1
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Cecchini M, Cleary JM, Shyr Y, Chao J, Uboha N, Cho M, Shields A, Pant S, Goff L, Spencer K, Kim E, Stein S, Kortmansky JS, Canosa S, Sklar J, Swisher EM, Radke M, Ivy P, Boerner S, Durecki DE, Hsu CY, LoRusso P, Lacy J. NCI10066: a Phase 1/2 study of olaparib in combination with ramucirumab in previously treated metastatic gastric and gastroesophageal junction adenocarcinoma. Br J Cancer 2024; 130:476-482. [PMID: 38135713 PMCID: PMC10844282 DOI: 10.1038/s41416-023-02534-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/20/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Our preclinical work revealed tumour hypoxia induces homologous recombination deficiency (HRD), increasing sensitivity to Poly (ADP-ribose) polymerase inhibitors. We aimed to induce tumour hypoxia with ramucirumab thereby sensitising tumours to olaparib. PATIENTS AND METHODS This multi-institution single-arm Phase 1/2 trial enrolled patients with metastatic gastroesophageal adenocarcinoma refractory to ≥1 systemic treatment. In dose escalation, olaparib was evaluated at escalating dose levels with ramucirumab 8 mg/kg day 1 in 14-day cycles. The primary endpoint of Phase 1 was the recommended Phase 2 dose (RP2D), and in Phase 2 the primary endpoint was the overall response rate (ORR). RESULTS Fifty-one patients received ramucirumab and olaparib. The RP2D was olaparib 300 mg twice daily with ramucirumab 8 mg/kg. In evaluable patients at the RP2D the ORR was 6/43 (14%) (95% CI 4.7-25.6). The median progression-free survival (PFS) was 2.8 months (95% CI 2.3-4.2) and median overall survival (OS) was 7.3 months (95% CI 5.7-13.0). Non-statistically significant improvements in PFS and OS were observed for patients with tumours with mutations in HRD genes. CONCLUSIONS Olaparib and ramucirumab is well-tolerated with efficacy that exceeds historical controls with ramucirumab single agent for gastric cancer in a heavily pre-treated patient population.
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Affiliation(s)
- Michael Cecchini
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - James M Cleary
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University, Nashville, TN, 37203, USA
| | - Joseph Chao
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA, 91010, USA
| | - Nataliya Uboha
- Department of Medicine, University of Wisconsin, Madison, WI, 53792, USA
| | - May Cho
- Department of Medicine, University of California Irvine, Irvine, CA, 92868, USA
| | - Anthony Shields
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, 48201, USA
| | - Shubham Pant
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Laura Goff
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, TN, 37203, USA
| | - Kristen Spencer
- Department of Medicine, Perlmutter Cancer Center of NYU Langone Health and NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Edward Kim
- Department of Internal Medicine, University of California Davis, Davis, CA, 95817, USA
| | - Stacey Stein
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Jeremy S Kortmansky
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Sandra Canosa
- Department of Pathology, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Jeffrey Sklar
- Department of Pathology, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Elizabeth M Swisher
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98195, USA
| | - Marc Radke
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98195, USA
| | - Percy Ivy
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Scott Boerner
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Diane E Durecki
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Chih-Yuan Hsu
- Department of Biostatistics, Vanderbilt University, Nashville, TN, 37203, USA
| | - Patricia LoRusso
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Jill Lacy
- Department of Internal Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, 06510, USA
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2
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De Marco K, Sanese P, Simone C, Grossi V. Histone and DNA Methylation as Epigenetic Regulators of DNA Damage Repair in Gastric Cancer and Emerging Therapeutic Opportunities. Cancers (Basel) 2023; 15:4976. [PMID: 37894343 PMCID: PMC10605360 DOI: 10.3390/cancers15204976] [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: 06/19/2023] [Revised: 09/25/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Gastric cancer (GC), one of the most common malignancies worldwide, is a heterogeneous disease developing from the accumulation of genetic and epigenetic changes. One of the most critical epigenetic alterations in GC is DNA and histone methylation, which affects multiple processes in the cell nucleus, including gene expression and DNA damage repair (DDR). Indeed, the aberrant expression of histone methyltransferases and demethylases influences chromatin accessibility to the DNA repair machinery; moreover, overexpression of DNA methyltransferases results in promoter hypermethylation, which can suppress the transcription of genes involved in DNA repair. Several DDR mechanisms have been recognized so far, with homologous recombination (HR) being the main pathway involved in the repair of double-strand breaks. An increasing number of defective HR genes are emerging in GC, resulting in the identification of important determinants of therapeutic response to DDR inhibitors. This review describes how both histone and DNA methylation affect DDR in the context of GC and discusses how alterations in DDR can help identify new molecular targets to devise more effective therapeutic strategies for GC, with a particular focus on HR-deficient tumors.
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Affiliation(s)
- Katia De Marco
- Medical Genetics, National Institute of Gastroenterology—IRCCS “Saverio de Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy; (K.D.M.); (P.S.)
| | - Paola Sanese
- Medical Genetics, National Institute of Gastroenterology—IRCCS “Saverio de Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy; (K.D.M.); (P.S.)
| | - Cristiano Simone
- Medical Genetics, National Institute of Gastroenterology—IRCCS “Saverio de Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy; (K.D.M.); (P.S.)
- Medical Genetics, Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), University of Bari Aldo Moro, 70124 Bari, Italy
| | - Valentina Grossi
- Medical Genetics, National Institute of Gastroenterology—IRCCS “Saverio de Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy; (K.D.M.); (P.S.)
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3
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Cinicola J, Mamidanna S, Yegya-Raman N, Spencer K, Deek MP, Jabbour SK. A Review of Advances in Radiotherapy in the Setting of Esophageal Cancers. Surg Oncol Clin N Am 2023; 32:433-459. [PMID: 37182986 DOI: 10.1016/j.soc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Esophageal cancer is the eighth most common cancer worldwide and is the sixth most common cause of cancer-related mortality. The paradigm has shifted to include a multimodality approach with surgery, chemotherapy, targeted therapy (including immunotherapy), and radiation therapy. Advances in radiotherapy through techniques such as intensity modulated radiotherapy and proton beam therapy have allowed for the more dose homogeneity and improved organ sparing. In addition, recent studies of targeted therapies and predictive approaches in patients with locally advanced disease provide clinicians with new approaches to modify multimodality treatment to improve clinical outcomes.
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Affiliation(s)
- Joshua Cinicola
- Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA
| | - Swati Mamidanna
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA
| | - Nikhil Yegya-Raman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristen Spencer
- New York Langone Perlmutter Cancer Center, New York, NY, USA
| | - Matthew P Deek
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA
| | - Salma K Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA.
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4
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Pihlak R, Fong C, Starling N. Targeted Therapies and Developing Precision Medicine in Gastric Cancer. Cancers (Basel) 2023; 15:3248. [PMID: 37370858 PMCID: PMC10296575 DOI: 10.3390/cancers15123248] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Gastric cancer is an aggressive disease with survival remaining poor in the advanced setting. More than a decade after the first targeted treatment was approved, still only HER2, MSI and PDL-1 status have reached everyday practice in terms of guiding treatment options for these patients. However, various new targets and novel treatments have recently been investigated and have shown promise in improving survival outcomes. In this review, we will summarise previous and currently ongoing studies on predictive biomarkers, possible new targeted treatments, potential reasons for conflicting trial results and hope for the future of precision medicine in gastric cancer.
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Affiliation(s)
| | | | - Naureen Starling
- Gastrointestinal/Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (R.P.); (C.F.)
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5
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Sheikh H, Ryder D, Bateman A, Chalmers A, Jackson A. Radiotherapy and olaparib in combination for carcinoma of the oesophagus: A phase I study. Clin Transl Radiat Oncol 2023; 40:100614. [PMID: 36949958 PMCID: PMC10025123 DOI: 10.1016/j.ctro.2023.100614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/04/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023] Open
Abstract
Background and purpose Radical concurrent chemoradiotherapy (CRT) for oesophageal cancer is associated with significant morbidity and is unsuitable for some patients. Olaparib, an inhibitor of the DNA repair enzyme poly-(ADP)-ribose polymerase (PARP) has radiosensitising properties and may be better tolerated than chemotherapy. Materials and methods We performed a phase 1 study of olaparib with radiotherapy (RT) in oesophageal cancer patients unsuitable for conventional CRT to determine its maximum tolerated dose (MTD) in this setting. Results Eight patients were recruited. One of 5 patients receiving olaparib 50 mg twice daily and two of 3 receiving 100 mg twice daily experienced dose limiting toxicity (DLT). Conclusions Olaparib 100 mg twice daily exceeded the MTD in combination with RT in these patients. 50 mg twice daily may be the MTD but this cannot be stated with certainty as the study closed before full recruitment.
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Affiliation(s)
- Hamid Sheikh
- The Christie NHS Foundation Trust, 550 Wilmslow Rd, Manchester M20 4BX, UK
| | - David Ryder
- Manchester Clinical Trials Unit, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Andrew Bateman
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Anthony Chalmers
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, Garscube Estate, Glasgow G61 1QH, UK
| | - Andrew Jackson
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
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6
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Ferrari A, Fiocca R, Bonora E, Domizio C, Fonzi E, Angeli D, Domenico Raulli G, Mattioli S, Martinelli G, Molinari C. Detection of a Novel MSI2-C17orf64 Transcript in a Patient with Aggressive Adenocarcinoma of the Gastroesophageal Junction: A Case Report. Genes (Basel) 2023; 14:genes14040918. [PMID: 37107676 PMCID: PMC10137952 DOI: 10.3390/genes14040918] [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: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Adenocarcinoma of the esophagus (EAC) and gastroesophageal junction (GEJ-AC) is associated with poor prognosis, treatment resistance and limited systemic therapeutic options. To deeply understand the genomic landscape of this cancer type, and potentially identify a therapeutic target in a neoadjuvant chemotherapy non-responder 48-year-old man, we adopted a multi-omic approach. We simultaneously evaluated gene rearrangements, mutations, copy number status, microsatellite instability and tumor mutation burden. The patient displayed pathogenic mutations of the TP53 and ATM genes and variants of uncertain significance of three kinases genes (ERBB3, CSNK1A1 and RPS6KB2), along with FGFR2 and KRAS high copy number amplification. Interestingly, transcriptomic analysis revealed the Musashi-2 (MSI2)-C17orf64 fusion that has never been reported before. Rearrangements of the RNA-binding protein MSI2 with a number of partner genes have been described across solid and hematological tumors. MSI2 regulates several biological processes involved in cancer initiation, development and resistance to treatment, and deserves further investigation as a potential therapeutic target. In conclusion, our extensive genomic characterization of a gastroesophageal tumor refractory to all therapeutic approaches led to the discovery of the MSI2-C17orf64 fusion. The results underlie the importance of deep molecular analyses enabling the identification of novel patient-specific markers to be monitored during therapy or even targeted at disease evolution.
