2
|
Guo Y, Zhang W, He R, Zheng C, Liu X, Ge M, Xu J. Investigating the Association Between rs2439302 Polymorphism and Thyroid Cancer: A Systematic Review and Meta-Analysis. Front Surg 2022; 9:877206. [PMID: 35558387 PMCID: PMC9086625 DOI: 10.3389/fsurg.2022.877206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background and Aims The extent of surgical treatment for most patients with thyroid cancer (TC) remains controversial and varies widely. As an emerging technology, genetic testing facilitates tumor typing and disease progression monitoring and is expected to influence the choice of surgical approach for patients with TC. Recent genome-wide association studies (GWASs) have identified that rs2439302 (8p12) variants near NRG1 are associated with TC risk; however, the results remain inconclusive. Therefore, we aimed to perform a meta-analysis to clarify the association between rs2439302 variants and the risk of TC. Methods We search eligible studies using Pubmed, Scopus, Embase, Web of Science, and Cochrane library by July 2021. We analyzed the pooled OR and the corresponding 95% confidence interval (95% CI) of the included studies and then conducted subgroup analysis according to the ethnicity. We also performed a sensitivity analysis to validate the findings. Results This meta-analysis finally included 7 studies involving 6,090 cases and 14,461 controls. Results showed that the G allele of the rs2439302 polymorphism was a significant risk factor of TC in Allele (G/C), Dominant (GG+GC/CC), Recessive (GG/GC+CC), Homozygote (GG/CC), Heterozygote (GC/CC) models, with pooled ORs of 1.38 (95%CI, 1.31–1.45), 1.51 (95%CI, 1.41–1.62), 1.52 (95%CI, 1.40–1.66), 1.90 (95%CI, 1.71–2.10), and 1.40 (95%CI, 1.30–1.51), respectively. The subgroup analysis showed that rs2439302 polymorphism was associated with higher TC risk in different ethnicities with OR > 1. The sensitivity analysis exhibited that the results were stable by omitting any included studies. Conclusions The study revealed that rs2439302 variants were associated with higher TC risk and may have a major influence on the choice of operative approach for patients with TC.
Collapse
Affiliation(s)
- Yawen Guo
- Department of Head and Neck Surgery, Otolaryngology & Head and Neck Center, Cancer Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China
| | - Wanchen Zhang
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ru He
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Chuanming Zheng
- Department of Head and Neck Surgery, Otolaryngology & Head and Neck Center, Cancer Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China
| | - Xuefeng Liu
- Neck and Breast Department 3, Tumour Hospital of Mudanjiang City, Mudanjiang, China
| | - Minghua Ge
- Department of Head and Neck Surgery, Otolaryngology & Head and Neck Center, Cancer Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China
| | - Jiajie Xu
- Department of Head and Neck Surgery, Otolaryngology & Head and Neck Center, Cancer Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China
- *Correspondence: Jiajie Xu
| |
Collapse
|
3
|
Prete AA, Procaccio L, Bergamo F, Rasola C, Nappo F, Zagonel V, Lonardi S. An Unexpected Tumor Reduction: Treatment with Olaparib Monotherapy in Heavily Pretreated BRCA2 Mutated Metastatic Pancreatic Cancer. Curr Oncol 2022; 29:544-550. [PMID: 35200549 PMCID: PMC8870641 DOI: 10.3390/curroncol29020049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/24/2022] [Indexed: 12/25/2022] Open
Abstract
PARP inhibitors are largely recognized as active drugs in BRCA-mutated breast and ovarian malignancies. In pancreatic ductal adenocarcinoma, the PARP inhibitor olaparib has recently been approved as maintenance treatment in patients with germline BRCA mutations reaching disease control after a platinum-based first line chemotherapy, proving significant benefit on progression free survival. On the other hand, little evidence is available regarding olaparib as single agent after progression with standard treatment in BRCA-mutated pancreatic ductal adenocarcinoma. A 61-year-old female patient harboring germline BRCA2 mutation was treated at our institution for a pancreatic ductal adenocarcinoma with lung and liver metastases. The patient received three previous lines of treatment with standard therapies, as follows: after the third line treatment failure, we started a further line of treatment with olaparib in off-label prescription. After the first two cycles, a CT scan documented partial response, with complete regression of lung metastases. The response was maintained after four cycles, with further response and clinical benefit. The radiologic and clinical response was maintained for 6 months. This case highlights the potential of olaparib as single agent after progression with standard treatment in BRCA-mutated pancreatic cancer.
