment, serum levels of CTX and RANKL decreased in all patients (P < 0.001) whereas OPG increased in 76.9% of patients (P = 0.009, 95% CI 0.56-0.91). There was no significant reduction of Ki67 values from baseline (geometric mean [GM] change after treatment; 0.98, 95% CI 0.76-1.26; P = 0.90). Twenty-four pre- and post-treatment tumor pairs were available for RNAseq, IHC and TILs evaluation. There was a significant increase in the percentage of stromal TILs after treatment (GM change of 1.75, 95% CI 1.28–2.39; P = 0.001). 1084 differentially expressed genes were identified and pathway analysis revealed enrichment of several immune processes. CIBERSORT revealed an enrichment of CD8+ T cells (GM change 1.72, 95% CI 1.19–2.48; P = 0.006) and a decrease of Treg cells (0.71, 95% CI 0.52–0.98, P = 0.040). These results were confirmed by IHC of CD8+ and CD4+/Foxp3+ cells (GM change 1.59, 95% CI 1.14–2.21; P = 0.008 and 0.63, 95% CI 0.49–0.83, P = 0.001, respectively).
Conclusion
Short course of denosumab did not reduce tumor proliferation rate. However, it induced a significant increase in TILs and CD8 cytotoxic T cells, while Treg infiltration decreased. These findings suggest an immunomodulatory role for denosumab in young breast cancer and that its use in combination could boost immunotherapy efficacy.
Citation Format: Nguyen B, Marion M, Salgado R, Venet D, Vuylsteke P, Polastro L, Wieldiers H, Simon P, Lindeman G, Larsimont D, Van den Eynden G, Velghe C, Rothe F, Garaud S, Michiels S, Willard-Gallo K, Azim Jr HA, Loi S, Piccart M, Sotiriou C. The immunomodulatory potential of denosumab in breast cancer: results from D-BEYOND, a window of opportunity trial evaluating a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-06.
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Affiliation(s)
- B Nguyen
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - M Marion
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - R Salgado
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - D Venet
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - P Vuylsteke
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - L Polastro
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - H Wieldiers
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - P Simon
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - G Lindeman
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - D Larsimont
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - G Van den Eynden
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - C Velghe
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - F Rothe
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - S Garaud
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - S Michiels
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - K Willard-Gallo
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - HA Azim Jr
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - S Loi
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - M Piccart
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - C Sotiriou
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
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Solinas C, de Wind A, Van den Eynden G, Ameye L, Garaud S, De Silva P, Boisson A, Noel G, Langouo Fontsa M, Buisseret L, de Azambuja E, Francis PA, Di Leo A, Crown JP, Sotiriou C, Larsimont D, Paesmans M, Piccart-Gebhart M, Willard-Gallo K. Abstract PD5-09: Immune parameters associated with survival in triple negative and HER2-positive breast cancer patients with 10 years of follow-up. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The clinical utility of tumor-infiltrating lymphocytes (TIL) is actively being investigated in breast cancer (BC). It is unclear whether TIL spatial location and organization in tertiary lymphoid structures (TLS) have an impact on prognosis. Additionally, the significance of PD-1 and PD-L1 expression is being debated due to conflicting data from several studies. We hypothesize that the presence, extent and spatial location of multiple immune biomarkers, reflecting ongoing immune responses, will be consistently associated with a good prognosis in highly infiltrated BC [triple-negative (TNBC) and HER2+].
The relationship between these immune biomarkers and clinical outcome was examined in the TNBC and HER2+ cohorts of node-positive BC patients enrolled in the BIG 02-98 adjuvant phase III trial with available material for immunohistochemical (IHC) labeling (N=113 and N=136, respectively). HER2+ patients did not receive trastuzumab. Dual IHC staining was performed on full-face consecutive tissue sections. Scoring was independently performed by two pathologists, blinded to the clinical data, and included: global, intratumoral and stromal TIL and TLS, assessed on CD3/CD20 slides; the percentage and location of PD-1 and PD-L1 expression, assessed on PD-1/PD-L1 slides. TIL were considered as a categorical variable with different cut-offs used for each parameter and for each cohort (TNBC and HER2+). Invasive disease-free survival (I-DFS) and overall survival (OS) were analyzed (median follow-up: 10 years). Cox proportional hazard models were used for survival analyses.
The TNBC cohort revealed an association between global TIL and outcome [adjusted hazard ratio (HR) for I-DFS: 0.27 (0.15-0.51); OS: 0.26 (0.13-0.53)]. Similar results were observed for stromal and intratumoral TIL. PD-L1 expression within TLS was an independent predictor of OS, after adjustment for tumor size and age [HR: 0.30 (0.09-0.99)]. Multivariate analysis reveals this effect was principally driven by high stromal TIL (>17.5% based on CD3/CD20 assessment) (χ2 OS: p=0.009). In contrast, no significant prognostic associations were found in the overall HER2+ cohort. However high T cell TIL were associated with improved I-DFS and OS in the ER-/HER2+ group [I-DFS: 0.34 (0.14-0.80); OS: 0.32 (0.12-0.86)] and stromal TIL were associated with improved I-DFS in the ER+/HER2+ group [HR: 0.29 (0.09-0.94)] (univariate analyses). No significant associations between the number of TLS nor the expression of PD-1 with outcomes were observed in either cohorts.
The presence of PD-L1+ TLS, driven by high baseline TIL, was associated with an excellent prognosis in node-positive TNBC. This observation might reflect specific immune activities taking place in these mini lymph node-like structures adjacent to the tumor bed where specific antitumor memory immune responses could be generated. No different prognostic impact was observed when analyzing TIL spatial location. Although the statistical power of the study might be limited, in line with previous findings our data reveal that, among the immune parameters evaluated, TIL are the strongest predictor of outcome in TNBC, while PD-L1+ TLS could be a new and important parameter that requires further investigation.
Citation Format: Solinas C, de Wind A, Van den Eynden G, Ameye L, Garaud S, De Silva P, Boisson A, Noel G, Langouo Fontsa M, Buisseret L, de Azambuja E, Francis PA, Di Leo A, Crown JP, Sotiriou C, Larsimont D, Paesmans M, Piccart-Gebhart M, Willard-Gallo K. Immune parameters associated with survival in triple negative and HER2-positive breast cancer patients with 10 years of follow-up [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-09.
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Affiliation(s)
- C Solinas
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - A de Wind
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - G Van den Eynden
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - L Ameye
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - S Garaud
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - P De Silva
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - A Boisson
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - G Noel
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - M Langouo Fontsa
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - L Buisseret
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - E de Azambuja
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - PA Francis
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - A Di Leo
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - JP Crown
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - C Sotiriou
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - D Larsimont
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - M Paesmans
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - M Piccart-Gebhart
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
| | - K Willard-Gallo
- Molecular Immunology Unit, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium; Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Bruxelles, Belgium; Peter MacCallum Cancer Centre, St. Vincent's Hospital, University of Melbourne, and Breast Cancer Trials Australia and New Zealand, University of Newcastle, Melbourne, Australia; Hospital of Prato, Prato, Italy; Medical Oncology, Vincent's University Hospital, Dublin, Ireland
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Nguyen B, Venet D, Lambertini M, Desmedt C, Salgado R, Horlings HM, Rothé F, Sotiriou C. Imprint of parity and age at first pregnancy on the genomic landscape of subsequent breast cancer. Breast Cancer Res 2019; 21:25. [PMID: 30770770 PMCID: PMC6377756 DOI: 10.1186/s13058-019-1111-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/31/2019] [Indexed: 12/12/2022] Open
Abstract
Background Although parity and age at first pregnancy are among the most known extrinsic factors that modulate breast cancer risk, their impact on the biology of subsequent breast cancer has never been explored in depth. Recent data suggest that pregnancy-induced tumor protection is different according to breast cancer subtypes, with parity and young age at first pregnancy being associated with a marked reduction in the risk of developing luminal subtype but not triple negative breast cancer. In this study, we investigated the imprint of parity and age at first pregnancy on the pattern of somatic mutations, somatic copy number alterations, transcriptomic profiles, and tumor immune microenvironment by assessing tumor-infiltrating lymphocytes (TILs) levels of subsequent breast cancer. Methods A total of 313 patients with primary breast cancer with available whole genome, RNA sequencing, and TILs data were included in this study. We used a multivariate analysis adjusted for age at diagnosis, pathological stage, molecular subtypes, and histological subtypes. We compared nulliparous vs. parous, late parous vs. early parous, and nulliparous vs. pregnancy-associated breast cancer (PABC) patients. Late and early parous patients were grouped by using the median age at first pregnancy. PABC was defined as patients diagnosed up to 10 years postpartum. Results Genomic alterations of breast cancer were associated with age at first pregnancy but not with parity status alone. Independently of clinicopathological features, early parous patients developed tumors characterized by a higher number of Indels (Padj = 0.002), a lower frequency of CDH1 mutations (1.2% vs. 12.7%; Padj = 0.013), a higher frequency of TP53 mutations (50% vs. 22.5%; Padj = 0.010), and MYC amplification (28% vs. 7%; Padj = 0.008). PABC were associated with increased TILs infiltration (Padj = 0.0495). Conclusions These findings highlight an unprecedented link between reproductive history and the genomic landscape of subsequent breast cancer. We further hypothesize that TP53-mutant premalignant lesions could be less susceptible to the protective effect of an early parity, which might explain the difference of parity-induced protection according to breast cancer subtypes. This work also advocates that reproductive history should be routinely collected in future large-scale genomic studies addressing the biology of female cancers. Electronic supplementary material The online version of this article (10.1186/s13058-019-1111-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bastien Nguyen
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium. .,Present Address: Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
| | - David Venet
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Matteo Lambertini
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Department of Medical Oncology, Clinica di Oncologia Medica, Ospedale Policlinico San Martino, & Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Christine Desmedt
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Department of Pathology, GZA-ZNA, Antwerp, Belgium
| | - Hugo Mark Horlings
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Françoise Rothé
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Desmedt C, Veys I, Nguyen B, Leduc S, Bareche Y, Majjaj S, Boeckx B, Lambrechts D, Sotiriou C. Abstract P3-07-04: Molecular characterization of mucinous breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-07-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Mucinous carcinoma, a special histological subtype of breast cancer (BC) which accounts for ˜2% of all invasive breast tumors, is characterized by the presence of extracellular mucin, typically expresses the estrogen receptor (ER), and lacks HER2 amplification. The majority of patients with mucinous BC are older at diagnosis, rarely present axillary lymph node metastases, and are associated with a better prognosis as compared to invasive ductal cancer patients (IDC, formally referred to as “breast cancer of no special type”). So far, it is unknown what is driving the mucinous phenotype of these tumors. Here we interrogated the genomics, transcriptomics, immune infiltration and epigenetics profiles of these tumors, using a retrospective institutional series and a publicly available dataset.
Patients and methods
After central pathology review and DNA extraction, a total of 31 pure mucinous cases from Institut J. Bordet Biobank were included (referred to as IJB cohort). Tumor infiltrating lymphocytes (TILs) were assessed on hematoxylin and eosin (H&E). Low pass whole genome sequencing was conducted to assess ploidy and to detect copy number aberrations (CNAs). A second cohort was analyzed from a publicly available dataset (referred to as BRCA560 cohort), with available centrally reviewed histology subtyping and DNA methylation profiles (Nik-Zainal et al. Nature 2016). 207 ER+ primary BC, 14 of which were mucinous, had HumanMethylation450K methylation profiles. RNAseq was available for a subset of 145 cancers, 13 of which were mucinous. DNA methylation data was processed in R using the minfi package. Beta-values were normalized (preprocessQuantile) and dmpFinder was used to identify differentially methylated positions.
Results
In the IJB cohort, whole genome sequencing revealed that all but two tumors were diploid. The most frequently deleted cancer genes were RB1 (38,1%), CDH1 (23,8%), BRCA2 (38,1%),TP53 (23,8%), MAP2K4 (23,8%), EGFR (28,6%) and PGR (23,8%). In terms of amplifications, only ZNF217 (19,4%) and FGFR1/ZNF703 (9,5%) were observed. These mucinous tumors generally displayed low TIL levels (median=5%). In the BRCA560 cohort, there was no significant difference in the clinico-pathological features of ER+ IDC vs mucinous subtypes. At the genomic level, we identified a lower frequency of PIK3CA mutations as compared to ER+ IDC from the same cohort. At the DNA methylation level, we identified 8013 differentially methylated CpGs (q-val < .05) between IDC and mucinous tumors. The top differentially methylated CpG mapped to MUC2, an extracellular mucin. MUC2 was significantly demethylated in mucinous tumors as compared to IDC (q-val <.001). There was a negative association between methylation level of this CpG and MUC2 expression (rho = - 0.27, p< .001). Finally, MUC2 expression was significantly increased in mucinous tumors as compared to IDC (p< .001).
Conclusion
To the best of our knowledge, this study is the first to report hypomethylation of MUC2 in mucinous carcinoma of the breast, as a possible mechanism of extracellular production of mucin in these tumors. Furthermore, it highlights the minor immune infiltration of these cancers, possibly prevented by the mucin, and sheds light on the few genomic alterations present in these overall stable cancer genomes.
Citation Format: Desmedt C, Veys I, Nguyen B, Leduc S, Bareche Y, Majjaj S, Boeckx B, Lambrechts D, Sotiriou C. Molecular characterization of mucinous breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-07-04.