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Affiliation(s)
- Anna Ferrari
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, FC, Italy
| | - Roberto Fiocca
- Unit of Anatomic Pathology, Ospedale Policlinico San Martino IRCCS, 16125 Genova, Italy
- Department of Surgical and Diagnostic Sciences (DISC), University of Genova, 16125 Genova, Italy
| | - Elena Bonora
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Via Massarenti 9, 40126 Bologna, Italy
| | - Chiara Domizio
- Department of Life Sciences and Biotechnology, Ferrara University, 44124 Ferrara, Italy
| | - Eugenio Fonzi
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, FC, Italy
| | - Davide Angeli
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, FC, Italy
| | | | - Sandro Mattioli
- GVM Care & Research Group, Division of Thoracic Surgery-Maria Cecilia Hospital, 48022 Cotignola, RA, Italy
- Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
| | - Giovanni Martinelli
- Scientific Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, FC, Italy
| | - Chiara Molinari
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, FC, Italy
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7
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Kwon M, Kim G, Kim R, Kim KT, Kim ST, Smith S, Mortimer PGS, Hong JY, Loembé AB, Irurzun-Arana I, Koulai L, Kim KM, Kang WK, Dean E, Park WY, Lee J. Phase II study of ceralasertib (AZD6738) in combination with durvalumab in patients with advanced gastric cancer. J Immunother Cancer 2022; 10:jitc-2022-005041. [PMID: 35790315 PMCID: PMC9258491 DOI: 10.1136/jitc-2022-005041] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Targeting the DNA damage repair (DDR) pathways is an attractive strategy for boosting cancer immunotherapy. Ceralasertib (AZD6738) is an oral kinase inhibitor of ataxia telangiectasia and Rad3 related protein, which is a master regulator of DDR. We conducted a phase II trial of ceralasertib plus durvalumab in patients with previously treated advanced gastric cancer (AGC) to demonstrate the safety, tolerability, and clinical activity of the combination. METHODS This phase II, open-label, single-center, non-randomized study was designed to evaluate the efficacy and safety of ceralasertib in combination with durvalumab in patients with AGC. The study drug regimen was ceralasertib (240 mg two times a day) days 15-28 in a 28-day cycle in combination with durvalumab (1500 mg) at day 1 every 4 weeks. The primary end point was overall response rate (ORR) by Response Evaluation Criteria in Solid Tumors (V.1.1). Exploratory biomarker analysis was performed using fresh tumor biopsies in all enrolled patients. RESULTS Among 31 patients, the ORR, disease control rate, median progression-free survival (PFS), and overall survival were 22.6% (95% CI 9.6% to 41.1%), 58.1% (95% CI 39.1% to 75.5%), 3.0 (95% CI 2.1 to 3.9) months, and 6.7 (95% CI 3.8 to 9.6) months, respectively. Common adverse events were manageable with dose modification. A subgroup of patients with a loss of ataxia telangiectasia mutated (ATM) expression and/or high proportion of mutational signature attributable to homologous repair deficiency (sig. HRD) demonstrated a significantly longer PFS than those with intact ATM and low sig. HRD (5.60 vs 1.65 months; HR 0.13, 95% CI 0.045 to 0.39; long-rank p<0.001). During the study treatment, upregulation of the innate immune response by cytosolic DNA, activation of intratumoral lymphocytes, and expansion of circulating tumor-reactive CD8 +T cell clones were identified in responders. Enrichment of the tumor vasculature signature was associated with treatment resistance. CONCLUSIONS Ceralasertib plus durvalumab has promising antitumor activity, with durable responses in patients with refractory AGC. Thus, a biomarker-driven trial is required. TRIAL REGISTRATION NCT03780608.
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Affiliation(s)
- Minsuk Kwon
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Hematology-Oncology, Ajou University, Suwon, Republic of Korea
| | - Gahyun Kim
- Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea.,Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Ryul Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu-Tae Kim
- Department of Physiology, Ajou University, Suwon, Republic of Korea
| | - Seung Tae Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | - Jung Yong Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | | | - Kyoung-Mee Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Ki Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Emma Dean
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Gangnam-gu, Republic of Korea
| | - Jeeyun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea .,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
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8
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The role of PARP inhibitors in gastrointestinal cancers. Crit Rev Oncol Hematol 2022; 171:103621. [PMID: 35124199 DOI: 10.1016/j.critrevonc.2022.103621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 12/24/2022] Open
Abstract
The use of BReast CAncer (BRCA) mutations as biomarkers for sensitivity to DNA damage response (DDR) targeted drugs and platinum agents is well documented in breast and gynaecological cancers. More recently the successful use DDR targeted therapies including poly (ADP-ribose) polymerases (PARP) inhibitors has been shown to extend to other germline and somatic deficiencies within the homologous recombination (HR) pathway1-3. Gastrointestinal (GI) cancers are lagging behind other tumour types when it comes to personalising treatment with targeted therapies. Current methods of identifying PARP-inhibitor sensitivity in gastrointestinal cancers are based on analogies from other cancer types despite there being a lack of uniformity in determining HR status between tumour types. There is an urgent clinical need to better understand the treatment implications of DDR alterations in gastrointestinal cancers. We have reviewed PARP-inhibitor use in pancreatic, gastroesophageal, hepatobiliary and colorectal cancers and explored HRD as a biomarker for sensitivity to PARP-inhibitors.
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9
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Sahgal P, Huffman BM, Patil DT, Chatila WK, Yaeger R, Cleary JM, Sethi NS. Early TP53 Alterations Shape Gastric and Esophageal Cancer Development. Cancers (Basel) 2021; 13:5915. [PMID: 34885025 PMCID: PMC8657039 DOI: 10.3390/cancers13235915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022] Open
Abstract
Gastric and esophageal (GE) adenocarcinomas are the third and sixth most common causes of cancer-related mortality worldwide, accounting for greater than 1.25 million annual deaths. Despite the advancements in the multi-disciplinary treatment approaches, the prognosis for patients with GE adenocarcinomas remains poor, with a 5-year survival of 32% and 19%, respectively, mainly due to the late-stage diagnosis and aggressive nature of these cancers. Premalignant lesions characterized by atypical glandular proliferation, with neoplastic cells confined to the basement membrane, often precede malignant disease. We now appreciate that premalignant lesions also carry cancer-associated mutations, enabling disease progression in the right environmental context. A better understanding of the premalignant-to-malignant transition can help us diagnose, prevent, and treat GE adenocarcinoma. Here, we discuss the evidence suggesting that alterations in TP53 occur early in GE adenocarcinoma evolution, are selected for under environmental stressors, are responsible for shaping the genomic mechanisms for pathway dysregulation in cancer progression, and lead to potential vulnerabilities that can be exploited by a specific class of targeted therapy.
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Affiliation(s)
- Pranshu Sahgal
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (P.S.); (B.M.H.); (J.M.C.)
- Cancer Program, Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard University, Cambridge, MA 02142, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Brandon M. Huffman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (P.S.); (B.M.H.); (J.M.C.)
| | - Deepa T. Patil
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
| | - Walid K. Chatila
- Tri-Institutional Program in Computational Biology and Medicine, Weill Cornell Medical College, New York, NY 10021, USA;
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Rona Yaeger
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - James M. Cleary
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (P.S.); (B.M.H.); (J.M.C.)
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA
- Gastrointestinal Cancer Center, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Nilay S. Sethi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; (P.S.); (B.M.H.); (J.M.C.)
- Cancer Program, Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard University, Cambridge, MA 02142, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA
- Gastrointestinal Cancer Center, Dana-Farber Cancer Institute, Boston, MA 02215, USA
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10
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Basile D, Simionato F, Cappetta A, Garattini SK, Roviello G, Aprile G. State-of-the-Art of Monoclonal Antibodies for the Treatment of Gastric Cancer. Biologics 2021; 15:451-462. [PMID: 34764633 PMCID: PMC8572727 DOI: 10.2147/btt.s290323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/05/2021] [Indexed: 12/07/2022]
Abstract
Gastric cancer (GC) is a complex and heterogeneous disease with poor prognosis and limited available treatment options. During recent years, several molecular stratifications have been proposed to optimize the overall treatment strategy for GC patients. Breakthroughs in cancer biology and in molecular profiling through DNA and RNA sequencing are now opening novel landscapes, leading to the personalization of molecular matched therapy. In particular, therapies against HER2, Claudine 18.2, Fibroblast Growth Factor Receptors (FGFR), and other molecular alterations could significantly improve survival outcomes in the advance phase of the disease. Furthermore, immunotherapy with checkpoint inhibitors also represents a promising option in a selected population. Hoping that precision oncology will enter soon in clinical practice, our review describes the state of the art of many novel pathways and the current evidence supporting the use of monoclonal antibodies implicated in GC treatment.
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Affiliation(s)
- Debora Basile
- Department of Oncology, San Bortolo General Hospital, AULSS8 Berica, Vicenza, Italy
| | - Francesca Simionato
- Department of Oncology, San Bortolo General Hospital, AULSS8 Berica, Vicenza, Italy
| | - Alessandro Cappetta
- Department of Oncology, San Bortolo General Hospital, AULSS8 Berica, Vicenza, Italy
| | | | - Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Firenze, Firenze, Italy
| | - Giuseppe Aprile
- Department of Oncology, San Bortolo General Hospital, AULSS8 Berica, Vicenza, Italy
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11
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Fong CYK, Chau I. Harnessing biomarkers of response to improve therapy selection in esophago-gastric adenocarcinoma. Pharmacogenomics 2021; 22:703-726. [PMID: 34120461 PMCID: PMC8265282 DOI: 10.2217/pgs-2020-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 04/21/2021] [Indexed: 12/16/2022] Open
Abstract
Advanced esophago-gastric (OG) adenocarcinomas have a high mortality rate and new therapeutic options are urgently required. Despite recent advances in understanding the molecular characteristics of OG cancers, tumor heterogeneity poses a challenge in developing new therapeutics capable of improving patient outcomes. Consequently, chemotherapy remains the mainstay of systemic treatment, with the HER2 being the only predictive biomarker routinely targeted in clinical practice. Recent data indicate that immunotherapy will be incorporated into first-line chemotherapy, but further research is required to refine patient selection. This review will summarize the clinical strategies being evaluated to utilize our knowledge of predictive biomarkers with reference to novel therapeutics, and discuss the barriers to implementing precision oncology in OG adenocarcinoma.