Collapse
Affiliation(s)
- Alessandra Anna Prete
- Oncology Unit 1, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy; (L.P.); (F.B.); (C.R.); (F.N.); (V.Z.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy
- Correspondence: (A.A.P.); (S.L.); Tel.: +39-049-8215917 (A.A.P.); +39-049-8215910 (S.L.)
| | - Letizia Procaccio
- Oncology Unit 1, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy; (L.P.); (F.B.); (C.R.); (F.N.); (V.Z.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy
| | - Francesca Bergamo
- Oncology Unit 1, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy; (L.P.); (F.B.); (C.R.); (F.N.); (V.Z.)
| | - Cosimo Rasola
- Oncology Unit 1, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy; (L.P.); (F.B.); (C.R.); (F.N.); (V.Z.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy
| | - Floriana Nappo
- Oncology Unit 1, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy; (L.P.); (F.B.); (C.R.); (F.N.); (V.Z.)
| | - Vittorina Zagonel
- Oncology Unit 1, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy; (L.P.); (F.B.); (C.R.); (F.N.); (V.Z.)
| | - Sara Lonardi
- Oncology Unit 3, Veneto Institute of Oncology IOV–IRCCS, 35128 Padua, Italy
- Correspondence: (A.A.P.); (S.L.); Tel.: +39-049-8215917 (A.A.P.); +39-049-8215910 (S.L.)
| |
Collapse
|
4
|
Hammel P, Zhang C, Matile J, Colle E, Hadj-Naceur I, Gagaille MP, Bouattour M, Cros J, de Mestier L, Lamuraglia M. PARP inhibition in treatment of pancreatic cancer. Expert Rev Anticancer Ther 2020; 20:939-945. [PMID: 32936674 DOI: 10.1080/14737140.2020.1820330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Tumor control and survival of patients with metastatic pancreatic ductal adenocarcinoma (PDAC) has improved with more effective polychemotherapies. The identification of novel therapeutic targets is strongly needed in order to propose maintenance therapies that improve quality of life while maintaining tumor control. AREAS COVERED PDAC with mutations in homologous recombination repair genes such as BRCA are particularly sensitive to platinum agents. Recently, the potential role of poly(ADP-ribose) polymerase (PARP) inhibitors was suggested. The POLO study has shown that olaparib was efficient and well-tolerated as maintenance therapy in patients with germline BRCA1/2 mutation and a metastatic PDAC controlled after a platinum-based induction chemotherapy. EXPERT OPINION The demonstration of olaparib efficacy in patients with metastatic PDAC and BRCA germline mutation has paved the way for maintenance with a targeted therapy. Further studies are needed to assess; the potential role for PARPI in earlier forms of PDAC, those with somatic or more rare BRACness signatures, to overcome primary or secondary resistances to PARPi, and to combine them with other antitumoral agents.