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Affiliation(s)
- C Desmedt
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - I Veys
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - B Nguyen
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - S Leduc
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - Y Bareche
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - S Majjaj
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - B Boeckx
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - D Lambrechts
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
| | - C Sotiriou
- Institut Jules Bordet- Université Libre de Bruxelles, Brussels, Belgium; VIB-KU Leuven Center for Cancer Biology, Leuven, Belgium
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Sonnenblick A, Venet D, Brohée S, Pondé N, Sotiriou C. pAKT pathway activation is associated with PIK3CA mutations and good prognosis in luminal breast cancer in contrast to p-mTOR pathway activation. NPJ Breast Cancer 2019; 5:7. [PMID: 30729154 PMCID: PMC6355773 DOI: 10.1038/s41523-019-0102-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 01/08/2019] [Indexed: 12/19/2022] Open
Abstract
Numerous studies have focused on the PI3K/AKT/mTOR pathway in estrogen receptor positive (ER) breast cancer (BC), as a linear signal transduction pathway and reported its association with worse clinical outcomes. We developed gene signatures that reflect the level of expression of phosphorylated-Serine473-AKT (pAKT) and phosphorylated-Serine2448-mTOR (p-mTOR) separately, capturing their corresponding level of pathway activation. Our analysis revealed that the pAKT pathway activation was associated with luminal A BC while the p-mTOR pathway activation was more associated with luminal B BC (Kruskal-Wallis test p < 10-10). pAKT pathway activation was significantly associated with better outcomes (multivariable HR, 0.79; 95%CI, 0.74-0.85; p = 2.5 × 10-10) and PIK3CA mutations (p = 0.0001) whereas p-mTOR pathway activation showed worse outcomes (multivariable HR,1.1; 95%CI, 1.1-1.2; p = 9.9 × 10-4) and associated with p53 mutations (p = 0.04). in conclusion, our data show that pAKT and p-mTOR pathway activation have differing impact on prognosis and suggest that they are not linearly connected in luminal breast cancers.
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Affiliation(s)
- Amir Sonnenblick
- 1Oncology Division, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Venet
- 2Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sylvain Brohée
- 2Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Noam Pondé
- 2Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- 2Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Nik-Zainal S, Davies H, Staaf J, Ramakrishna M, Glodzik D, Zou X, Martincorena I, Alexandrov LB, Martin S, Wedge DC, Van Loo P, Ju YS, Smid M, Brinkman AB, Morganella S, Aure MR, Lingjærde OC, Langerød A, Ringnér M, Ahn SM, Boyault S, Brock JE, Broeks A, Butler A, Desmedt C, Dirix L, Dronov S, Fatima A, Foekens JA, Gerstung M, Hooijer GKJ, Jang SJ, Jones DR, Kim HY, King TA, Krishnamurthy S, Lee HJ, Lee JY, Li Y, McLaren S, Menzies A, Mustonen V, O’Meara S, Pauporté I, Pivot X, Purdie CA, Raine K, Ramakrishnan K, Rodríguez-González FG, Romieu G, Sieuwerts AM, Simpson PT, Shepherd R, Stebbings L, Stefansson OA, Teague J, Tommasi S, Treilleux I, Van den Eynden GG, Vermeulen P, Vincent-Salomon A, Yates L, Caldas C, van’t Veer L, Tutt A, Knappskog S, Tan BKT, Jonkers J, Borg Å, Ueno NT, Sotiriou C, Viari A, Futreal PA, Campbell PJ, Span PN, Van Laere S, Lakhani SR, Eyfjord JE, Thompson AM, Birney E, Stunnenberg HG, van de Vijver MJ, Martens JWM, Børresen-Dale AL, Richardson AL, Kong G, Thomas G, Stratton MR. Author Correction: Landscape of somatic mutations in 560 breast cancer whole-genome sequences. Nature 2019; 566:E1. [DOI: 10.1038/s41586-019-0883-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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115
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Loi S, Drubay D, Adams S, Pruneri G, Francis PA, Lacroix-Triki M, Joensuu H, Dieci MV, Badve S, Demaria S, Gray R, Munzone E, Lemonnier J, Sotiriou C, Piccart MJ, Kellokumpu-Lehtinen PL, Vingiani A, Gray K, Andre F, Denkert C, Salgado R, Michiels S. Tumor-Infiltrating Lymphocytes and Prognosis: A Pooled Individual Patient Analysis of Early-Stage Triple-Negative Breast Cancers. J Clin Oncol 2019; 37:559-569. [PMID: 30650045 DOI: 10.1200/jco.18.01010] [Citation(s) in RCA: 469] [Impact Index Per Article: 93.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of the current study was to conduct a pooled analysis of studies that have investigated the prognostic value of tumor-infiltrating lymphocytes (TILs) in early-stage triple negative breast cancer (TNBC). METHODS Participating studies had evaluated the percentage infiltration of stromally located TILs (sTILs) that were quantified in the same manner in patient diagnostic samples of early-stage TNBC treated with anthracycline-based chemotherapy with or without taxanes. Cox proportional hazards regression models stratified by trial were used for invasive disease-free survival (iDFS; primary end point), distant disease-free survival (D-DFS), and overall survival (OS), fitting sTILs as a continuous variable adjusted for clinicopathologic factors. RESULTS We collected individual data from 2,148 patients from nine studies. Average age was 50 years (range, 22 to 85 years), and 33% of patients were node negative. The average value of sTILs was 23% (standard deviation, 20%), and 77% of patients had 1% or more sTILs. sTILs were significantly lower with older age ( P = .001), larger tumor size ( P = .01), more nodal involvement ( P = .02), and lower histologic grade ( P = .001). A total of 736 iDFS and 548 D-DFS events and 533 deaths were observed. In the multivariable model, sTILs added significant independent prognostic information for all end points (likelihood ratio χ2, 48.9 iDFS; P < .001; χ2, 55.8 D-DFS; P < .001; χ2, 48.5 OS; P < .001). Each 10% increment in sTILs corresponded to an iDFS hazard ratio of 0.87 (95% CI, 0.83 to 0.91) for iDFS, 0.83 (95% CI, 0.79 to 0.88) for D-DFS, and 0.84 (95% CI, 0.79 to 0.89) for OS. In node-negative patients with sTILs ≥ 30%, 3-year iDFS was 92% (95% CI, 89% to 98%), D-DFS was 97% (95% CI, 95% to 99%), and OS was 99% (95% CI, 97% to 100%). CONCLUSION This pooled data analysis confirms the strong prognostic role of sTILs in early-stage TNBC and excellent survival of patients with high sTILs after adjuvant chemotherapy and supports the integration of sTILs in a clinicopathologic prognostic model for patients with TNBC. This model can be found at www.tilsinbreastcancer.org .
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Affiliation(s)
- Sherene Loi
- 1 Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Damien Drubay
- 2 Gustave Roussy, Université Paris-Saclay, Villejuif, France.,3 Université Paris-Sud, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | - Sylvia Adams
- 4 New York University School of Medicine, New York, NY
| | - Giancarlo Pruneri
- 5 Fondazione Istituto di Ricovero e Cura a Carattere Scientifico-Isituto Nazionale dei Tumori, Universita degli Studi di Milano, Milan, Italy
| | - Prudence A Francis
- 1 Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | | | - Heikki Joensuu
- 7 Helsinki University Central Hospital, Helsinki, Finland
| | - Maria Vittoria Dieci
- 8 University of Padova, Padova, Italy.,9 Veneto Insitute of Oncology-IOV-IRCCS, Padua, Italy
| | | | | | | | | | | | - Christos Sotiriou
- 14 Institut Jules Bordet, Universite Libre de Bruxelles, Brussels, Belgium
| | - Martine J Piccart
- 14 Institut Jules Bordet, Universite Libre de Bruxelles, Brussels, Belgium
| | | | | | | | - Fabrice Andre
- 2 Gustave Roussy, Université Paris-Saclay, Villejuif, France.,3 Université Paris-Sud, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | | | - Roberto Salgado
- 1 Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia.,18 GZA, Antwerp, Belgium
| | - Stefan Michiels
- 2 Gustave Roussy, Université Paris-Saclay, Villejuif, France.,3 Université Paris-Sud, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
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Powles RL, Redmond D, Sotiriou C, Loi S, Fumagalli D, Nuciforo P, Harbeck N, de Azambuja E, Sarp S, Di Cosimo S, Huober J, Baselga J, Piccart-Gebhart M, Elemento O, Pusztai L, Hatzis C. Association of T-Cell Receptor Repertoire Use With Response to Combined Trastuzumab-Lapatinib Treatment of HER2-Positive Breast Cancer: Secondary Analysis of the NeoALTTO Randomized Clinical Trial. JAMA Oncol 2018; 4:e181564. [PMID: 29902299 DOI: 10.1001/jamaoncol.2018.1564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Importance Dual anti-HER2 blockade increased the rate of pathologic complete response (pCR) in the Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimisation (NeoALTTO) trial, and high immune gene expression was associated with pCR in all treatment arms. So far, no marker has been identified that is specifically associated with the benefit from dual HER2 blockade. Objective To examine if use of the T-cell β chain variable genes adds to the potential association of immune gene signatures with response to dual HER2 blockade. Design, Setting, and Participants In the NeoALTTO trial, HER2-positive patients recruited between January 5, 2008, and May 27, 2010, were treated with paclitaxel plus either lapatinib or trastuzumab or both as neoadjuvant therapy. In this study, RNA sequencing data from baseline tumor specimens of 245 patients in the NeoALTTO trial were analyzed and reads were aligned to TRBV gene reference sequences using a previously published Basic Local Alignment Search Tool T-cell receptor mapping pipeline. Total TRBV gene use, Shannon entropy, and gene richness were calculated for each tumor, and nonnegative matrix factorization was used to define TRBV co-use metagenes (TMGs). The association between TRBV metrics, tumor genomic metrics, and response was assessed with multivariable logistic regression. Statistical analysis was performed from January 23 to December 2, 2017. Main Outcomes and Measures The association between TRBV use metrics and pCR. Results Among the 245 women with available data (mean [SD] age, 49 [11] years), total TRBV use correlated positively with a gene expression signature for immune activity (Spearman ρ = 0.93; P < .001). High use of TRBV11-3 and TMG2, characterized by high use of TRBV4.3, TRBV6.3, and TRBV7.2, was associated with a higher rate of pCR to dual HER2-targeted therapy (TRBV11-3 interaction: odds ratio, 2.63 [95% CI, 1.22-6.47]; P = .02; TMG2 interaction: odds ratio, 3.39 [95% CI, 1.57-8.27]; P = .004). Immune-rich cancers with high TMG2 levels (n = 92) had significantly better response to dual HER2-targeted treatment compared with the single therapy arms (rate of pCR, 68% [95% CI, 52%-83%] vs 21% [95% CI, 10%-31%]; P < .001), whereas those with low TMG2 levels did not benefit from dual therapy. High TMG2 levels were also associated with a higher rate of pCR to the combined therapy in immune-poor tumors (n = 30; pCR, 50% [95% CI, 22%-78%] vs 6% [95% CI, 0%-16%]; P = .009). Conclusions and Relevance Use patterns of TRBV genes potentially provide information about the association with response to dual HER2 blockade beyond immune gene signatures. High use of TRBV11.3 or TRBV4.3, TRBV6.3, and TRBV7.2 identifies patients who have a better response to dual HER2 targeted therapy. Trial Registration ClinicalTrials.gov Identifier: NCT00553358.
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Affiliation(s)
- Ryan L Powles
- Breast Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut.,Computational Biology and Bioinformatics Program, Yale University, New Haven, Connecticut
| | - David Redmond
- Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sherene Loi
- Division of Cancer Medicine and Research, Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia
| | - Debora Fumagalli
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Paolo Nuciforo
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology, University of Munich, Munich, Germany
| | - Evandro de Azambuja
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Jens Huober
- Department of Obstetrics and Gynecology, University of Ulm, Ulm, Germany
| | - Jose Baselga
- Breast Medical Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martine Piccart-Gebhart
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Elemento
- Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York.,Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medical College, New York, New York
| | - Lajos Pusztai
- Breast Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Christos Hatzis
- Breast Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
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Loibl S, Majewski I, Guarneri V, Nekljudova V, Holmes E, Bria E, Denkert C, Schem C, Sotiriou C, Loi S, Untch M, Conte P, Bernards R, Piccart M, von Minckwitz G, Baselga J. PIK3CA mutations are associated with reduced pathological complete response rates in primary HER2-positive breast cancer: pooled analysis of 967 patients from five prospective trials investigating lapatinib and trastuzumab. Ann Oncol 2018; 29:2151. [PMID: 29701763 DOI: 10.1093/annonc/mdx803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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118
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Shi W, Jiang T, Nuciforo P, Hatzis C, Holmes E, Harbeck N, Sotiriou C, Peña L, Loi S, Rosa DD, Chia S, Wardley A, Ueno T, Rossari J, Eidtmann H, Armour A, Piccart-Gebhart M, Rimm DL, Baselga J, Pusztai L. Pathway level alterations rather than mutations in single genes predict response to HER2-targeted therapies in the neo-ALTTO trial. Ann Oncol 2018; 29:2152. [PMID: 29701764 DOI: 10.1093/annonc/mdx805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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119
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Klauschen F, Müller KR, Binder A, Bockmayr M, Hägele M, Seegerer P, Wienert S, Pruneri G, de Maria S, Badve S, Michiels S, Nielsen T, Adams S, Savas P, Symmans F, Willis S, Gruosso T, Park M, Haibe-Kains B, Gallas B, Thompson A, Cree I, Sotiriou C, Solinas C, Preusser M, Hewitt S, Rimm D, Viale G, Loi S, Loibl S, Salgado R, Denkert C. Scoring of tumor-infiltrating lymphocytes: From visual estimation to machine learning. Semin Cancer Biol 2018; 52:151-157. [DOI: 10.1016/j.semcancer.2018.07.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 12/12/2022]
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120
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Ignatiadis M, Brandao M, Maetens M, Ponde N, Martel S, Drisis S, Veys I, Mazy S, Bollue E, Neven P, Duhoux F, Chapiro J, Awada A, Besse-Hammer T, Paesmans M, Piccart M, Vuylsteke P, Sotiriou C. Neoadjuvant biomarker research study of palbociclib combined with endocrine therapy in estrogen receptor positive/HER2 negative breast cancer: The phase II NeoRHEA trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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121
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Jose V, Fumagalli D, Rothé F, Majjaj S, Loi S, Michiels S, Sotiriou C. Feasibility of developing reliable gene expression modules from FFPE derived RNA profiled on Affymetrix arrays. PLoS One 2018; 13:e0203346. [PMID: 30169535 PMCID: PMC6118369 DOI: 10.1371/journal.pone.0203346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/20/2018] [Indexed: 11/19/2022] Open
Abstract
The reliability of differential gene expression analysis on formalin-fixed, paraffin-embedded (FFPE) expression profiles generated using Affymetrix arrays is questionable, due to the high range of percent-present values reported in studies which profiled FFPE samples using this technology. Moreover, the validity of gene-modules derived from external datasets in FFPE microarray expression profiles is unknown. By generating matched gene expression profiles using RNAs derived from fresh-frozen (FF) and FFPE preserved breast tumors with Affymetrix arrays and FF/FFPE RNA specific amplification-and-labeling kits, the reliability of differential expression analysis and the validity of gene modules derived from external datasets were investigated. Specifically, the reliability of differential expression analysis was investigated by developing de-novo ER/HER2 pathway gene-modules from the matched datasets and validating them on external FF/FFPE gene expression datasets using ROC analysis. Spearman's rank correlation coefficient of module scores between matched FFPE/frozen datasets was used to measure the reliability of gene-modules derived from external datasets in FFPE expression profiles. Independent of the array/amplification-kit/sample preservation method used, de-novo ER/HER2 gene-modules derived from all matched datasets showed similar prediction performance in the independent validation (AUC range in FFPE dataset; ER: 0.93-0.95, HER2: 0.85-0.91), except for the de-novo ER/HER2 gene-module derived from the FFPE dataset using the 3'IVT kit (AUC range in FFPE dataset; ER: 0.79-0.81, HER2: 0.78). Among the external gene modules considered, roughly ~50% gene modules showed high concordance between expression profiles derived from matching FF and FFPE RNA. The remaining discordant gene modules between FF and FFPE expression profiles showed high concordance within matching FF datasets and within matching FFPE datasets independently, implying that microarrays still require improved amplification-and-sample-preparation protocols for deriving 100% concordant expression profiles from matching FF and FFPE RNA.
