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Alexander J, Schipper K, Nash S, Brough R, Kemp H, Iacovacci J, Isacke C, Natrajan R, Sawyer E, Lord CJ, Haider S. Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer. Br J Cancer 2024; 130:1828-1840. [PMID: 38600325 PMCID: PMC11130209 DOI: 10.1038/s41416-024-02679-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Invasive Lobular Carcinoma (ILC) is a morphologically distinct breast cancer subtype that represents up to 15% of all breast cancers. Compared to Invasive Breast Carcinoma of No Special Type (IBC-NST), ILCs exhibit poorer long-term outcome and a unique pattern of metastasis. Despite these differences, the systematic discovery of robust prognostic biomarkers and therapeutically actionable molecular pathways in ILC remains limited. METHODS Pathway-centric multivariable models using statistical machine learning were developed and tested in seven retrospective clinico-genomic cohorts (n = 996). Further external validation was performed using a new RNA-Seq clinical cohort of aggressive ILCs (n = 48). RESULTS AND CONCLUSIONS mRNA dysregulation scores of 25 pathways were strongly prognostic in ILC (FDR-adjusted P < 0.05). Of these, three pathways including Cell-cell communication, Innate immune system and Smooth muscle contraction were also independent predictors of chemotherapy response. To aggregate these findings, a multivariable machine learning predictor called PSILC was developed and successfully validated for predicting overall and metastasis-free survival in ILC. Integration of PSILC with CRISPR-Cas9 screening data from breast cancer cell lines revealed 16 candidate therapeutic targets that were synthetic lethal with high-risk ILCs. This study provides interpretable prognostic and predictive biomarkers of ILC which could serve as the starting points for targeted drug discovery for this disease.
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Affiliation(s)
- John Alexander
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Koen Schipper
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Sarah Nash
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
- Breast Cancer Genetics, King's College London, London, SE1 9RT, UK
| | - Rachel Brough
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Harriet Kemp
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Jacopo Iacovacci
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Clare Isacke
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Rachael Natrajan
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Elinor Sawyer
- Breast Cancer Genetics, King's College London, London, SE1 9RT, UK
| | - Christopher J Lord
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Syed Haider
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK.
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Demetriou D, Lockhat Z, Brzozowski L, Saini KS, Dlamini Z, Hull R. The Convergence of Radiology and Genomics: Advancing Breast Cancer Diagnosis with Radiogenomics. Cancers (Basel) 2024; 16:1076. [PMID: 38473432 DOI: 10.3390/cancers16051076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Despite significant progress in the prevention, screening, diagnosis, prognosis, and therapy of breast cancer (BC), it remains a highly prevalent and life-threatening disease affecting millions worldwide. Molecular subtyping of BC is crucial for predictive and prognostic purposes due to the diverse clinical behaviors observed across various types. The molecular heterogeneity of BC poses uncertainties in its impact on diagnosis, prognosis, and treatment. Numerous studies have highlighted genetic and environmental differences between patients from different geographic regions, emphasizing the need for localized research. International studies have revealed that patients with African heritage are often diagnosed at a more advanced stage and exhibit poorer responses to treatment and lower survival rates. Despite these global findings, there is a dearth of in-depth studies focusing on communities in the African region. Early diagnosis and timely treatment are paramount to improving survival rates. In this context, radiogenomics emerges as a promising field within precision medicine. By associating genetic patterns with image attributes or features, radiogenomics has the potential to significantly improve early detection, prognosis, and diagnosis. It can provide valuable insights into potential treatment options and predict the likelihood of survival, progression, and relapse. Radiogenomics allows for visual features and genetic marker linkage that promises to eliminate the need for biopsy and sequencing. The application of radiogenomics not only contributes to advancing precision oncology and individualized patient treatment but also streamlines clinical workflows. This review aims to delve into the theoretical underpinnings of radiogenomics and explore its practical applications in the diagnosis, management, and treatment of BC and to put radiogenomics on a path towards fully integrated diagnostics.
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Affiliation(s)
- Demetra Demetriou
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Hatfield, Pretoria 0028, South Africa
| | - Zarina Lockhat
- Department of Radiology, Faculty of Health Sciences, Steve Biko Academic Hospital, University of Pretoria, Hatfield, Pretoria 0028, South Africa
| | - Luke Brzozowski
- Translational Research and Core Facilities, University Health Network, Toronto, ON M5G 1L7, Canada
| | - Kamal S Saini
- Fortrea Inc., 8 Moore Drive, Durham, NC 27709, USA
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Zodwa Dlamini
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Hatfield, Pretoria 0028, South Africa
| | - Rodney Hull
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Hatfield, Pretoria 0028, South Africa
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Göker M, Denys H, Hendrix A, De Wever O, Van de Vijver K, Braems G. Histologic tumor type as a determinant of survival in hormone receptor-positive, HER2-negative, pT1-3 invasive ductal and lobular breast cancer. Breast Cancer Res 2023; 25:146. [PMID: 37993928 PMCID: PMC10664297 DOI: 10.1186/s13058-023-01745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
PURPOSE The aim of the study was to compare the difference in survival between invasive ductal (IDC) and lobular carcinoma (ILC). METHODS Data of patients (n = 1843) with a hormone receptor-positive, HER2-negative, pT1-3 IDC or ILC cancer without distant metastasis, treated at the Ghent University Hospital over the time period 2001-2015, were analyzed. RESULTS ILC represented 13.9% of the tumors, had a higher percentage of pT3 and pN3 stages than IDC, lymphovascular space invasion (LVSI) was less present and Ki-67 was mostly low. 73.9% of ILCs were grade 2, whereas IDC had more grade 1 and grade 3 tumors. Kaplan-Meier curves and log-rank testing showed a significant worse DFS for ILC with pN ≥ 1 than for their IDC counterpart. In a multivariable Cox regression analysis the histologic tumor type, ductal or lobular, was a determinant of DFS over 120 months (IDC as reference; hazard ratio for ILC 1.77, 95% CI 1.08-2.90) just as the ER Allred score (hazard ratio 0.84, 95% CI 0.78-0.91), LVSI (hazard ratio 1.75, 95% CI 1.12-2.74) and pN3 (hazard ratio 2.29, 95% CI 1.03-5.09). Determinants of OS over ten years were age (hazard ratio 1.05, 95% CI 1.02-1.07), LVSI (hazard ratio 3.62, 95% CI 1.92-6.82) and the ER Allred score (hazard ratio 0.80, 95% CI 0.73-0.89). CONCLUSION The histologic tumor type, ductal or lobular, determines DFS in hormone receptor-positive, HER2-negative, pT1-3 breast cancer besides the ER Allred score, LVSI and pN3.
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Affiliation(s)
- Menekse Göker
- Department of Gynaecology, Ghent University Hospital, Ghent, Belgium.
| | - Hannelore Denys
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - An Hendrix
- Laboratory for Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium
| | - Olivier De Wever
- Laboratory for Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium
| | | | - Geert Braems
- Department of Gynaecology, Ghent University Hospital, Ghent, Belgium
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Batra H, Mouabbi JA, Ding Q, Sahin AA, Raso MG. Lobular Carcinoma of the Breast: A Comprehensive Review with Translational Insights. Cancers (Basel) 2023; 15:5491. [PMID: 38001750 PMCID: PMC10670219 DOI: 10.3390/cancers15225491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
The second most common breast carcinoma, invasive lobular carcinoma, accounts for approximately 15% of tumors of breast origin. Its incidence has increased in recent times due in part to hormone replacement therapy and improvement in diagnostic modalities. Although believed to arise from the same cell type as their ductal counterpart, invasive lobular carcinomas (ILCs) are a distinct entity with different regulating genetic pathways, characteristic histologies, and different biology. The features most unique to lobular carcinomas include loss of E-Cadherin leading to discohesion and formation of a characteristic single file pattern on histology. Because most of these tumors exhibit estrogen receptor positivity and Her2 neu negativity, endocrine therapy has predominated to treat these tumors. However novel treatments like CDK4/6 inhibitors have shown importance and antibody drug conjugates may be instrumental considering newer categories of Her 2 Low breast tumors. In this narrative review, we explore multiple pathological aspects and translational features of this unique entity. In addition, due to advancement in technologies like spatial transcriptomics and other hi-plex technologies, we have tried to enlist upon the characteristics of the tumor microenvironment and the latest associated findings to better understand the new prospective therapeutic options in the current era of personalized treatment.
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Affiliation(s)
- Harsh Batra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Jason Aboudi Mouabbi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Qingqing Ding
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (Q.D.); (A.A.S.)
| | - Aysegul A. Sahin
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (Q.D.); (A.A.S.)
| | - Maria Gabriela Raso
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
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Wang R, Xu K, Chen Q, Hu Q, Zhang J, Guan X. Cuproptosis engages in c-Myc-mediated breast cancer stemness. J Transl Med 2023; 21:409. [PMID: 37353799 PMCID: PMC10288777 DOI: 10.1186/s12967-023-04204-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/15/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Intra-tumoral heterogeneity (ITH) is a distinguished hallmark of cancer, and cancer stem cells (CSCs) contribute to this malignant characteristic. Therefore, it is of great significance to investigate and even target the regulatory factors driving intra-tumoral stemness. c-Myc is a vital oncogene frequently overexpressed or amplified in various cancer types, including breast cancer. Our previous study indicated its potential association with breast cancer stem cell (BCSC) biomarkers. METHODS In this research, we performed immunohistochemical (IHC) staining on sixty breast cancer surgical specimens for c-Myc, CD44, CD24, CD133 and ALDH1A1. Then, we analyzed transcriptomic atlas of 1533 patients with breast cancer from public database. RESULTS IHC staining indicated the positive correlation between c-Myc and BCSC phenotype. Then, we used bioinformatic analysis to interrogate transcriptomics data of 1533 breast cancer specimens and identified an intriguing link among c-Myc, cancer stemness and copper-induced cell death (also known as "cuproptosis"). We screened out cuproptosis-related characteristics that predicts poor clinical outcomes and found that the pro-tumoral cuproptosis-based features were putatively enriched in MYC-targets and showed a significantly positive correlation with cancer stemness. CONCLUSION In addition to previous reports on its oncogenic roles, c-Myc showed significant correlation to stemness phenotype and copper-induced cell toxicity in breast cancer tissues. Moreover, transcriptomics data demonstrated that pro-tumoral cuproptosis biomarkers had putative positive association with cancer stemness. This research combined clinical samples with large-scale bioinformatic analysis, covered description and deduction, bridged classic oncogenic mechanisms to innovative opportunities, and inspired the development of copper-based nanomaterials in targeting highly heterogeneous tumors.
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Affiliation(s)
- Runtian Wang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Kun Xu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qin Chen
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qin Hu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China
| | - Jian Zhang
- Phase I Clinical Trial Center, Fudan University Shanghai Cancer Center, Shanghai, China.
| | - Xiaoxiang Guan
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, 211166, China.
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Fan P, Wang J, Li R, Chang K, Liu L, Wang Y, Wang Z, Zhang B, Ji C, Zhang J, Chen S, Ling R. Development and validation of an endoplasmic reticulum stress-related molecular prognostic model for breast cancer. Front Oncol 2023; 13:1178595. [PMID: 37313465 PMCID: PMC10258344 DOI: 10.3389/fonc.2023.1178595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/15/2023] [Indexed: 06/15/2023] Open
Abstract
Background Breast cancer is the most frequently diagnosed cancer and a leading cause of cancer-related death in women. Endoplasmic reticulum stress (ERS) plays a crucial role in the pathogenesis of several malignancies. However, the prognostic value of ERS-related genes in breast cancer has not been thoroughly investigated. Methods We downloaded and analyzed expression profiling data for breast invasive carcinoma samples in The Cancer Genome Atlas-Breast Invasive Carcinoma (TCGA-BRCA) and identified 23 ERS-related genes differentially expressed between the normal breast tissue and primary breast tumor tissues. We constructed and validated risk models using external test datasets. We assessed the differences in sensitivity to common antitumor drugs between high- and low-scoring groups using the Genomics of Drug Sensitivity in Cancer (GDSC) database, evaluated the sensitivity of patients in high- and low-scoring groups to immunotherapy using the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm, and assessed immune and stromal cell infiltration in the tumor microenvironment (TME) using the Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data (ESTIMATE) algorithm. We also analyzed the expression of independent factors in the prognostic model using the Western-blot analysis for correlation in relation to breast cancer. Results Using multivariate Cox analysis, FBXO6, PMAIP1, ERP27, and CHAC1 were identified as independent prognostic factors in patients with breast cancer. The risk score in our model was defined as the endoplasmic reticulum score (ERScore). ERScore had high predictive power for overall survival in patients with breast cancer. The high-ERScore group exhibited a worse prognosis, lower drug sensitivity, and lower immunotherapy response and immune infiltration than did the low-ERScore group. Conclusions based on ERScore were consistent with Western-blot results. Conclusion We constructed and validated for the first time an endoplasmic reticulum stress-related molecular prognostic model for breast cancer with reliable predictive properties and good sensitivity, as an important addition to the prognostic prediction model for breast cancer.