Collapse
Affiliation(s)
- Pascal Hammel
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Chen Zhang
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Julia Matile
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Elise Colle
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Imene Hadj-Naceur
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | | | - Mohamed Bouattour
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Jérôme Cros
- Department of Pathology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Louis de Mestier
- Department of Gastroenterology and Pancreatology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| | - Michele Lamuraglia
- Departments of Digestive and Medical Oncology, Hôpital Beaujon (AP-HP, Clichy) and Paris University , France
| |
Collapse
|
5
|
Halama N, Haberkorn U. The Unmet Needs of the Diagnosis, Staging, and Treatment of Gastrointestinal Tumors. Semin Nucl Med 2020; 50:389-398. [PMID: 32768003 DOI: 10.1053/j.semnuclmed.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
New scientific insights in cancer biology and immunobiology have changed the clinical practice of medical oncology in recent years. The molecular stratification of solid tumors has led to improved clinical outcomes and is a key part in the diagnostic workup. Beyond mutational spectra (like Rat sarcoma [RAS] mutations or tumor mutational burden), the investigation of the immunological microenvironment has attracted more efforts. Especially as immunotherapies have changed the standard treatment for some solid tumors dramatically and have become an important part of routine oncology, also for gastrointestinal tumors. Still only a subgroup of patients benefits from immunotherapy in gastrointestinal tumors with prominent examples from colorectal, pancreatic or gastric cancer. Not only microsatellite instability as a marker for response to immunotherapy has shown its utility, there plenty of other approaches currently being investigated to better stratify and understand the microenvironment. But these insights have not translated into clinical utility. Reasons for this are limited technical capabilities for stratification and for coping with heterogeneity of tumor cells and the microenvironment as such. So the situation for gastrointestinal tumors has shown mainly progress for a subgroup of immunotherapy-receptive tumors (eg, microsatellite instability), but advances for the remaining majority have been in the area of stratification and combinatorial therapies, including approaches without chemotherapy. Molecular stratification (eg, B-Rapidly Accelerated Fibrosarcoma [BRAF] V600E mutation in colorectal cancer or NRG1 fusions in Kirsten-rat sarcoma (KRAS) Wild-Type Pancreatic Cancer) has clearly improved the possibilities for directed therapies, but there is a plethora of clinical situations where further developments are needed to improve patient care. Finding these areas and identifying the technical approach to unravel the complexities is the next decisive step. Here the recent advances are summarized and an outlook on possible diagnostic and treatment options in areas of unmet need is given with the context of new molecular imaging possibilities and cutting edge advances in nuclear medicine.
Collapse
Affiliation(s)
- Niels Halama
- German Cancer Research Center (DKFZ), Department of Translational Immunotherapy, German Cancer Research Center (DKFZ), Germany; Helmholtz-Institute for Translational Oncology Mainz (HI-TRON Mainz), Germany; Department of Medical Oncology and Internal Medicine VI, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Institute for Immunology, University Hospital Heidelberg, University Heidelberg.
| | - Uwe Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, Germany; Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| |
Collapse
|
6
|
Park W, Chen J, Chou JF, Varghese AM, Yu KH, Wong W, Capanu M, Balachandran V, McIntyre CA, El Dika I, Khalil DN, Harding JJ, Ghalehsari N, McKinnell Z, Chalasani SB, Makarov V, Selenica P, Pei X, Lecomte N, Kelsen DP, Abou-Alfa GK, Robson ME, Zhang L, Berger MF, Schultz N, Chan TA, Powell SN, Reis-Filho JS, Iacobuzio-Donahue CA, Riaz N, O'Reilly EM. Genomic Methods Identify Homologous Recombination Deficiency in Pancreas Adenocarcinoma and Optimize Treatment Selection. Clin Cancer Res 2020; 26:3239-3247. [PMID: 32444418 PMCID: PMC7380542 DOI: 10.1158/1078-0432.ccr-20-0418] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/07/2020] [Accepted: 04/08/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Genomic methods can identify homologous recombination deficiency (HRD). Rigorous evaluation of their outcome association to DNA damage response-targeted therapies like platinum in pancreatic ductal adenocarcinoma (PDAC) is essential in maximizing therapeutic outcome. EXPERIMENTAL DESIGN We evaluated progression-free survival (PFS) and overall survival (OS) of patients with advanced-stage PDAC, who had both germline- and somatic-targeted gene sequencing. Homologous recombination gene mutations (HRm) were evaluated: BRCA1, BRCA2, PALB2, ATM, BAP1, BARD1, BLM, BRIP1, CHEK2, FAM175A, FANCA, FANCC, NBN, RAD50, RAD51, RAD51C, and