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Affiliation(s)
- Caroline YK Fong
- The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Ian Chau
- The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
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12
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Development of an Immunohistochemical Assay to Detect the Ataxia-Telangiectasia Mutated (ATM) Protein in Gastric Carcinoma. Appl Immunohistochem Mol Morphol 2021; 28:303-310. [PMID: 31206368 PMCID: PMC7147393 DOI: 10.1097/pai.0000000000000786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ataxia-telangiectasia mutated (ATM), a key activator of DNA damage response mechanisms, represents a potential biomarker for targeted gastric carcinoma therapies. A phase II study (Study 39; NCT01063517) designed to investigate the combination olaparib plus paclitaxel in patients with recurrent or metastatic gastric cancer did not meet its primary endpoint of progression-free survival; however, an improvement in the secondary endpoint of overall survival was recorded with a greater overall survival benefit noted in patients with ATM-negative tumors. An ATM immunohistochemical (IHC) diagnostic assay was developed to identify patients who may respond favorably to targeted therapies and deployed in the confirmatory phase III GOLD trial (NCT01924533). The VENTANA ATM (Y170) assay was developed for investigational use in formalin-fixed, paraffin-embedded gastric carcinoma samples using an anti-ATM rabbit monoclonal antibody (clone Y170) and was optimized with OptiView DAB IHC Detection Kit on a BenchMark ULTRA instrument. The assay was deployed in studies assessing sensitivity, specificity, robustness, precision, and determining optimal ATM staining cutoff to define ATM-deficiency (ATM-low). The ATM (Y170) assay met all predefined product development acceptance criteria. Multiple parameters were characterized, including repeatability, reproducibility, analytical sensitivity, specificity, robustness, and product stability. The scoring algorithm was defined; gastric carcinoma samples were considered ATM-negative or ATM-positive when <25% or ≥25%, respectively, of tumor cell nuclei expressed ATM at any IHC stain intensity and nuclei of immune and/or endothelial cells expressed ATM at a moderate stain intensity (internal positive control). Results highlight reproducibility of the assay, supporting suitability for investigational use for evaluation of gastric carcinoma samples using tumor cell staining cutoff of <25% to define ATM-deficiency. Using this ATM assay, phase III GOLD trial (NCT01924533) clinical trial did not meet its primary endpoint, only suggesting, but not demonstrating, that assessment of ATM levels by IHC could possibly be useful in assessing the degree of benefit that may be achieved by adding olaparib to paxitaxel when treating gastric carcinoma. The utility of ATM (Y170) assay as a companion diagnostic requires further clinical validation.
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13
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Javle M, Shacham-Shmueli E, Xiao L, Varadhachary G, Halpern N, Fogelman D, Boursi B, Uruba S, Margalit O, Wolff RA, Golan T. Olaparib Monotherapy for Previously Treated Pancreatic Cancer With DNA Damage Repair Genetic Alterations Other Than Germline BRCA Variants: Findings From 2 Phase 2 Nonrandomized Clinical Trials. JAMA Oncol 2021; 7:693-699. [PMID: 33662100 DOI: 10.1001/jamaoncol.2021.0006] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance The subtype of pancreatic ductal adenocarcinoma cancer (PDAC) with DNA damage repair (DDR) deficiency from BRCA1/2 variants has a favorable prognosis and is sensitive to platinum analogues and poly-(adenosine diphosphate-ripose) polymerase (PARP) inhibition with olaparib. Approximately 10% to 20% of patients with PDAC have DDR genetic alterations other than germline BRCA variants. This population has been termed as having BRCAness. An opportunity exists to define the clinical phenotype, molecular underpinnings, and effectiveness of PARP inhibitors for this population. Objective To examine the therapeutic effectiveness of the PARP inhibitor olaparib for patients with pancreatic cancer with BRCAness. Design, Setting, and Participants Two parallel phase 2 nonrandomized clinical trials were conducted from November 11, 2016, to October 2, 2018, among 46 patients in Israel and Texas to determine the effectiveness of olaparib as monotherapy in advanced, previously treated PDAC with BRCAness. Inclusion criteria were treatment with 1 or more prior systemic therapies for advanced PDAC, Eastern Cooperative Oncology Group performance status of 0 to 1, and lack of the germline BRCA1/2 variant. BRCAness in these studies was defined as previously known DDR genetic alterations (DDR-GAs), personal or family history of BRCA-associated cancers (without DDR-GAs), or ATM protein loss as determined by immunohistochemistry. Main Outcomes and Measures The primary study end point was the objective response rate, and the secondary end points were progression-free survival and overall survival (OS). Results Forty-eight patients were enrolled, and 46 (26 women [57%]; mean [SD] age, 65.5 [11.1] years) were evaluable. The median treatment duration with olaparib was 3.0 months (interquartile range, 1.8-6.4 months). A total of 24 patients had the DDR phenotype (DDR-GAs), 17 had a family history of BRCA-associated cancers without DDR-GAs, and 5 had ATM loss as determined by immunohistochemistry. The DDR-GAs included ATM (n = 14), PALB2 (n = 2), ARID1A (n = 3), BRCA somatic (n = 1), PTEN (n = 1), RAD51 (n = 1), CCNE (n = 1), and FANCB (n = 2). Common toxic effects were grade 1 to 2 anemia, fatigue, anorexia, and nausea. One patient had a confirmed partial response (2%), 33 patients experienced stable disease (72%), of whom 11 (24%) experienced disease stability longer than 4 months and 12 patients had progressive disease (26%). The response duration for the patient with confirmed partial response was 3.9 months. Median progression-free survival was 3.7 months (95% CI, 2.9-5.7) and was significantly higher for patients with DDR-GAs (5.7 months; 95% CI, 3.6-8.8 months; P = .008) and platinum-sensitive PDAC (4.1 months; 95% CI, 3.6-7.8 months; P = .01). The estimated median OS was 9.9 months (95% CI, 7.6-16.1 months) in the study and 13.6 months (95% CI, 9.69 to not reached) in the prespecified DDR-GA cohort. Conclusions and Relevance The definition of the BRCAness phenotype in PDAC may be limited to patients harboring DDR-GAs. In these 2 phase 2 nonrandomized clinical trials, olaparib was well tolerated and showed limited antitumor activity in patients with advanced, platinum-sensitive PDAC with DDR-GAs. These conclusions suggest a potential therapeutic opportunity for a subset of patients with PDAC.
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Affiliation(s)
- Milind Javle
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | | | - Lianchun Xiao
- Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
| | - Gauri Varadhachary
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Naama Halpern
- Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - David Fogelman
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Ben Boursi
- Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Syeda Uruba
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Ofer Margalit
- Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Robert A Wolff
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Talia Golan
- Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel
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14
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Abstract
OPINION STATEMENT Despite a decreasing incidence in the USA, gastric cancer is highly prevalent worldwide. Furthermore, gastric cancer remains highly lethal with median survival of less than 1 year for metastatic disease. The backbone of therapy against metastatic gastric cancer remains cytotoxic chemotherapy, but recent advances in the molecular understanding of gastric cancer have renewed hope within that targeted agents can be leveraged to improve survival and reduce toxicity. For example, in patients with human epidermal growth factor-2 (HER2)-positive gastric cancer, the addition of trastuzumab to frontline chemotherapy improves survival. In the second line, oncologists can now administer a vascular endothelial growth factor (VEGF) receptor inhibitor, ramucirumab, as a single agent or in combination with chemotherapy, and the immune checkpoint inhibitor pembrolizumab is approved in multiple settings dependent on the Programmed Death Ligand 1 (PD-L1) status. For patients with metastatic disease, our approach to standard of care in the first-line setting is a 5FU/platinum doublet with trastuzumab for HER2-positive tumors. In the second-line setting, most patients receive ramucirumab + paclitaxel, but those that are MSI high receive pembrolizumab. For squamous cell carcinoma of the esophagus with high PD-L1 status (combined positive score (CPS) ≥ 10), we recommend pembrolizumab in the second line. While for PD-L1 ≥ 1% gastroesophageal adenocarcinoma, we do not recommend pembrolizumab before the third-line setting, although this may change in the near future for CPS ≥ 10. The future landscape for targeted therapy in gastric cancer is promising. Numerous clinical trials evaluating the combination immune therapy with molecularly targeted agents are generating much excitement. Moreover, genomic data from The Cancer Center Genome (TCGA) and Asian Cancer Research Group (ACRG) classifications is being used to identify molecular subtypes to enable future clinical trials to include biomarker-enriched patient populations.
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15
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Hoppe MM, Sundar R, Tan DSP, Jeyasekharan AD. Biomarkers for Homologous Recombination Deficiency in Cancer. J Natl Cancer Inst 2019; 110:704-713. [PMID: 29788099 DOI: 10.1093/jnci/djy085] [Citation(s) in RCA: 208] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/06/2018] [Indexed: 12/11/2022] Open
Abstract
Defective DNA repair is a common hallmark of cancer. Homologous recombination is a DNA repair pathway of clinical interest due to the sensitivity of homologous recombination-deficient cells to poly-ADP ribose polymerase (PARP) inhibitors. The measurement of homologous recombination deficiency (HRD) in cancer is therefore vital to the appropriate design of clinical trials incorporating PARP inhibitors. However, methods to identify HRD in tumors are varied and controversial. Understanding existing and new methods to measure HRD is important to their appropriate use in clinical trials and practice. The aim of this review is to summarize the biology and clinical validation of current methods to measure HRD, to aid decision-making for patient stratification and translational research in PARP inhibitor trials. We discuss the current clinical development of PARP inhibitors, along with established indicators for HRD such as germline BRCA1/2 mutation status and clinical response to platinum-based therapy. We then examine newer assays undergoing clinical validation, including 1) somatic mutations in homologous recombination genes, 2) "genomic scar" assays using array-based comparative genomic hybridization (aCGH), single nucleotide polymorphism (SNP) analysis or mutational signatures derived from next-generation sequencing, 3) transcriptional profiles of HRD, and 4) phenotypic or functional assays of protein expression and localization. We highlight the strengths and weaknesses of each of these assays, for consideration during the design of studies involving PARP inhibitors.
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Affiliation(s)
- Michal M Hoppe
- Cancer Science Institute of Singapore, National University Hospital, Singapore
| | - Raghav Sundar
- Department of Haematology-Oncology, National University Hospital, Singapore
| | - David S P Tan
- Cancer Science Institute of Singapore, National University Hospital, Singapore.,Department of Haematology-Oncology, National University Hospital, Singapore
| | - Anand D Jeyasekharan
- Cancer Science Institute of Singapore, National University Hospital, Singapore.,Department of Haematology-Oncology, National University Hospital, Singapore
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16
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Abstract
Alterations in DNA damage response (DDR) pathways are hallmarks of cancer. Incorrect repair of DNA lesions often leads to genomic instability. Ataxia telangiectasia mutated (ATM), a core component of the DNA repair system, is activated to enhance the homologous recombination (HR) repair pathway upon DNA double-strand breaks. Although ATM signaling has been widely studied in different types of cancer, its research is still lacking compared with other DDR-involved molecules such as PARP and ATR. There is still a vast research opportunity for the development of ATM inhibitors as anticancer agents. Here, we focus on the recent findings of ATM signaling in DNA repair of cancer. Previous studies have identified several partners of ATM, some of which promote ATM signaling, while others have the opposite effect. ATM inhibitors, including KU-55933, KU-60019, KU-59403, CP-466722, AZ31, AZ32, AZD0156, and AZD1390, have been evaluated for their antitumor effects. It has been revealed that ATM inhibition increases a cancer cell's sensitivity to radiotherapy. Moreover, the combination with PARP or ATR inhibitors has synergistic lethality in some cancers. Of note, among these ATM inhibitors, AZD0156 and AZD1390 achieve potent and highly selective ATM kinase inhibition and have an excellent ability to penetrate the blood-brain barrier. Currently, AZD0156 and AZD1390 are under investigation in phase I clinical trials. Taken together, targeting ATM may be a promising strategy for cancer treatment. Hence, further development of ATM inhibitors is urgently needed in cancer research.