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Affiliation(s)
- Pengyu Fan
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jiajia Wang
- The State Key Laboratory of Cancer Biology, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi’an, China
| | - Ruolei Li
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Kexin Chang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Liuyin Liu
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Yaping Wang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Zhe Wang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Bo Zhang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Cheng Ji
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jian Zhang
- The State Key Laboratory of Cancer Biology, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi’an, China
| | - Suning Chen
- Department of Pharmacy, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Rui Ling
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
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Zhang D, Wang Y, Zhao F, Yang Q. Integrated multiomics analyses unveil the implication of a costimulatory molecule score on tumor aggressiveness and immune evasion in breast cancer: A large-scale study through over 8,000 patients. Comput Biol Med 2023; 159:106866. [PMID: 37068318 DOI: 10.1016/j.compbiomed.2023.106866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/05/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Although immunotherapy has revolutionised cancer management, reliable genomic biomarkers for identifying eligible patient subpopulations are lacking. Costimulatory molecules play a crucial role in mounting anti-tumour responses, and clinical trials targeting these novel biomarkers are underway. However, whether these molecules can determine tumour aggressiveness and the risk of tumour evasion in breast cancer (BC) remains largely unknown. METHODS The whole-tissue transcriptomic data of 8236 patients with BC from 15 independent cohorts were extracted. An integrated scoring system named 'costimulatory molecule score' (CMS) was constructed and sufficient validated using least absolute shrinkage and selection operator regression (1000 iterations) and the random survival forest algorithm (1000 trees). The correlation among CMSs, cancer genotypes and clinicopathological characteristics was examined. Extensive multiomics and immunogenomic analyses were performed to investigate and verify the association among CMSs, enriched pathways, potential intrinsic and extrinsic immune escape mechanisms, immunotherapy response and therapeutic options. RESULTS The predictive role of CMS model that relies on expression pattern of merely 5 costimulatory genes for prognosis is almost universally applicable to BC patients in a platform-independent manner. Through internal and external in silico validation, high CMS was characterized by favorable genotypes but decreased tumor immunogenicity, activation of stroma, immune-suppressive states and potential immunotherapeutic resistance. Similar results were observed in a real-world immunotherapy cohort and Pan-Cancer analysis. CONCLUSION This comprehensive characterization indicates CMS model may be complemented for predicting tumor aggressiveness and immune evasion in BC patients, underlining the future clinical potential for further exploration of resistance mechanisms and optimization of immunotherapeutic strategies.
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Affiliation(s)
- Dong Zhang
- Department of Breast Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Department of Clinical Medicine, The First Clinical College, Shandong University, Jinan, 250012, China
| | - Yingnan Wang
- Department of Breast Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Department of Clinical Medicine, The First Clinical College, Shandong University, Jinan, 250012, China
| | - Faming Zhao
- Key Laboratory of Environmental Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qifeng Yang
- Department of Breast Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Pathology Tissue Bank, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China; Research Institute of Breast Cancer, Shandong University, Jinan, 250102, China.
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8
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Yang Y, Wang Z, He M, Diao L, Yu B, Li D. NAD+ biosynthesis metabolism predicts prognosis and indicates immune microenvironment for breast cancer. Pathol Oncol Res 2023; 29:1610956. [PMID: 37006438 PMCID: PMC10063816 DOI: 10.3389/pore.2023.1610956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023]
Abstract
The growing evidence implies that tumor cells need to increase NAD+ levels by upregulating NAD+ biosynthesis to satisfy their growth demand. NAD+ biosynthesis metabolism is implicated in tumor progression. Breast cancer (BC) is the most common malignant malignancy in the world. Nevertheless, the prognostic significance of NAD+ biosynthesis and its relationship with the tumor immune microenvironment in breast cancer still need further investigation. In this study, we obtained the mRNA expression data and clinical information of BC samples from public databases and calculated the level of NAD+ biosynthesis activity by single-sample gene set enrichment analysis (ssGSEA). We then explored the relationship between the NAD+ biosynthesis score, infiltrating immune cells, prognosis significance, immunogenicity and immune checkpoint molecules. The results demonstrated that patients with high NAD+ biosynthetic score displayed poor prognosis, high immune infiltration, high immunogenicity, elevated PD-L1 expression, and might more benefit from immunotherapy. Taken together, our studies not only deepened the understanding of NAD+ biosynthesis metabolism of breast cancer but also provided new insights into personalized treatment strategies and immunological therapies to improve the outcomes of breast cancer patients.
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Affiliation(s)
- Yuting Yang
- Department of Immunology, Medical College of Qingdao University, Qingdao, Shandong, China
| | - Ze Wang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing Institute of Lifeomics, Beijing, China
| | - Mengqi He
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing Institute of Lifeomics, Beijing, China
| | - Lihong Diao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Biyue Yu
- School of Life Sciences, Hebei University, Baoding, Hebei, China
| | - Dong Li
- Department of Immunology, Medical College of Qingdao University, Qingdao, Shandong, China
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing Institute of Lifeomics, Beijing, China
- *Correspondence: Dong Li,
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9
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Calhoun BC, Dabbs DJ. Lack of Standardization in the Diagnosis of Invasive Lobular Carcinoma of the Breast. Mod Pathol 2023; 36:100041. [PMID: 36788075 DOI: 10.1016/j.modpat.2022.100041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/09/2022] [Accepted: 10/09/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Benjamin C Calhoun
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - David J Dabbs
- Pathology and Second Opinion Service, PreludeDX, Laguna Hills, California
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Oesterreich S, Nasrazadani A, Zou J, Carleton N, Onger T, Wright MD, Li Y, Demanelis K, Ramaswamy B, Tseng G, Lee AV, Williams N, Kruse M. Clinicopathological Features and Outcomes Comparing Patients With Invasive Ductal and Lobular Breast Cancer. J Natl Cancer Inst 2022; 114:1511-1522. [PMID: 36239760 PMCID: PMC9664185 DOI: 10.1093/jnci/djac157] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is increasing interest in better understanding the biology and clinical presentation of invasive lobular cancer (ILC), which is the most common special histological subtype of breast cancer. Limited large contemporary data sets are available allowing comparison of clinicopathologic features between ILC and invasive ductal cancer (IDC). METHODS The Great Lakes Breast Cancer Consortium was formed to compare clinical behavior of ILC (n = 3617) and IDC (n = 30 045) from 33 662 patients treated between 1990 and 2017 at 3 large clinical centers. We used Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching to evaluate treatment differences and outcomes. All statistical testing used 2-sided P values. RESULTS Compared with IDC, patients with ILC were more frequently diagnosed at later stages and with more lymph node involvement (corrected P < .001). Estrogen receptor-positive ILCs were of lower grade (grade 1 and 2: 90% in ILC vs 72% in IDC) but larger in size (T3 and 4: 14.3% in ILC vs 3.4% in IDC) (corrected P < .001), and since 1990, the mean ILC size detected at diagnosis increased yearly. Patients with estrogen receptor (ER)-positive ILC underwent statistically significantly more mastectomies compared with ER-positive IDC (57% vs 46%). Using Kaplan-Meier analysis, patients with ER-positive ILC had statistically significantly worse disease-free survival and overall survival than ER-positive IDC although 6 times more IDCs were classified as high risk by OncotypeDx Breast Recurrence Score assay. CONCLUSIONS This large, retrospective, collaborative analysis with 3 clinical centers identified meaningful differences in clinicopathological features between ILC and IDC, providing further evidence that these are 2 different entities requiring different clinical management.
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Affiliation(s)
- Steffi Oesterreich
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Magee-Women’s Research Institute and Women’s Cancer Research Center, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Azadeh Nasrazadani
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Magee-Women’s Research Institute and Women’s Cancer Research Center, Pittsburgh, PA, USA
- Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jian Zou
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Neil Carleton
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Magee-Women’s Research Institute and Women’s Cancer Research Center, Pittsburgh, PA, USA
- Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tiffany Onger
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | | | - Yujia Li
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Bhuvaneswari Ramaswamy
- James Cancer Hospital, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - George Tseng
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Adrian V Lee
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Magee-Women’s Research Institute and Women’s Cancer Research Center, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nicole Williams
- James Cancer Hospital, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Megan Kruse
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
- Case Western Comprehensive Cancer Center, Cleveland, OH, USA
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Chen H, Tian T, Luo H, Jiang Y. Identification of differentially expressed genes at the single-cell level and prognosis prediction through bulk RNA sequencing data in breast cancer. Front Genet 2022; 13:979829. [PMID: 36186437 PMCID: PMC9523223 DOI: 10.3389/fgene.2022.979829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The invention and development of single-cell technologies have contributed a lot to the understanding of tumor heterogeneity. The objective of this research was to investigate the differentially expressed genes (DEGs) between normal and tumor cells at the single-cell level and explore the clinical application of these genes with bulk RNA-sequencing data in breast cancer.Methods: We collected single-cell, bulk RNA sequencing (RNA-seq) and microarray data from two public databases. Through single-cell analysis of 23,909 mammary gland cells from seven healthy donors and 33,138 tumor cells from seven breast cancer patients, cell type-specific DEGs between normal and tumor cells were identified. With these genes and the bulk RNA-seq data, we developed a prognostic signature and validated the efficacy in two independent cohorts. We also explored the differences of immune infiltration and tumor mutational burden (TMB) between the different risk groups.Results: A total of 6,175 cell-type-specific DEGs were obtained through the single-cell analysis between normal and tumor cells in breast cancer, of which 1,768 genes intersected with the bulk RNA-seq data. An 18-gene signature was constructed to assess the outcomes in breast cancer patients. The efficacy of the signature was notably prominent in two independent cohorts. The low-risk group showed higher immune infiltration and lower TMB. Among the 18 genes in the signature, 16 were also differentially expressed in the bulk RNA-seq dataset.Conclusion: Cell-type-specific DEGs between normal and tumor cells were identified through single-cell transcriptome data. The signature constructed with these DEGs could stratify patients efficiently. The signature was also closely correlated with immune infiltration and TMB. Nearly all the genes in the signature were also differentially expressed at the bulk RNA-seq level.
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12
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Xu L. Crosstalk of three novel types of programmed cell death defines distinct microenvironment characterization and pharmacogenomic landscape in breast cancer. Front Immunol 2022; 13:942765. [PMID: 36032140 PMCID: PMC9403178 DOI: 10.3389/fimmu.2022.942765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/13/2022] [Indexed: 11/14/2022] Open
Abstract
Background Prior studies have highlighted that novel programmed cell death (PCD) modalities, including ferroptosis, pyroptosis, and necroptosis, are correlated with tumor progression and antitumor immunity. Nonetheless, comprehensive analysis of tumor microenvironment (TME) profiles mediated by the crosstalk of distinct PCD forms has not been conducted in breast cancer (BC). Methods Here, we curated 34 identified PCD-associated genes (PCDAGs) and applied the consensus clustering algorithm to establish PCD-mediated tumor patterns in BC. Subsequently, based on prognostic differentially expressed genes extracted from distinct PCD-mediated patterns, we applied the LASSO algorithm to construct CD_Score. Furthermore, the correlation analysis between CD_Score and TME features, molecular subtypes, clinicopathological characteristics, drug response, and immunotherapeutic efficacy was performed. Results Three distinct PCD-clusters were determined among 2,038 BC samples, which did not only display different clinical outcomes but highly correlated to the established immunological tumor phenotypes: “desert,” “excluded,” and “inflamed” immune profiles. Based on the CD_Score derived from the PCD-related gene signature, BC patients could be stratified into CD_Score-low and -high group, of which the former displayed satisfactory survival outcome and enhanced immune infiltration. Further exploration identified that the CD_Score-high group significantly correlated with elevated neoantigen load and higher mutation frequency in SMGs (e.g., TP53 and MAP3K1) and reduced expression of immune checkpoint proteins. Conclusions This research is the first to emphasize the close relationship between distinct cell death modalities and the diversity and complexity of immune infiltration in TME. We established the CD_Score, which could help enhance our cognition of TME features and facilitate the clinical application of immunotherapy.