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Affiliation(s)
- Vinu Jose
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Debora Fumagalli
- Breast International Group, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Françoise Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Samira Majjaj
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sherene Loi
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Stefan Michiels
- Service de Biostatistique et D’Epidémiologie, Gustave Roussy, CESP, U1018, Université Paris-Sud, Faculté de Médcine, Université Paris-Saclay, Villejuif, France
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Department of Medicine, Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- * E-mail:
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Nguyen B, Venet D, Azim HA, Brown D, Desmedt C, Lambertini M, Majjaj S, Pruneri G, Peccatori F, Piccart M, Rothé F, Sotiriou C. Breast cancer diagnosed during pregnancy is associated with enrichment of non-silent mutations, mismatch repair deficiency signature and mucin mutations. NPJ Breast Cancer 2018; 4:23. [PMID: 30109263 PMCID: PMC6078984 DOI: 10.1038/s41523-018-0077-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/04/2018] [Accepted: 07/09/2018] [Indexed: 12/22/2022] Open
Abstract
Breast cancer diagnosed during pregnancy (BCP) is a rare and highly challenging disease. To investigate the impact of pregnancy on the biology of breast cancer, we conducted a comparative analysis of a cohort of BCP patients and non-pregnant control patients by integrating gene expression, copy number alterations and whole genome sequencing data. We showed that BCP exhibit unique molecular characteristics including an enrichment of non-silent mutations, a higher frequency of mutations in mucin gene family and an enrichment of mismatch repair deficiency mutational signature. This provides important insights into the biology of BCP and suggests that these features may be implicated in promoting tumor progression during pregnancy. In addition, it provides an unprecedented resource for further understanding the biology of breast cancer in young women and how pregnancy could modulate tumor biology.
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Affiliation(s)
- Bastien Nguyen
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - David Venet
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Hatem A. Azim
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Internal Medicine, American University of Beirut (AUB), Beirut, Lebanon
| | - David Brown
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Christine Desmedt
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Matteo Lambertini
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Samira Majjaj
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Giancarlo Pruneri
- Department of Pathology, IRCCS Istituto Nazionale Tumori, Milan and University of Milan, School of Medicine, Milan, Italy
| | | | - Martine Piccart
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Françoise Rothé
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Ignatiadis M, Litière S, Rothe F, Riethdorf S, Proudhon C, Fehm T, Aalders K, Forstbauer H, Fasching P, Brain E, Vuylsteke P, Guardiola E, Lorenz R, Pantel K, Tryfonidis K, Janni W, Piccart M, Sotiriou C, Rack B, Pierga JY. Trastuzumab versus observation for HER2 nonamplified early breast cancer with circulating tumor cells (EORTC 90091-10093, BIG 1-12, Treat CTC): a randomized phase II trial. Ann Oncol 2018; 29:1777-1783. [DOI: 10.1093/annonc/mdy211] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dupont F, Clatot F, Venet D, Kruys V, Fumagalli D, Detours V, Rothé F, Sotiriou C. Abstract 3801: Functional relevance of A-to-I RNA editing on the immune response in breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3801] [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: RNA editing is a post-transcriptional modification that changes double stranded RNA sequences (dsRNA). The most common way of editing in humans is the Adenosine-to-Inosine type, which is catalyzed by members of the ADAR enzymes family. A-to-I RNA editing has been shown to be essential for normal tissue development but also plays a crucial role in many cancers. We have notably shown that in breast cancer the editing frequency is increased in tumors as compared to normal tissue and correlates with ADAR expression. We also showed that type I IFN response and ADAR DNA copy number together explain 53% of ADAR expression in breast cancers. Moreover, the implication of ADAR-mediated RNA editing in preventing the sensing of endogenous dsRNA leading to inhibition of the immune response has been recently reported. ADAR-mediated RNA editing may play a crucial role in tumor progression by modulating immune response through the dsRNA sensing pathway. Here, we aim to assess the influence of ADAR-mediated RNA editing in the sensing of endogenous dsRNA and the immune response in breast cancer.
MATERIAL & METHODS: ADAR expression was modulated in MDAMB231 breast cancer cell line using shRNA lentiviral transduction and lentiviral plasmid transduction for ADAR inhibition and ADAR wild-type and editing-deficient mutant overexpression respectively. ADAR expression was assessed by RTqPCR/Western blotting. dsRNA level was evaluated by immunofluorescence using the dsRNA-specific J2 antibody (Scicons).
RESULTS: Poly I:C transfection, mimicking dsRNAs, as well as IFN Type I exposure induced the immune response in BC cell lines, in particular it increases the expression of RIG-I, MDA5 and IRF7 involved in the dsRNA sensing pathway. DNMTi treatment, known as an inducer of dsRNA level, also activated cytosolic dsRNA response in these cells in a dose dependent manner. In order to assess the role of ADAR-mediated RNA editing in the activation of the dsRNA sensing pathway, we exposed MDAMB231 cell lines in which ADAR expression was modulated to DNMTi. A wide range of doses of DNMTi, from 0.3 to 50μM, and time of exposure, from 3h to 72h, were tested. The cytosolic dsRNA pathway was induced in a dose dependent manner after DNMTi exposure. However, no effect of ADAR modulation on the activation of the pathway was observed. No difference in dsRNA levels was observed after activation of the immune pathway by DNMTi or IFN exposure, nor after ADAR modulation.
CONCLUSION & PERSPECTIVES: dsRNA pathway activation by DNMTi, poly I:C transfection or IFN Type I treatment is not dependent of ADAR in MDAMB231 cell lines. Moreover, in contrast to data in colorectal cell lines, our data suggest that DNMTi exposure does not increase cytosolic dsRNA level.
Citation Format: Floriane Dupont, Florian Clatot, David Venet, Véronique Kruys, Debora Fumagalli, Vincent Detours, Françoise Rothé, Christos Sotiriou. Functional relevance of A-to-I RNA editing on the immune response in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3801.
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Affiliation(s)
| | - Florian Clatot
- 2Henri-Becquerel Center and INSERM U1245, Bruxelles, France
| | - David Venet
- 1Institut Jules Bordet - ULB, Bruxelles, Belgium
| | - Véronique Kruys
- 3Institut de Biologie et de Médecine Moléculaires - ULB, Gosselies, Belgium
| | | | - Vincent Detours
- 5IRIBHM, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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Nguyen B, Maetens M, Salgado R, Venet D, Vuylsteke P, Polastro L, Wieldiers H, Simon P, Lindeman G, Larsimont D, Eynden GVD, Velghe C, Rothe F, Garaud S, Michiels S, Willard-gallo K, Azim HA, Loi S, Piccart M, Sotiriou C. Abstract CT101: D-BEYOND: A window of opportunity trial evaluating denosumab, a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-ct101] [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: 11/16/2022]
Abstract
Abstract
Background
Breast cancer (BC) in young women has unique biology and poor prognosis. Previous reports suggest that they often express RANKL, which was also shown to play a role in mammary tumorigenesis and the etiology of BRCA1/2 related BC. Here, we present the primary results of D-BEYOND, a window of opportunity study investigating the biological activity of the RANKL inhibitor; denosumab in pre-menopausal BC patients.
Methods
D-BEYOND is a prospective, phase IIa, single-arm, multicenter study assessing the effect of denosumab on BC biology in premenopausal women with early BC (NCT01864798). Patients received two subcutaneous injections of denosumab (120mg), one week apart, followed by breast surgery. Blood, tumor and normal adjacent breast tissue were collected at baseline and at surgery. The primary endpoint was geometric mean change in tumor Ki67 assessed by immunohistochemistry (IHC) from baseline to surgery. Absolute Ki67 responders were defined as having <2.7% IHC staining in the post-treatment tumor. Serum levels of soluble RANKL (sRANKL), OPG and C-terminal telopeptide (CTX) were assessed by ELISA. Ki67, RANK and RANKL expression were assessed by IHC. The percentage of tumor infiltrating lymphocytes (TILs) were also evaluated. Pre- and post-treatment values were compared using a paired t-test.
Results
A total of 27 patients were enrolled in the study between October 2013 and July 2016. The median age was 45 years (range 35-51 years). Tumors of 21 patients were hormone receptor positive (77.8%), 4 were HER2 positive (14.8%) and 2 were triple negative (7.4%). No serious adverse events were reported, the most frequent non-serious adverse event being arthralgia (14.8%). After treatment, serum levels of CTX and sRANKL decreased in all patients (P < 0.001) whereas serum levels of OPG increased in 76.9% of patients (P = 0.009, 95% CI 0.56-0.91). There was no significant reduction of Ki67 values from baseline (geometric mean change after treatment; 0.98, 95% CI 0.76-1.26; P = 0.90) and there were no absolute Ki67 responders. Twenty-four pre- and post-treatment tumor pairs were available for RANK/L staining and TILs assessment. There was no significant difference in RANKL and RANK H-score in tumors after treatment (P = 0.842, P = 0.142, respectively) but we observed a decrease of RANKL H-score in 3 tumors (12.5%) and an increase of RANK H-score in 5 tumors (20%). Interestingly, there was a significant increase in the percentage of stromal TILs after treatment (geometric mean change of 2.51, 95% CI 1.58-3.97; P = 0.004). There were 10/24 patients (41.7%) with a change in TILs of at least 10%, all of them having an increase in TILs presence (P = 0.002).
Conclusion
Short course of denosumab did not reduce tumor proliferation rate. However, it induced a significant increase in TILs. These findings suggest that denosumab may potentiate immunotherapy efficacy, at least in young BC patients. Additional results including immune cell profiling by multiplex IHC and RNA-sequencing of tumor and normal tissues will be presented at the meeting.
Citation Format: Bastien Nguyen, Marion Maetens, Roberto Salgado, David Venet, Peter Vuylsteke, Laura Polastro, Hans Wieldiers, Philippe Simon, Geoff Lindeman, Denis Larsimont, Gert Van den Eynden, Chloe Velghe, Francoise Rothe, Soizic Garaud, Stefan Michiels, Karen Willard-gallo, Hatem A. Azim, Sherene Loi, Martine Piccart, Christos Sotiriou. D-BEYOND: A window of opportunity trial evaluating denosumab, a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr CT101.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Geoff Lindeman
- 5Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | | | | | | | | | | | | | | | | | - Sherene Loi
- 9Peter MacCallum Cancer Centre, Melbourne, Australia
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Bareche Y, Venet D, Aftimos P, Ignatiadis M, Piccart M, Rothe F, Sotiriou C. Abstract 3698: Unraveling triple-negative breast cancer molecular heterogeneity using an integrative multiomic analysis. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction : Triple negative breast cancers (TNBCs) represent about 10-20% of all breast cancers and show worse prognosis compared to other molecular subtypes with increased likelihood of early distant recurrence and death. Recent efforts of genome-wide gene expression profiling analyses have improved our understanding of the biological complexity and diversity of TNBCs reporting, at least 6 different molecular subtypes of TNBC namely Basal-like 1 (BL1), basal-like 2 (BL2), immunomodulatory (IM), mesenchymal (M), mesenchymal stem-like (MSL) and luminal androgen receptor (LAR). However, little is known regarding the potential driving molecular events within each subtype, their difference in survival and response to therapy. Further insight into the underlying genomic alterations is therefore needed.
