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Starzyńska A, Adamska P, Sejda A, Sakowicz-Burkiewicz M, Adamski ŁJ, Marvaso G, Wychowański P, Jereczek-Fossa BA. Any Role of PIK3CA and PTEN Biomarkers in the Prognosis in Oral Squamous Cell Carcinoma? Life (Basel) 2020; 10:E325. [PMID: 33287350 PMCID: PMC7761816 DOI: 10.3390/life10120325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) accounts for 95% of the lesions in the oral cavity. Despite development in OSCC management, the outcome is still unsatisfactory. Identification of new therapies in OSCC is urgently needed. One objective of such treatment may be a signaling pathway of phosphatidylinositol 3-kinase. The study group included 92 patients treated for OSCC at the University Clinical Centre in Gdańsk, Poland. Study was performed on formalin-fixed paraffin-embedded samples from primary OSCC. Phosphatidylinositol-4,5-bisphosphate 3-kinase (PIK3CA) and phosphatase and tensin homolog encoded on chromosome 10 (PTEN) protein expression was assessed by immunohistochemistry (IHC). PIK3CA gene copy number was analyzed using chromogenic and silver in situ hybridization where molecular probes are marked by chromogens and silver ions. PIK3CA IHC H-score ≥ 70 was found in 51.65% patients, and loss of PTEN protein was noticed in 31.46% cases. PIK3CA amplification was detected in 5 tumors. In the case of PTEN protein expression, there was an inverse correlation with the T stage of the primary tumor (r = -0.243) and positive correlation with a 5-year survival (r = 0.235). The number of copies of the PIK3CA gene was associated with the tumor grading (r = 0.208). The present study shows that loss of PTEN protein and the grading (p = 0.040), distant metastases (p = 0.033), smoking (p = 0.016), and alcohol abuse (p = 0.042) were prognostic factors for the survival of patients with OSCC. In contrast, the presence of amplification and OSCC on the floor of the mouth resulted in a nearly six-fold increase in the risk of shortening survival (p = 0.037). Our finding suggests a potential prognostic significance of PTEN loss and PIK3CA amplification in OSCC. Future studies are needed to confirm our results.
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Affiliation(s)
- Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (Ł.J.A.)
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (Ł.J.A.)
| | - Aleksandra Sejda
- Department of Pathomorphology, University of Warmia and Mazury, 18 Żołnierska Street, 10-561 Olsztyn, Poland;
| | - Monika Sakowicz-Burkiewicz
- Department of Molecular Medicine, Medical University of Gdańsk, 17 Smoluchowskiego Street, 80-214 Gdańsk, Poland;
| | - Łukasz Jan Adamski
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (Ł.J.A.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20-141 Milan, Italy; (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20-112 Milan, Italy
| | - Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 Binieckiego Street, 02-097 Warsaw, Poland;
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20-141 Milan, Italy; (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20-112 Milan, Italy
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2
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Kriegsmann K, Zgorzelski C, Muley T, Christopoulos P, von Winterfeld M, Herpel E, Goeppert B, Mechtersheimer G, Sinn P, Stenzinger A, Schirmacher P, Winter H, Eichinger M, Warth A, Kriegsmann M. Immunohistological expression of oestrogen receptor, progesterone receptor, mammaglobin, human epidermal growth factor receptor 2 and GATA-binding protein 3 in non-small-cell lung cancer. Histopathology 2020; 77:900-914. [PMID: 32634256 DOI: 10.1111/his.14203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/27/2020] [Accepted: 07/02/2020] [Indexed: 12/11/2022]
Abstract
