1
|
May T, Smith CL, Kelley W, East K, Orlando L, Cochran M, Colletto S, Moss I, Nakano-Okuno M, Korf B, Limdi N. Does genetic testing offer utility as a supplement to traditional family health history intake for inherited disease risk? Fam Pract 2023; 40:760-767. [PMID: 36856778 DOI: 10.1093/fampra/cmad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
CONTENT This study examines the potential utility of genetic testing as a supplement to family health history to screen for increased risk of inherited disease. Medical conditions are often misreported or misunderstood, especially those related to different forms of cardiac disease (arrhythmias vs. structural heart disease vs. coronary artery disease), female organ cancers (uterine vs. ovarian vs. cervical), and type of cancer (differentiating primary cancer from metastases to other organs). While these nuances appear subtle, they can dramatically alter medical management. For example, different types of cardiac failure (structural, arrhythmia, and coronary artery disease) have inherited forms that are managed with vastly different approaches. METHODS Using a dataset of over 6,200 individuals who underwent genetic screening, we compared the ability of genetic testing and traditional family health history to identify increased risk of inherited disease. A further, in-depth qualitative study of individuals for whom risk identified through each method was discordant, explored whether this discordance could be addressed through changes in family health history intake. FINDINGS Of 90 individuals for whom genetic testing indicated significant increased risk for inherited disease, two-thirds (66%) had no corroborating family health history. Specifically, we identify cardiomyopathy, arrhythmia, and malignant hyperthermia as conditions for which discordance between genetic testing and traditional family health history was greatest, and familial hypercholesterolaemia, Lynch syndrome, and hereditary breast and ovarian cancer as conditions for which greater concordance existed. CONCLUSION We conclude that genetic testing offers utility as a supplement to traditional family health history intake over certain conditions.
Collapse
Affiliation(s)
- Thomas May
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Crystal L Smith
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Whitley Kelley
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Kelly East
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Lori Orlando
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Meagan Cochran
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Sierra Colletto
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Irene Moss
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| | - Mariko Nakano-Okuno
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| | - Bruce Korf
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| | - Nita Limdi
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| |
Collapse
|
2
|
Trendowski MR, Sample C, Baird T, Sadeghpour A, Moon D, Ruterbusch JJ, Beebe-Dimmer JL, Cooney KA. Germline Variants in DNA Damage Repair Genes and HOXB13 Among Black Patients With Early-Onset Prostate Cancer. JCO Precis Oncol 2022; 6:e2200460. [PMID: 36446039 PMCID: PMC9812633 DOI: 10.1200/po.22.00460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Genetic studies of prostate cancer susceptibility have predominantly focused on non-Hispanic White men, despite the observation that Black men are more likely to develop prostate cancer and die from the disease. Therefore, we sought to identify genetic variants in Black patients diagnosed with early-onset prostate cancer. METHODS Whole-exome sequencing of germline DNA from a population-based cohort of Black men diagnosed with prostate cancer at age 62 years or younger was performed. Analysis was focused on a panel of DNA damage repair (DDR) genes and HOXB13. All discovered variants were ranked according to their pathogenic potential based upon REVEL score, evidence from existing literature, and prevalence in the cohort. Logistic regression was used to investigate associations between mutation status and relevant clinical characteristics. RESULTS Among 743 Black prostate cancer patients, we identified 26 unique pathogenic (P) or likely pathogenic (LP) variants in 14 genes (including HOXB13, BRCA1/2, BRIP1, ATM, CHEK2, and PALB2) among 30 men, or approximately 4.0% of the patient population. We also identified 33 unique variants of unknown significance in 16 genes among 39 men. Because of the rarity of these variants in the population, most associations between clinical characteristics did not achieve statistical significance. However, our results suggest that carriers for P or LP (P/LP) variants were more likely to have a first-degree relative diagnosed with DDR gene-associated cancer, have a higher prostate-specific antigen at time of diagnosis, and be diagnosed with metastatic disease. CONCLUSION Variants in DDR genes and HOXB13 may be important cancer risk factors for Black men diagnosed with early-onset prostate cancer, and are more frequently observed in men with a family history of cancer.