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Affiliation(s)
- Mei Hua Jin
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Do-Youn Oh
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
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17
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Sugino T, Ichikawa-Tomikawa N, Tanaka M, Shishito N, Miura T, Abe M, Muramatsu K, Oishi T, Kakuda Y, Kawata T, Akiyama Y. Identification of S100A14 as a metastasis-promoting molecule in a murine organotropic metastasis model. Clin Exp Metastasis 2019; 36:411-422. [PMID: 31263990 DOI: 10.1007/s10585-019-09979-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/10/2019] [Indexed: 12/12/2022]
Abstract
Cancer metastasis shows great diversity in target organs, routes and molecular mechanisms depending on the type of cancer and even on the individual patients. To identify key molecules involved in metastasis, we constructed a murine model system including multiple sublines with different organotropism and pathways of metastasis. We selected metastatic sublines from a murine mammary tumor cell line MCH66. Using this model, we extracted metastasis-related molecules by gene expression screening methods and verified their metastasis-promoting effects by gene knockdown or overexpression experiments. For the candidates promoting metastasis, we analyzed molecular functions involved in metastasis: cell growth, motility and invasive activity. We established a metastasis model including low metastatic sublines (66C8, 66LM, 66-4) and highly metastatic counterparts with various organotropism, such as to the lung (66Lu10), liver (HM-KAN5) and general organs (66HM and its clones: HM1-6 and HM1-7). The sublines basically exhibited the invasion-independent metastasis pathway characterized by endothelial cell-covered tumor emboli, whereas 66HM and HM-KAN5 showed an alternative metastasis pathway based on invasion in part and in whole, respectively. Comprehensive gene analysis extracted several molecular candidates responsible for metastasis. S100A14 was identified as one of the promissing candidates promoting lung-metastasis, which was verified by gene knockdown experiments in vivo. In addition, in vivo and in vitro functional analyses demonstrated that S100A14 enhanced scattering, motility and invasiveness of mouse tumor cells. Our model system may be adaptable to the diversity of metastasis in human cancers and useful for exploring the molecular mechanism responsible for metastasis.
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Affiliation(s)
- Takashi Sugino
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan.
| | - Naoki Ichikawa-Tomikawa
- Department of Basic Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mizuko Tanaka
- Department of Basic Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Namiko Shishito
- Department of Cardiology, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Tomiko Miura
- Department of Basic Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masato Abe
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan
| | - Koji Muramatsu
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan
| | - Takuma Oishi
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan
| | - Yuko Kakuda
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan
| | - Takuya Kawata
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan
| | - Yasuto Akiyama
- Division of Immunotherapy, Shizuoka Cancer Center Research Institute, Shizuoka, Japan
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18
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Tu HF, Chen MY, Lai JCY, Chen YL, Wong YW, Yang CC, Chen HY, Hsia SM, Shih YH, Shieh TM. Arecoline-regulated ataxia telangiectasia mutated expression level in oral cancer progression. Head Neck 2019; 41:2525-2537. [PMID: 30821076 DOI: 10.1002/hed.25718] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 01/02/2019] [Accepted: 02/07/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Ataxia telangiectasia mutated (ATM) regulates DNA repair and cell cycle. The present study analyzed arecoline-induced ATM expression during oral cancer progression. METHODS In vitro studies were performed using oral squamous cell carcinoma (OSCC) cell lines treated with arecoline to analyze cell response and ATM regulation. in vivo studies were performed using immunohistochemistry to detect ATM expression in normal, oral potentially malignant disorder (OPMD), and OSCC tissues. RESULTS Low-dose arecoline induced cell proliferation, ATM promoter activity, and DNA repair. High-dose arecoline induced cell cycle arrest, apoptosis, and DNA damage. ATM was overexpressed in OPMD tissues but was downregulated in OSCC tissues. ATM expression level was associated with the risk of developing dysplasia, buccal-OSCC, and with OSCC survival rate. CONCLUSION High ATM expression helps DNA repair mechanisms to maintain the cells in the OPMD stage, but low ATM expression causes DNA damage accumulation to increase cell malignancy.
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Affiliation(s)
- Hsi-Feng Tu
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Department of Dentistry, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Michael Yuanchien Chen
- Department of Oral & Maxillofacial Surgery, China Medical University Hospital, Taichung, Taiwan.,School of Dentistry, College of Dentistry, China Medical University, Taichung, Taiwan
| | - Joseph Chieh-Yui Lai
- Department of Dental Hygiene, College of Health Care, China Medical University, Taichung, Taiwan
| | - Yi-Ling Chen
- Department of Dental Hygiene, College of Health Care, China Medical University, Taichung, Taiwan
| | - Yih-Wen Wong
- School of Dentistry, College of Dentistry, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Yang
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Yuan Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Shih-Min Hsia
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.,School of Food and Safety, Taipei Medical University, Taipei, Taiwan.,Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Tzong-Ming Shieh
- Department of Dental Hygiene, College of Health Care, China Medical University, Taichung, Taiwan
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19
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Pilié PG, Tang C, Mills GB, Yap TA. State-of-the-art strategies for targeting the DNA damage response in cancer. Nat Rev Clin Oncol 2019; 16:81-104. [PMID: 30356138 PMCID: PMC8327299 DOI: 10.1038/s41571-018-0114-z] [Citation(s) in RCA: 667] [Impact Index Per Article: 133.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Genomic instability is a key hallmark of cancer that arises owing to defects in the DNA damage response (DDR) and/or increased replication stress. These alterations promote the clonal evolution of cancer cells via the accumulation of driver aberrations, including gene copy-number changes, rearrangements and mutations; however, these same defects also create vulnerabilities that are relatively specific to cancer cells, which could potentially be exploited to increase the therapeutic index of anticancer treatments and thereby improve patient outcomes. The discovery that BRCA-mutant cancer cells are exquisitely sensitive to inhibition of poly(ADP-ribose) polymerase has ushered in a new era of research on biomarker-driven synthetic lethal treatment strategies for different cancers. The therapeutic landscape of antitumour agents targeting the DDR has rapidly expanded to include inhibitors of other key mediators of DNA repair and replication, such as ATM, ATR, CHK1 and CHK2, DNA-PK and WEE1. Efforts to optimize these therapies are ongoing across a range of cancers, involving the development of predictive biomarker assays of responsiveness (beyond BRCA mutations), assessment of the mechanisms underlying intrinsic and acquired resistance, and evaluation of rational, tolerable combinations with standard-of-care treatments (such as chemotherapeutics and radiation), novel molecularly targeted agents and immune-checkpoint inhibitors. In this Review, we discuss the current status of anticancer therapies targeting the DDR.
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Affiliation(s)
- Patrick G Pilié
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Investigational Cancer Therapeutics (Phase I Program), The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gordon B Mills
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Khalifa Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Timothy A Yap
- Department of Investigational Cancer Therapeutics (Phase I Program), The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Khalifa Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- The Institute for Applied Cancer Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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20
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Suh KJ, Ryu HS, Lee KH, Kim H, Min A, Kim TY, Yang Y, Lee HB, Moon HG, Han SW, Oh DY, Han W, Park IA, Noh DY, Im SA. Prognostic effects of abnormal DNA damage response protein expression in breast cancer. Breast Cancer Res Treat 2019; 175:117-127. [DOI: 10.1007/s10549-019-05128-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 01/01/2019] [Indexed: 12/20/2022]
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21
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Klempner SJ, Bhangoo MS, Luu HY, Kim ST, Chao J, Kim KM, Lee J. Low ATM expression and progression-free and overall survival in advanced gastric cancer patients treated with first-line XELOX chemotherapy. J Gastrointest Oncol 2018; 9:1198-1206. [PMID: 30603142 PMCID: PMC6286926 DOI: 10.21037/jgo.2018.09.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 08/14/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Gastric cancer (GC) is a leading cause of cancer-specific mortality with limited biologically informed treatments. The ataxia telangiectasia mutated (ATM) gene is critically involved in the repair of double-stranded DNA breaks and a component of DNA damage repair (DDR) pathways. Platinum salts are hypothesized to have increased efficacy in tumors deficient in DDR pathways. We sought to investigate an association between ATM status and response to XELOX in a homogenous first line GC patient cohort. METHODS A clinically annotated cohort of 137 Korean patients with advanced GC treated with first-line XELOX was retrospectively examined for ATM status by immunohistochemistry. Correlation between ATM expression and clinicopathologic variables was performed by two-tailed, unpaired t-tests and Fisher's exact tests. Kaplan-Meier survival analysis curves and Cox proportional hazards models were used to evaluate for independent predictors of disease-free survival (DFS) and overall survival (OS). RESULTS Low ATM expression was observed in 19.0% (26/137) of patients and was not associated with clinicopathologic features or response rate to XELOX. Univariate, but not multivariable, logistic regression and Cox analysis identified ATM as an independent risk factor influencing OS and DFS. A higher ECOG score independently predicted worse survival [hazard ratio (HR) 2.96, P=0.016] and complete surgical resection independently protected against progression of disease (HR 0.69, P=0.007). CONCLUSIONS Low ATM expression was not associated with increased response rates to XELOX in a single-institution cohort of advanced GC patients. Similarly, ATM status did not predict DFS or OS after platinum-based chemotherapy.