Aims : Here, we aimed to study the genomic aberrations that drive each of these TNBC subtypes by applying an integrated analysis of somatic mutation, copy number and gene expression of 550 TNBC derived from Molecular Taxonomy of Breast Cancer International (METABRIC) and The Cancer Genome Atlas (TCGA) consortia.
Methods : The METABRIC & the TCGA datasets were used, with available data for copy-number aberrations, somatic mutations and gene expression. ER, HER2 and PR status were inferred based on the bimodality of their mRNA expression level. TNBC samples (n=550) were classified according to Lehmann's molecular subtypes using the TNBCtype online subtyping tool (http://cbc.mc.vanderbilt.edu/tnbc).
Results : We were able to globally reproduce Lehmann's classification with Basal-like 1 (BL1), Immunomodulatory (IM), Androgen-Receptor-like (LAR), Mesenchymal-like (M) and Mesenchymal Stem Cell-like (MSL) being the most stable TNBC subtypes. Each subtype showed significant clinic-pathological characteristic differences. Using a multivariate model, the IM and LAR subtypes showed to be associated with a better prognosis (HR=0.68; CI=0.46-0.99; p=0.043) and a worst prognosis (HR=1.47; CI=1.0-2.14; p=0.046), respectively. BL1 subtype was found to be most genomically instable subtype with high TP53 mutation (92%) and copy-number deletion in genes involved in DNA repair mechanism (BRCA2, MDM2, PTEN, RB1 & TP53). LAR tumours were associated with higher mutational burden with significantly enriched mutations in PI3KCA (55%), AKT1 (13%) and CDH1 (13%) genes. M and MSL subtypes were associated with higher signature score for angiogenesis. IM showed high expression levels of immune signatures and check-point inhibitor genes such as PD1, PDL1 and CTLA4.
Conclusions : Our findings highlight for the first time the substantial genomic heterogeneity that characterize TNBC molecular subtypes, allowing for a better understanding of the disease biology as well as the identification of several candidate targets paving novel approaches for the development of anti-cancer therapeutics for TNBC.
Citation Format: Yacine Bareche, David Venet, Philippe Aftimos, Michail Ignatiadis, Martine Piccart, Francoise Rothe, Christos Sotiriou. Unraveling triple-negative breast cancer molecular heterogeneity using an integrative multiomic analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3698.
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Collignon E, Canale A, Al Wardi C, Bizet M, Calonne E, Dedeurwaerder S, Garaud S, Naveaux C, Barham W, Wilson A, Bouchat S, Hubert P, Van Lint C, Yull F, Sotiriou C, Willard-Gallo K, Noel A, Fuks F. Immunity drives TET1 regulation in cancer through NF-κB. Sci Adv 2018; 4:eaap7309. [PMID: 29938218 PMCID: PMC6010319 DOI: 10.1126/sciadv.aap7309] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/09/2018] [Indexed: 05/27/2023]
Abstract
Ten-eleven translocation enzymes (TET1, TET2, and TET3), which induce DNA demethylation and gene regulation by converting 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC), are often down-regulated in cancer. We uncover, in basal-like breast cancer (BLBC), genome-wide 5hmC changes related to TET1 regulation. We further demonstrate that TET1 repression is associated with high expression of immune markers and high infiltration by immune cells. We identify in BLBC tissues an anticorrelation between TET1 expression and the major immunoregulator family nuclear factor κB (NF-κB). In vitro and in mice, TET1 is down-regulated in breast cancer cells upon NF-κB activation through binding of p65 to its consensus sequence in the TET1 promoter. We lastly show that these findings extend to other cancer types, including melanoma, lung, and thyroid cancers. Together, our data suggest a novel mode of regulation for TET1 in cancer and highlight a new paradigm in which the immune system can influence cancer cell epigenetics.
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Affiliation(s)
- Evelyne Collignon
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Annalisa Canale
- Laboratory of Tumor and Development Biology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA)–Cancer, University of Liège, Liège, Belgium
| | - Clémence Al Wardi
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Martin Bizet
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Emilie Calonne
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Sarah Dedeurwaerder
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Soizic Garaud
- Molecular Immunology Unit, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Céline Naveaux
- Molecular Immunology Unit, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Whitney Barham
- Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA
| | - Andrew Wilson
- Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA
| | - Sophie Bouchat
- Service of Molecular Virology, Department of Molecular Biology, U-CRC, ULB, Gosselies, Belgium
| | - Pascale Hubert
- Laboratory of Experimental Pathology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Carine Van Lint
- Service of Molecular Virology, Department of Molecular Biology, U-CRC, ULB, Gosselies, Belgium
| | - Fiona Yull
- Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Jules Bordet Institute, ULB, Brussels, Belgium
| | | | - Agnès Noel
- Laboratory of Tumor and Development Biology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA)–Cancer, University of Liège, Liège, Belgium
| | - François Fuks
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
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Chumsri S, Serie D, Mashadi-Hossein A, Kachergus JM, Warren S, Colon-Otero G, Partridge AH, Carey LA, Hilbers F, Van Dooren V, Holmes E, Di Cosimo S, Werner O, Huober JB, Baselga J, Sotiriou C, Perez EA, Dueck AC, Moreno-Aspitia A, Thompson EA. Association between adaptive immune signature and outcome in HER2-positive breast cancer treated with trastuzumab and lapatinib in the NCCTG-N9831 (Alliance) and NeoALTTO trials. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.577] [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)
| | | | | | | | | | | | | | | | | | | | | | - Serena Di Cosimo
- Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Jens Bodo Huober
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Jose Baselga
- Memorial Sloan Kettering Cancer Center, New York, NY
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Poggio F, Bruzzone M, Ceppi M, Ponde NF, La Valle G, Sotiriou C, Del Mastro L, De Azambuja E, Lambertini M. Platinum-based neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC): A systematic review and meta-analysis of randomized controlled trials (RCTs). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.595] [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)
- Francesca Poggio
- Department of Medical Oncology, Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.), Bruxelles, Belgium
| | - Marco Bruzzone
- Unit of Clinical Epidemiology, Ospedale Policlinico San Martino, Genova, Italy
| | - Marcello Ceppi
- Unit of Clinical Epidemiology, Ospedale Policlinico San Martino, Genova, Italy
| | | | - Giovanni La Valle
- Health Director Ospedale Policlinico San Martino IRCCS per l’Oncologia, Genova, Italy
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Risi E, Biagioni C, Benelli M, Migliaccio I, McCartney A, Bonechi M, Guarducci C, Hilbers F, Di Cosimo S, Baselga J, Romagnoli D, Boccalini G, Vitale S, Grilli A, Bicciato S, Sotiriou C, Biganzoli L, Di Leo A, Malorni L. A RB-1 loss of function gene-signature (RBsig) as a tool to predict response to neoadjuvant chemotherapy (CT) plus anti-HER2 agents (H): A substudy of the NeoALTTO trial (BIG 1-06). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.570] [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)
- Emanuela Risi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | | | | | - Ilenia Migliaccio
- Sandro Pitigliani Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Amelia McCartney
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Martina Bonechi
- Sandro Pitigliani Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Cristina Guarducci
- Sandro Pitigliani Translational Research Unit, Hospital of Prato, Prato, Italy
| | | | - Serena Di Cosimo
- Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Jose Baselga
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dario Romagnoli
- Bioinformatics Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy
| | - Giulia Boccalini
- Sandro Pitigliani Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Stefania Vitale
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Andrea Grilli
- Center for Genome Research, Department of Life Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvio Bicciato
- Department of Biomedical Science, Centre from Genome Research, Univeristy of Modena and Reggio Emilia, Modena, Italy
| | | | - Laura Biganzoli
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Angelo Di Leo
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Luca Malorni
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
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Shi W, Jiang T, Nuciforo P, Hatzis C, Holmes E, Harbeck N, Sotiriou C, Peña L, Loi S, Rosa DD, Chia S, Wardley A, Ueno T, Rossari J, Eidtmann H, Armour A, Piccart-Gebhart M, Rimm DL, Baselga J, Pusztai L. Pathway level alterations rather than mutations in single genes predict response to HER2-targeted therapies in the neo-ALTTO trial. Ann Oncol 2018; 28:128-135. [PMID: 28177460 DOI: 10.1093/annonc/mdw434] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background We performed whole-exome sequencing of pretreatment biopsies and examined whether genome-wide metrics of overall mutational load, clonal heterogeneity or alterations at variant, gene, and pathway levels are associated with treatment response and survival. Patients and Methods Two hundred and three biopsies from the NeoALTTO trial were analyzed. Mutations were called with MuTect, and Strelka, using pooled normal DNA. Associations between DNA alterations and outcome were evaluated by logistic and Cox-proportional hazards regression. Results There were no recurrent single gene mutations significantly associated with pathologic complete response (pCR), except PIK3CA [odds ratio (OR) = 0.42, P = 0.0185]. Mutations in 33 of 714 pathways were significantly associated with response, but different genes were affected in different individuals. PIK3CA was present in 23 of these pathways defining a ‘trastuzumab resistance-network’ of 459 genes. Cases with mutations in this network had low pCR rates to trastuzumab (2/50, 4%) compared with cases with no mutations (9/16, 56%), OR = 0.035; P < 0.001. Mutations in the ‘Regulation of RhoA activity’ pathway were associated with higher pCR rate to lapatinib (OR = 14.8, adjusted P = 0.001), lapatinib + trastuzumab (OR = 3.0, adjusted P = 0.09), and all arms combined (OR = 3.77, adjusted P = 0.02). Patients (n = 124) with mutations in the trastuzumab resistance network but intact RhoA pathway had 2% (1/41) pCR rate with trastuzumab alone (OR = 0.026, P = 0.001) but adding lapatinib increased pCR rate to 45% (17/38, OR = 1.68, P = 0.3). Patients (n = 46) who had no mutations in either gene set had 6% pCR rate (1/15) with lapatinib, but had the highest pCR rate, 52% (8/15) with trastuzumab alone. Conclusions Mutations in the RhoA pathway are associated with pCR to lapatinib and mutations in a PIK3CA-related network are associated with resistance to trastuzumab. The combined mutation status of these two pathways could define patients with very low response rate to trastuzumab alone that can be augmented by adding lapatinib or substituting trastuzumab with lapatinib.
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Affiliation(s)
- W Shi
- Department of Breast Medical Oncology, Yale University, Yale Cancer Center, New Haven, USA
| | - T Jiang
- Department of Breast Medical Oncology, Yale University, Yale Cancer Center, New Haven, USA
| | - P Nuciforo
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - C Hatzis
- Department of Breast Medical Oncology, Yale University, Yale Cancer Center, New Haven, USA
| | - E Holmes
- Frontier Science, Inverness, Scotland
| | - N Harbeck
- Breast Center, Department of Obstetrics and Gynecology, University of Munich, Germany
| | - C Sotiriou
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - L Peña
- Spanish Breast Cancer Cooperative Group SOLTI, Barcelona, Spain
| | - S Loi
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - D D Rosa
- Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - S Chia
- Department of Medical Oncology, BC Cancer Agency, Vancouver, Canada
| | - A Wardley
- The Christie/NIHR Clinical Research Facility, Manchester, UK
| | - T Ueno
- Department of Breast Surgery, Kyoto University Hospital, Kyoto, Japan
| | - J Rossari
- Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - H Eidtmann
- Department of Obstetrics and Gynecology, Campus Kiel, University Hospital Kiel, Kiel, Germany
| | | | - M Piccart-Gebhart
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - D L Rimm
- Department of Breast Medical Oncology, Yale University, Yale Cancer Center, New Haven, USA
| | - J Baselga
- Memorial Sloan-Kettering Cancer Center, Memorial Hospital, New York, USA
| | - L Pusztai
- Department of Breast Medical Oncology, Yale University, Yale Cancer Center, New Haven, USA
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132
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Raspé E, Coulonval K, Pita JM, Paternot S, Rothé F, Twyffels L, Brohée S, Craciun L, Larsimont D, Kruys V, Sandras F, Salmon I, Van Laere S, Piccart M, Ignatiadis M, Sotiriou C, Roger PP. CDK4 phosphorylation status and a linked gene expression profile predict sensitivity to palbociclib. EMBO Mol Med 2018; 9:1052-1066. [PMID: 28566333 PMCID: PMC5538335 DOI: 10.15252/emmm.201607084] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [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] [Indexed: 11/09/2022] Open
Abstract
Cyclin D-CDK4/6 are the first CDK complexes to be activated in the G1 phase in response to oncogenic pathways. The specific CDK4/6 inhibitor PD0332991 (palbociclib) was recently approved by the FDA and EMA for treatment of advanced ER-positive breast tumors. Unfortunately, no reliable predictive tools are available for identifying potentially responsive or insensitive tumors. We had shown that the activating T172 phosphorylation of CDK4 is the central rate-limiting event that initiates the cell cycle decision and signals the presence of active CDK4. Here, we report that the profile of post-translational modification including T172 phosphorylation of CDK4 differs among breast tumors and associates with their subtypes and risk. A gene expression signature faithfully predicted CDK4 modification profiles in tumors and cell lines. Moreover, in breast cancer cell lines, the CDK4 T172 phosphorylation best correlated with sensitivity to PD0332991. This gene expression signature identifies tumors that are unlikely to respond to CDK4/6 inhibitors and could help to select a subset of patients with HER2-positive and basal-like tumors for clinical studies on this class of drugs.