Collapse
Affiliation(s)
| | | | - Tara Baird
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI,Barbara Ann Karmanos Cancer Institute, Detroit, MI
| | - Azita Sadeghpour
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - David Moon
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Julie J. Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI,Barbara Ann Karmanos Cancer Institute, Detroit, MI
| | - Jennifer L. Beebe-Dimmer
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI,Barbara Ann Karmanos Cancer Institute, Detroit, MI,Jennifer L. Beebe-Dimmer, MPH, PhD, Karmanos Cancer Institute, 4100 John R, MM04, Detroit, MI 48201; e-mail:
| | - Kathleen A. Cooney
- Department of Medicine, Duke University School of Medicine, Durham, NC,Duke Cancer Institute, Durham, NC
| |
Collapse
|
3
|
Velazquez-Roman J, Angulo-Zamudio UA, León-Sicairos N, Medina-Serrano J, DeLira-Bustillos N, Villamil-Ramírez H, Canizales-Quinteros S, Macías-Kauffer L, Campos-Romero A, Alcántar-Fernández J, Canizalez-Roman A. Association of FTO, ABCA1, ADRB3, and PPARG variants with obesity, type 2 diabetes, and metabolic syndrome in a Northwest Mexican adult population. J Diabetes Complications 2021; 35:108025. [PMID: 34420811 DOI: 10.1016/j.jdiacomp.2021.108025] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 11/28/2022]
Abstract
AIM To identify associations among allelic variants of the genes FTO, ABCA1, ADRB3, and PPARG with anthropometric and biochemical traits, metabolic diseases (obesity, T2D or metabolic syndrome) in an adult population from Northwest Mexico. METHODS Blood samples were collected from 846 subjects including 266 normal weight subjects, 285 with obesity, and 295 with T2D. Of the 846 persons in the study, 365 presented metabolic syndrome diagnostic criteria. Anthropometric and biochemical traits were recorded and 4 single nucleotide polymorphisms (SNPs): FTO rs9939609 A-allele, ABCA1 rs9282541 A-allele, ADRB3 rs4994 G-allele, and PPARG rs1801282 G-allele were genotyped by real-time PCR. RESULTS FTO rs9939609 A-allele was significantly associated with obesity (p: 8.3 × 10-4), and metabolic syndrome (p: 0.001), but no individual SNPs were significantly associated with T2D. Finally, the cumulative risk of the four SNPs was significantly associated with obesity (p: 1.95 × 10-4). CONCLUSION Associations in FTO, ABCA, ADRB3, and PPARG SNPs presented in this study with obesity and metabolic syndrome could represent a risk for developing metabolic diseases in Northwest Mexican adult subjects.
Collapse
Affiliation(s)
- Jorge Velazquez-Roman
- School of Medicine, CIASaP, Autonomous University of Sinaloa, 80246 Culiacan, Sinaloa, Mexico
| | - Uriel A Angulo-Zamudio
- School of Medicine, CIASaP, Autonomous University of Sinaloa, 80246 Culiacan, Sinaloa, Mexico
| | - Nidia León-Sicairos
- School of Medicine, CIASaP, Autonomous University of Sinaloa, 80246 Culiacan, Sinaloa, Mexico; Pediatric Hospital of Sinaloa, 80200 Culiacan, Sinaloa, Mexico
| | - Julio Medina-Serrano
- Programa de Maestría en Ciencias en Biomedicina Molecular, UAS, 80246 Culiacan, Sinaloa, Mexico; Coordinación de Planeación y Enlace Institucional, Órgano de Operación Administrativa Desconcentrada (OOAD) de Sinaloa, Instituto Mexicano del Seguro Social (IMSS), Culiacan Sinaloa, Mexico
| | - Nora DeLira-Bustillos
- Programa de Maestría en Ciencias en Biomedicina Molecular, UAS, 80246 Culiacan, Sinaloa, Mexico
| | - Hugo Villamil-Ramírez
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/INMEGEN, Mexico City, Mexico
| | - Samuel Canizales-Quinteros
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/INMEGEN, Mexico City, Mexico
| | - Luis Macías-Kauffer
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/INMEGEN, Mexico City, Mexico
| | | | | | - Adrian Canizalez-Roman
- School of Medicine, CIASaP, Autonomous University of Sinaloa, 80246 Culiacan, Sinaloa, Mexico; The Women's Hospital, Secretariat of Health, 80020 Culiacan, Sinaloa, Mexico.