AIMS Non-small-cell lung cancer (NSCLC) and breast cancer are common entities. Staining for oestrogen receptor (ER), progesterone receptor (PgR), mammaglobin (MAMG) and GATA-binding protein 3 (GATA3) is frequently performed to confirm a mammary origin in the appropriate diagnostic setting. However, comprehensive data on the immunohistological expression of these markers in NSCLC are limited. Therefore, the aim of this study was to analyse a large cohort of NSCLCs and correlate the staining results with clinicopathological variables. METHODS AND RESULTS A tissue microarray was stained for ER, PgR, MAMG, human epidermal growth factor receptor 2 (HER2), and GATA3, and included 636 adenocarcinomas (ADCs), 536 squamous cell carcinomas (SqCCs), 65 large-cell-carcinomas, 34 pleomorphic carcinomas, and 20 large-cell neuroendocrine carcinomas. HER2 status was determined for immunohistochemically positive cases with chromogenic in-situ hybridisation. Markers with a proportion of ≥5% positive cases in ADC and SqCC were considered for survival analysis. Among ADCs, 62 (10%), 17 (3%), one (<1%), seven (1%), and 49 (8%) cases were positive for ER, PgR, MAMG, HER2, and GATA3, respectively. Among SqCCs, 10 (2%), 14 (3%), two (<1%) and 109 (20%) cases were positive for ER, PgR, HER2, and GATA3, but none of the samples showed positivity for MAMG. ER positivity was associated with ADC, female sex, smaller tumour size, and lower clinical stage. None of the markers had an impact on survival. CONCLUSION We report on ER, PgR, MAMG, HER2 and GATA3 expression in a large cohort of NSCLCs. Interpretation of these markers in the differential diagnostic setting should be based on a multimarker panel.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Internal Medicine V, Haematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Thomas Muley
- Translational Lung Research Centre Heidelberg, Member of the German Centre for Lung Research (DZL), Thoraxklinik at Heidelberg University, Heidelberg, Germany.,Translational Research Unit, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Petros Christopoulos
- Department of Thoracic Oncology, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | | | - Esther Herpel
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Benjamin Goeppert
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Peter Sinn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Albrecht Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg, Member of the German Centre for Lung Research (DZL), Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hauke Winter
- Translational Lung Research Centre Heidelberg, Member of the German Centre for Lung Research (DZL), Thoraxklinik at Heidelberg University, Heidelberg, Germany.,Translational Research Unit, Thoraxklinik at Heidelberg University, Heidelberg, Germany.,Department of Thoracic Surgery, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Monika Eichinger
- Department of Radiology, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Arne Warth
- Institute of Pathology, Cytopathology, and Molecular Pathology, UEGP MVZ Gießen/Wetzlar/Limburg, Limburg, Germany
| | - Mark Kriegsmann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg, Member of the German Centre for Lung Research (DZL), Thoraxklinik at Heidelberg University, Heidelberg, Germany.,Translational Research Unit, Thoraxklinik at Heidelberg University, Heidelberg, Germany
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3
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Lamberti G, Andrini E, Sisi M, Rizzo A, Parisi C, Di Federico A, Gelsomino F, Ardizzoni A. Beyond EGFR, ALK and ROS1: Current evidence and future perspectives on newly targetable oncogenic drivers in lung adenocarcinoma. Crit Rev Oncol Hematol 2020; 156:103119. [PMID: 33053439 DOI: 10.1016/j.critrevonc.2020.103119] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/31/2020] [Accepted: 09/27/2020] [Indexed: 02/06/2023] Open
Abstract
Lung cancer is the leading cause of cancer death worldwide. In the past decade EGFR, ALK and ROS1 TKIs lead to an unprecedented survival improvement of oncogene-addicted NSCLC patients, with better toxicity profile compared to chemotherapy. In recent years the implementation of high-throughput sequencing platforms led to the identification of uncommon molecular alterations in oncogenic drivers, such as BRAF, MET, RET, HER2 and NTRK. Moreover, newly developed drugs have been found to be active against hard to target drivers, such as KRAS. Specific TKIs targeting these genomic alterations are currently in clinical development and showed impressive activity and survival improvement, leading to FDA-accelerated approval for some of them. However, virtually all patients develop resistance to TKIs by on-target or off-target mechanisms. Here we review the clinicopathological features, the emerging targeted therapies and mechanisms of resistance and strategies to overcome them of KRAS, BRAF, MET, RET, HER2 and NTRK-addicted advanced NSCLCs.