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Affiliation(s)
- Eric Raspé
- WELBIO and Institute of Interdisciplinary Research (IRIBHM), Campus Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium .,ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium
| | - Katia Coulonval
- WELBIO and Institute of Interdisciplinary Research (IRIBHM), Campus Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.,ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium
| | - Jaime M Pita
- WELBIO and Institute of Interdisciplinary Research (IRIBHM), Campus Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.,ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium
| | - Sabine Paternot
- WELBIO and Institute of Interdisciplinary Research (IRIBHM), Campus Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.,ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium
| | - Françoise Rothé
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium.,Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Laure Twyffels
- Laboratoire de Biologie Moléculaire du Gène, Faculté des Sciences, Université libre de Bruxelles (ULB), Brussels, Belgium.,Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sylvain Brohée
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium.,Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ligia Craciun
- Tumor Bank of the Jules Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Véronique Kruys
- Laboratoire de Biologie Moléculaire du Gène, Faculté des Sciences, Université libre de Bruxelles (ULB), Brussels, Belgium.,Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Flavienne Sandras
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Biobank of the Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Isabelle Salmon
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium.,Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Biobank of the Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Steven Van Laere
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - Martine Piccart
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium.,Medical Oncology Clinic, Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Michail Ignatiadis
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium.,Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christos Sotiriou
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium .,Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre P Roger
- WELBIO and Institute of Interdisciplinary Research (IRIBHM), Campus Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium .,ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium
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133
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Groheux D, Biard L, Lehmann-Che J, Teixeira L, Bouhidel FA, Poirot B, Bertheau P, Merlet P, Espié M, Resche-Rigon M, Sotiriou C, de Cremoux P. Tumor metabolism assessed by FDG-PET/CT and tumor proliferation assessed by genomic grade index to predict response to neoadjuvant chemotherapy in triple negative breast cancer. Eur J Nucl Med Mol Imaging 2018; 45:1279-1288. [DOI: 10.1007/s00259-018-3998-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/21/2018] [Indexed: 12/18/2022]
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134
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Vandeputte C, Kehagias P, El Housni H, Ameye L, Laes JF, Desmedt C, Sotiriou C, Deleporte A, Puleo F, Geboes K, Delaunoit T, Demolin G, Peeters M, D'Hondt L, Janssens J, Carrasco J, Marechal R, Galdon MG, Heimann P, Paesmans M, Flamen P, Hendlisz A. Circulating tumor DNA in early response assessment and monitoring of advanced colorectal cancer treated with a multi-kinase inhibitor. Oncotarget 2018; 9:17756-17769. [PMID: 29707145 PMCID: PMC5915153 DOI: 10.18632/oncotarget.24879] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 06/08/2017] [Accepted: 03/01/2018] [Indexed: 12/18/2022] Open
Abstract
Predictive biomarkers are eagerly awaited in advanced colorectal cancer (aCRC). Targeted sequencing performed on tumor and baseline plasma samples in 20 patients with aCRC treated with regorafenib identified 89 tumor-specific mutations of which ≥50% are also present in baseline plasma. Droplet digital PCR (ddPCR) assays were optimized to monitor circulating tumor DNA (ctDNA) levels in plasmatic samples collected throughout the treatment course and showed the importance of using the absolute value for ctDNA rather than the mutant/wild type ratio in monitoring the therapy outcome. High baseline cell free DNA (cfDNA) levels are associated with shorter overall survival (OS) (HR 7.38, P=0.001). An early increase (D14) in mutated copies/mL is associated with a significantly worse PFS (HR 6.12, P=0.008) and OS (HR 8.02, P=0.004). These data suggest a high prognostic value for early ctDNA level changes and support the use of blood-born genomic markers as a tool for treatment.
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Affiliation(s)
- Caroline Vandeputte
- Gastro Intestinal Oncology Unit, Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Pashalina Kehagias
- Gastro Intestinal Oncology Unit, Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Hakim El Housni
- Department of Medical Genetics, Hôpital Erasme-ULB, Brussels, Belgium
| | - Lieveke Ameye
- Data Centre, Institut Jules Bordet, Brussels, Belgium
| | | | - Christine Desmedt
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Amélie Deleporte
- Gastro Intestinal Oncology Unit, Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Francesco Puleo
- Gastro Intestinal Oncology Unit, Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - Karen Geboes
- Service of Digestive Oncology, Universitair Ziekenhuis Gent, Gent, Belgium
| | | | - Gauthier Demolin
- Gastroenterology Department, Centre Hospitalier Chrétien St-Joseph, Liège, Belgium
| | - Marc Peeters
- Oncology Department, Universitair Ziekenhuis Antwerpen, Antwerpen, Belgium
| | - Lionel D'Hondt
- Oncology Department, Centre Hospitalier Universitaire, UCL Namur (site de Godinne), Dinant, Belgium
| | - Jos Janssens
- Department of Gastroenterology, AZ Turnhout, Turnhout, Belgium
| | - Javier Carrasco
- Oncology Department, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Raphaël Marechal
- Department of Gastroenterology, GI Cancer Unit, ULB-Erasme, Brussels, Belgium
| | - Maria Gomez Galdon
- Department of Pathology, Jules Bordet Institute, Free University of Brussels, Brussels, Belgium
| | - Pierre Heimann
- Department of Medical Genetics, Hôpital Erasme-ULB, Brussels, Belgium
| | | | - Patrick Flamen
- Nucleair Medicine Imaging and Therapy Department, Institut Jules Bordet, Brussels, Belgium
| | - Alain Hendlisz
- Gastro Intestinal Oncology Unit, Medical Oncology, Institut Jules Bordet, Brussels, Belgium
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135
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Bareche Y, Venet D, Ignatiadis M, Aftimos P, Piccart M, Rothe F, Sotiriou C. Unravelling triple-negative breast cancer molecular heterogeneity using an integrative multiomic analysis. Ann Oncol 2018; 29:895-902. [PMID: 29365031 PMCID: PMC5913636 DOI: 10.1093/annonc/mdy024] [Citation(s) in RCA: 215] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Recent efforts of genome-wide gene expression profiling analyses have improved our understanding of the biological complexity and diversity of triple-negative breast cancers (TNBCs) reporting, at least six different molecular subtypes of TNBC namely Basal-like 1 (BL1), basal-like 2 (BL2), immunomodulatory (IM), mesenchymal (M), mesenchymal stem-like (MSL) and luminal androgen receptor (LAR). However, little is known regarding the potential driving molecular events within each subtype, their difference in survival and response to therapy. Further insight into the underlying genomic alterations is therefore needed. Patients and methods This study was carried out using copy-number aberrations, somatic mutations and gene expression data derived from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) and The Cancer Genome Atlas. TNBC samples (n = 550) were classified according to Lehmann's molecular subtypes using the TNBCtype online subtyping tool (http://cbc.mc.vanderbilt.edu/tnbc/). Results Each subtype showed significant clinic-pathological characteristic differences. Using a multivariate model, IM subtype showed to be associated with a better prognosis (HR = 0.68; CI = 0.46-0.99; P = 0.043) whereas LAR subtype was associated with a worst prognosis (HR = 1.47; CI = 1.0-2.14; P = 0.046). BL1 subtype was found to be most genomically instable subtype with high TP53 mutation (92%) and copy-number deletion in genes involved in DNA repair mechanism (BRCA2, MDM2, PTEN, RB1 and TP53). LAR tumours were associated with higher mutational burden with significantly enriched mutations in PI3KCA (55%), AKT1 (13%) and CDH1 (13%) genes. M and MSL subtypes were associated with higher signature score for angiogenesis. Finally, IM showed high expression levels of immune signatures and check-point inhibitor genes such as PD1, PDL1 and CTLA4. Conclusion Our findings highlight for the first time the substantial genomic heterogeneity that characterize TNBC molecular subtypes, allowing for a better understanding of the disease biology as well as the identification of several candidate targets paving novel approaches for the development of anticancer therapeutics for TNBC.
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Affiliation(s)
- Y Bareche
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - D Venet
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - M Ignatiadis
- Department of Medical Oncolog, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - P Aftimos
- Department of Medical Oncolog, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Piccart
- Department of Medical Oncolog, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - F Rothe
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - C Sotiriou
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Department of Medical Oncolog, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
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136
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Zardavas D, Te Marvelde L, Milne RL, Fumagalli D, Fountzilas G, Kotoula V, Razis E, Papaxoinis G, Joensuu H, Moynahan ME, Hennessy BT, Bieche I, Saal LH, Stal O, Iacopetta B, Jensen JD, O'Toole S, Lopez-Knowles E, Barbaraeschi M, Noguchi S, Azim HA, Lerma E, Bachelot T, Wang Q, Perez-Tenorio G, Can de Velde CJH, Rea DW, Sabine V, Bartlett JMS, Sotiriou C, Michiels S, Loi S. Tumor PIK3CA Genotype and Prognosis in Early-Stage Breast Cancer: A Pooled Analysis of Individual Patient Data. J Clin Oncol 2018; 36:981-990. [PMID: 29470143 DOI: 10.1200/jco.2017.74.8301] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha ( PIK3CA) mutations are frequently observed in primary breast cancer. We evaluated their prognostic relevance by performing a pooled analysis of individual patient data. Patients and Methods Associations between PIK3CA status and clinicopathologic characteristics were tested by applying Cox regression models adjusted for age, tumor size, nodes, grade, estrogen receptor (ER) status, human epidermal growth factor receptor 2 (HER2) status, treatment, and study. Invasive disease-free survival (IDFS) was the primary end point; distant disease-free survival (DDFS) and overall survival (OS) were also assessed, overall and by breast cancer subtypes. Results Data from 10,319 patients from 19 studies were included (median OS follow-up, 6.9 years); 1,787 patients (17%) received chemotherapy, 4,036 (39%) received endocrine monotherapy, 3,583 (35%) received both, and 913 (9%) received none or their treatment was unknown. PIK3CA mutations occurred in 32% of patients, with significant associations with ER positivity, increasing age, lower grade, and smaller size (all P < .001). Prevalence of PIK3CA mutations was 18%, 22%, and 37% in the ER-negative/HER2-negative, HER2-positive, and ER-positive/HER2-negative subtypes, respectively. In univariable analysis, PIK3CA mutations were associated with better IDFS (HR, 0.77; 95% CI, 0.71 to 0.84; P < .001), with evidence for a stronger effect in the first years of follow-up (0 to 5 years: HR, 0.73; 95% CI, 0.66 to 0.81; P < .001; 5 to 10 years: HR, 0.82; 95% CI, 0.68 to 0.99; P = .037); > 10 years: (HR, 1.15; 95% CI, 0.84 to 1.58; P = .38; P heterogeneity = .02). In multivariable analysis, PIK3CA genotype remained significant for improved IDFS ( P = .043), but not for the DDFS and OS end points. Conclusion In this large pooled analysis, PIK3CA mutations were significantly associated with a better IDFS, DDFS, and OS, but had a lesser prognostic effect after adjustment for other prognostic factors.
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Affiliation(s)
- Dimitrios Zardavas
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Luc Te Marvelde
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Roger L Milne
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Debora Fumagalli
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - George Fountzilas
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Vassiliki Kotoula
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Evangelia Razis
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - George Papaxoinis
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Heikki Joensuu
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Mary Ellen Moynahan
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Bryan T Hennessy
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Ivan Bieche
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Lao H Saal
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Olle Stal
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Barry Iacopetta
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Jeanette Dupont Jensen
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Sandra O'Toole
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Elena Lopez-Knowles
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Mattia Barbaraeschi
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Shinzaburo Noguchi
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Hatem A Azim
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Enrique Lerma
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Thomas Bachelot
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Qing Wang
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Gizeh Perez-Tenorio
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Cornelis J H Can de Velde
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Daniel W Rea
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Vicky Sabine
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - John M S Bartlett
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Christos Sotiriou
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Stefan Michiels
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Sherene Loi
- Dimitrios Zardavas and Debora Fumagalli, Breast International Group; Christos Sotiriou, Université Libre de Bruxelles, Brussels, Belgium; Luc te Marvelde and Roger L. Milne, Cancer Council; Roger L. Milne and Sherene Loi, University of Melbourne, Melbourne; Barry Iacopetta, University of Western Australia, Western Australia; Sandra O'Toole and Elena Lopez-Knowles, Garvan Institute of Medical Research, Darlinghurst, Australia; George Fountzilas and Vassiliki Kotoula, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki; Evangelia Razis, Hygeia Hospital; George Papaxoinis, Hippokration Hospital, Athens, Greece; Heikki Joensuu, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mary Ellen Moynahan, Memorial Sloan Kettering Cancer Center, New York, NY; Bryan T. Hennessy, Beaumont Hospital and Royal College of Surgeons, Dublin, Ireland; Ivan Bieche, Curie Institut, Paris; Thomas Bachelot, Centre de Recherche en Cancérologie de Lyon, Lyon; Stefan Michiels, Gustave Roussy and Inserm, Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, France; Lao H. Saal, Lund University, Lund; Olle Stal, Qing Wang, and Gizeh Perez-Tenorio, Linköping University, Linköping, Sweden; Jeanette Dupont Jensen, University of Southern Denmark, on behalf of the Danish Breast Cancer Cooperative Group, Odense, Denmark; Elena Lopez-Knowles, Royal Marsden NHS Trust and Institute of Cancer Research, London; Daniel W. Rea, University of Birmingham, Birmingham, United Kingdom; Mattia Barbaraeschi, Santa Chiara Hospital, Trento, Italy; Shinzaburo Noguchi, Osaka University, Osaka Japan; Hatem A. Azim Jr, American University of Beirut (AUB), Beirut, Lebanon; Enrique Lerma, Universitat Autònoma de Barcelona, Barcelona, Spain; Cornelis J.H. can de Velde, Leiden University Medical Center, Leiden, the Netherlands; Vicky Sabine, University of Guelph, Guelph; John M.S. Bartlett, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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de Cremoux P, Biard L, Poirot B, Bertheau P, Teixeira L, Lehmann-Che J, Bouhidel FA, Merlet P, Espié M, Resche-Rigon M, Sotiriou C, Groheux D. 18FDG-PET/CT and molecular markers to predict response to neoadjuvant chemotherapy and outcome in HER2-negative advanced luminal breast cancers patients. Oncotarget 2018; 9:16343-16353. [PMID: 29662649 PMCID: PMC5893244 DOI: 10.18632/oncotarget.24674] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/20/2017] [Accepted: 02/26/2018] [Indexed: 11/25/2022] Open
Abstract
Background The efficacy of neoadjuvant chemotherapy regimens in advanced luminal breast cancer patients is difficult to predict. Intrinsic properties of breast tumors, including altered gene expression profile and dynamic evaluation of metabolic properties of tumor cells using positron emission tomography/computed tomography (PET/CT) of tumor cells, have been identified to guide patient's prognosis. The aim of this study is to determine if both analyses may improve the prediction of response to neoadjuvant chemotherapy in ER-positive / HER2-negative breast cancers (BCs) patients. Methods We used metabolic PET parameters, at diagnosis and after two cycles of chemotherapy and proliferation gene expression profile on biopsy at diagnosis, in particular, the genomic grade index (GGI) analyzed by reverse transcription and quantitative polymerase chain reaction (RT-qPCR). The pathological response was the surrogate endpoint. Results The change of FDG uptake between baseline PET and interim PET after 2 cycles of neoadjuvant chemotherapy (ΔSUVmax) was highly associated with pCR (p=0.008). We also observed an ability of P53 mutated status (p=0.042), in addition to histological grade (p=0. 0004), and PR expression (p=0.01) to predict pCR in ER-positive BCs, whereas no proliferation marker predicted pCR (P=0.39 for GGI). Finally, only ΔSUVmax was significantly associated with event free survival (p=0.047). Conclusions Our results confirm the predictive and prognostic value of tumor ΔSUVmax in ER-positive /HER2-negative advanced BCs patients. These findings can be helpful to select high-risk patients within trials investigating novel treatment strategies.