| |
Collapse
|
4
|
Pinto AR, Silva J, Pinto R, Medeiros R. Aggressive prostate cancer phenotype and genome-wide association studies: where are we now? Pharmacogenomics 2020; 21:487-503. [PMID: 32343194 DOI: 10.2217/pgs-2019-0123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The majority of prostate cancer (PCa) is indolent, however, a percentage of patients are initially diagnosed with metastatic disease, for which there is a worse prognosis. There is a lack of biomarkers to identify men at greater risk for developing aggressive PCa. Genome-wide association studies (GWAS) scan the genome to search associations of SNPs with specific traits, like cancer. To date, eight GWAS have resulted in the reporting of 16 SNPs associated with aggressive PCa (p < 5.00 × 10-2). Still, validation studies need to be conducted to confirm the obtained results as GWAS can generate false-positive results. Furthermore, post-GWAS studies provide a better understanding of the functional consequences.
Collapse
Affiliation(s)
- Ana R Pinto
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center, (CI-IPOP) Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-4072 Porto, Portugal.,ICBAS, Abel Salazar Institute for the Biomedical Sciences, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Jani Silva
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center, (CI-IPOP) Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-4072 Porto, Portugal
| | - Ricardo Pinto
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center, (CI-IPOP) Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-4072 Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center, (CI-IPOP) Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-4072 Porto, Portugal.,Research Department, Portuguese League Against Cancer (NRNorte), Estrada Interior da Circunvalação, 6657, 4200-172 Porto, Portugal.,CEBIMED, Faculty of Health Sciences, Fernando Pessoa University, Praça 9 de Abril, 349, 4249-004 Porto, Portugal
| |
Collapse
|
5
|
May T, Evans JP. Addressing perceived economic obstacles to genetic testing as a way to mitigate disparities in family health history for adoptees. HEALTH ECONOMICS, POLICY, AND LAW 2020; 15:277-287. [PMID: 30567613 DOI: 10.1017/s1744133118000488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this paper, we ask whether or not we can afford to realize the potential benefits of genetic testing as a screening tool for adoptees. Our method is to provide reasonable cost and savings estimates. We argue that the prospect of cost neutrality should be sufficient to explore the targeted screening for a population who will otherwise suffer an avoidable health disparity in access to inherited disease information. Our goal here is to establish that the investment needed to attain these benefits is not beyond our means.
Collapse
Affiliation(s)
- Thomas May
- Floyd and Judy Rogers Endowed Professor, Elson S. Floyd College of Medicine, Washington State University, Vancouver, WA, USA
- Ethics and Genomics Program, HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Institute for Health and Aging, University of California San Francisco, San Francisco, CA, USA
| | - James P Evans
- Bryson Distinguished Professor of Genetics & Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
6
|
Nowinski S, Santaolalla A, O'Leary B, Loda M, Mirchandani A, Emberton M, Van Hemelrijck M, Grigoriadis A. Systematic identification of functionally relevant risk alleles to stratify aggressive versus indolent prostate cancer. Oncotarget 2018; 9:12812-12824. [PMID: 29560112 PMCID: PMC5849176 DOI: 10.18632/oncotarget.24400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/25/2018] [Indexed: 12/20/2022] Open
Abstract
Novel approaches for classification, including molecular features, are needed to direct therapy for men with low-grade prostate cancer (PCa), especially men on active surveillance. Risk alleles identified from genome-wide association studies (GWAS) could improve prognostication. Those risk alleles that coincided with genes and somatic copy number aberrations associated with progression of PCa were selected as the most relevant for prognostication. In a systematic literature review, a total of 698 studies were collated. Fifty-three unique SNPs residing in 29 genomic regions, including 8q24, 10q11 and 19q13, were associated with PCa progression. Functional studies implicated 21 of these single nucleotide polymorphisms (SNPs) as modulating the expression of genes in the androgen receptor pathway and several other oncogenes. In particular, 8q24, encompassing MYC, harbours a high density of SNPs conferring unfavourable pathological characteristics in low-grade PCa, while a copy number gain of MYC in low-grade PCa was associated with prostate-specific antigen recurrence after radical prostatectomy. By combining GWAS data with gene expression and structural rearrangements, risk alleles were identified that could provide a new basis for developing a prognostication tool to guide therapy for men with early prostate cancer.