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Affiliation(s)
- Giuseppe Lamberti
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Elisa Andrini
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Monia Sisi
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Alessandro Rizzo
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Claudia Parisi
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Alessandro Di Federico
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Francesco Gelsomino
- Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy.
| | - Andrea Ardizzoni
- Department of Specialized, Experimental and Diagnostic Medicine, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy
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4
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ERK phosphorylation as a marker of RAS activity and its prognostic value in non-small cell lung cancer. Lung Cancer 2020; 149:10-16. [PMID: 32947221 DOI: 10.1016/j.lungcan.2020.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Deregulated signal transduction pathways play a key role in development, progression and therapeutic resistance of non-small cell lung cancers (NSCLC). The purpose of this study is to assess the downstream markers of two well-characterized pathways and to correlate them with clinical outcome. DESIGN 670 patients with metastatic NSCLC were prospectively enrolled in a comprehensive biomarker profiling program at a single center from 2012 to 2016. Phosphorylation of extracellular signal-regulated kinase (p-ERK), and protein kinase B (p-AKT) was assessed by standardized immunohistochemistry. Product of scores for quantity and quality of staining were calculated (immunoreactive score, 0-9). Somatic mutations of Kirsten rat sarcoma viral oncogene homolog [KRAS], epithelial growth factor receptor [EGFR], v-Raf murine sarcoma viral oncogene homolog B [BRAF] and phosphatidylinositol 3-kinase [PIK3CA]) were detected by Sanger (2012-03/2015) and amplicon NGS (04/2015-02/2016). Patients enrolled during the first year (2012) were used as discovery cohort. Patients enrolled from 2013 to 02/2016 were used as validation cohort. Clinical data were retrieved from the electronic medical records and were analyzed retrospectively. RESULTS Using a discovery cohort, we identified an immunoreactive score of p-ERK ≥3 to be prognostically relevant. The validation cohort confirmed that higher levels of p-ERK correlated with worse overall survival (OS) and higher proportion of RAS mutations. Multivariate analysis including established risk factors such EGFR, ALK or ROS mutations and metastatic disease showed a trend of a detrimental effect of high p-ERK on OS (HR 1.23, CI 0.94-1.59, p = 0.131 for p-ERK immunoreactive score ≥3) and time to treatment failure after first-line therapy in the validation cohort. Phosphorylated AKT did not correlate with clinical outcome. CONCLUSION While serving as a prognosticator in univariate analysis, highly phosphorylated ERK does not convey a significant prognostic effect for OS in the presence of other prognostic factors. Phosphorylated ERK indicates a higher activity of RAS in advanced NSCLC.
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5
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Concordance analysis between HER2 immunohistochemistry and in situ hybridization in non-small cell lung cancer. Int J Biol Markers 2018; 33:49-54. [PMID: 28478639 DOI: 10.5301/ijbm.5000271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE This study aimed to elucidate the concordance between human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) and in situ hybridization (ISH) and the diagnostic accuracy of HER2 IHC in non-small cell lung cancer (NSCLC) through a meta-analysis and diagnostic test accuracy review. METHODS Seven eligible studies and 1,217 patients with NSCLC were included in the review. The concordance between HER2 IHC and ISH was analyzed. To confirm the diagnostic accuracy of HER2 IHC, the sensitivity and specificity were analyzed and the area under the curve (AUC) in the summary receiver operating characteristic (SROC) curve was calculated. RESULTS The concordance rate between HER2 IHC and ISH was 0.795 (95% confidence interval [CI] 0.534-0.929). In the HER2 IHC-negative (score 0/1+) subgroup, the concordance rate was 0.975 (95% CI 0.854-0.996). The concordance rates of the HER2 IHC score 2+ and 3+ subgroups were 0.091 (95% CI 0.039-0.197) and 0.665 (95% CI 0.446-0.830), respectively. In diagnostic test accuracy review, the pooled sensitivity and specificity were 0.67 (95% CI 0.54-0.78) and 0.89 (95% CI 0.87-0.91), respectively. The AUC in the SROC curve was 0.891 and the diagnostic odds ratio was 16.99 (95% CI 5.08-56.76). CONCLUSIONS HER2 IHC was largely in agreement with ISH in cases of HER2 IHC score 0/1+. Because the concordance rates of HER2 IHC score 2/3+ cases were lower than that of HER2 IHC score 0/1+ cases, further studies for detailed analysis criteria for HER2 IHC score 2+ or 3+ are required.