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Affiliation(s)
- Patricia de Cremoux
- Molecular Oncology Unit, Saint-Louis Hospital, Paris, France.,University Paris-Diderot, Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France
| | - Lucie Biard
- Department of Biostatistics, Saint-Louis Hospital, Paris, France.,University Paris-Diderot, Sorbonne Paris Cité, INSERM UMR 1153 ECSTRA team, Paris, France
| | - Brigitte Poirot
- Molecular Oncology Unit, Saint-Louis Hospital, Paris, France
| | - Philippe Bertheau
- Department of Pathology, Saint-Louis Hospital, Paris, France.,University Paris-Diderot, Sorbonne Paris Cité, INSERM UMR-S-1165, Paris, France
| | - Luis Teixeira
- University Paris-Diderot, Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France.,Breast Diseases Unit, Saint-Louis Hospital, Paris, France
| | - Jacqueline Lehmann-Che
- Molecular Oncology Unit, Saint-Louis Hospital, Paris, France.,University Paris-Diderot, Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France
| | | | - Pascal Merlet
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France
| | - Marc Espié
- University Paris-Diderot, Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France.,Breast Diseases Unit, Saint-Louis Hospital, Paris, France
| | - Matthieu Resche-Rigon
- Department of Biostatistics, Saint-Louis Hospital, Paris, France.,University Paris-Diderot, Sorbonne Paris Cité, INSERM UMR 1153 ECSTRA team, Paris, France
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - David Groheux
- University Paris-Diderot, Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France.,Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France
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138
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Fimereli D, Fumagalli D, Brown D, Gacquer D, Rothé F, Salgado R, Larsimont D, Sotiriou C, Detours V. Genomic hotspots but few recurrent fusion genes in breast cancer. Genes Chromosomes Cancer 2018; 57:331-338. [PMID: 29436103 DOI: 10.1002/gcc.22533] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/07/2018] [Accepted: 02/09/2018] [Indexed: 02/04/2023] Open
Abstract
The advent of next generation sequencing technologies has boosted the interest in exploring the role of fusion genes in the development and progression of solid tumors. In breast cancer, most of the detected gene fusions seem to be "passenger" events while the presence of recurrent and driver fusions is still under study. We performed RNA sequencing in 55 well-characterized breast cancer samples and 10 adjacent normal breast tissues, complemented by an analysis of SNP array data. We explored the presence of fusion genes and defined their association with breast cancer subtypes, clinical-pathologic characteristics and copy number aberrations. Overall, 370 fusions were detected across the majority of the samples. HER2+ samples had significantly more fusions than triple negative and luminal subtypes. The number of fusions was correlated with histological grade, Ki67 and tumor size. Clusters of fusion genes were observed across the genome and a significant correlation of fusions with copy number aberrations and more specifically amplifications was also revealed. Despite the large number of fusion events, only a few were recurrent, while recurrent individual genes forming fusions with different partners were also detected including the estrogen receptor 1 gene in the previously detected ESR1-CCDC170 fusion. Overall we detected novel gene fusion events while we confirmed previously reported fusions. Genomic hotspots of fusion genes, differences between subtypes and small number of recurrent fusions are the most relevant characteristics of these events in breast cancer. Further investigation is necessary to comprehend the biological significance of these fusions.
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Affiliation(s)
- Danai Fimereli
- IRIBHM, Université Libre de Bruxelles (ULB), 808 route de Lennik, Brussels, 1070, Belgium
| | - Debora Fumagalli
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bld de Waterloo, 125, Brussels, 1000, Belgium
| | - David Brown
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bld de Waterloo, 125, Brussels, 1000, Belgium
| | - David Gacquer
- IRIBHM, Université Libre de Bruxelles (ULB), 808 route de Lennik, Brussels, 1070, Belgium
| | - Françoise Rothé
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bld de Waterloo, 125, Brussels, 1000, Belgium
| | - Roberto Salgado
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bld de Waterloo, 125, Brussels, 1000, Belgium
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bld de Waterloo, 125, Brussels, 1000, Belgium
| | - Christos Sotiriou
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bld de Waterloo, 125, Brussels, 1000, Belgium
| | - Vincent Detours
- IRIBHM, Université Libre de Bruxelles (ULB), 808 route de Lennik, Brussels, 1070, Belgium.,WELBIO, 808 route de Lennik, Brussels, 1070, Belgium
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139
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Buisseret L, Pommey S, Allard B, Garaud S, Bergeron MA, Cousineau I, Ameye L, Paesmans M, Crown JPA, Di Leo A, Piccart-Gebhart M, Willard-Gallo K, Sotiriou C, Stagg J. Abstract PD6-07: Clinical significance of CD73 expression in triple-negative breast cancer from the BIG 02-98 adjuvant phase III clinical trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CD73 is an ecto-enzyme that promotes tumor immune escape through the production of immunosuppressive extracellular adenosine in the tumor microenvironment. Several CD73 inhibitors and adenosine receptor antagonists are being evaluated in phase I clinical trials.
Objective: To investigate the prognosis significance of CD73 in human triple-negative breast cancer.
Design and setting: This is a prospective-retrospective biomarker analysis. Using multiplex immunofluorescence and image analysis, we assessed CD73 protein expression on tumor cells, tumor-infiltrating leukocytes and stromal cells on full-face sections from formalin-fixed paraffin-embedded primary breast tumors.
Participants: 122 samples of triple-negative breast cancer from the BIG 02-98 adjuvant phase III clinical trial were included in our analysis. This trial compared the addition of taxanes to anthracyclines-based chemotherapy in node-positive breast cancer.
Results: Our results demonstrated that high levels of CD73 expression on epithelial tumor cells were significantly associated with reduced disease-free survival (DFS) and overall survival (OS) in patients with triple-negative breast cancer. Using the median as a threshold between low and high levels of CD73 on epithelial cells, hazard ratios (HR) adjusted for grade, number of positive lymph nodes and tumor size, were of 2.21 (95% confidence interval (CI): 1.15-4.25); p=0.02 for DFS and of 2.47 (95%CI: 1.21-5.07); p=0.01 for OS. CD73 expression negatively correlated with tumor immune infiltration (Spearman's R= -0.50, p<0.0001). Patients with high levels of CD73 and low levels of tumor-infiltrating leukocytes had the worse clinical outcome (HR: 4.24 (1.90-9.45), p<0.001 for DFS, HR: 3.91 (1.65-9.31), p=0.002 for OS) compared to patients with low CD73 and high tumor-immune infiltration. Flow cytometric analysis of tumor-infiltrating leukocytes revealed a high frequency of CD73-expressing B cells and higher CD73 expression on tumor-infiltrating myeloid cells and natural killer cells compared to peripheral blood.
Conclusion and relevance: Taken together, our study provides further support that CD73 expression is associated with a poor prognosis and reduced anti-tumor immunity in human triple-negative breast cancer and that targeting CD73 could be a promising strategy to reprogram the tumor microenvironment in this breast cancer subtype.
Citation Format: Buisseret L, Pommey S, Allard B, Garaud S, Bergeron MA, Cousineau I, Ameye L, Paesmans M, Crown JPA, Di Leo A, Piccart-Gebhart M, Willard-Gallo K, Sotiriou C, Stagg J. Clinical significance of CD73 expression in triple-negative breast cancer from the BIG 02-98 adjuvant phase III clinical trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD6-07.
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Affiliation(s)
- L Buisseret
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - S Pommey
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - B Allard
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - S Garaud
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - MA Bergeron
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - I Cousineau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - L Ameye
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - M Paesmans
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - JPA Crown
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - A Di Leo
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - M Piccart-Gebhart
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - K Willard-Gallo
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - C Sotiriou
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
| | - J Stagg
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Institut Jules Bordet- Université Libre de Bruxelles, Belgium; Irish Clinical Oncology Research Group, Dublin, Ireland; Hospital of Prato, Prato, Italy
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140
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Ignatiadis M, Litiere S, Rothe F, Riethdorf S, Proudhon C, Fehm T, Aalders K, Forstbauer H, Fasching P, Brain E, Vuylsteke P, Guardiola E, Lorenz R, Pantel K, Tryfonidis K, Janni W, Piccart M, Sotiriou C, Rack B, Pierga JY. Abstract P1-13-09: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- M Ignatiadis
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - S Litiere
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - F Rothe
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - S Riethdorf
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - C Proudhon
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - T Fehm
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - K Aalders
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - H Forstbauer
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - P Fasching
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - E Brain
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - P Vuylsteke
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - E Guardiola
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - R Lorenz
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - K Pantel
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - K Tryfonidis
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - W Janni
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - M Piccart
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - C Sotiriou
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - B Rack
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - J-Y Pierga
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
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Bareche Y, Venet D, Rothe F, Sotiriou C. Abstract P2-07-02: Uncovering TNBC molecular heterogeneity by applying integrative “omics” analyses with potential clinical implications. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-07-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Triple-negative breast cancer (TNBC), representing about 10-20% of all breast cancers (BC), is a heterogeneous disease characterized by a clinically aggressive course, higher relapse rates and worse overall survival as compared to other BC subtypes. Recent efforts of genome-wide gene expression profiling have improved our understanding of the biological diversity of TNBCs reporting at least 6 different molecular subtypes namely Basal-like 1 (BL1), basal-like 2 (BL2), immunomodulatory (IM), mesenchymal (M), mesenchymal stem-like (MSL) and luminal androgen receptor (LAR). Little is known regarding the potential driving molecular events characterizing each subtype, their difference in survival and response to therapy. Moreover, limited progress has been made so far in the development of effective therapeutic strategies in TNBC partly due to the lack of obvious genetic targets. Further insight into the underlying genomic alterations is therefore needed.
Aims: Here, we aimed to study the genomic aberrations that drive each of the TNBC molecular subtypes as defined by Lehmann et al. by applying an integrative analysis combining somatic mutation, copy number aberrations and gene expression profiles of 272 TNBC derived from METABRIC consortium.
Methods: In silico analyses were performed using microarray, copy number aberrations profiles (CNA) and mutation profiles data retrieved from 272 TNBC patients from the METABRIC consortium. Somatic mutation profiles were derived from targeted sequencing of 173 cancer genes. CNAs at the gene level were computed using GISTIC 2.0.22. The relationship between TNBC molecular subtypes and genomic aberrations were analysed using Fisher test. Survival analyses were performed using Cox proportional hazard models adjust for standard clinical and pathologic variables.
Results: Using a multivariate model, IM and M subtypes were significantly associated with good (HR=0.53; FDR=0.01) and poor (HR=1.8; FDR=0.01) prognosis respectively. BL1 subtype was found to be the most genomically instable subtype with high frequency of TP53 mutations (93%) and copy-number deletions in genes involved in DNA repair mechanisms (BRCA2, MDM2, RB1 and TP53) and MYC overexpression. BL2 subtype was enriched with TP53 (95%) and PIK3CA mutations (52%), whereas LAR subtype was characterized by high frequency of PI3KCA mutations (44%). Of interest, for these two subtypes, mutations in genes in the PI3K signalling pathway were mutually exclusive. IM subtype was enriched in NCOR2 mutations (13%), a co-repressor of the Notch pathway, associated with lower gene expression (p=0.035). M and MSL subtypes were significantly associated with higher signature scores for angiogenesis. In addition, M subtype was associated with higher frequency of NOTCH1 mutations (M p=2.4E-2).
Conclusions: This integrative analysis combining somatic mutation, copy number and gene expression profiles shed new light on TNBC molecular heterogeneity, highlighting TNBC subtype-specific genomic aberrations which could potentially open new avenues for the development of effective targeted therapies in each TNBC molecular subtype such as DNA repair, Notch and angiogenesis.