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Affiliation(s)
- Samuel J. Klempner
- The Angeles Clinic and Research Institute, Los Angeles, CA, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Hubert Y. Luu
- Department of Surgery, University of California, San Francisco, CA, USA
| | - Seung Tae Kim
- Department of Medicine, Samsung Medical Center, Seoul, Korea
| | - Joseph Chao
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Kyoung-Mee Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Seoul, Korea
| | - Jeeyun Lee
- Department of Medicine, Samsung Medical Center, Seoul, Korea
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22
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Sundar R, Miranda S, Rodrigues DN, Chénard-Poirier M, Dolling D, Clarke M, Figueiredo I, Bertan C, Yuan W, Ferreira A, Chistova R, Boysen G, Perez DR, Tunariu N, Mateo J, Wotherspoon A, Chau I, Cunningham D, Valeri N, Carreira S, de Bono J. Ataxia Telangiectasia Mutated Protein Loss and Benefit From Oxaliplatin-based Chemotherapy in Colorectal Cancer. Clin Colorectal Cancer 2018; 17:280-284. [PMID: 30042009 DOI: 10.1016/j.clcc.2018.05.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/15/2018] [Accepted: 05/31/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Loss of ataxia telangiectasia mutated (ATM), a key protein regulating DNA repair signaling, has been suggested to increase sensitivity to DNA damaging agents. We conducted a study analyzing the loss of ATM protein expression in colorectal cancer and correlated this with clinical outcomes. MATERIALS AND METHODS The clinical outcomes data and tumor samples from metastatic colorectal cancer patients referred to the Royal Marsden Hospital Drug Development Unit (United Kingdom) from 2012 to 2016 and providing consent for a molecular characterization study were analyzed. Immunohistochemistry (IHC) slides were assessed by a pathologist for nuclear staining intensity of ATM and semiquantitatively scored. ATM loss was defined as a nuclear H-score of ≤ 10. RESULTS Of 223 colorectal cancer samples, ATM IHC loss was identified in 17 (8%). ATM loss was independent of the RAS and RAF mutational status. ATM loss was associated with superior overall survival after first-line oxaliplatin-based therapy (49 vs. 32 months; hazard ratio [HR], 2.52) but not with irinotecan-based therapy (24 vs. 33 months; HR, 0.72). ATM loss was not prognostic for survival from the diagnosis (50 vs. 44 months; HR, 1.43). CONCLUSION ATM could be considered a biomarker for the development of novel DNA repair targeting agents and treatment of colorectal cancer.
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Affiliation(s)
- Raghav Sundar
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London, UK; Department of Haematology-Oncology, National University Health System, Singapore
| | | | | | | | | | | | | | | | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | | | | | | | | | - Nina Tunariu
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London, UK
| | | | | | - Ian Chau
- The Royal Marsden NHS Trust, London, UK
| | | | | | | | - Johann de Bono
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London, UK.
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Flynn M, Young K, Cunningham D, Starling N. The evolving immunotherapeutic landscape in advanced oesophagogastric cancer. Ther Adv Med Oncol 2018; 10:1758835918786228. [PMID: 30034550 PMCID: PMC6048671 DOI: 10.1177/1758835918786228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/25/2018] [Indexed: 12/13/2022] Open
Abstract
Improvements in median overall survival in the advanced oesophagogastric (OG) setting have plateaued, underlining the need for improved therapeutic approaches in this patient population. Immunotherapeutics are inducing unexpected durable responses in an expanding list of advanced disease indications. Although OG cancers have traditionally been considered to be more challenging to treat with immunotherapy than some other malignancies because of their variable tumour mutational burden and relative scarcity of infiltrating T cells, immune checkpoint inhibitor (ICPI) trials conducted over the last few years suggest there is an important role for these treatments. ICPI efficacy may be demonstrated in specific molecular subtypes of OG cancer. This review outlines the improvements in defining predictive biomarkers of responsiveness to ICPIs. Increasingly, identification of an expanding list of ICPI resistance mechanisms will drive biomarker-directed research. In addition, the specific rationale to combine ICPIs with chemotherapies, radiotherapies, targeted therapies and other novel immunotherapeutic drugs will be discussed.
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Affiliation(s)
- Michael Flynn
- Department of Medicine, Royal Marsden Hospital,
London, UK
| | - Kate Young
- Department of Medicine, Royal Marsden Hospital,
London, UK
| | | | - Naureen Starling
- Department of Medicine, Royal Marsden Hospital,
203 Fulham Road, Chelsea, London SW3 6JJ, UK
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Villaruz LC, Jones H, Dacic S, Abberbock S, Kurland BF, Stabile LP, Siegfried JM, Conrads TP, Smith NR, O'Connor MJ, Pierce AJ, Bakkenist CJ. ATM protein is deficient in over 40% of lung adenocarcinomas. Oncotarget 2018; 7:57714-57725. [PMID: 27259260 PMCID: PMC5295384 DOI: 10.18632/oncotarget.9757] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 04/28/2016] [Indexed: 12/16/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality in the USA and worldwide, and of the estimated 1.2 million new cases of lung cancer diagnosed every year, over 30% are lung adenocarcinomas. The backbone of 1st-line systemic therapy in the metastatic setting, in the absence of an actionable oncogenic driver, is platinum-based chemotherapy. ATM and ATR are DNA damage signaling kinases activated at DNA double-strand breaks (DSBs) and stalled and collapsed replication forks, respectively. ATM protein is lost in a number of cancer cell lines and ATR kinase inhibitors synergize with cisplatin to resolve xenograft models of ATM-deficient lung cancer. We therefore sought to determine the frequency of ATM loss in a tissue microarray (TMA) of lung adenocarcinoma. Here we report the validation of a commercial antibody (ab32420) for the identification of ATM by immunohistochemistry and estimate that 61 of 147 (41%, 95% CI 34%-50%) cases of lung adenocarcinoma are negative for ATM protein expression. As a positive control for ATM staining, nuclear ATM protein was identified in stroma and immune infiltrate in all evaluable cases. ATM loss in lung adenocarcinoma was not associated with overall survival. However, our preclinical findings in ATM-deficient cell lines suggest that ATM could be a predictive biomarker for synergy of an ATR kinase inhibitor with standard-of-care cisplatin. This could improve clinical outcome in 100,000's of patients with ATM-deficient lung adenocarcinoma every year.
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Affiliation(s)
- Liza C Villaruz
- University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Sanja Dacic
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Shira Abberbock
- University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brenda F Kurland
- University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Laura P Stabile
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jill M Siegfried
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Thomas P Conrads
- Inova Schar Cancer Institute, Inova Center for Personalized Health, Falls Church, VA, USA
| | | | | | | | - Christopher J Bakkenist
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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25
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Ferrara R, Simionato F, Ciccarese C, Grego E, Cingarlini S, Iacovelli R, Bria E, Tortora G, Melisi D. The development of PARP as a successful target for cancer therapy. Expert Rev Anticancer Ther 2017; 18:161-175. [DOI: 10.1080/14737140.2018.1419870] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Roberto Ferrara
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - Francesca Simionato
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Chiara Ciccarese
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Elisabetta Grego
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Sara Cingarlini
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Roberto Iacovelli
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Emilio Bria
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giampaolo Tortora
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Davide Melisi
- Section of Oncology, Department of Medicine, Università degli Studi di Verona, Verona, Italy
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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26
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Smyth E. Missing a GOLDen opportunity in gastric cancer. Lancet Oncol 2017; 18:1561-1563. [PMID: 29103869 DOI: 10.1016/s1470-2045(17)30719-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 09/06/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Elizabeth Smyth
- Gastrointestinal Oncology & Lymphoma Unit, Royal Marsden Hospital, London & Sutton SW3 6JJ, UK.
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27
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Bang YJ, Xu RH, Chin K, Lee KW, Park SH, Rha SY, Shen L, Qin S, Xu N, Im SA, Locker G, Rowe P, Shi X, Hodgson D, Liu YZ, Boku N. Olaparib in combination with paclitaxel in patients with advanced gastric cancer who have progressed following first-line therapy (GOLD): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2017; 18:1637-1651. [PMID: 29103871 DOI: 10.1016/s1470-2045(17)30682-4] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Olaparib combined with paclitaxel has previously shown a significant improvement in overall survival versus placebo plus paclitaxel as second-line therapy in a phase 2 study in Asian patients with advanced gastric cancer, especially in those with ataxia-telangiectasia mutated protein (ATM)-negative tumours. Here, we report the primary efficacy and safety analyses from a subsequent phase 3 trial. METHODS This double-blind, randomised, placebo-controlled, phase 3 study (GOLD) recruited Asian patients aged 18 years or older (≥20 years if Japanese) with advanced gastric cancer that had progressed following, or during, first-line chemotherapy. Patients were randomly assigned (1:1) to receive oral olaparib (100 mg twice daily) plus paclitaxel (80 mg/m2 intravenously) or matching placebo plus paclitaxel. Randomisation was done through an interactive voice response system and no stratification factors were used. Patients and investigators were masked to treatment allocation. Two co-primary populations were assessed: the overall population of all patients and patients whose tumours were ATM-negative (identified after randomisation, before the data cutoff date, March 28, 2016). The primary endpoint in both populations was overall survival (defined as the time from the date of randomisation until death from any cause before data cutoff); a significant difference was defined as p<0·025. Efficacy was assessed in the intention-to-treat populations and safety in patients who received at least one dose of treatment. This trial is registered with ClinicalTrials.gov, number NCT01924533 (study ID, D081BC00004), and is ongoing but no longer recruiting participants. FINDINGS Between Sept 3, 2013, and March 28, 2016, 643 patients were enrolled from 58 study sites in hospitals and medical centres in China, Japan, South Korea, and Taiwan. 525 eligible patients were randomly assigned: 263 to receive olaparib plus paclitaxel and 262 to receive placebo plus paclitaxel. 94 patients were determined to have ATM-negative tumours before unmasking for the primary analysis (48 in the olaparib plus paclitaxel group and 46 in the placebo plus paclitaxel group). Overall survival did not differ between treatment groups in the overall patient population (median overall survival 8·8 months [95% CI 7·4-9·6] in the olaparib group vs 6·9 months [6·3-7·9] in the placebo group; HR 0·79 [97·5% CI 0·63-1·00]; p=0·026) or in the ATM-negative population (12·0 months [7·8-18·1] vs 10·0 months [6·4-13·3]; 0·73 [0·40-1·34]; p=0·25). In the overall patient population, the most common grade 3 or worse adverse events in the olaparib plus paclitaxel group were neutropenia (78 [30%] of 262 patients), leucopenia (42 [16%]), and decreased neutrophil count (40 [15%]); in the placebo plus paclitaxel group, they were neutropenia (59 [23%] of 259 patients), leucopenia (27 [10%]), and decreased white blood cell count (21 [8%]). Adverse events with an outcome of death causally related to study treatment (according to investigator assessment) were reported in two patients: liver injury in one patient (<1%) in the olaparib plus paclitaxel group and cardiac failure in one patient (<1%) in the placebo plus paclitaxel group. INTERPRETATION The GOLD study did not meet its primary objective of showing a significant improvement in overall survival with olaparib in the overall or ATM-negative population of Asian patients with advanced gastric cancer. The study generated informative efficacy and safety data regarding the use of olaparib in combination with a chemotherapeutic agent and provides a foundation for future studies in this difficult-to-treat patient population. FUNDING AstraZeneca.