Collapse
Affiliation(s)
- Salpie Nowinski
- Cancer Bioinformatics, Innovation Hub, Guy's Cancer Centre, King's College London, London, UK
| | - Aida Santaolalla
- Translational Oncology & Urology Research, King's College London, London, UK
| | - Ben O'Leary
- Breast Cancer NOW Centre, The Institute of Cancer Research, The Royal Marsden Hospital, London, UK
| | - Massimo Loda
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Ayesha Mirchandani
- Cancer Bioinformatics, Innovation Hub, Guy's Cancer Centre, King's College London, London, UK
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
| | | | - Anita Grigoriadis
- Cancer Bioinformatics, Innovation Hub, Guy's Cancer Centre, King's College London, London, UK
| |
Collapse
|
7
|
Risk Model for Prostate Cancer Using Environmental and Genetic Factors in the Spanish Multi-Case-Control (MCC) Study. Sci Rep 2017; 7:8994. [PMID: 28827750 PMCID: PMC5566549 DOI: 10.1038/s41598-017-09386-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/26/2017] [Indexed: 12/11/2022] Open
Abstract
Prostate cancer (PCa) is the second most common cancer among men worldwide. Its etiology remains largely unknown compared to other common cancers. We have developed a risk stratification model combining environmental factors with family history and genetic susceptibility. 818 PCa cases and 1,006 healthy controls were compared. Subjects were interviewed on major lifestyle factors and family history. Fifty-six PCa susceptibility SNPs were genotyped. Risk models based on logistic regression were developed to combine environmental factors, family history and a genetic risk score. In the whole model, compared with subjects with low risk (reference category, decile 1), those carrying an intermediate risk (decile 5) had a 265% increase in PCa risk (OR = 3.65, 95% CI 2.26 to 5.91). The genetic risk score had an area under the ROC curve (AUROC) of 0.66 (95% CI 0.63 to 0.68). When adding the environmental score and family history to the genetic risk score, the AUROC increased by 0.05, reaching 0.71 (95% CI 0.69 to 0.74). Genetic susceptibility has a stronger risk value of the prediction that modifiable risk factors. While the added value of each SNP is small, the combination of 56 SNPs adds to the predictive ability of the risk model.
Collapse
|
8
|
May T, Strong KA, Zusevics KL, Jeruzal J, Farrell MH, LaPean Kirschner A, Derse AR, Evans JP, Grotevant HD. Does Lack of "Genetic-Relative Family Health History" Represent a Potentially Avoidable Health Disparity for Adoptees? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2016; 16:33-38. [PMID: 27901440 DOI: 10.1080/15265161.2016.1240255] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Many adoptees face a number of challenges relating to separation from biological parents during the adoption process, including issues concerning identity, intimacy, attachment, and trust, as well as (for older adopted children) language and other cultural challenges. One common health challenge faced by adoptees involves lack of access to genetic-relative family health history (GRFHx). Lack of GRFHx represents a disadvantage due to a reduced capacity to identify diseases and recommend appropriate screening for conditions for which the adopted person may be at increased risk. In this article, we draw out common features of traditionally understood "health disparities" in order to identify analogous features in the context of adoptees' lack of GRFHx.