Citation Format: Bareche Y, Venet D, Rothe F, Sotiriou C. Uncovering TNBC molecular heterogeneity by applying integrative “omics” analyses with potential clinical implications [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-07-02.
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Affiliation(s)
- Y Bareche
- Breast Cancer Translational Research Laboratory, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - D Venet
- Breast Cancer Translational Research Laboratory, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - F Rothe
- Breast Cancer Translational Research Laboratory, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
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Venet D, Rothé F, Dupont F, Maetens M, Fumagalli D, Salgado R, Bradbury I, Pusztai L, Harbeck N, Izquierdo M, de la Pena L, Ignatiadis M, de Azambuja E, Huober J, Nuciforo P, Baselga J, Piccart M, Loi S, Sotiriou C. Abstract P2-05-04: Deregulation of A-to-I RNA editing is associated with poor prognosis in HER2+ breast cancers in the neoALTTO trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
A-to-I RNA editing, a post-transcriptional modification of the RNA catalyzed by the ADAR family of enzymes, is emerging as a widespread phenomenon in breast cancer (BC). A-to-I RNA editing is more frequent in the highly repetitive Alu regions but can affect both coding and non-coding regions. It has been shown to greatly impact cell functionality. In a recent report, we have shown that A-to-I RNA editing is regulated both by ADAR copy number and type I interferon response (Fumagalli et al. Cell Rep 2015). The main aim of the current study was to investigate the extent and profile of A-to-I RNA editing in HER2+ BC patients (pts) treated in the NeoALTTO trial, and to explore its impact on pathologic complete response (pCR) and survival.
Methods
Aligned RNAseq reads of sufficient quality and quantity were obtained for 252 of the 455 pts enrolled in the study, as described previously (Fumagalli et al. JAMA Oncol 2016). Editing sites from the rediPortal database were assessed. The editing level at a given site was computed by counting the number of Gs and As. Sites with coverage more than 10 were considered for further analyses. Editing in normal tissues was obtained from the GTEx project of the rediPortal database. Tumor infiltrating lymphocytes (TILs) and copy number aberrations were previously reported. Correlations between different parameters were assessed using Spearman correlations (ρ). The Mann-Whitney test was used to relate binary and numerical features. Event-free survival (EFS) analysis was performed using the Cox proportional hazard model.
Results
There was a median of 71470 edited sites per sample. As expected, mean editing per sample correlated with ADAR expression (ρ=59%, p<10-16) and ADAR copy number (ρ=54%, p<10-16). It was also correlated with the IFN-gamma driven signature (ρ=22%, p=0.0005), as well as with ESR1 gene expression (ρ=24%, p=0.0002). Neither ADAR expression nor mean editing was correlated with TILs (ρ=-0.5% and ρ=3%). No relationship between mean editing and pCR or EFS was found. The correlations between editing in NeoALTTO tumor samples and GTEx normal tissues were computed, and the median editing per sample was taken. These median correlations, ranging from 32% to 56%, were not associated with ADAR expression (ρ=-25%, p=6x10-5) nor mean editing (ρ=8%, p=0.19). Of interest, patients whose tumors showed low correlation with editing in normal tissues were associated with poor EFS (p=0.028, HR=0.56 to 0.96) suggesting that deregulation of RNA editing may impact disease progression and outcome. Similar results were obtained when the correlations were assessed between tumor samples instead of between tumor and normal samples (ρ between the two median editing: 76%; p-value survival: 0.013). The median correlations were not predictive for pCR (p=0.44). There was no interaction between editing and treatment arm.
Conclusions
Our study shows for the first time that deregulated RNA editing, as compared to editing in normal tissues, is a widespread phenomenon in HER2+ BC patients treated in the NeoALTTO trial and is associated with poor outcome. These results may provide new perspectives for the treatment of HER2+ disease by developing therapies targeting RNA editing.
Citation Format: Venet D, Rothé F, Dupont F, Maetens M, Fumagalli D, Salgado R, Bradbury I, Pusztai L, Harbeck N, Izquierdo M, de la Pena L, Ignatiadis M, de Azambuja E, Huober J, Nuciforo P, Baselga J, Piccart M, Loi S, Sotiriou C. Deregulation of A-to-I RNA editing is associated with poor prognosis in HER2+ breast cancers in the neoALTTO trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-05-04.
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Affiliation(s)
- D Venet
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - F Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - F Dupont
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Maetens
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - D Fumagalli
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - R Salgado
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - I Bradbury
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - L Pusztai
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - N Harbeck
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Izquierdo
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - L de la Pena
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Ignatiadis
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - E de Azambuja
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - J Huober
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - P Nuciforo
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - J Baselga
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Piccart
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - S Loi
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
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Nguyen B, Venet D, Desmedt C, Pruneri G, Peccatori F, Mardis ER, Azim HA, Rothé F, Sotiriou C. Abstract P2-05-01: Whole genome sequencing reveals enrichment of mutations in mucin gene family in breast cancer diagnosed during pregnancy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Pregnancy is known to modulate breast cancer (BC) risk. Different reproductive behaviors have been shown to impact not only the risk of developing BC but also the phenotypes of these tumors. Breast cancer diagnosed during pregnancy (BCP) is a rare disease but could serve as a good model to understand how pregnancy modulates BC biology. In this project, we aim to interrogate the effect of pregnancy on the biology of BC by performing whole genome sequencing (WGS) using a unique series of BC patients diagnosed during pregnancy (BCP).
Method
Whole genome sequencing was performed for 35 BCP and 20 non-pregnant controls matched for age and stage with available clinic-pathological data. DNA extracted from primary tumor and matched adjacent normal FFPE tissues was assessed using WGS on Illumina HiSeqXTen platform targeting 60x and 30x coverage for tumor and normal DNA respectively. Briefly, 2x150bp paired end sequence data were generated, cleaned, trimmed and aligned to the reference genome (hg19) using bwa-mem. Somatic mutations were detected using Strelka and annotated using SnpEff. Mutational signatures were extracted using deconstructSigs. Differences on mutational profiles between BCP and case controls were assessed using Wilcoxon test for continuous variables and Fisher exact test for categorical variables.
Result
No difference in clinic-pathological features was observed between BCP and control patients. A median of 10084 and 13829 SNVs and of 26 and 21 indels were identified in the BCP and controls respectively, no significant difference between the two groups being observed (p = 0.703 and p = 0.851). Of interest, a significantly higher number of mutations was found in the BCP as compared to the control group when considering only mutations associated with a deleterious effect (median: 20 vs. 12, p = 0.027). As expected, TP53 and PIK3CA were the most frequently mutated genes both in BCP and control cases without any significant difference between the groups (34.3% vs. 22.2%, p = 0.53 and 20.0% vs. 16.7%, p = 1, respectively). Interestingly, there was a significant enrichment of non-silent mutations in the mucin genes family (MUC2, MUC4, MUC12, MUC16, MUC17, MUC20) in the BCP group: 45.7% of BCP vs. 11.1% of control cases had at least one such mutation (p = 0.015). A similar significant result (45.7% vs. 23.1%, p = 0.034) was found when comparing BCP with BC control cases from the TCGA dataset (selected to have similar age, ER and PR distribution, N = 56). When comparing the distribution of the twelve BC mutational signatures, a borderline significant enrichment with a signature depicting mismatch-repair deficiency (signature 20) was observed in the BCP patients (p = 0.059).
Conclusion
This is the first study reporting the mutational landscape of breast cancer diagnosed during pregnancy using WGS. We found that BCP are associated with a higher number of putative driver mutations including mutations in mucin genes, shown to be implicated in tumorigenesis. Furthermore, BCP were enriched with a mismatch-repair deficiency signature. These results could open new avenues for the development of targeted therapeutic approaches for patients diagnosed with breast cancer during pregnancy.
Citation Format: Nguyen B, Venet D, Desmedt C, Pruneri G, Peccatori F, Mardis ER, Azim HA, Rothé F, Sotiriou C. Whole genome sequencing reveals enrichment of mutations in mucin gene family in breast cancer diagnosed during pregnancy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-05-01.
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Affiliation(s)
- B Nguyen
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - D Venet
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - C Desmedt
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - G Pruneri
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - F Peccatori
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - ER Mardis
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - HA Azim
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - F Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; European Institute of Oncology, Milan, Italy; McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
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Desmedt C, Demicheli R, Fornili M, Bachir I, Duca M, Viglietti G, Piccart M, Sotiriou C, Sosnowski M, Forget P, Biganzoli E. Abstract P1-10-12: Differential benefit of intra-operative administration of ketorolac on breast cancer disease recurrence according to baseline body mass index. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-10-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
According to the last estimates, 63% of the women in the US are either overweight or obese. Increased body mass index (BMI) has been recognized as a risk factor for developing breast cancer (BC) and associated with adverse survival. So far, few treatment modalities focusing on the biological features of BC patients with increased adiposity have been evaluated. In cancer patients, elevated leptin levels have been found, among others, to stimulate the Rho GTPase pathway, involved in cell adhesion and motility. Here, using a unique retrospective institutional cohort including a total of 847 BC patients, we aimed at assessing whether the intra-operative administration of ketorolac, a Non-Steroidal Anti-Inflammatory Drug (NSAID), with a recently documented Rho GTPase inhibitory activity, would be associated with an improvement in distant disease recurrence according to BMI. We further assessed in an independent series of 1,009 patients, the effect of intra-operative diclofenac, another NSAID without Rho GTPase inhibitory activity.
Patients and methods:
In the institutional retrospective and consecutive 'ketorolac' series of patients with primary BC surgery, 538 were treated with and 309 without a single-dose (typically 20 mg in patients under 60 kg and 30 mg in patients ≥60 kg) of intra-operative ketorolac. In the 'diclofenac' series, 789 patients were treated with intra-operative diclofenac (75 mg) and 220 without. Competing risk analysis of distant recurrences was done by crude cumulative incidence curves to be interpreted as the cumulative probability of distant metastases as first event and consistently by Fine & Gray semi-parametric models on sub-distribution hazards. Subgroup analyses were conducted according to the Dixon&Simon approach. These analyses were adjusted for standard clinico-pathological variables: NSAID use, tumor size, age, nodal status, grade, ER status, and BMI. The median follow-up time of the ketorolac and diclofenac cohort was 5.7 and 8.0 years, respectively.
Results:
In both cohorts, the administration of the NSAID was associated with younger age at diagnosis, consistent with previous reports. The administration of ketorolac was associated with decreased incidence of distant recurrences both in the unadjusted and adjusted analysis (HRadj= 0.55, 95%CI: 0.35-0.86, p=0.01). Subgroup analyses in patients with BMI<25 and ≥25 (overweight and obese) revealed that the effect was limited to the high BMI group of patients both in the unadjusted and adjusted analysis (HRadj= 0.58, 95%CI: 0.33-0.98). The administration of diclofenac was not associated with decreased incidence of distant recurrences, nor in the global population, neither in the BMI subgroups.
Conclusion:
The fact that only ketorolac but not diclofenac was associated with a significant reduction of distant recurrences in BC patients with elevated BMI could be explained by the specific Rho GTPase inhibitory effect of the R-enantiomer of ketorolac, absent in diclofenac. While this study is limited by its retrospective nature, it suggests a potentially important repositioning of ketorolac in the intra-operative treatment of BC patients with elevated BMI. A prospective study is on its way.
Citation Format: Desmedt C, Demicheli R, Fornili M, Bachir I, Duca M, Viglietti G, Piccart M, Sotiriou C, Sosnowski M, Forget P, Biganzoli E. Differential benefit of intra-operative administration of ketorolac on breast cancer disease recurrence according to baseline body mass index [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-10-12.
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Affiliation(s)
- C Desmedt
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - R Demicheli
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - M Fornili
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - I Bachir
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - M Duca
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - G Viglietti
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - M Piccart
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - C Sotiriou
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - M Sosnowski
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - P Forget
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
| | - E Biganzoli
- Institut Jules Bordet, Université Libre de Bruxelles (ULB); University of Milan; Universitair Ziekenhuis Brussel (UZ Brussel)
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Powles R, Redmond D, Sotiriou C, Loi S, Fumagalli D, Nuciforo P, Harbeck N, de Azambuja E, Sarp S, Di Cosimo S, Huober J, Baselga J, Piccart-Gebhart M, Elemento O, Hatzis C, Pusztai L. Abstract P2-09-01: T-cell receptor beta chain variable region (TRBV) expression patterns predict response to combined trastuzumab/lapatinib treatment in the NeoALTTO/BIG-1-06 trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Dual anti-HER2 blockade resulted in increased pathologic complete response rate (pCR) in the 3 arm NeoALTTO trial. High immune gene expression and the absence of PIK3CA pathway mutations are predictive of pCR in all treatment arms but no markers were identified that could predict which patients require dual HER2 targeted therapy. The goal of this analysis was to examine if TRBV expression could add to the predictive function of previously identified immune markers.
Patients and Methods: We analyzed RNA and Whole Exome sequencing data from 245 cancers (54% of all patients) included in the trial. The TRBV reference sequences were obtained from the International ImMunoGeneTics information system. Reads were aligned using a custom BLAST mapping pipeline and normalized by the total number of aligned reads in each sample. We calculated 3 T cell receptor metrics for each tumor including (i) total TRBV chain expression level, (ii) Shannon entropy of the normalized unique TRBV-expression frequencies which reflect TCR diversity and (iii) we also used non-negative matrix factorization (NMF) to define TRBV co-expression metagenes (TRBVMG). We evaluated correlation between these metrics and immune and proliferation gene expression signatures and genomic features of the cancer including clonal heterogeneity and mutation load. We assessed association between TRBV and pCR using multivariate logistic regression.