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Affiliation(s)
- Yung-Jue Bang
- Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
| | - Rui-Hua Xu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Keisho Chin
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea
| | - Se Hoon Park
- Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Sun Young Rha
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Lin Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | | | - Nong Xu
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Seock-Ah Im
- Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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Zhu M, Wang H, Cui J, Li W, An G, Pan Y, Zhang Q, Xing R, Lu Y. Calcium-binding protein S100A14 induces differentiation and suppresses metastasis in gastric cancer. Cell Death Dis 2017; 8:e2938. [PMID: 28726786 PMCID: PMC5550849 DOI: 10.1038/cddis.2017.297] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 05/24/2017] [Accepted: 05/25/2017] [Indexed: 02/05/2023]
Abstract
S100A14 is a calcium-binding protein involved in cell proliferation and differentiation as well as the metastasis of human tumors. In this study, we characterized the regulation of S100A14 expression between biological signatures and clinical pathological features in gastric cancer (GC). Our data demonstrated that S100A14 induced the differentiation of GC by upregulating the expression of E-cadherin and PGII. Moreover, S100A14 expression negatively correlated with cell migration and invasion in in vitro and in vivo experimental models. Interestingly, S100A14 blocked the store-operated Ca2+ influx by suppressing Orai1 and STIM1 expression, leading to FAK expression activation, focal adhesion assembly and MMP downregulation. Taken together, our results indicate that S100A14 may have a role in the induction of differentiation and inhibition of cell metastasis in GC.
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Affiliation(s)
- Min Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Hongyi Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jiantao Cui
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Wenmei Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Guo An
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cell Biology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Yuanming Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Qingying Zhang
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, China
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, 22 Xinling Road, Jinping District, Guangdong 515041, China. Tel: +86 754 88900445; Fax: +86 754 88557562; E-mail:
| | - Rui Xing
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
- Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. Tel: +86 10 88196731; Fax: +86 10 88122437; E-mail: or
| | - Youyong Lu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Molecular Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China
- Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. Tel: +86 10 88196731; Fax: +86 10 88122437; E-mail: or
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29
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WSB1 overcomes oncogene-induced senescence by targeting ATM for degradation. Cell Res 2016; 27:274-293. [PMID: 27958289 DOI: 10.1038/cr.2016.148] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/26/2016] [Accepted: 09/29/2016] [Indexed: 12/20/2022] Open
Abstract
Oncogene-induced senescence (OIS) or apoptosis through the DNA-damage response is an important barrier of tumorigenesis. Overcoming this barrier leads to abnormal cell proliferation, genomic instability, and cellular transformation, and finally allows cancers to develop. However, it remains unclear how the OIS barrier is overcome. Here, we show that the E3 ubiquitin ligase WD repeat and SOCS box-containing protein 1 (WSB1) plays a role in overcoming OIS. WSB1 expression in primary cells helps the bypass of OIS, leading to abnormal proliferation and cellular transformation. Mechanistically, WSB1 promotes ATM ubiquitination, resulting in ATM degradation and the escape from OIS. Furthermore, we identify CDKs as the upstream kinase of WSB1. CDK-mediated phosphorylation activates WSB1 by promoting its monomerization. In human cancer tissue and in vitro models, WSB1-induced ATM degradation is an early event during tumorigenic progression. We suggest that WSB1 is one of the key players of early oncogenic events through ATM degradation and destruction of the tumorigenesis barrier. Our work establishes an important mechanism of cancer development and progression in premalignant lesions.
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30
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Young K, Starling N, Cunningham D. Targeting deficient DNA damage repair in gastric cancer. Expert Opin Pharmacother 2016; 17:1757-66. [PMID: 27488684 DOI: 10.1080/14656566.2016.1217992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Over recent years our understanding of DNA damage repair has evolved leading to an expansion of therapies attempting to exploit DNA damage repair deficiencies across multiple solid tumours. Gastric cancer has been identified as a tumour where a subgroup of patients demonstrates deficiencies in the homologous recombination pathway providing a potential novel treatment approach for this poor prognosis disease. AREA COVERED This review provides an overview of DNA damage repair and how this has been targeted to date in other tumour types exploiting the concept of synthetic lethality. This is followed by a discussion of how deficiencies in homologous recombination may be identified across tumour types and on recent progress in targeting DNA repair deficiencies in gastric cancer. EXPERT OPINION Gastric cancer remains a difficult malignancy to treat and the possibility of targeting deficient DNA repair in a subgroup of patients is an exciting prospect. Future combinations with immunotherapy and radiotherapy are appealing and appear to have a sound biological rationale. However, much work remains to be done to understand the significance of the genetic and epigenetic alterations involved, to elucidate the optimum predictive signatures or biomarkers and to consider means of overcoming treatment resistance.
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Affiliation(s)
- Kate Young
- a Department of Medicine , The Royal Marsden NHS Foundation Trust, GI and Lymphoma Unit , Sutton , UK
| | - Naureen Starling
- a Department of Medicine , The Royal Marsden NHS Foundation Trust, GI and Lymphoma Unit , Sutton , UK
| | - David Cunningham
- a Department of Medicine , The Royal Marsden NHS Foundation Trust, GI and Lymphoma Unit , Sutton , UK
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Rabenau K, Hofstatter E. DNA Damage Repair and the Emerging Role of Poly(ADP-ribose) Polymerase Inhibition in Cancer Therapeutics. Clin Ther 2016; 38:1577-88. [PMID: 27368114 DOI: 10.1016/j.clinthera.2016.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 06/07/2016] [Accepted: 06/07/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE As a result of improved understanding of DNA repair mechanisms, poly(ADP-ribose) polymerase inhibitors (PARPi) are increasingly recognized to play an important therapeutic role in the treatment of cancer. The aim of this article is to provide a review of PARPi function in DNA damage repair and synthetic lethality and to demonstrate how these mechanisms can be exploited to provide new PARPi-based therapies to patients with solid tumors. METHODS Literature from a range of sources, including PubMed and MEDLINE, were searched to identify recent reports regarding DNA damage repair and PARPi. FINDINGS DNA damage repair is central to cellular viability. The family of poly(ADP-ribose) polymerase proteins play multiple intracellular roles in DNA repair, but function primarily in the resolution of repair of single-strand DNA breaks. Insights through the discovery of germline BRCA1/2 mutations led to the understanding of synthetic lethality and the potential therapeutic role of PARPi in the treatment of cancer. Further understanding of DNA damage repair and the concept of BRCA-like tumors have catalyzed PARPi clinical investigation in multiple oncologic settings. IMPLICATIONS PARPi hold great promise in the treatment of solid tumors, both as monotherapy and in combination with other cancer therapeutics. Multiple PARPi clinical trials are currently underway. Further understanding of aberrant DNA repair mechanisms in the germline and in the tumor genome will allow clinicians and researchers to apply PARPi most strategically in the era of personalized medicine.
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Affiliation(s)
- Karen Rabenau
- Yale University School of Medicine/Yale Cancer Center, New Haven, CT
| | - Erin Hofstatter
- Yale University School of Medicine/Yale Cancer Center, New Haven, CT.
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Suh KJ, Ryu HS, Lee KH, Kim H, Min A, Kim TY, Yang Y, Moon HG, Han SW, Oh DY, Han W, Park IA, Noh DY, Im SA. Loss of ataxia-telangiectasia-mutated protein expression correlates with poor prognosis but benefits from anthracycline-containing adjuvant chemotherapy in breast cancer. Breast Cancer Res Treat 2016; 158:233-41. [DOI: 10.1007/s10549-016-3869-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
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Abstract
Over the past 20 years, there has been considerable progress in our understanding of the biological functions of the BRCA1 and BRCA2 cancer susceptibility genes. This has led to the development of new therapeutic approaches that target tumours with loss-of-function mutations in either BRCA1 or BRCA2. Tumours that share molecular features of BRCA-mutant tumours - that is, those with 'BRCAness' - may also respond to similar therapeutic approaches. Several paradigm shifts require a reassessment of the concept of BRCAness, how this property is assayed and its relevance to our understanding of tumour biology and the treatment of cancer.
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Affiliation(s)
- Christopher J Lord
- Cancer Research UK Gene Function Laboratory and Breast Cancer Now Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Alan Ashworth
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California 94158, USA
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Javle M, Golan T, Maitra A. Changing the course of pancreatic cancer--Focus on recent translational advances. Cancer Treat Rev 2016; 44:17-25. [PMID: 26924195 DOI: 10.1016/j.ctrv.2016.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 02/08/2023]
Abstract
In the past decade, insightful preclinical research has led to important breakthroughs in our understanding of pancreatic cancer. Even though the vast majority of pancreatic cancers are KRAS mutated, not all pancreatic cancer tumors are "KRAS equal"; there seems to be varying dependencies on the KRAS pathway. While KRAS-targeting therapies have been disappointing in the clinic, 'synthetic lethal' approaches hold promise in this setting. The pancreatic cancer stromal microenvironment appears to have contradictory roles. While there is evidence to suggest that stromal barrier prevents drug delivery, in other circumstances, stroma can play a protective role and its disruption enhances tumor dissemination. Clinical trials aimed at manipulating the various stromal components are in progress. BRCA mutation-related pancreatic tumors illustrate a unique subtype with enhanced susceptibility to DNA damaging agents and PARP-inhibition. DNA repair defects in cancer extend beyond germ line BRCA mutation and may extend the indications for DNA repair-targeting agents. Immune strategies are an area of active investigation in pancreatic cancer. Although the initial trials of single-agent checkpoint inhibitors have been negative, combinational approaches using immune-modifying agents and vaccines appear promising and goal is to identify an 'immune-therapy responsive' profile in pancreatic cancer.
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Affiliation(s)
- Milind Javle
- MD Anderson Cancer Center, 1515, Holcombe Blvd, Unit 426, Houston, TX 77030, USA
| | - Talia Golan
- Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Anirban Maitra
- MD Anderson Cancer Center, 1515, Holcombe Blvd, Unit 426, Houston, TX 77030, USA
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35
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BRCAness revisited. NATURE REVIEWS. CANCER 2016. [PMID: 26775620 DOI: 10.1038/nrc.2015.21]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the past 20 years, there has been considerable progress in our understanding of the biological functions of the BRCA1 and BRCA2 cancer susceptibility genes. This has led to the development of new therapeutic approaches that target tumours with loss-of-function mutations in either BRCA1 or BRCA2. Tumours that share molecular features of BRCA-mutant tumours - that is, those with 'BRCAness' - may also respond to similar therapeutic approaches. Several paradigm shifts require a reassessment of the concept of BRCAness, how this property is assayed and its relevance to our understanding of tumour biology and the treatment of cancer.