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Van Baelen K, Geukens T, Maetens M, Tjan-Heijnen V, Lord CJ, Linn S, Bidard FC, Richard F, Yang WW, Steele RE, Pettitt SJ, Van Ongeval C, De Schepper M, Isnaldi E, Nevelsteen I, Smeets A, Punie K, Voorwerk L, Wildiers H, Floris G, Vincent-Salomon A, Derksen PWB, Neven P, Senkus E, Sawyer E, Kok M, Desmedt C. Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer. Ann Oncol 2022; 33:769-785. [PMID: 35605746 DOI: 10.1016/j.annonc.2022.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Invasive lobular breast cancer (ILC) is the second most common type of breast cancer after invasive breast cancer of no special type (NST), representing up to 15% of all breast cancers. DESIGN Latest data on ILC are presented, focusing on diagnosis, molecular make-up according to the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets (ESCAT) guidelines, treatment in the early and metastatic setting and ILC-focused clinical trials. RESULTS At the imaging level, magnetic resonance imaging-based and novel positron emission tomography/computed tomography-based techniques can overcome the limitations of currently used imaging techniques for diagnosing ILC. At the pathology level, E-cadherin immunohistochemistry could help improving inter-pathologist agreement. The majority of patients with ILC do not seem to benefit as much from (neo-)adjuvant chemotherapy as patients with NST, although chemotherapy might be required in a subset of high-risk patients. No differences in treatment efficacy are seen for anti-human epidermal growth factor receptor 2 (HER2) therapies in the adjuvant setting and cyclin-dependent kinases 4 and 6 inhibitors in the metastatic setting. The clinical utility of the commercially available prognostic gene expression-based tests is unclear for patients with ILC. Several ESCAT alterations differ in frequency between ILC and NST. Germline BRCA1 and PALB2 alterations are less frequent in patients with ILC, while germline CDH1 (gene coding for E-cadherin) alterations are more frequent in patients with ILC. Somatic HER2 mutations are more frequent in ILC, especially in metastases (15% ILC versus 5% NST). A high tumour mutational burden, relevant for immune checkpoint inhibition, is more frequent in ILC metastases (16%) than in NST metastases (5%). Tumours with somatic inactivating CDH1 mutations may be vulnerable for treatment with ROS1 inhibitors, a concept currently investigated in early and metastatic ILC. CONCLUSION ILC is a unique malignancy based on its pathological and biological features leading to differences in diagnosis as well as in treatment response, resistance and targets as compared to NST.
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Affiliation(s)
- K Van Baelen
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium; Departments of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - T Geukens
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium; General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - M Maetens
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium
| | - V Tjan-Heijnen
- Medical Oncology Department, Maastricht University Medical Center (MUMC), School of GROW, Maastricht, The Netherlands
| | - C J Lord
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - S Linn
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Departments of Medical Oncology, Amsterdam, The Netherlands; Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F-C Bidard
- Department of Medical Oncology, Institut Curie, UVSQ/Paris-Saclav University, Paris, France
| | - F Richard
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium
| | - W W Yang
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - R E Steele
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - S J Pettitt
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - C Van Ongeval
- Departments of Radiology, UZ Leuven, Leuven, Belgium
| | - M De Schepper
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium; Pathology, UZ Leuven, Leuven, Belgium
| | - E Isnaldi
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium
| | | | - A Smeets
- Surgical Oncology, UZ Leuven, Leuven, Belgium
| | - K Punie
- General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - L Voorwerk
- Departments of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H Wildiers
- General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - G Floris
- Pathology, UZ Leuven, Leuven, Belgium
| | | | - P W B Derksen
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Neven
- Departments of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - E Sawyer
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, Guy's Cancer Centre, King's College London, London, UK
| | - M Kok
- Departments of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Desmedt
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium.
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Huang G, Zhou J, Chen J, Liu G. Identification of pyroptosis related subtypes and tumor microenvironment infiltration characteristics in breast cancer. Sci Rep 2022; 12:10640. [PMID: 35739182 PMCID: PMC9226023 DOI: 10.1038/s41598-022-14897-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/13/2022] [Indexed: 12/24/2022] Open
Abstract
Understanding the association of pyroptosis with tumor progression, prognosis and effect on immunotherapeutic response in breast cancer (BC) is limited. This study analysed forty pyroptosis-related genes to construct the pyroptosis score. Association of the pyroptosis score with the overall survival, clinical features, tumor mutation load, immune cell infiltration, and treatment sensitivity of patients with BC was analysed. Out of 983 BC samples, 304 (30.93%) had genetic alterations with the highest TP53 frequency. We identified three separate subtypes associated with pyroptosis action. These subtypes correlate with the clinicopathological characteristics, TME immune cell infiltration, and disease prognosis. Based on the expression levels of the pyroptosis genes, we divided the pyroptosis score into a high group and a low group. The immune-activated pyroptosis subtype had a higher score with a better prognosis. We also observed that the pyroptosis score correlates with the tumor mutation burden. The pyroptosis score and disease prognosis were directly proportional. A higher pyroptosis score indicated a better prognosis. Results suggest that the pyroptosis-related gene prognosis model is closely related to the immune cell infiltration of BC. The three pyroptosis subtypes associated with BC assist in accurately identifying the tumor subtype, the prognosis of immunotherapy drugs and the patient’s therapeutic response.
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Affiliation(s)
- Guo Huang
- Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.,Key Laboratory of Tumor Cellular and Molecular Pathology, College of Hunan Province, Cancer Research Institute, University of South China, Hengyang, 421001, Hunan, China
| | - Jun Zhou
- Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.,Key Laboratory of Tumor Cellular and Molecular Pathology, College of Hunan Province, Cancer Research Institute, University of South China, Hengyang, 421001, Hunan, China
| | - Juan Chen
- The Second Affiliated Hospital, Department of Radiotherapy, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
| | - Guowen Liu
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China.
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Wang J, Katsaros D, Biglia N, Fu Y, Benedetto C, Loo L, Wang Z, Yu H. LncRNA ZNF582-AS1 Expression and Methylation in Breast Cancer and Its Biological and Clinical Implications. Cancers (Basel) 2022; 14:2788. [PMID: 35681777 PMCID: PMC9179509 DOI: 10.3390/cancers14112788] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Long non-coding RNAs (lncRNAs) play an important role in cellular activities and functions, but our understanding of their involvement in cancer is limited. Methods: TCGA data on RNA expression and DNA methylation were analyzed for lncRNAs' association with breast cancer survival, using the Cox proportional hazard regression model. Fresh tumor samples and clinical information from 361 breast cancer patients in our study were used to confirm the TCGA finding on ZNF582-AS1. A RT-qPCR method was developed to measure ZNF582-AS1 expression. Survival associations with ZNF582-AS1 were verified with a meta-analysis. In silico predictions of molecular targets and cellular functions of ZNF582-AS1 were performed based on its molecular signatures and nucleotide sequences. Results:ZNF582-AS1 expression was lower in breast tumors than adjacent normal tissues. Low ZNF582-AS1 was associated with high-grade or ER-negative tumors. Patients with high ZNF582-AS1 had a lower risk of relapse and death. These survival associations were confirmed in a meta-analysis and remained significant after adjustment for tumor grade, disease stage, patient age, and hormone receptor status. Correlation analysis indicated the possible suppression of ZNF582-AS1 expression by promoter methylation. Bioinformatics interrogation of molecular signatures suggested that ZNF582-AS1 could suppress tumor cell proliferation via downregulating the HER2-mediated signaling pathway. Analysis of online data also suggested that HIF-1-related transcription factors could suppress ZNF582-AS1 expression, and the lncRNA might bind to hsa-miR-940, a known oncogenic miRNA in breast cancer. Conclusions: ZNF582-AS1 may play a role in suppressing breast cancer progression. Elucidating the lncRNA's function and regulation may improve our understanding of the disease.
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Affiliation(s)
- Junlong Wang
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
- Department of Molecular Biosciences & Bioengineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino School of Medicine, 10124 Turin, Italy; (D.K.); (C.B.)
| | - Nicoletta Biglia
- Department of Surgical Sciences, Division of Obstetrics and Gynecology, University of Torino School of Medicine, Mauriziano Hospital, 10124 Turin, Italy;
| | - Yuanyuan Fu
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
- Department of Molecular Biosciences & Bioengineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino School of Medicine, 10124 Turin, Italy; (D.K.); (C.B.)
| | - Lenora Loo
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
| | - Zhanwei Wang
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
| | - Herbert Yu
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
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16
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Chen H, Luo H, Wang J, Li J, Jiang Y. Identification of a pyroptosis-related prognostic signature in breast cancer. BMC Cancer 2022; 22:429. [PMID: 35443644 PMCID: PMC9019977 DOI: 10.1186/s12885-022-09526-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background The relationship between pyroptosis and cancer is complex. It is controversial that whether pyroptosis represses or promotes tumor development. This study aimed to explore prognostic molecular characteristics to predict the prognosis of breast cancer (BRCA) based on a comprehensive analysis of pyroptosis-related gene expression data. Methods RNA-sequcing data of BRCA were collected from The Cancer Genome Atlas (TCGA) and Gene Expression Ominibus (GEO) datasets. First, pyroptosis-related differentially expressed genes (DEGs) between normal and tumor tissues were identified from the TCGA database. Based on the DEGs, 1053 BRCA patients were divided into two clusters. Second, DEGs between the two clusters were used to construct a signature by a least absolute shrinkage and selection operator (LASSO) Cox regression model, and the GEO cohort was used to validate the signature. Various statistical methods were applied to assess this gene signature. Finally, Single-sample gene set enrichment analysis (ssGSEA) was employed to compare the enrichment scores of 16 types of immune cells and 13 immune-related pathways between the low- and high-risk groups. We calculated the tumor mutational burden (TMB) of TCGA cohort and evaluated the correlations between the TMB and riskscores of the TCGA cohort. We also compared the TMB between the low- and high-risk groups. Results A total of 39 pyroptosis-related DEGs were identified from the TCGA-breast cancer dataset. A prognostic signature comprising 16 genes in the two clusters of DEGs was developed to divide patients into high-risk and low-risk groups, and its prognostic performance was excellent in two independent patient cohorts. The high-risk group generally had lower levels of immune cell infiltration and lower activity of immune pathway activity than did the low-risk group, and different risk groups revealed different proportions of immune subtypes. The TMB is higher in high-risk group compared with low-risk group. OS of low-TMB group is better than that of high-TMB group. Conclusion A 16-gene signature comprising pyroptosis-related genes was constructed to assess the prognosis of breast cancer patients and its prognostic performance was excellent in two independent patient cohorts. The signature was found closely associated with the tumor immune microenvironment and the potential correlation could provide some clues for further studies. The signature was also correlated with TMB and the mechanisms are still warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09526-z.
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Affiliation(s)
- Hanghang Chen
- Guangdong Provincial Key Laboratory of Proteomics, State Key Laboratory of Organ Failure Research, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, No.1023 Shatai South Road, Guangzhou, 510515, Guangdong Province, China
| | - Haihua Luo
- Guangdong Provincial Key Laboratory of Proteomics, State Key Laboratory of Organ Failure Research, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, No.1023 Shatai South Road, Guangzhou, 510515, Guangdong Province, China
| | - Jieyan Wang
- Guangdong Provincial Key Laboratory of Proteomics, State Key Laboratory of Organ Failure Research, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, No.1023 Shatai South Road, Guangzhou, 510515, Guangdong Province, China
| | - Jinming Li
- Guangdong Provincial Key Laboratory of Proteomics, State Key Laboratory of Organ Failure Research, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, No.1023 Shatai South Road, Guangzhou, 510515, Guangdong Province, China. .,Department of Bioinformatics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Yong Jiang
- Guangdong Provincial Key Laboratory of Proteomics, State Key Laboratory of Organ Failure Research, Department of Pathophysiology, School of Basic Medical Sciences, Southern Medical University, No.1023 Shatai South Road, Guangzhou, 510515, Guangdong Province, China.