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6
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Reis H, van der Vos KE, Niedworok C, Herold T, Módos O, Szendrői A, Hager T, Ingenwerth M, Vis DJ, Behrendt MA, de Jong J, van der Heijden MS, Peyronnet B, Mathieu R, Wiesweg M, Ablat J, Okon K, Tolkach Y, Keresztes D, Nagy N, Bremmer F, Gaisa NT, Chlosta P, Kriegsmann J, Kovalszky I, Timar J, Kristiansen G, Radzun H, Knüchel R, Schuler M, Black PC, Rübben H, Hadaschik BA, Schmid KW, van Rhijn BW, Nyirády P, Szarvas T. P
athogenic and targetable genetic alterations in 70 urachal adenocarcinomas. Int J Cancer 2018; 143:1764-1773. [PMID: 29672836 DOI: 10.1002/ijc.31547] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 03/12/2018] [Accepted: 03/28/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Henning Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital EssenEssen Germany
| | - Kristan E. van der Vos
- Division of Molecular CarcinogenesisNetherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
| | - Christian Niedworok
- Department of UrologyWest German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
| | - Thomas Herold
- Institute of Pathology, West German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital EssenEssen Germany
| | - Orsolya Módos
- Department of UrologySemmelweis UniversityBudapest Hungary
| | | | - Thomas Hager
- Institute of Pathology, West German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
| | - Marc Ingenwerth
- Institute of Pathology, West German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
| | - Daniël J. Vis
- Division of Molecular CarcinogenesisNetherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
| | - Mark A. Behrendt
- Department of Surgical Oncology (Urology)Netherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
- Department of Surgery, Division of UrologyUniversity Hospital of BaselBasel Switzerland
| | - Jeroen de Jong
- Department of PathologyNetherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
| | - Michiel S. van der Heijden
- Division of Molecular CarcinogenesisNetherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
- Department of Medical OncologyNetherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
| | | | | | - Marcel Wiesweg
- Department of Medical OncologyWest German Cancer Center, University of Duisburg Essen, University Hospital EssenEssen Germany
| | - Jason Ablat
- Vancouver Prostate CentreUniversity of British ColumbiaVancouver BC Canada
| | - Krzysztof Okon
- Department of PathomorphologyJagiellonian UniversityCracow Poland
| | - Yuri Tolkach
- Institute of Pathology, University of BonnBonn Germany
| | | | - Nikolett Nagy
- Department of UrologySemmelweis UniversityBudapest Hungary
| | - Felix Bremmer
- Institute of Pathology, University of GöttingenGöttingen Germany
| | - Nadine T. Gaisa
- Institute of Pathology, RWTH Aachen UniversityAachen Germany
| | - Piotr Chlosta
- Department of PathomorphologyJagiellonian UniversityCracow Poland
| | - Joerg Kriegsmann
- Center for Histology, Cytology and Molecular Diagnostics TrierTrier Germany
| | - Ilona Kovalszky
- First Institute of Pathology and Experimental Cancer Research, Semmelweis UniversityBudapest Hungary
| | - József Timar
- Second Department of PathologySemmelweis UniversityBudapest Hungary
| | | | | | - Ruth Knüchel
- Institute of Pathology, RWTH Aachen UniversityAachen Germany
| | - Martin Schuler
- German Cancer Consortium (DKTK), Partner Site University Hospital EssenEssen Germany
- Department of Medical OncologyWest German Cancer Center, University of Duisburg Essen, University Hospital EssenEssen Germany
| | - Peter C. Black
- Vancouver Prostate CentreUniversity of British ColumbiaVancouver BC Canada
| | - Herbert Rübben
- Department of UrologyWest German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
| | - Boris A. Hadaschik
- Department of UrologyWest German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital EssenEssen Germany
| | - Kurt Werner Schmid
- Institute of Pathology, West German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital EssenEssen Germany
| | - Bas W.G. van Rhijn
- Department of Surgical Oncology (Urology)Netherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdam Netherlands
| | - Péter Nyirády
- Department of UrologySemmelweis UniversityBudapest Hungary
| | - Tibor Szarvas
- Department of UrologyWest German Cancer Center, University of Duisburg‐Essen, University Hospital EssenEssen Germany
- Department of UrologySemmelweis UniversityBudapest Hungary
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7