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36
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Abstract
Over the past 20 years, there has been considerable progress in our understanding of the biological functions of the BRCA1 and BRCA2 cancer susceptibility genes. This has led to the development of new therapeutic approaches that target tumours with loss-of-function mutations in either BRCA1 or BRCA2. Tumours that share molecular features of BRCA-mutant tumours - that is, those with 'BRCAness' - may also respond to similar therapeutic approaches. Several paradigm shifts require a reassessment of the concept of BRCAness, how this property is assayed and its relevance to our understanding of tumour biology and the treatment of cancer.
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37
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Ye P, Zhang M, Fan S, Zhang T, Fu H, Su X, Gavine PR, Liu Q, Yin X. Intra-Tumoral Heterogeneity of HER2, FGFR2, cMET and ATM in Gastric Cancer: Optimizing Personalized Healthcare through Innovative Pathological and Statistical Analysis. PLoS One 2015; 10:e0143207. [PMID: 26587992 PMCID: PMC4654477 DOI: 10.1371/journal.pone.0143207] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/02/2015] [Indexed: 11/18/2022] Open
Abstract
Current drug development efforts on gastric cancer are directed against several molecular targets driving the growth of this neoplasm. Intra-tumoral biomarker heterogeneity however, commonly observed in gastric cancer, could lead to biased selection of patients. MET, ATM, FGFR2, and HER2 were profiled on gastric cancer biopsy samples. An innovative pathological assessment was performed through scoring of individual biopsies against whole biopsies from a single patient to enable heterogeneity evaluation. Following this, false negative risks for each biomarker were estimated in silico. 166 gastric cancer cases with multiple biopsies from single patients were collected from Shanghai Renji Hospital. Following pre-set criteria, 56 ~ 78% cases showed low, 15 ~ 35% showed medium and 0 ~ 11% showed high heterogeneity within the biomarkers profiled. If 3 biopsies were collected from a single patient, the false negative risk for detection of the biomarkers was close to 5% (exception for FGFR2: 12.2%). When 6 biopsies were collected, the false negative risk approached 0%. Our study demonstrates the benefit of multiple biopsy sampling when considering personalized healthcare biomarker strategy, and provides an example to address the challenge of intra-tumoral biomarker heterogeneity using alternative pathological assessment and statistical methods.
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Affiliation(s)
- Peng Ye
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
| | - Meizhuo Zhang
- Research & Development Information, AstraZeneca R&D, Shanghai, China
| | - Shuqiong Fan
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
| | - Tianwei Zhang
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
| | - Haihua Fu
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
| | - Xinying Su
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
| | - Paul R. Gavine
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
| | - Qiang Liu
- Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- * E-mail: (XY); (QL)
| | - Xiaolu Yin
- Asia & Emerging Markets iMed, AstraZeneca R&D, Shanghai, China
- * E-mail: (XY); (QL)
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Bang YJ, Im SA, Lee KW, Cho JY, Song EK, Lee KH, Kim YH, Park JO, Chun HG, Zang DY, Fielding A, Rowbottom J, Hodgson D, O'Connor MJ, Yin X, Kim WH. Randomized, Double-Blind Phase II Trial With Prospective Classification by ATM Protein Level to Evaluate the Efficacy and Tolerability of Olaparib Plus Paclitaxel in Patients With Recurrent or Metastatic Gastric Cancer. J Clin Oncol 2015; 33:3858-65. [PMID: 26282658 DOI: 10.1200/jco.2014.60.0320] [Citation(s) in RCA: 218] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Gastric cancer cell lines, particularly those with low levels of ataxia telangiectasia mutated (ATM), a key activator of DNA damage response, are sensitive to the poly (ADP-ribose) polymerase inhibitor olaparib. We compared the efficacy of olaparib plus paclitaxel (olaparib/paclitaxel) with paclitaxel alone in patients with recurrent or metastatic gastric cancer and assessed whether low ATM expression is predictive of improved clinical outcome for olaparib/paclitaxel. PATIENTS AND METHODS In this phase II, double-blind study (Study 39; NCT01063517), patients were randomly assigned to oral olaparib 100 mg twice per day (tablets) plus paclitaxel (80 mg/m(2) per day intravenously on days 1, 8, and 15 of every 28-day cycle) or placebo plus paclitaxel (placebo/paclitaxel), followed by maintenance monotherapy with olaparib (200 mg twice per day) or placebo. The study population was enriched to 50% for patients with low or undetectable ATM levels (ATMlow). Primary end point was progression-free survival (PFS). RESULTS One hundred twenty-three of 124 randomly assigned patients received treatment (olaparib/paclitaxel, n = 61; placebo/paclitaxel, n = 62). The screening prevalence of ATMlow patients was 14%. Olaparib/paclitaxel did not lead to a significant improvement in PFS versus placebo/paclitaxel (overall population: hazard ratio [HR], 0.80; median PFS, 3.91 v 3.55 months, respectively; ATMlow population: HR, 0.74; median PFS, 5.29 v 3.68 months, respectively). However, olaparib/paclitaxel significantly improved overall survival (OS) versus placebo/paclitaxel in both the overall population (HR, 0.56; 80% CI, 0.41 to 0.75; P = .005; median OS, 13.1 v 8.3 months, respectively) and the ATMlow population (HR, 0.35; 80% CI, 0.22 to 0.56; P = .002; median OS, not reached v 8.2 months, respectively). Olaparib/paclitaxel was generally well tolerated, with no unexpected safety findings. CONCLUSION Olaparib/paclitaxel is active in the treatment of patients with metastatic gastric cancer, with a greater OS benefit in ATMlow patients. A phase III trial in this setting is under way.
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Affiliation(s)
- Yung-Jue Bang
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China.
| | - Seock-Ah Im
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Keun-Wook Lee
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Jae Yong Cho
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Eun-Kee Song
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Kyung Hee Lee
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Yeul Hong Kim
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Joon Oh Park
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Hoo Geun Chun
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Dae Young Zang
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Anitra Fielding
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Jacqui Rowbottom
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Darren Hodgson
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Mark J O'Connor
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Xiaolu Yin
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Woo Ho Kim
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
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39
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Burtness B. Complexity in the Gastric Cancer Genome and a Biomarker-Driven Trial of Poly (ADP-Ribose) Polymerase Inhibition in Gastric Cancer. J Clin Oncol 2015; 33:3845-6. [PMID: 26282638 DOI: 10.1200/jco.2015.62.8487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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40
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Prognostic Significance of Nuclear Phospho-ATM Expression in Melanoma. PLoS One 2015; 10:e0134678. [PMID: 26275218 PMCID: PMC4537129 DOI: 10.1371/journal.pone.0134678] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 07/13/2015] [Indexed: 12/21/2022] Open
Abstract
UV radiation induced genomic instability is one of the leading causes for melanoma. Phosphorylation of Ataxia Telangiectasia Mutated (ATM) is one of the initial events that follow DNA damage. Phospho-ATM (p-ATM) plays a key role in the activation of DNA repair and several oncogenic pathways as well as in the maintenance of genomic integrity. The present study was therefore performed to understand the significance of p-ATM in melanoma progression and to correlate it with patient prognosis. Tissue microarray and immunohistochemical analysis were employed to study the expression of p-ATM in melanoma patients. A total of 366 melanoma patients (230 primary melanoma and 136 metastatic melanoma) were used for the study. Chi-square test, Kaplan-Meier, univariate and multivariate Cox regression analysis were used to elucidate the prognostic significance of p-ATM expression. Results revealed that both loss of, and gain in, p-ATM expression were associated with progression of melanoma from normal nevi to metastatic melanoma. Patients whose samples showed negative or strong p-ATM staining had significantly worse 5-year survival compared to patients who had weak to moderate expression. Loss of p-ATM expression was associated with relatively better 5-year survival, but the corresponding 10-year survival curve almost overlapped with that of strong p-ATM expression. p-ATM expression was found to be an independent prognostic factor for 5-year but not for 10-year patient survival. In conclusion our findings show that loss of p-ATM expression and gain-in p-ATM expression are indicators of worse melanoma patient survival.
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Davidson M, Okines AFC, Starling N. Current and Future Therapies for Advanced Gastric Cancer. Clin Colorectal Cancer 2015; 14:239-50. [PMID: 26524924 DOI: 10.1016/j.clcc.2015.05.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/29/2015] [Indexed: 12/23/2022]
Abstract
The treatment of patients with advanced gastric cancer remains a challenging area of oncology. Extensive trials of differing chemotherapy regimens have yielded no international consensus on the optimal combination, and overall survival with chemotherapy alone remains poor. Recently an improved understanding of the molecular drivers of the disease has opened up promising new avenues of treatment through the use of biological targeted agents. The anti-HER2 monoclonal antibody trastuzumab was the first targeted agent to significantly prolong survival in the first-line treatment of a molecularly-selected subgroup of patients. More recently the anti-vascular endothelial growth factor receptor 2 monoclonal antibody ramucirumab has demonstrated a modest survival benefit in previously treated patients as both a monotherapy and in combination with chemotherapy. Immunotherapy and the use of checkpoint inhibitors are a further exciting area of development with promising preliminary results for the activity of the anti-Programmed Death 1 Receptor antibody pembrolizumab and ongoing trials of a number of immune-modulating agents. Continuing research to identify novel targets and therapies aims to make further incremental gains in survival. In this review we outline the evidence base supporting current chemotherapy regimens and describe the latest advances in the development and use of molecularly targeted and immune-modulating agents.