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Loss of E-cadherin leads to Id2-dependent inhibition of cell cycle progression in metastatic lobular breast cancer. Oncogene 2022; 41:2932-2944. [PMID: 35437308 PMCID: PMC9122823 DOI: 10.1038/s41388-022-02314-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 12/30/2022]
Abstract
Invasive lobular breast carcinoma (ILC) is characterized by proliferative indolence and long-term latency relapses. This study aimed to identify how disseminating ILC cells control the balance between quiescence and cell cycle re-entry. In the absence of anchorage, ILC cells undergo a sustained cell cycle arrest in G0/G1 while maintaining viability. From the genes that are upregulated in anchorage independent ILC cells, we selected Inhibitor of DNA binding 2 (Id2), a mediator of cell cycle progression. Using loss-of-function experiments, we demonstrate that Id2 is essential for anchorage independent survival (anoikis resistance) in vitro and lung colonization in mice. Importantly, we find that under anchorage independent conditions, E-cadherin loss promotes expression of Id2 in multiple mouse and (organotypic) human models of ILC, an event that is caused by a direct p120-catenin/Kaiso-dependent transcriptional de-repression of the canonical Kaiso binding sequence TCCTGCNA. Conversely, stable inducible restoration of E-cadherin expression in the ILC cell line SUM44PE inhibits Id2 expression and anoikis resistance. We show evidence that Id2 accumulates in the cytosol, where it induces a sustained and CDK4/6-dependent G0/G1 cell cycle arrest through interaction with hypo-phosphorylated Rb. Finally, we find that Id2 is indeed enriched in ILC when compared to other breast cancers, and confirm cytosolic Id2 protein expression in primary ILC samples. In sum, we have linked mutational inactivation of E-cadherin to direct inhibition of cell cycle progression. Our work indicates that loss of E-cadherin and subsequent expression of Id2 drive indolence and dissemination of ILC. As such, E-cadherin and Id2 are promising candidates to stratify low and intermediate grade invasive breast cancers for the use of clinical cell cycle intervention drugs.
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Xu L, Hu Y, Liu W. Tumor Microenvironment-Mediated Immune Profiles Characterized by Distinct Survival Outcome and Immunotherapeutic Efficacy in Breast Cancer. Front Genet 2022; 13:840348. [PMID: 35401704 PMCID: PMC8992709 DOI: 10.3389/fgene.2022.840348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Numerous reports have highlighted that the tumor microenvironment (TME) is closely linked to survival outcome and therapeutic efficacy. However, a comprehensive investigation of the TME feature in breast cancer (BC) has not been performed. Methods: Here, we performed consensus clustering analysis based on TME cell expression profiles to construct TME pattern clusters and TME-related gene signature in BC. GSVA combined with CIBERSORT and ssGSEA algorithms were applied to evaluate the differences in biological pathway and immune cell infiltration level, respectively. The PCA method was employed to construct TME-score to quantify the TME-mediated pattern level in individual BC patients. Results: We determined two distinct TME gene clusters among 3,738 BC samples, which exhibited distinct survival outcome and enriched biological processes. The TME features demonstrated that these two clusters corresponded to the established immune profiles: hot and cold tumor phenotypes, respectively. Based on TME-related signature genes, we constructed the TME-score and stratified BC patients into low and high TME-score groups. Patients with high TME-score exhibited favorable outcome and increased infiltration of immune cells. Further investigation revealed that high TME-score was also related with high expression of immunosuppressive molecules, decreased tumor mutation burden (TMB), and high rate of mutation in significantly mutated genes (SMGs) (e.g., PIK3CA and CDH1). Conclusion: Assessing the TME-mediated pattern level of individual BC patients will assist us in better understanding the responses of BC patients to immunotherapies and directing more effective immunotherapeutic approaches.
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Affiliation(s)
- Lijun Xu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yaomin Hu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenwen Liu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Xu L, Hu Y, Liu W. Pyroptosis-Mediated Molecular Subtypes are Characterized by Distinct Tumor Microenvironment Infiltration Characteristics in Breast Cancer. J Inflamm Res 2022; 15:345-362. [PMID: 35079221 PMCID: PMC8779844 DOI: 10.2147/jir.s349186] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/24/2021] [Indexed: 01/29/2023] Open
Abstract
Background Numerous reports have highlighted that pyroptosis is closely linked to tumorigenesis and drug resistance of tumors. However, the potential role of pyroptosis in regulating immune cell infiltration in tumor microenvironment (TME) remains unclear. Methods Here, we performed consensus clustering analysis based on the expression of 10 typical pyroptosis-related regulators (PRRs) to construct pyroptosis-mediated tumor pattern clusters and pyroptosis-related gene signature in breast cancer (BC). GSVA combined with ssGSEA methods were applied to evaluate the differences in biological pathway and immune cell infiltration level, respectively. The PCA method was employed to construct the pyro-score to quantify the pyroptosis pattern level of individual BC patient. Results We determined three distinct pyro-clusters among 1852 BC samples, which exhibited different survival outcomes and enriched biological processes. The TME features demonstrated that these three clusters corresponded to three established immune profiles: immune-desert, immune-excluded and immune-inflamed phenotype, respectively. Based on pyroptosis-related signature genes, we constructed the pyro-score and stratified BC patients into high and low pyro-score group. Patients with high pyro-score exhibited favorable outcome and increased infiltration of immune cells. Further investigation revealed that high pyro-score was also related to high expression of immunosuppressive molecules, decreased tumor mutation burden (TMB) and high rate of mutation in significantly mutated genes (SMGs) (eg, PIK3CA and CDH1). Conclusion This research emphasizes the indispensable role of pyroptosis in TME complexity and diversity. Assessing the pyroptosis pattern level of individual BC patient will assist us in better understanding TME features and directing more effective immunotherapeutic approaches.
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Affiliation(s)
- Lijun Xu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People’s Republic of China
| | - Yaomin Hu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People’s Republic of China
| | - Wenwen Liu
- Department of Geratology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People’s Republic of China
- Correspondence: Wenwen Liu Email
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Nunes R, Sella T, Treuner K, Atkinson JM, Wong J, Zhang Y, Exman P, Dabbs D, Richardson AL, Schnabel CA, Sgroi DC, Oesterreich S, Cimino-Mathews A, Metzger O. Prognostic Utility of Breast Cancer Index to Stratify Distant Recurrence Risk in Invasive Lobular Carcinoma. Clin Cancer Res 2021; 27:5688-5696. [PMID: 34376532 PMCID: PMC9401569 DOI: 10.1158/1078-0432.ccr-21-0733] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/21/2021] [Accepted: 07/29/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE The prognostic utility of Breast Cancer Index (BCI) for risk assessment of overall (0-10 years), early (0-5 years), and late (5-10 years) distant recurrence (DR) in hormone receptor-positive (HR+) invasive lobular carcinoma (ILC) was evaluated. EXPERIMENTAL DESIGN BCI gene expression analysis was performed blinded to clinical outcome utilizing tumor specimens from patients with HR+ ILC from a multi-institutional cohort. The primary endpoint was time to DR. Kaplan-Meier analyses of overall, early, and late DR risk were performed, and statistical significance was evaluated by log-rank test and Cox proportional hazards regression. The prognostic contribution of BCI in addition to clinicopathologic factors was evaluated by likelihood ratio analysis. RESULTS Analysis of 307 patients (99% ER+, 53% T1, 42% N+, 70% grade II) showed significant differences in DR over 10 years based on BCI risk categories. BCI low- and intermediate-risk patients demonstrated similar DR rates of 7.6% and 8.0%, respectively, compared with 27.0% for BCI high-risk patients. BCI was a significant independent prognostic factor for overall 10-year DR [HR = 4.09; 95% confidence interval (CI), 2.00-8.34; P = 0.0001] as well as for both early (HR = 8.19; 95% CI, 1.85-36.30; P = 0.0042) and late (HR = 3.04; 95% CI, 1.32-7.00; P = 0.0224) DR. In multivariate analysis, BCI remained the only statistically significant prognostic factor for DR (HR = 3.49; 95% CI, 1.28-9.54; P = 0.0150). CONCLUSIONS BCI is an independent prognostic factor for ILC and significantly stratified patients for cumulative risk of 10-year, early, and late DR. BCI added prognostic value beyond clinicopathologic characteristics in this distinct subtype of breast cancer.
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Affiliation(s)
- Raquel Nunes
- Johns Hopkins University, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Tal Sella
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kai Treuner
- Biotheranostics, Inc., San Diego, California
| | - Jennifer M. Atkinson
- UPMC Hillman Cancer Center, University of Pittsburgh, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
| | - Jenna Wong
- Biotheranostics, Inc., San Diego, California
| | - Yi Zhang
- Biotheranostics, Inc., San Diego, California
| | - Pedro Exman
- Hospital Alemao Oswaldo Cruz, São Paulo, Brazil
| | - David Dabbs
- UPMC Hillman Cancer Center, University of Pittsburgh, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
| | - Andrea L. Richardson
- Johns Hopkins University, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | | | | | - Steffi Oesterreich
- UPMC Hillman Cancer Center, University of Pittsburgh, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
| | - Ashley Cimino-Mathews
- Johns Hopkins University, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Otto Metzger
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Corresponding Author: Otto Metzger, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215. E-mail:
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21
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Survival patterns of invasive lobular and invasive ductal breast cancer in a large population-based cohort with two decades of follow up. Breast 2021; 59:294-300. [PMID: 34388695 PMCID: PMC8361199 DOI: 10.1016/j.breast.2021.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Invasive lobular carcinoma (ILC) comprises 8-15 % of all invasive breast cancers and large population-based studies with >10 years of follow-up are rare. Whether ILC has a long-time prognosis different from that of invasive ductal carcinoma, (IDC) remains controversial. PURPOSE To investigate the excess mortality rate ratio (EMRR) of patients with ILC and IDC and to correlate survival with clinical parameters in a large population-based cohort. MATERIAL AND METHODS From 1989 through 2006, we identified 17,481 patients diagnosed with IDC (n = 14,583) or ILC (n = 2898), younger than 76 years from two Swedish Regional Cancer Registries. Relative survival (RS) during 20 years of follow up was analysed. RESULTS ILC was significantly associated with older age, larger tumours, ER positivity and well differentiated tumours. We noticed an improved survival for patients with ILC during the first five years, excess mortality rate ratio (EMRR) 0.64 (CI 95 % 0.53-0.77). This was shifted to a significant decreased survival 10-15 years after diagnosis (EMRR 1.49, CI 95 % 1.16-1.93). After 20 years the relative survival rates were similar, 0.72 for ILC and 0.73 for IDC. CONCLUSIONS During the first five years after surgery, the EMRR was lower for patients with ILC as compared to patients with IDC, but during the years 10-15 after surgery, we observed an increased EMRR for patients with ILC as compared to IDC. These EMRR between ILC and IDC were statistically significant but the absolute difference in excess mortality between the two groups was small.
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22
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Lobular Breast Cancer: Histomorphology and Different Concepts of a Special Spectrum of Tumors. Cancers (Basel) 2021; 13:cancers13153695. [PMID: 34359596 PMCID: PMC8345067 DOI: 10.3390/cancers13153695] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Invasive lobular breast cancer (ILC) is a special type of breast cancer (BC) that was first described in 1941. The diagnosis of ILC is made by microscopy of tumor specimens, which reveals a distinct morphology. This review recapitulates the developments in the microscopic assessment of ILC from 1941 until today. We discuss different concepts of ILC, provide an overview on ILC variants, and highlight advances which have contributed to a better understanding of ILC as a special histologic spectrum of tumors. Abstract Invasive lobular breast cancer (ILC) is the most common special histological type of breast cancer (BC). This review recapitulates developments in the histomorphologic assessment of ILC from its beginnings with the seminal work of Foote and Stewart, which was published in 1941, until today. We discuss different concepts of ILC and their implications. These concepts include (i) BC arising from mammary lobules, (ii) BC growing in dissociated cells and single files, and (iii) BC defined as a morpho-molecular spectrum of tumors with distinct histological and molecular characteristics related to impaired cell adhesion. This review also provides a comprehensive overview of ILC variants, their histomorphology, and differential diagnosis. Furthermore, this review highlights recent advances which have contributed to a better understanding of the histomorphology of ILC, such as the role of the basal lamina component laminin, the molecular specificities of triple-negative ILC, and E-cadherin to P-cadherin expression switching as the molecular determinant of tubular elements in CDH1-deficient ILC. Last but not least, we provide a detailed account of the tumor microenvironment in ILC, including tumor infiltrating lymphocyte (TIL) levels, which are comparatively low in ILC compared to other BCs, but correlate with clinical outcome. The distinct histomorphology of ILC clearly reflects a special tumor biology. In the clinic, special treatment strategies have been established for triple-negative, HER2-positive, and ER-positive BC. Treatment specialization for patients diagnosed with ILC is just in its beginnings. Accordingly, ILC deserves greater attention as a special tumor entity in BC diagnostics, patient care, and cancer research.