RTEL1 HRm status was grouped as: (i) germline versus somatic; (ii) core (BRCAs and PALB2) versus non-core (other HRm); and (iii) monoallelic versus biallelic. Genomic instability was compared using large-scale state transition, signature 3, and tumor mutation burden. RESULTS Among 262 patients, 50 (19%) had HRD (15% germline and 4% somatic). Both groups were analyzed together due to lack of difference in their genomic instability and outcome. Median [95% confidence interval (CI)] follow-up was 21.9 (1.4-57.0) months. Median OS and PFS were 15.5 (14.6-19) and 7 (6.1-8.1) months, respectively. Patients with HRD had improved PFS compared with no HRD when treated with first-line (1L) platinum [HR, 0.44 (95% CI: 0.29-0.67); P < 0.01], but not with 1L-non-platinum. Multivariate analysis showed HRD patients had improved OS regardless of their first-line treatment, but most had platinum exposure during their course. Biallelic HRm (11%) and core HRm (12%) had higher genomic instability, which translated to improved PFS on first-line platinum (1L-platinum) versus 1L-non-platinum. CONCLUSIONS Pathogenic HRm identifies HRD in patients with PDAC with the best outcome when treated with 1L-platinum. Biallelic HRm and core HRm further enriched benefit from 1L-platinum from HRD.
Collapse
Affiliation(s)
- Wungki Park
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
- Parker Institute for Cancer Immunotherapy, San Francisco, California
| | - Jiapeng Chen
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiation Oncology, Weill Cornell Medical College, New York, New York
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joanne F Chou
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Epidemiology and Biostatistics, Weill Cornell Medical College, New York, New York
| | - Anna M Varghese
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kenneth H Yu
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Winston Wong
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marinela Capanu
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Epidemiology and Biostatistics, Weill Cornell Medical College, New York, New York
| | - Vinod Balachandran
- Memorial Sloan Kettering Cancer Center, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
- Parker Institute for Cancer Immunotherapy, San Francisco, California
- Department of Surgery, Hepatopancreaticobiliary Surgery, Weill Cornell Medical College, New York, New York
| | - Caitlin A McIntyre
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Surgery, Hepatopancreaticobiliary Surgery, Weill Cornell Medical College, New York, New York
| | - Imane El Dika
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
| | - Danny N Khalil
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- Parker Institute for Cancer Immunotherapy, San Francisco, California
| | - James J Harding
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
| | | | - Zoe McKinnell
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sree B Chalasani
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
| | - Vladimir Makarov
- Memorial Sloan Kettering Cancer Center, New York, New York
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pier Selenica
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - Xin Pei
- Memorial Sloan Kettering Cancer Center, New York, New York
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nicolas Lecomte
- Memorial Sloan Kettering Cancer Center, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - David P Kelsen
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ghassan K Abou-Alfa
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
| | - Mark E Robson
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Clinical Genetics Service, Weill Cornell Medical College, New York, New York
| | - Liying Zhang
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - Michael F Berger
- Memorial Sloan Kettering Cancer Center, New York, New York
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nikolaus Schultz
- Memorial Sloan Kettering Cancer Center, New York, New York
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Timothy A Chan
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiation Oncology, Weill Cornell Medical College, New York, New York
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Simon N Powell
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiation Oncology, Weill Cornell Medical College, New York, New York
| | - Jorge S Reis-Filho
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - Christine A Iacobuzio-Donahue
- Memorial Sloan Kettering Cancer Center, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - Nadeem Riaz
- Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiation Oncology, Weill Cornell Medical College, New York, New York
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eileen M O'Reilly
- Memorial Sloan Kettering Cancer Center, New York, New York.
- Department of Medicine, Gastrointestinal Oncology Service, Weill Cornell Medical College, New York, New York
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|