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Zhao J, Chen X, Zheng J, Kong M, Wang B, Ding W. A genomic and clinicopathological study of non-small-cell lung cancers with discordant ROS1 gene status by fluorescence in-situ hybridisation and immunohistochemical analysis. Histopathology 2018; 73:19-28. [PMID: 29464758 DOI: 10.1111/his.13492] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/15/2018] [Indexed: 11/30/2022]
Abstract
AIMS ROS1 immunohistochemistry (IHC) using D4D6 antibody is a useful tool for screening patients with non-small-cell lung cancer (NSCLC) who may be suitable for targeted therapy. Many studies and our data have identified cases that express the ROS1 protein strongly but are negative for ROS1 by fluorescence in-situ hybridisation (FISH). The present study investigated the driver mutation and clinicopathological characteristics of 26 discordant cases (ROS1 IHC-positive but FISH-negative) to find new clues for distinguishing real ROS1-rearranged cases. METHODS AND RESULTS Tumours from 26 discordant cases were analysed for clinicopathological characteristics, mutations in EGFR, KRAS, ERBB2, BRAF and PIK3CA; fusions in ALK and RET; and amplifications in MET, ERBB2 and ROS1. ROS1-rearranged NSCLCs were significantly more likely to be found in younger patients and at an advanced stage; they showed cribriform features, extracellular mucus and psammoma bodies, whereas ROS1-discordant cases were found in older patients at a relatively early tumour-node-metastasis (TNM) stage and showed a lepidic growth pattern (all P < 0.001). Most ROS1-rearranged NSCLCs had no concurrent mutation, whereas 73% of discordant cases harboured genetic aberrations, including EGFR and ERBB2. Compared with general lung adenocarcinomas, ERBB-2 abnormality was disproportionately high in ROS1-discordant cases. Moreover, we optimised the scoring criteria for ROS1 IHC as 'H score > 150 and no concurrent mutations'; the specificity was then increased to 81.6%. CONCLUSIONS Compared with ROS1-rearranged cases, ROS1-discordant patients showed distinct clinical and morphological features and often harboured another oncogenic driver alteration. The use of optimised screening criteria will increase the specificity of ROS1 antibody.
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Affiliation(s)
- Jing Zhao
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaotong Chen
- Department of Pathology, The First Hospital of Yulin City, Guangxi, China
| | - Jing Zheng
- Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Mei Kong
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Bo Wang
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Ding
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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8
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Kasper S, Reis H, Ziegler S, Nothdurft S, Mueller A, Goetz M, Wiesweg M, Phasue J, Ting S, Wieczorek S, Even A, Worm K, Pogorzelski M, Breitenbuecher S, Meiler J, Paul A, Trarbach T, Schmid KW, Breitenbuecher F, Schuler M. Molecular dissection of effector mechanisms of RAS-mediated resistance to anti-EGFR antibody therapy. Oncotarget 2018; 8:45898-45917. [PMID: 28507280 PMCID: PMC5542236 DOI: 10.18632/oncotarget.17438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 04/03/2017] [Indexed: 12/22/2022] Open
Abstract
Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR), cetuximab and panitumumab, are a mainstay of metastatic colorectal cancer (mCRC) treatment. However, a significant number of patients suffer from primary or acquired resistance. RAS mutations are negative predictors of clinical efficacy of anti-EGFR antibodies in patients with mCRC. Oncogenic RAS activates the MAPK and PI3K/AKT pathways, which are considered the main effectors of resistance. However, the relative impact of these pathways in RAS-mutant CRC is less defined. A better mechanistic understanding of RAS-mediated resistance may guide development of rational intervention strategies. To this end we developed cancer models for functional dissection of resistance to anti-EGFR therapy in vitro and in vivo. To selectively activate MAPK- or AKT-signaling we expressed conditionally activatable RAF-1 and AKT in cancer cells. We found that either pathway independently protected sensitive cancer models against anti-EGFR antibody treatment in vitro and in vivo. RAF-1- and AKT-mediated resistance was associated with increased expression of anti-apoptotic BCL-2 proteins. Biomarkers of MAPK and PI3K/AKT pathway activation correlated with inferior outcome in a cohort of mCRC patients receiving cetuximab-based therapy. Dual pharmacologic inhibition of PI3K and MEK successfully sensitized primary resistant CRC models to anti-EGFR therapy. In conclusion, combined targeting of MAPK and PI3K/AKT signaling, but not single pathways, may be required to enhance the efficacy of anti-EGFR antibody therapy in patients with RAS-mutated CRC as well as in RAS wild type tumors with clinical resistance.