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23
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Jeschke J, Collignon E, Al Wardi C, Krayem M, Bizet M, Jia Y, Garaud S, Wimana Z, Calonne E, Hassabi B, Morandini R, Deplus R, Putmans P, Dube G, Singh NK, Koch A, Shostak K, Rizzotto L, Ross RL, Desmedt C, Bareche Y, Rothé F, Lehmann-Che J, Duterque-Coquillaud M, Leroy X, Menschaert G, Teixeira L, Guo M, Limbach PA, Close P, Chariot A, Leucci E, Ghanem G, Yuan BF, Willard-Gallo K, Sotiriou C, Marine JC, Fuks F. Downregulation of the FTO m 6A RNA demethylase promotes EMT-mediated progression of epithelial tumors and sensitivity to Wnt inhibitors. NATURE CANCER 2021; 2:611-628. [PMID: 35121941 PMCID: PMC10734094 DOI: 10.1038/s43018-021-00223-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 05/17/2021] [Indexed: 02/05/2023]
Abstract
Post-transcriptional modifications of RNA constitute an emerging regulatory layer of gene expression. The demethylase fat mass- and obesity-associated protein (FTO), an eraser of N6-methyladenosine (m6A), has been shown to play a role in cancer, but its contribution to tumor progression and the underlying mechanisms remain unclear. Here, we report widespread FTO downregulation in epithelial cancers associated with increased invasion, metastasis and worse clinical outcome. Both in vitro and in vivo, FTO silencing promotes cancer growth, cell motility and invasion. In human-derived tumor xenografts (PDXs), FTO pharmacological inhibition favors tumorigenesis. Mechanistically, we demonstrate that FTO depletion elicits an epithelial-to-mesenchymal transition (EMT) program through increased m6A and altered 3'-end processing of key mRNAs along the Wnt signaling cascade. Accordingly, FTO knockdown acts via EMT to sensitize mouse xenografts to Wnt inhibition. We thus identify FTO as a key regulator, across epithelial cancers, of Wnt-triggered EMT and tumor progression and reveal a therapeutically exploitable vulnerability of FTO-low tumors.
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Affiliation(s)
- Jana Jeschke
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Evelyne Collignon
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Clémence Al Wardi
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Mohammad Krayem
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Martin Bizet
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Yan Jia
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Soizic Garaud
- Molecular Immunology Laboratory, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Zéna Wimana
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, ULB, Brussels, Belgium
- Department of Nuclear Medicine, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Emilie Calonne
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Bouchra Hassabi
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Renato Morandini
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Rachel Deplus
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pascale Putmans
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Gaurav Dube
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Nitesh Kumar Singh
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Alexander Koch
- Department of Pathology, Maastricht UMC, Maastricht, the Netherlands
| | - Kateryna Shostak
- Laboratory of Medical Chemistry, GIGA Stem Cells, University of Liège, Liège, Belgium
| | - Lara Rizzotto
- Trace, LKI Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Robert L Ross
- Rieveschl Laboratories for Mass Spectrometry, Department of Chemistry, University of Cincinnati, Cincinnati, OH, USA
| | - Christine Desmedt
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, U-CRC, ULB, Brussels, Belgium
| | - Yacine Bareche
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, U-CRC, ULB, Brussels, Belgium
| | - Françoise Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, U-CRC, ULB, Brussels, Belgium
| | - Jacqueline Lehmann-Che
- Pathophysiology of Breast Cancer Team, Université de Paris, INSERM U976, HIPI, Paris, France
- Breast Disease Unit and Molecular Oncology Unit, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Martine Duterque-Coquillaud
- Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-UMR-S 1277, CANTHER, Lille, France
| | - Xavier Leroy
- Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-UMR-S 1277, CANTHER, Lille, France
- Department of Pathology, CHU Lille, Université Lille, Lille, France
| | - Gerben Menschaert
- Biobix, Laboratory of Bioinformatics and Computational Genomics, Ghent University, Ghent, Belgium
| | - Luis Teixeira
- Pathophysiology of Breast Cancer Team, Université de Paris, INSERM U976, HIPI, Paris, France
- Breast Disease Unit and Molecular Oncology Unit, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Mingzhou Guo
- Department of Gastroenterology & Hepatology, Chinese PLA General Hospital, Beijing, China
| | - Patrick A Limbach
- Rieveschl Laboratories for Mass Spectrometry, Department of Chemistry, University of Cincinnati, Cincinnati, OH, USA
| | - Pierre Close
- Laboratory of Cancer Signaling, GIGA Stem Cells, University of Liège, Liège, Belgium
- WELBIO, University of Liège, Liège, Belgium
| | - Alain Chariot
- Laboratory of Medical Chemistry, GIGA Stem Cells, University of Liège, Liège, Belgium
- WELBIO, University of Liège, Liège, Belgium
| | - Eleonora Leucci
- Trace, LKI Leuven Cancer Institute, KU Leuven, Leuven, Belgium
- Laboratory of RNA Cancer Biology, Department of Oncology, LKI, KU Leuven, Leuven, Belgium
| | - Ghanem Ghanem
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Bi-Feng Yuan
- College of Chemistry and Molecular Sciences, Wuhan University, Wuhan, China
| | - Karen Willard-Gallo
- Molecular Immunology Laboratory, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, U-CRC, ULB, Brussels, Belgium
| | - Jean-Christophe Marine
- Laboratory for Molecular Cancer Biology, VIB, KU Leuven, Leuven, Belgium
- Laboratory for Molecular Cancer Biology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - François Fuks
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium.
- WELBIO, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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24
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McCart Reed AE, Kalinowski L, Simpson PT, Lakhani SR. Invasive lobular carcinoma of the breast: the increasing importance of this special subtype. Breast Cancer Res 2021; 23:6. [PMID: 33413533 PMCID: PMC7792208 DOI: 10.1186/s13058-020-01384-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. ILCs are noted for their lack of E-cadherin function, which underpins their characteristic discohesive growth pattern, with cells arranged in single file and dispersed throughout the stroma. Typically, tumours are luminal in molecular subtype, being oestrogen and progesterone receptor positive, and HER2 negative. Since last reviewing the lobular literature (McCart Reed et al., Breast Cancer Res 17:12, 2015), there has been a considerable increase in research output focused on this tumour type, including studies into the pathology and management of disease, a high-resolution definition of the genomic landscape of tumours as well as the evolution of several potential therapeutic avenues. There abounds a huge amount of new data, which we will review herein.
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Affiliation(s)
- Amy E McCart Reed
- UQ Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Australia.
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia.
| | - Lauren Kalinowski
- UQ Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Australia
- Department of Histopathology, Sullivan Nicolaides Pathology, Bowen Hills, Brisbane, Australia
| | - Peter T Simpson
- UQ Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Australia
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia
| | - Sunil R Lakhani
- UQ Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Australia
- Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia
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25
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Christgen M, Gluz O, Harbeck N, Kates RE, Raap M, Christgen H, Clemens M, Malter W, Nuding B, Aktas B, Kuemmel S, Reimer T, Stefek A, Krabisch P, Just M, Augustin D, Graeser M, Baehner F, Wuerstlein R, Nitz U, Kreipe H. Differential impact of prognostic parameters in hormone receptor-positive lobular breast cancer. Cancer 2020; 126:4847-4858. [PMID: 32780421 DOI: 10.1002/cncr.33104] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Invasive lobular breast cancer (BC) is the second most common BC subtype. Prognostic parameters (tumor classification, lymph node status, histologic grade, Oncotype DX recurrence score [RS], progesterone receptor status, and Ki67 index) were retrospectively studied in a large, prospective clinical trial encompassing 2585 patients who had hormone receptor-positive early BC (the West German Study Group PlanB trial). METHODS BCs were centrally reviewed and classified as lobular (n = 353; 14%) or nonlobular (n = 2232; 86%). The median follow-up was 60 months. Five-year disease-free survival (DFS) estimates were obtained using the Kaplan-Meier method. Prognostic parameters were evaluated using Cox proportional hazard models. RESULTS Lobular BC was associated with higher tumor classification, higher lymph node status, lower histologic grade, lower Ki67 index, and low or intermediate RS. The prevalence of high RS (RS range, 26-100) was 3-fold lower in patients who had lobular BC compared with those who had nonlobular BC (8% vs 24%; P < .001). However, 5-year DFS estimates for lobular and nonlobular BC were similar (92.1% and 92.3%, respectively; P = .673). In multivariate analyses, prognostic parameters for DFS in lobular BC included grade 3 (hazard ratio, 5.06; 95% CI, 1.91-13.39) and a pathologic lymph node status (pN) of pN3 (hazard ratio, 12.16; 95% CI, 3.87-38.24), but not RS. By contrast, prognostic parameters in nonlobular BC included grade 3 (hazard ratio, 1.65; 95% CI, 1.11-2.44), pN3 (hazard ratio, 3.68; 95% CI, 1.60-8.46), and high RS (hazard ratio, 2.49; 95% CI, 1.69-3.68). CONCLUSIONS Lobular BC is associated with low and intermediate RS, although 5-year DFS is similar to that of nonlobular BC. The effect of the RS in lobular BC appears to be distinct from that in nonlobular BC. For risk assessment, the RS needs to be complemented by clinicopathologic parameters for therapy decision making.
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Affiliation(s)
| | - Oleg Gluz
- West German Study Group, Moenchengladbach, Germany.,Evangelical Hospital Bethesda, Lower Rhine Breast Center, Moenchengladbach, Germany
| | - Nadia Harbeck
- West German Study Group, Moenchengladbach, Germany.,Department of Gynecology and Obstetrics, Breast Center, Comprehensive Cancer Center Munich, University Hospital of the Ludwig Maximillian University of Munich, Munich, Germany
| | | | - Mieke Raap
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Michael Clemens
- Department of Oncology, Motherhouse of the Sisters of Mercy of St Charles Borromeo Clinics, Trier, Germany
| | - Wolfram Malter
- Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Benno Nuding
- Department of Gynecology and Obstetrics, Evangelical Hospital Bergisch Gladbach, Bergisch Gladbach, Germany
| | - Bahriye Aktas
- Department of Gynecology, University of Leipzig, Leipzig, Germany
| | - Sherko Kuemmel
- West German Study Group, Moenchengladbach, Germany.,Breast Center, Essen-Mitte Clinics, Essen, Germany
| | - Toralf Reimer
- Department of Gynecology and Obstetrics, Suedstadt Clinics, Rostock, Germany
| | - Andrea Stefek
- Altmark Breast Center, Johanniter Clinics Stendal, Stendal, Germany
| | | | | | | | - Monika Graeser
- West German Study Group, Moenchengladbach, Germany.,Evangelical Hospital Bethesda, Lower Rhine Breast Center, Moenchengladbach, Germany
| | | | - Rachel Wuerstlein
- West German Study Group, Moenchengladbach, Germany.,Department of Gynecology and Obstetrics, Breast Center, Comprehensive Cancer Center Munich, University Hospital of the Ludwig Maximillian University of Munich, Munich, Germany
| | - Ulrike Nitz
- West German Study Group, Moenchengladbach, Germany.,Evangelical Hospital Bethesda, Lower Rhine Breast Center, Moenchengladbach, Germany
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
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26
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BRAF/MEK Pathway is Associated With Breast Cancer in ER-dependent Mode and Improves ER Status-based Cancer Recurrence Prediction. Clin Breast Cancer 2020; 20:41-50.e8. [DOI: 10.1016/j.clbc.2019.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
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27
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Cornelissen LM, Drenth AP, van der Burg E, de Bruijn R, Pritchard CEJ, Huijbers IJ, Zwart W, Jonkers J. TRPS1 acts as a context-dependent regulator of mammary epithelial cell growth/differentiation and breast cancer development. Genes Dev 2019; 34:179-193. [PMID: 31879358 PMCID: PMC7000918 DOI: 10.1101/gad.331371.119] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/04/2019] [Indexed: 12/31/2022]
Abstract
In this study, Cornelissen et al. set out to elucidate the role of the GATA-type zinc finger transcription factor TRPS1 in breast cancer. Using in vitro and in vivo loss-of-function approaches, the authors demonstrate that TRPS1 can function as a context-dependent tumor suppressor in breast cancer, while being essential for growth and differentiation of normal mammary epithelial cells. The GATA-type zinc finger transcription factor TRPS1 has been implicated in breast cancer. However, its precise role remains unclear, as both amplifications and inactivating mutations in TRPS1 have been reported. Here, we used in vitro and in vivo loss-of-function approaches to dissect the role of TRPS1 in mammary gland development and invasive lobular breast carcinoma, which is hallmarked by functional loss of E-cadherin. We show that TRPS1 is essential in mammary epithelial cells, since TRPS1-mediated suppression of interferon signaling promotes in vitro proliferation and lactogenic differentiation. Similarly, TRPS1 expression is indispensable for proliferation of mammary organoids and in vivo survival of luminal epithelial cells during mammary gland development. However, the consequences of TRPS1 loss are dependent on E-cadherin status, as combined inactivation of E-cadherin and TRPS1 causes persistent proliferation of mammary organoids and accelerated mammary tumor formation in mice. Together, our results demonstrate that TRPS1 can function as a context-dependent tumor suppressor in breast cancer, while being essential for growth and differentiation of normal mammary epithelial cells.