Results: 65 distinct TRBV variants showed heterogeneous expression levels across cancers with strong co-expression patterns. Total TRBV expression correlated strongly with immune metagene expression (Spearman's ρ=0.93, P<0.001), but entropy had a weaker, inverse correlation with immune metagene expression (Spearman's ρ=-0.40, P<0.001). Associations between TRBV metrics and mutation load and clonal heterogeneity were weak. pCR correlated with higher total TRBV expression (Spearman's ρ=0.17, P<0.05). Correlation between entropy and pCR was non-significant (odds ratio (OR) for regressing entropy with pCR was <1). NMF identified 4 distinct TRBVMGs that showed substantial expression variation within immune cell rich cancers. ER-status, proliferation and immune-gene expression adjusted logistic regression analysis including a treatment-arm interaction term revealed that TRBVMG-2, characterized by high expression of TRBV4.3, TRBV6.3 and TRBV7.2 variants, was associated with higher pCR rate in patients treated with trastuzumab plus lapatinib (Interaction OR=3.23 adjusted P=0.03). In immune-rich cancers, TRBVMG-2 expression above the median was associated with higher pCR rate in the dual HER2 targeted treatment arm compared to the other arms (68% vs 21%, Fisher exact test P<0.001). Patients with immune cell rich cancers but TRBVMG-2 expression below the median had similar pCR rates in all arms (42% monotherapy vs. 28% dual therapy, P=0.46).
Conclusions: TRBV expression pattern can provide predictive information beyond known immune gene expression signatures. High expression of TRBV4.3, TRBV6.3 and TRBV7.2 variants is associated with higher pCR rate with dual HER2 targeted and paclitaxel neoadjuvant therapy.
Citation Format: Powles R, Redmond D, Sotiriou C, Loi S, Fumagalli D, Nuciforo P, Harbeck N, de Azambuja E, Sarp S, Di Cosimo S, Huober J, Baselga J, Piccart-Gebhart M, Elemento O, Hatzis C, Pusztai L. T-cell receptor beta chain variable region (TRBV) expression patterns predict response to combined trastuzumab/lapatinib treatment in the NeoALTTO/BIG-1-06 trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-01.
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Affiliation(s)
- R Powles
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - D Redmond
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Sotiriou
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - S Loi
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - D Fumagalli
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - P Nuciforo
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Harbeck
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - E de Azambuja
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - S Sarp
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - S Di Cosimo
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Huober
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Baselga
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Piccart-Gebhart
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - O Elemento
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Hatzis
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
| | - L Pusztai
- Yale University, New Haven, CT; Weill Cornell Medical College, New York, NY; Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia; Universite Libre de Bruxelles, Brussels, Belgium; Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Munich, Munich, Germany; Novartis Pharma AG, Basel, Switzerland; Istituto Nazionale Tumori, Milan, Italy; University of Ulm, Ulm, Germany; Memorial Sloan Kettering Cancer Center, New York, NY
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Allard B, Aspeslagh S, Garaud S, Dupont FA, Solinas C, Kok M, Routy B, Sotiriou C, Stagg J, Buisseret L. Immuno-oncology-101: overview of major concepts and translational perspectives. Semin Cancer Biol 2018; 52:1-11. [PMID: 29428479 DOI: 10.1016/j.semcancer.2018.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 02/06/2023]
Abstract
Cancer immunotherapy is demonstrating impressive clinical benefit in different malignancies and clinical oncologists are increasingly turning their attention to immune-oncology. It is now well recognized that innate and adaptive immune cells infiltrating tumors are associated with clinical outcomes and responses to treatments, and can be harnessed to patients' benefit. Considerable advances have also been made in understanding how cancers escape from immune attack. Targeting of immunological escape processes regulated by the expression of immune checkpoint receptors and ligands and the down-modulation of tumor antigen presentation is the basis of immuno-oncology treatments. Despite recent achievements, there remain a number of unresolved issues in order to successfully implement cancer immunotherapy in many cancers. Importantly, clinical biomarkers are still needed for better optimization of emerging combination immunotherapies and better treatment tailoring. In this review, we summarize the function of innate and adaptive immune cells in anti-tumor immunity and the general mechanisms exploited by tumor cells to escape and inhibit immune responses as well as therapeutic strategies developed to overcome these mechanisms and discuss emerging biomarkers in immuno-oncology.
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Affiliation(s)
- B Allard
- University of Montreal Hospital Research Centre, Montréal, Québec, Canada; Montreal Cancer Institute, Montreal, Quebec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada
| | - S Aspeslagh
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Garaud
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - F A Dupont
- Breast Cancer Translational Research Laboratory J-C Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - C Solinas
- Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Kok
- Department of Medical Oncology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - B Routy
- University of Montreal Hospital Research Centre, Montréal, Québec, Canada; Montreal Cancer Institute, Montreal, Quebec, Canada
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory J-C Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J Stagg
- University of Montreal Hospital Research Centre, Montréal, Québec, Canada; Montreal Cancer Institute, Montreal, Quebec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada
| | - L Buisseret
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast Cancer Translational Research Laboratory J-C Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
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Nagle AM, Erdem C, Levine K, Sotiriou C, Metzger O, Taylor DL, Lezon T, Oesterreich S, Lee AV. Abstract B158: Exploiting IGF1R pathway activation as a therapeutic strategy for E-cadherin deficient breast cancers. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-b158] [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
Insulin-like growth factor I (IGF1) plays an important role in breast cancer initiation and progression due to its regulation of cell proliferation, migration, and invasion. These characteristics make IGF1R an attractive therapeutic target; however, only a subset of patients show beneficial response to IGF1R inhibitors in clinical trials. To identify putative biomarkers of response to IGF1, we performed a proteomic screen in 21 breast cancer cell lines stimulated with IGF1. Using a novel integrated computational and experimental approach, we identified levels of E-cadherin (CDH1), a major component of the adherens junction (AJ), as a repressor of IGF1R signaling. CDH1 is genetically lost in invasive lobular breast cancer (ILC), a subtype of breast cancer that accounts for ~10-15% of total cases. E-cadherin is also downregulated in estrogen receptor (ER)-negative breast cancers that have undergone epithelial to mesenchymal transition. Consistent with the proteomic screen, knockdown of E-cadherin enhanced IGF1-induced activation of IGF1R and downstream Akt and ERK1/2 phosphorylation, and this enhanced cell cycle progression. Disruption of the AJ alone with an E-cadherin monoclonal antibody also enhanced IGF1R signaling. Further, we have shown a direct interaction of IGF1R and E-cadherin using in situ proximity ligation assay indicating a physical regulation of E-cadherin on IGF1R signaling. Supporting the clinical relevance of our observations, we found increased expression of IGF1 ligand and increased IGF1R phosphorylation in E-cadherin deficient ER+ ILC tumors in The Cancer Genome Atlas (TCGA) compared to ER+ invasive ductal carcinomas (IDC). We also discovered a correlation between mRNA expression and the activation of the IGF gene signature in (1) a cohort of ER+ ILC tumors compared to ER+ IDC and (2) a subset of ER-negative tumors within TCGA. We have previously published that IGF1R inhibitors are effective in inhibiting growth of ER-negative breast cancer cell lines and xenograft models in combination with chemotherapy. Thus, we focused our studies on understanding the utility of IGF1R pathway inhibition in ER+ ILC as a therapeutic strategy. Our data indicate that IGF1R and Akt pathway inhibitors are effective in inhibiting growth in ER+ ILC cell lines and ex vivo tumor culture, and synergize with standard-of-care anti-ER targeted therapy. Therefore, we hypothesize that loss of E-cadherin potentiates IGF1R signaling to enhance breast cancer progression and that loss of E-cadherin expression in ILC and ER-negative tumors may highlight those susceptible to IGF1R inhibition.
Citation Format: Alison M. Nagle, Cemal Erdem, Kevin Levine, Christos Sotiriou, Otto Metzger, D Lans Taylor, Timothy Lezon, Steffi Oesterreich, Adrian V. Lee. Exploiting IGF1R pathway activation as a therapeutic strategy for E-cadherin deficient breast cancers [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr B158.
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Criscitiello C, Bayar M, Curigliano G, Symmans F, Desmedt C, Bonnefoi H, Sinn B, Pruneri G, Vicier C, Pierga J, Denkert C, Loibl S, Sotiriou C, Michiels S, André F. A gene signature to predict high tumor-infiltrating lymphocytes after neoadjuvant chemotherapy and outcome in patients with triple-negative breast cancer. Ann Oncol 2018; 29:162-169. [DOI: 10.1093/annonc/mdx691] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Manem VSK, Salgado R, Aftimos P, Sotiriou C, Haibe-Kains B. Network science in clinical trials: A patient-centered approach. Semin Cancer Biol 2017; 52:135-150. [PMID: 29278737 DOI: 10.1016/j.semcancer.2017.12.006] [Citation(s) in RCA: 4] [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] [Received: 09/20/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 02/08/2023]
Abstract
There has been a paradigm shift in translational oncology with the advent of novel molecular diagnostic tools in the clinic. However, several challenges are associated with the integration of these sophisticated tools into clinical oncology and daily practice. High-throughput profiling at the DNA, RNA and protein levels (omics) generate a massive amount of data. The analysis and interpretation of these is non-trivial but will allow a more thorough understanding of cancer. Linear modelling of the data as it is often used today is likely to limit our understanding of cancer as a complex disease, and at times under-performs to capture a phenotype of interest. Network science and systems biology-based approaches, using machine learning and network science principles, that integrate multiple data sources, can uncover complex changes in a biological system. This approach will integrate a large number of potential biomarkers in preclinical studies to better inform therapeutic decisions and ultimately make substantial progress towards precision medicine. It will however require development of a new generation of clinical trials. Beyond discussing the challenges of high-throughput technologies, this review will develop a framework on how to implement a network science approach in new clinical trial designs in order to advance cancer care.
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Affiliation(s)
- Venkata S K Manem
- Bioinformatics and Computational Genomics Laboratory, Princess Margaret Cancer Center, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Department of Pathology, GZA Hospitals Antwerp, Belgium
| | - Philippe Aftimos
- Medical Oncology Clinic, Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Medical Oncology Clinic, Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | - Benjamin Haibe-Kains
- Bioinformatics and Computational Genomics Laboratory, Princess Margaret Cancer Center, Toronto, ON, Canada; Department of Computer Science, University of Toronto, Toronto, ON, Canada; Ontario Institute of Cancer Research, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
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150
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Fumagalli D, Wilson TR, Salgado R, Lu X, Yu J, O'Brien C, Walter K, Huw LY, Criscitiello C, Laios I, Jose V, Brown DN, Rothé F, Maetens M, Zardavas D, Savas P, Larsimont D, Piccart-Gebhart MJ, Michiels S, Lackner MR, Sotiriou C, Loi S. Somatic mutation, copy number and transcriptomic profiles of primary and matched metastatic estrogen receptor-positive breast cancers. Ann Oncol 2017; 27:1860-6. [PMID: 27672107 DOI: 10.1093/annonc/mdw286] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/14/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Estrogen receptor-positive (ER+) breast cancers (BCs) constitute the most frequent BC subtype. The molecular landscape of ER+ relapsed disease is not well characterized. In this study, we aimed to describe the genomic evolution between primary (P) and matched metastatic (M) ER+ BCs after failure of adjuvant therapy. MATERIALS AND METHODS A total of 182 ER+ metastatic BC patients with long-term follow-up were identified from a single institution. P tumor tissue was available for all patients, with 88 having matched M material. According to the availability of tumor material, samples were characterized using a 120 mutational hotspot qPCR, a 29 gene copy number aberrations (CNA) and a 400 gene expression panels. ESR1 mutations were assayed by droplet digital PCR. Molecular alterations were correlated with overall survival (OS) using the Cox proportional hazards regression models. RESULTS The median follow-up was 6.4 years (range 0.5-26.6 years). Genomic analysis of P tumors revealed somatic mutations in PIK3CA, KRAS, AKT1, FGFR3, HRAS and BRAF at frequencies of 41%, 6%, 5%, 2%, 1% and 2%, respectively, and CN amplification of CCND1, ZNF703, FGFR1, RSF1 and PAK1 at 23%, 19%, 17%, 12% and 11%, respectively. Mutations and CN amplifications were largely concordant between P and matched M (>84%). ESR1 mutations were found in 10.8% of the M but none of the P. Thirteen genes, among which ESR1, FOXA1, and HIF1A, showed significant differential expression between P and M. In P, the differential expression of 18 genes, among which IDO1, was significantly associated with OS (FDR < 0.1). CONCLUSIONS Despite the large concordance between P and matched M for the evaluated molecular alterations, potential actionable targets such as ESR1 mutations were found only in M. This supports the importance of characterizing the M disease. Other targets we identified, such as HIF1A and IDO1, warrant further investigation in this patient population.
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Affiliation(s)
- D Fumagalli
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - T R Wilson
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - R Salgado
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - X Lu
- Department of Biostatistics, Genentech Inc., South San Francisco, CA, USA
| | - J Yu
- Department of Biostatistics, Genentech Inc., South San Francisco, CA, USA
| | - C O'Brien
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - K Walter
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - L Y Huw
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - C Criscitiello
- Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, Milan, Italy
| | - I Laios
- Department of Pathology, Institut Jules Bordet, Brussels, Belgium
| | - V Jose
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - D N Brown
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - F Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - M Maetens
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - D Zardavas
- Breast International Group, Brussels, Belgium
| | - P Savas
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - D Larsimont
- Department of Pathology, Institut Jules Bordet, Brussels, Belgium
| | | | - S Michiels
- Division of Biostatistics and Epidemiology, Institut Gustave Roussy, Villejuif, France INSERM U1018, CESP, University of Paris, Villejuif, France
| | - M R Lackner
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium Division of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - S Loi
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
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