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Affiliation(s)
- Michael Davidson
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Alicia F C Okines
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Naureen Starling
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
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Hale MD, Gotoda T, Hayden JD, Grabsch HI. Endoscopic biopsies from gastrointestinal carcinomas and their suitability for molecular analysis: a review of the literature and recommendations for clinical practice and research. Histopathology 2015; 67:147-57. [DOI: 10.1111/his.12626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
| | - Takuji Gotoda
- Department of Gastroenterology and Hepatology; Tokyo Medical University; Tokyo Japan
| | - Jeremy David Hayden
- Department of Upper Gastrointestinal Surgery; St James's Institute of Oncology; Leeds Teaching Hospitals NHS Trust; Leeds UK
| | - Heike Irmgard Grabsch
- Leeds Institute of Cancer and Pathology; University of Leeds; Leeds UK
- Department of Pathology; Maastricht University Medical Center; Maastricht The Netherlands
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Jun SY, Eom DW, Park H, Bae YK, Jang KT, Yu E, Hong SM. Prognostic significance of CDX2 and mucin expression in small intestinal adenocarcinoma. Mod Pathol 2014; 27:1364-74. [PMID: 24603585 DOI: 10.1038/modpathol.2014.36] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 12/30/2013] [Accepted: 12/31/2013] [Indexed: 02/06/2023]
Abstract
The clinicopathological and prognostic significance of CDX2 and mucin expression have not been comprehensively evaluated in small intestinal adenocarcinoma. Immunohistochemical microarray analyses of CDX2, MUC1, MUC5AC, and MUC6 protein expressions in 189 surgically resected small intestinal adenocarcinoma cases were examined and compared with various clinicopathologic variables, including survival. CDX2, MUC1, MUC5AC, and MUC6 expressions were observed in 43.4% (82 patients), 37.6% (71), 31.7% (60), and 21.7% (41) of patients, respectively. Whereas CDX2 expression was found to be associated with low-grade tumors (P=0.034), fewer nodal metastases (P=0.019), and less perineural invasion (P=0.049) in small intestinal adenocarcinoma patients, patients expressing MUC1 tended to demonstrate high-grade (P=0.021) and nodular or infiltrative (P=0.020) tumors. On the basis of the combined CDX2, MUC1, MUC5AC, and MUC6 expression patterns, small intestinal adenocarcinoma patients were further classified as intestinal (CDX2+/MUC1-; 29.6%), pancreatobiliary (CDX2-/MUC1+; 23.8%), mixed (CDX2+/MUC1+; 13.8%), gastric (CDX2-/MUC1-/MUC5AC+ or MUC6+; 13.8%), or null (CDX2-/MUC1-/MUC5AC-/MUC6-; 19.0%). Among these immunophenotypes, intestinal-type patients demonstrated more frequent distal (jejunal or ileal; P=0.033), tubular (P=0.039), and low-grade tumors (P=0.004) and significantly better survival according to univariate (P<0.0001) and multivariate (P=0.001) analyses. In summary, intestinal immunophenotype adenocarcinomas are associated with distal (jejunal or ileal), tubular, and low-grade tumors and better survival outcomes. Hence, CDX2 and mucin immunohistochemical staining may provide better estimations of survival after surgical resection and intestinal immunophenotype could therefore be used as a better prognostic indicator of small intestinal adenocarcinoma.
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Affiliation(s)
- Sun-Young Jun
- Department of Pathology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea
| | - Dae Woon Eom
- Department of Pathology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Hosub Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Kyung Bae
- Department of Pathology, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Kee-Taek Jang
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunsil Yu
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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44
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Kubota E, Williamson CT, Ye R, Elegbede A, Peterson L, Lees-Miller SP, Bebb DG. Low ATM protein expression and depletion of p53 correlates with olaparib sensitivity in gastric cancer cell lines. Cell Cycle 2014; 13:2129-37. [PMID: 24841718 DOI: 10.4161/cc.29212] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Small-molecule inhibitors of poly (ADP-ribose) polymerase (PARP) have shown considerable promise in the treatment of homologous recombination (HR)-defective tumors, such as BRCA1- and BRCA2-deficient breast and ovarian cancers. We previously reported that mantle cell lymphoma cells with deficiency in ataxia telangiectasia mutated (ATM) are sensitive to PARP-1 inhibitors in vitro and in vivo. Here, we report that PARP inhibitors can potentially target ATM deficiency arising in a solid malignancy. We show that ATM protein expression varies between gastric cancer cell lines, with NUGC4 having significantly reduced protein levels. Significant correlation was found between ATM protein expression and sensitivity to the PARP inhibitor olaparib, with NUGC4 being the most sensitive. Moreover, reducing ATM kinase activity using a small-molecule inhibitor (KU55933) or shRNA-mediated depletion of ATM protein enhanced olaparib sensitivity in gastric cancer cell lines with depletion or inactivation of p53. Our results demonstrate that ATM is a potential predictive biomarker for PARP-1 inhibitor activity in gastric cancer harboring disruption of p53, and that combined inhibition of ATM and PARP-1 is a rational strategy for expanding the utility of PARP-1 inhibitors to gastric cancer with p53 disruption.
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Affiliation(s)
- Eiji Kubota
- Department of Biochemistry & Molecular Biology; University of Calgary; Calgary, Alberta, Canada; Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada
| | - Christopher T Williamson
- Department of Biochemistry & Molecular Biology; University of Calgary; Calgary, Alberta, Canada; Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada
| | - Ruiqiong Ye
- Department of Biochemistry & Molecular Biology; University of Calgary; Calgary, Alberta, Canada; Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada
| | - Anifat Elegbede
- Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada; Tom Baker Cancer Center; Calgary, Alberta, Canada
| | - Lars Peterson
- Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada; Tom Baker Cancer Center; Calgary, Alberta, Canada
| | - Susan P Lees-Miller
- Department of Biochemistry & Molecular Biology; University of Calgary; Calgary, Alberta, Canada; Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada
| | - D Gwyn Bebb
- Southern Alberta Cancer Research Institute; University of Calgary; Calgary, Alberta, Canada; Tom Baker Cancer Center; Calgary, Alberta, Canada
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Kim HS, Lee HE, Yang HK, Kim WH. High lactate dehydrogenase 5 expression correlates with high tumoral and stromal vascular endothelial growth factor expression in gastric cancer. Pathobiology 2013; 81:78-85. [PMID: 24401755 DOI: 10.1159/000357017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 11/05/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lactate dehydrogenase 5 (LDH5) is a major lactate dehydrogenase isoenzyme catalyzing the transformation of pyruvate to lactate to provide anaerobic energy. Vascular endothelial growth factor (VEGF) is expressed in both tumor and stromal cells in gastric cancer. Our aim was to study the prognostic effect of LDH5, and tumoral and stromal expression of the angiogenic factor VEGF in gastric cancer, and the intercorrelation of tissue expression of both factors. METHODS Tissue microarray analysis of 382 consecutive gastric cancer resection specimens was used for immunohistochemistry of LDH5 and VEGF, and expression of LDH5, tumoral VEGF, and stromal VEGF was categorized into low and high groups. RESULTS High expression was observed for LDH5 in 57.9% (219/378), tumoral VEGF in 35.7% (136/381), and stromal VEGF in 58.5% (223/381) of the specimens. Regarding high expression of LDH5 and VEGF, significant associations with intestinal type, advanced gastric cancer, lymph node metastasis, higher TNM stage, and upper-third location were noted. Positive intercorrelations occurred among the expression of LDH5 and VEGF. Results of survival analyses revealed a significant association of high expression of LDH5 and VEGF with lower survival (overall and disease-free survival). Five-year survival rates were significantly lower in tumors with high LDH5 and tumoral VEGF expression in diffuse- or mixed-type cancers and high expression of stromal VEGF in intestinal-type cancer. CONCLUSION The results of our study showed that high LDH5 and VEGF expression in both tumor and stroma was a prognostic factor for patients with gastric cancers, especially diffuse- or mixed-type cancers. Therefore, LDH5 expression may play a role in the regulation of tumoral and stromal VEGF expression in gastric cancer. Our results suggest the potential use of LDH5 expression as a biomarker for response to VEGF-targeted therapy.
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Affiliation(s)
- Hee Sung Kim
- Department of Pathology, Chung Ang University, Seoul, Republic of Korea
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Kim HS, Choi SI, Min HL, Kim MA, Kim WH. Mutation at intronic repeats of the ataxia-telangiectasia mutated (ATM) gene and ATM protein loss in primary gastric cancer with microsatellite instability. PLoS One 2013; 8:e82769. [PMID: 24324828 PMCID: PMC3855840 DOI: 10.1371/journal.pone.0082769] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 10/27/2013] [Indexed: 11/18/2022] Open
Abstract
Ataxia-telangiectasia mutated (ATM) is a Ser/Thr protein kinase that plays a critical role in DNA damage-induced signaling and initiation of cell cycle checkpoint signaling in response to DNA-damaging agents such as ionizing radiation. We have previously reported the ATM protein loss by immunohistochemistry (IHC) in 16% of human gastric cancer (GC) tissue. We hypothesized that ATM gene intron mutations targeted by microsatellite instability (MSI) cause ATM protein loss in a subset of GC. We studied mononucleotide mutations at the intron of ATM gene, ATM IHC and MSI in GC. Ten human gastric cancer cell lines were studied for the ATM gene mutation at introns, RT-PCR, direct sequencing, and immunohistochemistry. GC tissues of 839 patients were analyzed for MSI and ATM IHC. Among them, 604 cases were analyzed for the ATM mutations at introns preceding exon 6, exon 10 and exon 20. Two human GC cell lines (SNU-1 and -638) showed ATM intron mutations, deletion in RT-PCR and direct sequencing, and ATM protein loss by IHC. The frequencies of ATM mutation, MSI, and ATM protein loss were 12.9% (78/604), 9.2% (81/882) and 15.2% (134/839), respectively. Analysis of associations among MSI, ATM gene mutation, and ATM protein loss revealed highly co-existing ATM gene alterations and MSI. ATM intron mutation and ATM protein loss were detected in 69.3% (52/75) and 53.3% (40/75) of MSI positive GC. MSI positivity and ATM protein loss were present in 68.4% (52/76) and 48.7% (37/76) of GC with ATM intron mutation. ATM mutation and ATM protein loss had characteristics of old age, distal location of tumor, large tumor size, and histologic intestinal type. Our study might be interpreted as that ATM gene mutation at intron might be targeted by MSI and lead to ATM protein loss in a selected group of GC.
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Affiliation(s)
- Hee Sung Kim
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seung Im Choi
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Hae Lim Min
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Min A. Kim
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Ho Kim
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Lee HE, Han N, Kim MA, Lee HS, Yang HK, Lee BL, Kim WH. DNA damage response-related proteins in gastric cancer: ATM, Chk2 and p53 expression and their prognostic value. Pathobiology 2013; 81:25-35. [PMID: 23969480 DOI: 10.1159/000351072] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 04/03/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aims of this study were to assess expressions of the DNA damage response (DDR)-related proteins and to investigate their clinical significances in gastric carcinoma. METHODS Two independent cohorts, a training set (n=524) and validation set (n=394), of gastric cancer patients were enrolled. Ataxia telangiectasia mutated (ATM), checkpoint kinase 2 (Chk2), and p53 expressions were examined by immunohistochemistry using tissue microarray. RESULTS ATM loss, Chk2 loss, and p53 positivity were observed in 21.8, 14.1, and 36.1% of the training set, and in 17.3, 12.2, and 35.8% of the validation set, respectively. In the training set, the aberrant expressions of ATM, Chk2, or p53 were significantly associated with an advanced TNM stage and poor disease-specific survival. This association was verified in the validation set. Chk2 positivity and p53 negativity were significantly related to a prolonged disease-specific survival. Also, patients with nonaberrant expressional levels of all 3 DDR-related proteins had a more favorable outcome than others. Multivariate analyses showed that Chk2 loss and at least 1 aberrant DDR-related protein remained as independent prognostic factors of poor disease-specific survival. CONCLUSIONS This study elucidated the prognostic implications of DDR-related proteins, and suggests that their aberrant expressions play critical roles in the development and progression of gastric cancer.
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Affiliation(s)
- Hee Eun Lee
- Department of Pathology, Seoul National University Hospital, Seoul, South Korea
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