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Affiliation(s)
- Lisette M Cornelissen
- Division of Molecular Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Anne Paulien Drenth
- Division of Molecular Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Eline van der Burg
- Division of Molecular Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Roebi de Bruijn
- Division of Molecular Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Colin E J Pritchard
- Transgenic Core Facility, Mouse Clinic for Cancer and Aging (MCCA), The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Ivo J Huijbers
- Transgenic Core Facility, Mouse Clinic for Cancer and Aging (MCCA), The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Wilbert Zwart
- Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Division of Oncogenomics, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Laboratory of Chemical Biology, Institute for Complex Molecular Systems, Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, the Netherlands
| | - Jos Jonkers
- Division of Molecular Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands.,Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
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28
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McCart Reed AE, Lal S, Kutasovic JR, Wockner L, Robertson A, de Luca XM, Kalita-de Croft P, Dalley AJ, Coorey CP, Kuo L, Ferguson K, Niland C, Miller G, Johnson J, Reid LE, Males R, Saunus JM, Chenevix-Trench G, Coin L, Lakhani SR, Simpson PT. LobSig is a multigene predictor of outcome in invasive lobular carcinoma. NPJ Breast Cancer 2019; 5:18. [PMID: 31263747 PMCID: PMC6597578 DOI: 10.1038/s41523-019-0113-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/22/2019] [Indexed: 12/12/2022] Open
Abstract
Invasive lobular carcinoma (ILC) is the most common special type of breast cancer, and is characterized by functional loss of E-cadherin, resulting in cellular adhesion defects. ILC typically present as estrogen receptor positive, grade 2 breast cancers, with a good short-term prognosis. Several large-scale molecular profiling studies have now dissected the unique genomics of ILC. We have undertaken an integrative analysis of gene expression and DNA copy number to identify novel drivers and prognostic biomarkers, using in-house (n = 25), METABRIC (n = 125) and TCGA (n = 146) samples. Using in silico integrative analyses, a 194-gene set was derived that is highly prognostic in ILC (P = 1.20 × 10-5)-we named this metagene 'LobSig'. Assessing a 10-year follow-up period, LobSig outperformed the Nottingham Prognostic Index, PAM50 risk-of-recurrence (Prosigna), OncotypeDx, and Genomic Grade Index (MapQuantDx) in a stepwise, multivariate Cox proportional hazards model, particularly in grade 2 ILC cases (χ 2, P = 9.0 × 10-6), which are difficult to prognosticate clinically. Importantly, LobSig status predicted outcome with 94.6% accuracy amongst cases classified as 'moderate-risk' according to Nottingham Prognostic Index in the METABRIC cohort. Network analysis identified few candidate pathways, though genesets related to proliferation were identified, and a LobSig-high phenotype was associated with the TCGA proliferative subtype (χ 2, P < 8.86 × 10-4). ILC with a poor outcome as predicted by LobSig were enriched with mutations in ERBB2, ERBB3, TP53, AKT1 and ROS1. LobSig has the potential to be a clinically relevant prognostic signature and warrants further development.
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Affiliation(s)
- Amy E. McCart Reed
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Samir Lal
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
- Present Address: Pfizer Oncology Research, San Diego, CA 92121 USA
| | - Jamie R. Kutasovic
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Leesa Wockner
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, QLD 4006 Australia
| | - Alan Robertson
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Xavier M. de Luca
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Priyakshi Kalita-de Croft
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Andrew J. Dalley
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Craig P. Coorey
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Luyu Kuo
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Kaltin Ferguson
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Colleen Niland
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Gregory Miller
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
- Pathology Queensland, The Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia
| | - Julie Johnson
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Lynne E. Reid
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Renique Males
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | - Jodi M. Saunus
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
| | | | - Lachlan Coin
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Sunil R. Lakhani
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
- Pathology Queensland, The Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia
| | - Peter T. Simpson
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029 Australia
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Barupal DK, Gao B, Budczies J, Phinney BS, Perroud B, Denkert C, Fiehn O. Prioritization of metabolic genes as novel therapeutic targets in estrogen-receptor negative breast tumors using multi-omics data and text mining. Oncotarget 2019; 10:3894-3909. [PMID: 31231467 PMCID: PMC6570467 DOI: 10.18632/oncotarget.26995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/13/2019] [Indexed: 01/12/2023] Open
Abstract
Estrogen-receptor negative (ERneg) breast cancer is an aggressive breast cancer subtype in the need for new therapeutic options. We have analyzed metabolomics, proteomics and transcriptomics data for a cohort of 276 breast tumors (MetaCancer study) and nine public transcriptomics datasets using univariate statistics, meta-analysis, Reactome pathway analysis, biochemical network mapping and text mining of metabolic genes. In the MetaCancer cohort, a total of 29% metabolites, 21% proteins and 33% transcripts were significantly different (raw p <0.05) between ERneg and ERpos breast tumors. In the nine public transcriptomics datasets, on average 23% of all genes were significantly different (raw p <0.05). Specifically, up to 60% of the metabolic genes were significantly different (meta-analysis raw p <0.05) across the transcriptomics datasets. Reactome pathway analysis of all omics showed that energy metabolism, and biosynthesis of nucleotides, amino acids, and lipids were associated with ERneg status. Text mining revealed that several significant metabolic genes and enzymes have been rarely reported to date, including PFKP, GART, PLOD1, ASS1, NUDT12, FAR1, PDE7A, FAHD1, ITPK1, SORD, HACD3, CDS2 and PDSS1. Metabolic processes associated with ERneg tumors were identified by multi-omics integration analysis of metabolomics, proteomics and transcriptomics data. Overall results suggested that TCA anaplerosis, proline biosynthesis, synthesis of complex lipids and mechanisms for recycling substrates were activated in ERneg tumors. Under-reported genes were revealed by text mining which may serve as novel candidates for drug targets in cancer therapies. The workflow presented here can also be used for other tumor types.
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Affiliation(s)
- Dinesh Kumar Barupal
- West Coast Metabolomics Center, University of California, Davis, CA, USA.,Co-first authors and contributed equally to this work
| | - Bei Gao
- West Coast Metabolomics Center, University of California, Davis, CA, USA.,Co-first authors and contributed equally to this work
| | - Jan Budczies
- Institute of Pathology, Charité University Hospital, Berlin, Germany
| | - Brett S Phinney
- UC Davis Genome Center, University of California, Davis, CA, USA
| | - Bertrand Perroud
- UC Davis Genome Center, University of California, Davis, CA, USA
| | - Carsten Denkert
- Institute of Pathology, Charité University Hospital, Berlin, Germany.,German Institute of Pathology, Philipps-University Marburg, Marburg, Germany
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California, Davis, CA, USA
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30
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Zhang W, Li W, Zhang J, Wang N. Data Integration of Hybrid Microarray and Single Cell Expression Data to Enhance Gene Network Inference. Curr Bioinform 2019. [DOI: 10.2174/1574893614666190104142228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background:
Gene Regulatory Network (GRN) inference algorithms aim to explore
casual interactions between genes and transcriptional factors. High-throughput transcriptomics
data including DNA microarray and single cell expression data contain complementary
information in network inference.
Objective:
To enhance GRN inference, data integration across various types of expression data
becomes an economic and efficient solution.
Method:
In this paper, a novel E-alpha integration rule-based ensemble inference algorithm is
proposed to merge complementary information from microarray and single cell expression data.
This paper implements a Gradient Boosting Tree (GBT) inference algorithm to compute
importance scores for candidate gene-gene pairs. The proposed E-alpha rule quantitatively
evaluates the credibility levels of each information source and determines the final ranked list.
Results:
Two groups of in silico gene networks are applied to illustrate the effectiveness of the
proposed E-alpha integration. Experimental outcomes with size50 and size100 in silico gene
networks suggest that the proposed E-alpha rule significantly improves performance metrics
compared with single information source.
Conclusion:
In GRN inference, the integration of hybrid expression data using E-alpha rule
provides a feasible and efficient way to enhance performance metrics than solely increasing
sample sizes.
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Affiliation(s)
- Wei Zhang
- Institute of Cyber-Systems and Control, Zhejiang University, Hangzhou, 310013, China
| | - Wenchao Li
- Institute of Cyber-Systems and Control, Zhejiang University, Hangzhou, 310013, China
| | - Jianming Zhang
- Institute of Cyber-Systems and Control, Zhejiang University, Hangzhou, 310013, China
| | - Ning Wang
- Institute of Cyber-Systems and Control, Zhejiang University, Hangzhou, 310013, China
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31
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The estrogen receptor coactivator AIB1 is a new putative prognostic biomarker in ER-positive/HER2-negative invasive lobular carcinoma of the breast. Breast Cancer Res Treat 2019; 175:305-316. [PMID: 30796653 PMCID: PMC6533234 DOI: 10.1007/s10549-019-05138-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 01/18/2019] [Indexed: 12/20/2022]
Abstract
Purpose According to the 2017 St Gallen surrogate definitions of the intrinsic subtypes, Ki67, progesterone receptor (PR) and Nottingham histological grade (NHG) are used for prognostic classification of estrogen receptor (ER) positive/HER2-negative breast cancer into luminal A- or luminal B-like. The aim of the present study was to investigate if additional biomarkers, related to endocrine signaling pathways, e.g., amplified in breast cancer 1 (AIB1), androgen receptor (AR), and G protein-coupled estrogen receptor (GPER), can provide complementary prognostic information in a subset of ER-positive/HER-negative invasive lobular carcinoma (ILC). Methods Biomarkers from 224 patients were analyzed immunohistochemically on tissue microarray. The primary endpoint was breast cancer mortality (BCM), analyzed with 10- and 25-year follow-up (FU). In addition, the prognostic value of gene expression data for these biomarkers was analyzed in three publicly available ILC datasets. Results AIB1 (high vs. low) was associated to BCM in multivariable analysis (adjusted for age, tumor size, nodal status, NHG, Ki67, luminal-like classification, and adjuvant systemic therapy) with 10-year FU (HR 6.8, 95% CI 2.3–20, P = 0.001) and 25-year FU (HR 3.0, 95% CI 1.1–7.8, P = 0.03). The evidence of a prognostic effect of AIB1 could be confirmed by linking gene expression data to outcome in independent publicly available ILC datasets. AR and GPER were neither associated to BCM with 10-year nor with 25-year FU (P > 0.33). Furthermore, Ki67 and NHG were prognostic for BCM at both 10-year and 25-year FU, whereas PR was not. Conclusions AIB1 is a new putative prognostic biomarker in ER-positive/HER2-negative ILC. Electronic supplementary material The online version of this article (10.1007/s10549-019-05138-7) contains supplementary material, which is available to authorized users.
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32
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Li J, Wang W, Xia P, Wan L, Zhang L, Yu L, Wang L, Chen X, Xiao Y, Xu C. Identification of a five-lncRNA signature for predicting the risk of tumor recurrence in patients with breast cancer. Int J Cancer 2018; 143:2150-2160. [PMID: 29707762 DOI: 10.1002/ijc.31573] [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: 09/22/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 01/03/2023]
Abstract
Long non-coding RNAs (lncRNAs) are a major class of non-coding RNAs, and the functional deregulations of lncRNAs have been shown to be associated with the development and progression of BC. In this work, we conduct an integrative analysis on five re-annotated lncRNA expression datasets from the Gene Expression Omnibus (GEO) which included a total of 891 BC samples. We identified a five-lncRNA signature that was significantly associated with DFS in the training cohort of 327 patients. We found the five-lncRNA signature could effectively stratify patients in the training dataset into high- and low-risk groups with significantly different DFS (p = 3.29 × 10-5 , log-rank test). The five-lncRNA signature was effectively validated in four independent cohorts, and prognostic analysis results showed that the five-lncRNA signature was independent of clinical prognostic factors, such as BC subtypes and adjuvant treatments. Furthermore, GSEA suggested that the five-lncRNA signature was involved in BC metastasis-related pathways. Our findings indicate that these five lncRNAs may be implicated in BC pathogenesis, and further, these lncRNAs may potentially serve as novel candidate biomarkers for the identification of BC patients at high risk for tumor recurrence.