Collapse
Affiliation(s)
- Thomas May
- a HudsonAlpha Institute for Biotechnology and University of California San Francisco
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Verma M. Genome-wide association studies and epigenome-wide association studies go together in cancer control. Future Oncol 2016; 12:1645-64. [PMID: 27079684 PMCID: PMC5551540 DOI: 10.2217/fon-2015-0035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/22/2016] [Indexed: 02/07/2023] Open
Abstract
Completion of the human genome a decade ago laid the foundation for: using genetic information in assessing risk to identify individuals and populations that are likely to develop cancer, and designing treatments based on a person's genetic profiling (precision medicine). Genome-wide association studies (GWAS) completed during the past few years have identified risk-associated single nucleotide polymorphisms that can be used as screening tools in epidemiologic studies of a variety of tumor types. This led to the conduct of epigenome-wide association studies (EWAS). This article discusses the current status, challenges and research opportunities in GWAS and EWAS. Information gained from GWAS and EWAS has potential applications in cancer control and treatment.
Collapse
Affiliation(s)
- Mukesh Verma
- Methods & Technologies Branch, Epidemiology & Genomics Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute (NCI), NIH, 9609 Medical Center Drive, Suite 4E102, Rockville, MD 20850, USA
| |
Collapse
|
10
|
Lange EM, Ribado JV, Zuhlke KA, Johnson AM, Keele GR, Li J, Wang Y, Duan Q, Li G, Gao Z, Li Y, Xu J, Zheng SL, Cooney KA. Assessing the Cumulative Contribution of New and Established Common Genetic Risk Factors to Early-Onset Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2015; 25:766-72. [PMID: 26671023 DOI: 10.1158/1055-9965.epi-14-0995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/08/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We assessed the evidence for association between 23 recently reported prostate cancer variants and early-onset prostate cancer and the aggregate value of 63 prostate cancer variants for predicting early-onset disease using 931 unrelated men diagnosed with prostate cancer prior to age 56 years and 1,126 male controls. METHODS Logistic regression models were used to test the evidence for association between the 23 new variants and early-onset prostate cancer. Weighted and unweighted sums of total risk alleles across these 23 variants and 40 established variants were constructed. Weights were based on previously reported effect size estimates. Receiver operating characteristic curves and forest plots, using defined cut-points, were constructed to assess the predictive value of the burden of risk alleles on early-onset disease. RESULTS Ten of the 23 new variants demonstrated evidence (P < 0.05) for association with early-onset prostate cancer, including four that were significant after multiple test correction. The aggregate burden of risk alleles across the 63 variants was predictive of early-onset prostate cancer (AUC = 0.71 using weighted sums), especially in men with a high burden of total risk alleles. CONCLUSIONS A high burden of risk alleles is strongly associated with early-onset prostate cancer. IMPACT Our results provide the first formal replication for several of these 23 new variants and demonstrate that a high burden of common-variant risk alleles is a major risk factor for early-onset prostate cancer. Cancer Epidemiol Biomarkers Prev; 25(5); 766-72. ©2015 AACR.
Collapse
Affiliation(s)
- Ethan M Lange
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina. Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
| | - Jessica V Ribado
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina
| | - Kimberly A Zuhlke
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Anna M Johnson
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Gregory R Keele
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina
| | - Jin Li
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina
| | - Yunfei Wang
- Center for Translational Science, Children's National Medical Center, George Washington University, Washington, D.C
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina
| | - Ge Li
- Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem, North Carolina
| | - Zhengrong Gao
- Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem, North Carolina
| | - Yun Li
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina. Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Jianfeng Xu
- Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem, North Carolina
| | - S Lilly Zheng
- Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem, North Carolina
| | - Kathleen A Cooney
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan. Department of Urology, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
11
|
Little J, Wilson B, Carter R, Walker K, Santaguida P, Tomiak E, Beyene J, Usman Ali M, Raina P. Multigene panels in prostate cancer risk assessment: a systematic review. Genet Med 2015; 18:535-44. [PMID: 26426883 DOI: 10.1038/gim.2015.125] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 07/27/2015] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Single-nucleotide polymorphism (SNP) panel tests have been proposed for use in the detection of, and prediction of risk for, prostate cancer and as prognostic indicator in affected men. A systematic review was undertaken to address three research questions to evaluate the analytic validity, clinical validity, clinical utility, and prognostic validity of SNP-based panels. METHODS Data sources comprised MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and EMBASE; these were searched from inception to April 2013. The gray-literature searches included contact with manufacturers. Eligible studies included English-language studies evaluating commercially available SNP panels. Study selection and risk of bias assessment were undertaken by two independent reviewers. RESULTS Twenty-one studies met eligibility criteria. All focused on clinical validity and evaluated 18 individual panels with 2 to 35 SNPs. All had poor discriminative ability (overall area under receiver-operator characteristic curves, 58-74%; incremental gain resulting from inclusion of SNP data, 2.5-11%) for predicting risk of prostate cancer and/or distinguishing between aggressive and asymptomatic/latent disease. The risk of bias of the studies, as assessed by the Newcastle Ottawa Scale (NOS) and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tools, was moderate. CONCLUSION The evidence on currently available SNP panels is insufficient to assess analytic validity, and at best the panels assessed would add a small and clinically unimportant improvement to factors such as age and family history in risk stratification (clinical validity). No evidence on the clinical utility of current panels is available.Genet Med 18 6, 535-544.