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Affiliation(s)
- Stefan Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Sophie Ziegler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Silke Nothdurft
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Andre Mueller
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Moritz Goetz
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Marcel Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Jeannette Phasue
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Saskia Ting
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Sarah Wieczorek
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Anna Even
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Karl Worm
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Michael Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Sandra Breitenbuecher
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Johannes Meiler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Andreas Paul
- Department of General, Visceral und Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Tanja Trarbach
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany.,Present address: Center for Tumor Biology and Integrative Medicine, Hospital Wilhelmshaven, 26389 Wilhelmshaven, Germany
| | - Kurt Werner Schmid
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Frank Breitenbuecher
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Martin Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45122 Essen, Germany
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9
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Yang L, Che Y, Guo L, Zheng B, Wang B, Yang Z, Zhu Y, Li J. Correlation analysis of mesenchymal-epithelial transition factor protein and human epidermal growth receptor 2 protein expression in 1479 cases of lung adenocarcinoma in China. Thorac Cancer 2018; 9:439-444. [PMID: 29400000 PMCID: PMC5879060 DOI: 10.1111/1759-7714.12595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 12/18/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To investigate the correlation between mesenchymal-epithelial transition factor (C-Met) and human epidermal growth receptor 2 (HER2) protein expression in primary lung adenocarcinoma tissues. METHOD A total of 1479 resected primary lung adenocarcinoma patients were enrolled in the present study for detecting of C-Met and HER2 protein by immunohistochemistry, and correlation analysis was made between the above two biomarkers and related clinicopathological features. RESULT Both C-Met and HER2 proteins were found to stain highly positive in lung adenocarcinomas, and a positive correlation was found between them (χ2 = 118.5, P = 2.707 × 10-21 ). In addition, HER2 protein expression was correlated with sex, pathological stage, lymph node metastasis, and major subtypes; and C-Met was correlated with sex (P < 0.05). CONCLUSION The expression of C-Met and HER2 protein in lung adenocarcinoma is highly correlated, and whether it is synergistic in the targeted therapy of lung adenocarcinoma deserves further study.
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Affiliation(s)
- Lin Yang
- Department of PathologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yiqun Che
- Department of Clinical LaboratoryNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Lei Guo
- Department of PathologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Bo Zheng
- Department of PathologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Bingning Wang
- Department of PathologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Zhenxi Yang
- Department of Clinical LaboratoryNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yixiang Zhu
- Department of Medical OncologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Junling Li
- Department of Medical OncologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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10
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Reis H, Metzenmacher M, Goetz M, Savvidou N, Darwiche K, Aigner C, Herold T, Eberhardt WE, Skiba C, Hense J, Virchow I, Westerwick D, Bogner S, Ting S, Kasper S, Stuschke M, Nensa F, Herrmann K, Hager T, Schmid KW, Schuler M, Wiesweg M. MET Expression in Advanced Non-Small-Cell Lung Cancer: Effect on Clinical Outcomes of Chemotherapy, Targeted Therapy, and Immunotherapy. Clin Lung Cancer 2018; 19:e441-e463. [PMID: 29631966 DOI: 10.1016/j.cllc.2018.03.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/08/2018] [Accepted: 03/10/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The receptor tyrosine kinase MET is implicated in malignant transformation, tumor progression, metastasis, and acquired treatment resistance. We conducted an analysis of the effect of MET expression and MET genomic aberrations on the outcome of patients with advanced or metastatic pulmonary adenocarcinomas prospectively enrolled in an institutional precision oncology program. PATIENTS AND METHODS Standardized immunohistochemistry (IHC) analyses of MET and markers of pathway activation were available in 384 patients, and next-generation sequencing-based MET hotspot mutation analyses were available from 892 patients. Clinical data were retrieved with a median follow-up from initial diagnosis of 37 months. RESULTS High MET expression, defined as MET IHC 3+ or MET H-Score in the upper quartile, was observed in 102 of 384 patients (26.6%). MET exon 14 mutations were only detected in 7 of 892 patients (0.78%). High MET expression correlated with activation markers of the mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathways only in cases without Kirsten rat sarcoma viral oncogene homolog (KRAS), epidermal growth factor receptor (EGFR), v-Raf murine sarcoma viral oncogene homolog B (BRAF), anaplastic lymphoma kinase (ALK) and proto-oncogene tyrosine-protein kinase ROS (ROS1) aberrations. There was no association of MET expression with outcome during chemotherapy. High MET expression negatively affected the outcome during EGFR-targeting therapy but was associated with more favorable results with programmed death 1/programmed death ligand 1 (PD-L1)-directed therapy, independent of smoking history, PD-L1 expression or KRAS mutation. Two patients with MET exon 14 mutation and high PD-L1 expression failed to respond to pembrolizumab. CONCLUSION MET expression affects the outcomes of targeted therapies in non-small-cell lung cancer, thus supporting the development of biomarker-informed combination strategies. The interaction of MET expression and MET mutation with immune checkpoint inhibitor therapy is novel and merits further investigation.