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Affiliation(s)
- Jie Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Weida Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Peng Xia
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Linyun Wan
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Li Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lei Yu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lily Wang
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.,University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Xi Chen
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.,University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Yun Xiao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Cardiovascular Medicine Research, Harbin Medical University, Ministry of Education, China
| | - Chaohan Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, Heilongjiang, China
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33
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Espié M, Bécourt S, Ledoux F. Cancer lobulaire infiltrant : épidémiologie, histoire naturelle, principes thérapeutiques. IMAGERIE DE LA FEMME 2017. [DOI: 10.1016/j.femme.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Ma T, Liang F, Oesterreich S, Tseng GC. A Joint Bayesian Model for Integrating Microarray and RNA Sequencing Transcriptomic Data. J Comput Biol 2017; 24:647-662. [PMID: 28541721 PMCID: PMC5510692 DOI: 10.1089/cmb.2017.0056] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
As the sequencing cost continued to drop in the past decade, RNA sequencing (RNA-seq) has replaced microarray to become the standard high-throughput experimental tool to analyze transcriptomic profile. As more and more datasets are generated and accumulated in the public domain, meta-analysis to combine multiple transcriptomic studies to increase statistical power has received increasing popularity. In this article, we propose a Bayesian hierarchical model to jointly integrate microarray and RNA-seq studies. Since systematic fold change differences across RNA-seq and microarray for detecting differentially expressed genes have been previously reported, we replicated this finding in several real datasets and showed that incorporation of a normalization procedure to account for the bias improves the detection accuracy and power. We compared our method with the popular two-stage Fisher's method using simulations and two real applications in a histological subtype (invasive lobular carcinoma) of breast cancer comparing PR+ versus PR- and early-stage versus late-stage patients. The result showed improved detection power and more significant and interpretable pathways enriched in the detected biomarkers from the proposed Bayesian model.
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Affiliation(s)
- Tianzhou Ma
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Faming Liang
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Steffi Oesterreich
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
- Women's Cancer Research Center, Pittsburgh, Pennsylvania
| | - George C. Tseng
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Computational Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Desmedt C, Zoppoli G, Sotiriou C, Salgado R. Transcriptomic and genomic features of invasive lobular breast cancer. Semin Cancer Biol 2017; 44:98-105. [PMID: 28400203 DOI: 10.1016/j.semcancer.2017.03.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 02/07/2023]
Abstract
Accounting for 10-15% of all breast neoplasms, invasive lobular breast cancer (ILC) is the second most common histological subtype of breast cancer after invasive ductal breast cancer (IDC). Understanding ILC biology, which differs from IDC in terms of clinical presentation, treatment response, relapse timing and patterns, is essential in order to adopt novel, disease-specific management strategies. While the contribution of the histological subtypes to tumour biology has been poorly investigated and acknowledged in the past, recently several major, independent efforts have led to the assembly and molecular characterization of well-annotated ILC case sets. In this review, we provide a critical overview of the literature exploring ILC, through comprehensive and multiomic methods. The first part specifically focuses on ILC transcriptomic features by reviewing the intrinsic molecular subtypes, the application of gene expression scores for the prediction of recurrence, and the identification of gene expression subtypes. The second part describes the main research efforts that lead to the identification of the genomic landscape of ILC, with a special focus to findings that differentiate ILC from IDC and carry potential clinical relevance.
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Affiliation(s)
- Christine Desmedt
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, 1000 Brussels, Belgium.
| | - Gabriele Zoppoli
- Department of Internal Medicine (DiMI), University of Genoa and Istituto di Ricovero e Cura a Carattere Scientifico San Martino-National Cancer Institute, Genoa, Italy
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, 1000 Brussels, Belgium
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory J.-C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, 1000 Brussels, Belgium; Department of Pathology/TCRU, Sint Augustinus, Wilrijk, Belgium
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Christgen M, Steinemann D, Kühnle E, Länger F, Gluz O, Harbeck N, Kreipe H. Lobular breast cancer: Clinical, molecular and morphological characteristics. Pathol Res Pract 2016; 212:583-97. [DOI: 10.1016/j.prp.2016.05.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/11/2016] [Accepted: 05/04/2016] [Indexed: 01/20/2023]
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37
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Desmedt C, Zoppoli G, Gundem G, Pruneri G, Larsimont D, Fornili M, Fumagalli D, Brown D, Rothé F, Vincent D, Kheddoumi N, Rouas G, Majjaj S, Brohée S, Van Loo P, Maisonneuve P, Salgado R, Van Brussel T, Lambrechts D, Bose R, Metzger O, Galant C, Bertucci F, Piccart-Gebhart M, Viale G, Biganzoli E, Campbell PJ, Sotiriou C. Genomic Characterization of Primary Invasive Lobular Breast Cancer. J Clin Oncol 2016; 34:1872-81. [DOI: 10.1200/jco.2015.64.0334] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose Invasive lobular breast cancer (ILBC) is the second most common histologic subtype after invasive ductal breast cancer (IDBC). Despite clinical and pathologic differences, ILBC is still treated as IDBC. We aimed to identify genomic alterations in ILBC with potential clinical implications. Methods From an initial 630 ILBC primary tumors, we interrogated oncogenic substitutions and insertions and deletions of 360 cancer genes and genome-wide copy number aberrations in 413 and 170 ILBC samples, respectively, and correlated those findings with clinicopathologic and outcome features. Results Besides the high mutation frequency of CDH1 in 65% of tumors, alterations in one of the three key genes of the phosphatidylinositol 3-kinase pathway, PIK3CA, PTEN, and AKT1, were present in more than one-half of the cases. HER2 and HER3 were mutated in 5.1% and 3.6% of the tumors, with most of these mutations having a proven role in activating the human epidermal growth factor receptor/ERBB pathway. Mutations in FOXA1 and ESR1 copy number gains were detected in 9% and 25% of the samples. All these alterations were more frequent in ILBC than in IDBC. The histologic diversity of ILBC was associated with specific alterations, such as enrichment for HER2 mutations in the mixed, nonclassic, and ESR1 gains in the solid subtype. Survival analyses revealed that chromosome 1q and 11p gains showed independent prognostic value in ILBC and that HER2 and AKT1 mutations were associated with increased risk of early relapse. Conclusion This study demonstrates that we can now begin to individualize the treatment of ILBC, with HER2, HER3, and AKT1 mutations representing high-prevalence therapeutic targets and FOXA1 mutations and ESR1 gains deserving urgent dedicated clinical investigation, especially in the context of endocrine treatment.
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Affiliation(s)
- Christine Desmedt
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Gabriele Zoppoli
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Gunes Gundem
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Giancarlo Pruneri
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Denis Larsimont
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Marco Fornili
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Debora Fumagalli
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - David Brown
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Françoise Rothé
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Delphine Vincent
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Naima Kheddoumi
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Ghizlane Rouas
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Samira Majjaj
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Sylvain Brohée
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Peter Van Loo
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Patrick Maisonneuve
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Roberto Salgado
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Thomas Van Brussel
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Diether Lambrechts
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Ron Bose
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Otto Metzger
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Christine Galant
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - François Bertucci
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Martine Piccart-Gebhart
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Giuseppe Viale
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Elia Biganzoli
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Peter J. Campbell
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
| | - Christos Sotiriou
- Christine Desmedt, Gabriele Zoppoli, Denis Larsimont, Debora Fumagalli, David Brown, Françoise Rothé, Delphine Vincent, Naima Kheddoumi, Ghizlane Rouas, Samira Majjaj, Sylvain Brohée, Roberto Salgado, Martine Piccart-Gebhart, and Christos Sotiriou, Institut Jules Bordet; Christine Galant, Cliniques Universitaires Saint Luc, Brussels; Peter Van Loo, University of Leuven; Thomas Van Brussel and Diether Lambrechts, VIB Vesalius Research Center, Leuven, Belgium; Gabriele Zoppoli, University of Genoa and
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Barroso-Sousa R, Metzger-Filho O. Differences between invasive lobular and invasive ductal carcinoma of the breast: results and therapeutic implications. Ther Adv Med Oncol 2016; 8:261-6. [PMID: 27482285 DOI: 10.1177/1758834016644156] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Invasive lobular carcinoma (ILC) is the second most common histologic subtype of breast cancer (BC): ILC differs from invasive ductal carcinoma (IDC) in its clinicopathological characteristics and responsiveness to systemic therapy. From the clinical standpoint, data suggest that ILC derives a distinct benefit from systemic therapy compared to IDC. In addition, comprehensive molecular analyses have been reported for ILCs, confirming that these tumors have specific genomic profiles compared to IDC. Despite these differences, clinical trials and practical clinical guidelines tend to treat BC as a single entity. Here we discuss these clinical and molecular data and their therapeutic implications.
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Affiliation(s)
- Romualdo Barroso-Sousa
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Otto Metzger-Filho
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Yawkey 1238, Boston, MA 02215, USA
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Metzger Filho O, Giobbie-Hurder A, Mallon E, Gusterson B, Viale G, Winer EP, Thürlimann B, Gelber RD, Colleoni M, Ejlertsen B, Debled M, Price KN, Regan MM, Coates AS, Goldhirsch A. Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial. J Clin Oncol 2015; 33:2772-9. [PMID: 26215945 PMCID: PMC4550691 DOI: 10.1200/jco.2015.60.8133] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma. PATIENTS AND METHODS Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor-positive with high (luminal B [LB] -like) or low (luminal A [LA] -like) proliferative activity by Ki-67 labeling index. Survival analyses were performed with weighted Cox models that used inverse probability of censoring weighted modeling. RESULTS The median follow-up time was 8.1 years. In multivariable models for disease-free survival (DFS), significant interactions between treatment and histology (ILC or IDC; P = .006) and treatment and subgroup (LB like or LA like; P = .01) were observed. In the ILC subset, there was a 66% reduction in the hazard of a DFS event with letrozole for LB (hazard ratio [HR], 0.34; 95% CI, 0.21 to 0.55) and a 50% reduction for LA subtypes (HR, 0.50; 95% CI, 0.32 to 0.78). In the IDC subset, there was a significant 35% reduction in the hazard of a DFS event with letrozole for the LB subtype (HR, 0.65; 95% CI, 0.53 to 0.79), but no difference between treatments was noted for IDC and the LA subtype (HR, 0.95; 95% CI, 0.76 to 1.20). CONCLUSION The magnitude of benefit of adjuvant letrozole is greater for patients diagnosed with lobular carcinoma versus ductal carcinoma.
