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Eustace AJ, Conlon NT, McDermott MSJ, Browne BC, O'Leary P, Holmes FA, Espina V, Liotta LA, O'Shaughnessy J, Gallagher C, O'Driscoll L, Rani S, Madden SF, O'Brien NA, Ginther C, Slamon D, Walsh N, Gallagher WM, Zagozdzon R, Watson WR, O'Donovan N, Crown J. Development of acquired resistance to lapatinib may sensitise HER2-positive breast cancer cells to apoptosis induction by obatoclax and TRAIL. BMC Cancer 2018; 18:965. [PMID: 30305055 PMCID: PMC6180577 DOI: 10.1186/s12885-018-4852-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 09/24/2018] [Indexed: 12/30/2022] Open
Abstract
Background Lapatinib has clinical efficacy in the treatment of trastuzumab-refractory HER2-positive breast cancer. However, a significant proportion of patients develop progressive disease due to acquired resistance to the drug. Induction of apoptotic cell death is a key mechanism of action of lapatinib in HER2-positive breast cancer cells. Methods We examined alterations in regulation of the intrinsic and extrinsic apoptosis pathways in cell line models of acquired lapatinib resistance both in vitro and in patient samples from the NCT01485926 clinical trial, and investigated potential strategies to exploit alterations in apoptosis signalling to overcome lapatinib resistance in HER2-positive breast cancer. Results In this study, we examined two cell lines models of acquired lapatinib resistance (SKBR3-L and HCC1954-L) and showed that lapatinib does not induce apoptosis in these cells. We identified alterations in members of the BCL-2 family of proteins, in particular MCL-1 and BAX, which may play a role in resistance to lapatinib. We tested the therapeutic inhibitor obatoclax, which targets MCL-1. Both SKBR3-L and HCC1954-L cells showed greater sensitivity to obatoclax-induced apoptosis than parental cells. Interestingly, we also found that the development of acquired resistance to lapatinib resulted in acquired sensitivity to TRAIL in SKBR3-L cells. Sensitivity to TRAIL in the SKBR3-L cells was associated with reduced phosphorylation of AKT, increased expression of FOXO3a and decreased expression of c-FLIP. In SKBR3-L cells, TRAIL treatment caused activation of caspase 8, caspase 9 and caspase 3/7. In a second resistant model, HCC1954-L cells, p-AKT levels were not decreased and these cells did not show enhanced sensitivity to TRAIL. Furthermore, combining obatoclax with TRAIL improved response in SKBR3-L cells but not in HCC1954-L cells. Conclusions Our findings highlight the possibility of targeting altered apoptotic signalling to overcome acquired lapatinib resistance, and identify potential novel treatment strategies, with potential biomarkers, for HER2-positive breast cancer that is resistant to HER2 targeted therapies. Electronic supplementary material The online version of this article (10.1186/s12885-018-4852-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alex J Eustace
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.
| | - Neil T Conlon
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Martina S J McDermott
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Brigid C Browne
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Patrick O'Leary
- UCD School of Biomolecular and Biomedical Science, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Frankie A Holmes
- Texas Oncology-Memorial Hermann Memorial City, US Oncology Research, 925 Gessner Road #550, Houston, TX, 77024-2546, USA
| | | | | | | | - Clair Gallagher
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Lorraine O'Driscoll
- School of Pharmacy & Pharmaceutical Sciences, and Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Sweta Rani
- School of Pharmacy & Pharmaceutical Sciences, and Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Stephen F Madden
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.,Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Neil A O'Brien
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, California, Los Angeles, USA
| | - Charles Ginther
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, California, Los Angeles, USA
| | - Dennis Slamon
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, California, Los Angeles, USA
| | - Naomi Walsh
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - William M Gallagher
- UCD School of Biomolecular and Biomedical Science, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Radoslaw Zagozdzon
- Department of Clinical Immunology, Transplantation Institute, Medical University of Warsaw, Nowogrodzka, 59, Warsaw, Poland
| | - William R Watson
- UCD School of Biomolecular and Biomedical Science, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Norma O'Donovan
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - John Crown
- Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.,Department of Oncology, St. Vincent's University Hospital, Dublin, Ireland
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Toomey S, Eustace AJ, Fay J, Sheehan KM, Carr A, Milewska M, Madden SF, Teiserskiene A, Kay EW, O'Donovan N, Gallagher W, Grogan L, Breathnach O, Walshe J, Kelly C, Moulton B, Kennedy MJ, Gullo G, Hill AD, Power C, Duke D, Hambly N, Crown J, Hennessy BT. Impact of somatic PI3K pathway and ERBB family mutations on pathological complete response (pCR) in HER2-positive breast cancer patients who received neoadjuvant HER2-targeted therapies. Breast Cancer Res 2017; 19:87. [PMID: 28750640 PMCID: PMC5530949 DOI: 10.1186/s13058-017-0883-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/13/2017] [Indexed: 12/17/2022] Open
Abstract
Background The Cancer Genome Atlas analysis revealed that somatic EGFR, receptor tyrosine-protein kinase erbB-2 (ERBB2), Erb-B2 receptor tyrosine kinase 3 (ERBB3) and Erb-B2 receptor tyrosine kinase 4 (ERBB4) gene mutations (ERBB family mutations) occur alone or co-occur with somatic mutations in the gene encoding the phosphatidylinositol 3-kinase (PI3K) catalytic subunit (PIK3CA) in 19% of human epidermal growth factor receptor 2 (HER2)-positive breast cancers. Because ERBB family mutations can activate the PI3K/AKT pathway and likely have similar canonical signalling effects to PI3K pathway mutations, we investigated their combined impact on response to neoadjuvant HER2-targeted therapies. Methods Baseline tumour biopsies were available from 74 patients with HER2-positive breast cancer who were enrolled in the phase II TCHL neoadjuvant study (ICORG 10-05) assessing TCH (docetaxel, carboplatin, trastuzumab) (n = 38) versus TCL (docetaxel, carboplatin, lapatinib) (n = 10) versus TCHL (docetaxel, carboplatin, trastuzumab, lapatinib) (n = 40), each for six cycles. Activating mutations in PIK3CA and ERBB family genes were identified using mass spectrometry-based genotyping. Phosphatase and tensin homolog (PTEN) expression was assessed by immunohistochemistry. Results PIK3CA and/or ERBB family mutations were detected in 23 (31.1%) tumour samples tested, whereas PTEN expression was low in 31.1% of cases tested. Mutation frequency was similar in each treatment arm (31.3% in TCH arm, 30% in TCL arm and 31.3% in TCHL arm) and was not influenced by oestrogen receptor (ER) status (27.6% in ER-negative patients, 33.3% in ER-positive patients) or progesterone receptor (PR) status (32.6% in PR-negative patients, 29% in PR-positive patients). There was no significant difference in pathological complete response (pCR) rates between 47 patients with wild-type (WT) tumours and 22 patients whose tumours carried mutations (in either PIK3CA or ERBB family genes) (42.5% vs. 54.5%; p = 0.439). Similarly, there was no significant difference in pCR rates between patients with PIK3CA/ERBB family mutated/PTEN-low (i.e., PI3K-activated) tumours and patients without PI3K activation (50% vs. 44%; p = 0.769). However, in the TCHL (but not the TCH) group, the pCR rate was higher for 9 patients with PIK3CA/ERBB family mutated tumours than for 20 patients with PIK3CA/ERBB family WT tumours (77.8% vs. 35%; p = 0.05). Conclusions Our results indicate that patients who receive neoadjuvant TCHL and have PIK3CA/ERBB family mutated tumours may be more likely to have a pCR than patients with WT tumours. Trial registration ClinicalTrials.gov, NCT01485926. Registered on 2 December 2011. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0883-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sinead Toomey
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland.
| | - Alexander J Eustace
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland
| | - Joanna Fay
- Department of Histopathology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Katherine M Sheehan
- Department of Histopathology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aoife Carr
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland
| | - Malgorzata Milewska
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland
| | - Stephen F Madden
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland
| | | | - Elaine W Kay
- Department of Histopathology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Norma O'Donovan
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - William Gallagher
- Cancer Biology and Therapeutics Laboratory, UCD School of Biomolecular and Biomedical Science, UCD Conway Institute,, University College Dublin, Dublin, Ireland
| | - Liam Grogan
- Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | - Oscar Breathnach
- Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | - Janice Walshe
- Department of Medical Oncology, St. Vincent's University Hospital, Dublin, Ireland
| | - Catherine Kelly
- Department of Medical Oncology, The Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - M John Kennedy
- Department of Medical Oncology, St. James Hospital, Dublin, Ireland
| | - Guiseppe Gullo
- Department of Medical Oncology, St. Vincent's University Hospital, Dublin, Ireland
| | - Arnold D Hill
- Department of Surgery, Royal College of Surgeons In Ireland, Dublin, Ireland
| | - Colm Power
- Department of Surgery, Royal College of Surgeons In Ireland, Dublin, Ireland
| | - Deirdre Duke
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Niamh Hambly
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - John Crown
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.,Department of Medical Oncology, St. Vincent's University Hospital, Dublin, Ireland
| | - Bryan T Hennessy
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin 9, Ireland.,Cancer Trials Ireland, Dublin, Ireland.,Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
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6
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Toomey S, Eustace AJ, Pritzker LB, Pritzker KPH, Fay J, O'Grady A, Cummins R, Grogan L, Kennedy J, O'Connor D, Young L, Kay EW, O'Donovan N, Gallagher WM, Kalachand R, Crown J, Hennessy BT. RE: RNA Disruption Assay as a Biomarker of Pathological Complete Response in Neoadjuvant Trastuzumab-Treated Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Natl Cancer Inst 2016; 108:djw111. [PMID: 27377904 DOI: 10.1093/jnci/djw111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/09/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sinead Toomey
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Alex J Eustace
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH).
| | - Laura B Pritzker
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Ken P H Pritzker
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Joanna Fay
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Anthony O'Grady
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Robert Cummins
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Liam Grogan
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - John Kennedy
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Darran O'Connor
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Leonie Young
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Elaine W Kay
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Norma O'Donovan
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - William M Gallagher
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Roshni Kalachand
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - John Crown
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
| | - Bryan T Hennessy
- Medical Oncology Group, Dept. of Molecular Medicine (ST, AJE, RK, BTH), Department of Pathology (JF, AO, RC, EK), Molecular and Cellular Therapeutics (DO), and Endocrine Oncology Research Group, Department of Surgery (LY), Royal College of Surgeons in Ireland, Dublin, Ireland; RNA Diagnostics Inc., Toronto, Ontario, Canada (LBP, KPHP); Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (KPHP); Department of Oncology, Beaumont Hospital, Dublin, Ireland (LG, BTH); Department of Oncology, St. James Hospital, Dublin, Ireland (JK); Molecular Therapeutics for Cancer Ireland, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland (NO, JC); School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland (WMG); Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland (JC); All Ireland Clinical Oncology Research Group (BTH)
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