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Affiliation(s)
- Henning Reis
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Metzenmacher
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Moritz Goetz
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nikoleta Savvidou
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kaid Darwiche
- Department of Pulmonary Medicine, Section of Interventional Pneumology, Ruhrlandklinik - University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery and Endoscopy, Ruhrlandklinik - University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Herold
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Wilfried E Eberhardt
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Division of Thoracic Oncology, Ruhrlandklinik - University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Charlotte Skiba
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jörg Hense
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Isabel Virchow
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniela Westerwick
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Simon Bogner
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Saskia Ting
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Stuschke
- Department of Radiotherapy, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Felix Nensa
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ken Herrmann
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany; Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Hager
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kurt W Schmid
- Institute of Pathology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Martin Schuler
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Division of Thoracic Oncology, Ruhrlandklinik - University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
| | - Marcel Wiesweg
- Department of Medical Oncology, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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11
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Wiesweg M, Reis H, Köster T, Goetz M, Worm K, Herold T, Paul A, Dechêne A, Schumacher B, Markus P, Virchow I, Kostbade K, Wolf N, Zaun G, Metzenmacher M, Schmid KW, Schuler M, Kasper S. Phosphorylation of p70 Ribosomal Protein S6 Kinase β-1 is an Independent Prognostic Parameter in Metastatic Colorectal Cancer. Clin Colorectal Cancer 2018. [PMID: 29526493 DOI: 10.1016/j.clcc.2018.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Deregulation of signal transduction pathways plays a critical role in oncogenesis of colorectal cancer (CRC) and directly affects sensitivity to targeted therapies. Against this background we developed a comprehensive biomarker profiling program including markers of downstream signaling to study their association with clinical outcomes. PATIENTS AND METHODS A prospectively studied cohort of 160 patients with metastatic CRC was included. Standard diagnostic workup included mutational analyses of Kirsten rat sarcoma viral oncogene homolog (KRAS), neuroblastoma RAS viral oncogene homolog (NRAS), and v-Raf murine sarcoma viral oncogene homolog B (BRAF). In addition, markers of mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) and mammalian target of rapamycin pathway activation (phosphorylation of extracellular signal-regulated kinase [ERK], AKT, and p70 ribosomal protein S6 kinase β-1 [p70S6K]) were studied using standardized immunohistochemistry. RESULTS There was a significant correlation between markers of ERK and AKT activation in the full cohort. In addition, phosphorylation of p70S6K correlated strongly with ERK and AKT phosphorylation and primary tumor localization in the right colon. Subgroup analyses specified these correlations to patients with all-RAS wild type tumors. In contrast, tumors harboring RAS mutations predominantly exhibited ERK phosphorylation. Interestingly, patients with CRC showing high p70S6K phosphorylation (highest quartile) had a significantly inferior overall survival (hazard ratio [HR], 2.4; P = .002) irrespective of RAS mutational status. This effect remained significant in multivariate analysis (P = .002). A patient subgroup characterized by high p70S6K phosphorylation and right-sided primary tumors had a particularly poor prognosis with a dramatically inferior overall survival (HR, 5.2; P < .001). Patients with right-sided primary tumor and low p70S6K phosphorylation had responses to anti-epidermal growth factor receptor antibody-based therapies and overall survival similar to patients with left-sided primary tumors. CONCLUSION High phosphorylation of p70S6K is a novel, independent biomarker for poor prognosis, in particular in patients with right-sided primary tumors.