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MESH Headings
- Adult
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Aromatase Inhibitors/therapeutic use
- Biomarkers, Tumor/analysis
- Breast Neoplasms/drug therapy
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Lobular/chemistry
- Carcinoma, Lobular/drug therapy
- Chemotherapy, Adjuvant
- Disease-Free Survival
- Female
- Humans
- Ki-67 Antigen/analysis
- Letrozole
- Middle Aged
- Nitriles/therapeutic use
- Receptor, ErbB-2/analysis
- Tamoxifen/therapeutic use
- Treatment Outcome
- Triazoles/therapeutic use
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Affiliation(s)
- Otto Metzger Filho
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.
| | - Anita Giobbie-Hurder
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Elizabeth Mallon
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Barry Gusterson
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Giuseppe Viale
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Eric P Winer
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Beat Thürlimann
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Richard D Gelber
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Marco Colleoni
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Bent Ejlertsen
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Marc Debled
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Karen N Price
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Meredith M Regan
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Alan S Coates
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
| | - Aron Goldhirsch
- Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia
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Wong H, Lau S, Cheung P, Wong TT, Parker A, Yau T, Epstein RJ. Lobular breast cancers lack the inverse relationship between ER/PR status and cell growth rate characteristic of ductal cancers in two independent patient cohorts: implications for tumor biology and adjuvant therapy. BMC Cancer 2014; 14:826. [PMID: 25385074 PMCID: PMC4236427 DOI: 10.1186/1471-2407-14-826] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 10/23/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Although invasive lobular carcinoma (ILC) of the breast differs from invasive ductal carcinoma (IDC) in numerous respects - including its genetics, clinical phenotype, metastatic pattern, and chemosensitivity - most experts continue to manage ILC and IDC identically in the adjuvant setting. Here we address this discrepancy by comparing early-stage ILC and IDC in two breast cancer patient cohorts of differing nationality and ethnicity. METHODS The clinicopathologic features of 2029 consecutive breast cancer patients diagnosed in Hong Kong (HK) and Australia (AUS) were compared. Interrelationships between tumor histology and other clinicopathologic variables, including ER/PR and Ki67, were analysed. RESULTS Two hundred thirty-nine patients were identified with ILC (11.8%) and 1790 patients with IDC. AUS patients were older (p <0.001) and more often postmenopausal (p <0.03) than HK patients. As expected, ILC tumors were lower in grade and proliferative rate, and more often ER-positive and HER2-negative, than IDC (p <0.002); yet despite this, ILC tumors were as likely as IDC to present with nodal metastases (p >0.7). Moreover, whereas IDC tumors exhibited a strongly negative relationship between ER/PR and Ki67 status (p <0.0005), ILC tumors failed to demonstrate any such inverse relationship (p >0.6). CONCLUSION These data imply that the primary adhesion defect in ILC underlies a secondary stromal-epithelial disconnect between hormonal signaling and tumor growth, suggesting in turn that this peritumoral feedback defect could reduce both the antimetastatic (adjuvant) and tumorilytic (palliative) efficacy of cytotoxic therapies for such tumors. Hence, we caution against assuming similar adjuvant chemotherapeutic survival benefits for ILC and IDC tumors with similar ER and Ki67, whether based on immunohistochemical or gene expression assays.
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Affiliation(s)
| | | | | | | | | | - Thomas Yau
- Division of Hematology/Oncology, University Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
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Guiu S, Wolfer A, Jacot W, Fumoleau P, Romieu G, Bonnetain F, Fiche M. Invasive lobular breast cancer and its variants: how special are they for systemic therapy decisions? Crit Rev Oncol Hematol 2014; 92:235-57. [PMID: 25129506 DOI: 10.1016/j.critrevonc.2014.07.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 06/01/2014] [Accepted: 07/21/2014] [Indexed: 12/16/2022] Open
Abstract
The WHO classification of breast tumors distinguishes, besides invasive breast cancer 'of no special type' (former invasive ductal carcinoma, representing 60-70% of all breast cancers), 30 special types, of which invasive lobular carcinoma (ILC) is the most common (5-15%). We review the literature on (i) the specificity and heterogeneity of ILC biology as documented by various analytical techniques, including the results of molecular testing for risk of recurrence; (ii) the impact of lobular histology on prediction of prognosis and effect of systemic therapies in patients. Though it is generally admitted that ILC has a better prognosis than IDC, is endocrine responsive, and responds poorly to chemotherapy, currently available data do not unanimously support these assumptions. This review demonstrates some lack of specific data and a need for improving clinical research design to allow oncologists to make informed systemic therapy decisions in patients with ILC. Importantly, future studies should compare various endpoints in ILC breast cancer patients among the group of hormonosensitive breast cancer.
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Affiliation(s)
- Séverine Guiu
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 1 rue du Professeur Marion, 21000 Dijon, France; Department of Medical Oncology, CHUV, rue du Bugnon 46, 1011 Lausanne, Switzerland.
| | - Anita Wolfer
- Department of Medical Oncology, CHUV, rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - William Jacot
- Department of Medical Oncology, Institute of Cancerology of Montpellier, 208 Avenue des Apothicaires-Parc Euromédecine, 34298 Montpellier Cedex 5, France
| | - Pierre Fumoleau
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Gilles Romieu
- Department of Medical Oncology, Institute of Cancerology of Montpellier, 208 Avenue des Apothicaires-Parc Euromédecine, 34298 Montpellier Cedex 5, France
| | - Franck Bonnetain
- Oncology Unit of Methodology and Quality of Life (EA 3181), CHU Besançon, 2 place Saint-Jacques, 25000 Besançon, France
| | - Maryse Fiche
- University Institute of Pathology, CHUV, rue du Bugnon 25, 1011 Lausanne, Switzerland
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Response and prognosis after neoadjuvant chemotherapy in 1,051 patients with infiltrating lobular breast carcinoma. Breast Cancer Res Treat 2014; 144:153-62. [DOI: 10.1007/s10549-014-2861-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
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Harbeck N, Sotlar K, Wuerstlein R, Doisneau-Sixou S. Molecular and protein markers for clinical decision making in breast cancer: today and tomorrow. Cancer Treat Rev 2013; 40:434-44. [PMID: 24138841 DOI: 10.1016/j.ctrv.2013.09.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 09/18/2013] [Accepted: 09/20/2013] [Indexed: 01/31/2023]
Abstract
In early breast cancer (eBC), established clinicopathological factors are not sufficient for clinical decision making particularly regarding adjuvant chemotherapy since substantial over- or undertreatment may occur. Thus, novel protein- and molecular markers have been put forward as decision aids. Since these potential prognosis and/or predictive tests differ substantially regarding their methodology, analytical and clinical validation, this review attempts to summarize the essential facts for clinicians. This review focuses on those markers which are the most advanced so far in their development towards routine clinical application, i.e. two protein markers (i.e. uPA/PAI-1 and IHC4) and six molecular multigene tests (i.e. Mammaprint®, Oncotype DX®, PAM50, Endopredict®, the 97-gene genomic grade, and 76 gene Rotterdam signatures). Next to methodological aspects, we summarized the clinical evidences, in particular the main prospective clinical trials which have already been fully recruited (i.e. MINDACT, TAILORx, WSG PLAN B) or are still ongoing (i.e. RxPONDER/SWOG S1007, WSG-ADAPT). Last but not least, this review points out the key elements for clinicians to select one test among the wide panel of proposed assays, for a specific population of patients in term of level of evidence, analytical and clinical validity as well as cost effectiveness.
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Affiliation(s)
- Nadia Harbeck
- Brustzentrum, Universitätsfrauenklinik, Klinikum Großhadern, Marchioninistr. 15, München, Germany.
| | - Karl Sotlar
- Pathologisches Institut, Ludwig-Maximilians-Universität München, Thalkirchner Strasse. 36, München, Germany.
| | - Rachel Wuerstlein
- Brustzentrum, Klinikum der Universität München, Maistraße 11, 80337 Munich, Germany.
| | - Sophie Doisneau-Sixou
- Brustzentrum, Klinikum der Universität München, Maistraße 11, 80337 Munich, Germany; Université Paul Sabatier Toulouse III, Faculté des Sciences Pharmaceutiques, 31062 Toulouse Cedex 09, France.
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Metzger-Filho O, Catteau A, Michiels S, Buyse M, Ignatiadis M, Saini KS, de Azambuja E, Fasolo V, Naji S, Canon JL, Delrée P, Coibion M, Cusumano P, Jossa V, Kains JP, Larsimont D, Richard V, Faverly D, Cornez N, Vuylsteke P, Vanderschueren B, Peyro-Saint-Paul H, Piccart M, Sotiriou C. Genomic Grade Index (GGI): feasibility in routine practice and impact on treatment decisions in early breast cancer. PLoS One 2013; 8:e66848. [PMID: 23990869 PMCID: PMC3747186 DOI: 10.1371/journal.pone.0066848] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 05/10/2013] [Indexed: 12/22/2022] Open
Abstract
Purpose Genomic Grade Index (GGI) is a 97-gene signature that improves histologic grade (HG) classification in invasive breast carcinoma. In this prospective study we sought to evaluate the feasibility of performing GGI in routine clinical practice and its impact on treatment recommendations. Methods Patients with pT1pT2 or operable pT3, N0-3 invasive breast carcinoma were recruited from 8 centers in Belgium. Fresh surgical samples were sent at room temperature in the MapQuant Dx™ PathKit for centralized genomic analysis. Genomic profiles were determined using Affymetrix U133 Plus 2.0 and GGI calculated using the MapQuant Dx® protocol, which defines tumors as low or high Genomic Grade (GG-1 and GG-3 respectively). Results 180 pts were recruited and 155 were eligible. The MapQuant test was performed in 142 cases and GGI was obtained in 78% of cases (n=111). Reasons for failures were 15 samples with <30% of invasive tumor cells (11%), 15 with insufficient RNA quality (10%), and 1 failed hybridization (<1%). For tumors with an available representative sample (≥ 30% inv. tumor cells) (n=127), the success rate was 87.5%. GGI reclassified 69% of the 54 HG2 tumors as GG-1 (54%) or GG-3 (46%). Changes in treatment recommendations occurred mainly in the subset of HG2 tumors reclassified into GG-3, with increased use of chemotherapy in this subset. Conclusion The use of GGI is feasible in routine clinical practice and impacts treatment decisions in early-stage breast cancer. Trial Registration ClinicalTrials.gov NCT01916837, http://clinicaltrials.gov/ct2/show/NCT01916837
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Affiliation(s)
| | | | - Stefan Michiels
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Marc Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium
| | | | - Kamal S. Saini
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | | | | - Paul Delrée
- Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | | | | | | | - Denis Larsimont
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Hôpitaux Iris-Sud, Brussels, Belgium
| | | | | | | | | | | | | | - Martine Piccart
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- * E-mail:
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Metzger-Filho O, Procter M, de Azambuja E, Leyland-Jones B, Gelber RD, Dowsett M, Loi S, Saini KS, Cameron D, Untch M, Smith I, Gianni L, Baselga J, Jackisch C, Bell R, Sotiriou C, Viale G, Piccart-Gebhart M. Magnitude of Trastuzumab Benefit in Patients With HER2-Positive, Invasive Lobular Breast Carcinoma: Results From the HERA Trial. J Clin Oncol 2013; 31:1954-60. [DOI: 10.1200/jco.2012.46.2440] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To evaluate the benefit of adjuvant trastuzumab in patients diagnosed with human epidermal growth factor receptor 2 (HER2) –positive invasive lobular carcinoma (ILC) enrolled onto the Herceptin Adjuvant (HERA) trial. Patients and Methods Patients randomly assigned to receive one year of trastuzumab and one year of observation in the HERA trial were included (n = 3,401). Centrally reviewed estrogen receptor (ER), progesterone receptor (PgR), and HER2 copy numbers were used. First site-specific relapse pattern was evaluated for ILC and invasive ductal carcinoma (IDC). The magnitude of trastuzumab benefit was assessed using the Cox proportional hazards model for disease-free survival (DFS) and overall survival (OS). Results Median follow-up time was 4 years. A total of 187 ILC and 3,213 IDC patients were included. High Allred scores (6 to 8) were more common in patients with ILC than IDC for both ER (36.9% v 22.7%) and PgR (44.1% v 28.5%). A trend toward decreased HER2 copy number was observed in the ILC group. The ILC and IDC subgroups had similar patterns of first site of disease relapse. DFS hazard ratios (HRs) comparing 1 year of trastuzumab versus observation were 0.63 for ILC (95% CI, 0.34 to 1.15) and 0.77 for IDC (95% CI, 0.67 to 0.89; P for interaction = .49). The OS HRs comparing 1 year of trastuzumab versus observation were 0.60 for ILC (95% CI, 0.27 to 1.31) and 0.86 for IDC (95% CI, 0.71 to 1.06; P for interaction = .29). Conclusion In this retrospective analysis, there was no suggestion that patients in the ILC cohort experienced a different magnitude of benefit from adjuvant trastuzumab than those in the IDC cohort.
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Affiliation(s)
- Otto Metzger-Filho
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Marion Procter
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Evandro de Azambuja
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Brian Leyland-Jones
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Richard D. Gelber
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Mitchell Dowsett
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Sherene Loi
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Kamal S. Saini
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - David Cameron
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Michael Untch
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Ian Smith
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Luca Gianni
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Jose Baselga
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Christian Jackisch
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Richard Bell
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Christos Sotiriou
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Giuseppe Viale
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
| | - Martine Piccart-Gebhart
- Otto Metzger-Filho and Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, MA; Otto Metzger-Filho, Evandro de Azambuja, Kamal S. Saini, Christos Sotiriou, and Martine Piccart-Gebhart, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium; Marion Procter, Frontier Science Scotland, Kincraig; Mitchell Dowsett and Ian Smith, Royal Marsden Hospital; Ian Smith, Institute of Cancer Research, London; David Cameron, University of
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