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Affiliation(s)
- Marcel Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Tobias Köster
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Moritz Goetz
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Karl Worm
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Thomas Herold
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Paul
- Department of General, Visceral and Transplantation Surgery, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Alexander Dechêne
- Department of Gastroenterology and Hepatology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | - Peter Markus
- Department of General, Visceral and Trauma Surgery, Elisabeth Hospital Essen, Essen, Germany
| | - Isabel Virchow
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Karina Kostbade
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Nathalie Wolf
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Gregor Zaun
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Martin Metzenmacher
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Kurt W Schmid
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; German Cancer Consortium, Partner Site University Hospital Essen, Essen, Germany
| | - Martin Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; German Cancer Consortium, Partner Site University Hospital Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; German Cancer Consortium, Partner Site University Hospital Essen, Essen, Germany.
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12
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Saffroy R, Morère JF, Bosselut N, Innominato PF, Hamelin J, Trédaniel J, Masse S, Dussaule-Duchatelle V, Balaton A, Validire P, Guettier C, Bouchahda M, Lemoine A. Impact of country of birth on genetic testing of metastatic lung adenocarcinomas in France: African women exhibit a mutational spectrum more similar to Asians than to Caucasians. Oncotarget 2017; 8:50792-50803. [PMID: 28881604 PMCID: PMC5584205 DOI: 10.18632/oncotarget.15132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/09/2017] [Indexed: 01/15/2023] Open
Abstract
Background Limited data are available on the prevalence of oncogenic driver mutations in Caucasian populations, and especially in Europeans. Aim To evaluate the targetable mutational spectra in unselected patients with lung adenocarcinoma in routine clinical practice from several French hospitals, using the same molecular platform. Patients and Methods Samples from 2,219 consecutive patients with histologically-proven advanced lung adenocarcinoma were centrally analysed at a referenced and certified diagnostic platform in order to test for activating and resistance mutations in EGFR, KRAS, BRAF, ERBB2 and PI3KCA. Demographic and clinical features were retrieved from the medical charts. Multivariate binary logistic regression was used to determine the independent predictive factors for the occurrence of specific mutations, in the whole study population or in selected subgroups. Findings The overall respective incidence of EGFR, KRAS, BRAF, ERBB2 and PI3KCA mutations was 10.5%, 0.9%, 25%, 1.5%, 2.1% and 1.4%, in our study sample including 87.4% white Caucasians, 10.8% Africans and 1.8% Asians; 60.6% men, 30.7% never smoker (median age: 68.3 years). Ethnicity was an independent predictor for EGFR, KRAS and ERBB2 gene abnormalities. In all cases, a significantly higher prevalence of targetable EGFR and ERBB2, and a lower prevalence of resistance KRAS mutations were observed in African women as compared to African men or Caucasians. Conclusions In real life conditions of routine genetic testing, we have identified subsets of patients with specific targetable activating somatic mutations according to ethnicity, who could preferentially benefit from anti-EGFR and anti-ERBB2 targeted therapies.
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Affiliation(s)
- Raphael Saffroy
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Jean-François Morère
- INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.,AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France
| | - Nelly Bosselut
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Pasquale F Innominato
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France.,INSERM UMR-935, Université Paris-Sud, Hôpital Paul Brousse, Villejuif, France.,Cancer Chronotherapy Unit, Cancer Research Centre, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Department of Oncology, Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Jocelyne Hamelin
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Jean Trédaniel
- Hôpital Saint Joseph, Department of Respiratory Medicine, Université Paris 5, Paris, France
| | - Sophie Masse
- Groupe Hospitalier Nord Essonne, Department of Pathology, Longjumeau, France
| | | | - André Balaton
- Hôpital Saint Joseph, Department of Pathology, Paris, France.,ACP Bievres-les Ulis, Department of Pathology, Les Ulis, France
| | - Pierre Validire
- Institut Mutualiste Montsouris, Department of Pathology, Paris, France
| | - Catherine Guettier
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Pathology, Platform Oncomolpath/INCa, Villejuif, France
| | - Mohamed Bouchahda
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France.,Ramsay-GDS Clinique du Mousseau, Department of Medical Oncology, Evry, France
| | - Antoinette Lemoine
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
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