Collapse
Affiliation(s)
- Julian Little
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Brenda Wilson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ron Carter
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kate Walker
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Pasqualina Santaguida
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Eva Tomiak
- The Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Joseph Beyene
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Muhammad Usman Ali
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Parminder Raina
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
12
|
May T, Strong KA, Khoury MJ, Evans JP. Can targeted genetic testing offer useful health information to adoptees? Genet Med 2015; 17:533-5. [PMID: 25905442 DOI: 10.1038/gim.2015.58] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 01/25/2023] Open
Affiliation(s)
- Thomas May
- 1] Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin, USA [2] Institute for Health and Aging, University of California San Francisco, San Francisco, CA, USA
| | - Kimberly A Strong
- Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Muin J Khoury
- Office of Public Health Genomics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James P Evans
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
13
|
Grill S, Fallah M, Leach RJ, Thompson IM, Hemminki K, Ankerst DP. A simple-to-use method incorporating genomic markers into prostate cancer risk prediction tools facilitated future validation. J Clin Epidemiol 2015; 68:563-73. [PMID: 25684153 DOI: 10.1016/j.jclinepi.2015.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To incorporate single-nucleotide polymorphisms (SNPs) into the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC). STUDY DESIGN AND SETTING A multivariate random-effects meta-analysis of likelihood ratios (LRs) for 30 validated SNPs was performed, allowing the incorporation of linkage disequilibrium. LRs for an SNP were defined as the ratio of the probability of observing the SNP in prostate cancer cases relative to controls and estimated by published allele or genotype frequencies. LRs were multiplied by the PCPTRC prior odds of prostate cancer to provide updated posterior odds. RESULTS In the meta-analysis (prostate cancer cases/controls = 386,538/985,968), all but two of the SNPs had at least one statistically significant allele LR (P < 0.05). The two SNPs with the largest LRs were rs16901979 [LR = 1.575 for one risk allele, 2.552 for two risk alleles (homozygous)] and rs1447295 (LR = 1.307 and 1.887, respectively). CONCLUSION The substantial investment in genome-wide association studies to discover SNPs associated with prostate cancer risk and the ability to integrate these findings into the PCPTRC allows investigators to validate these observations, to determine the clinical impact, and to ultimately improve clinical practice in the early detection of the most common cancer in men.
Collapse
Affiliation(s)
- Sonja Grill
- Department of Life Sciences of the Technical University Munich, Liesel-Beckmann-Str. 2, 85354 Freising, Germany.
| | - Mahdi Fallah
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Im Neuenheimer Feld 580, Im Technologiepark, 69120 Heidelberg, Germany
| | - Robin J Leach
- Department of Urology of the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA; Department of Cellular and Structural Biology of the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Ian M Thompson
- Department of Urology of the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Im Neuenheimer Feld 580, Im Technologiepark, 69120 Heidelberg, Germany; Center for Primary Health Care Research, Lund University, Box 117, 221 00 LUND, Sweden
| | - Donna P Ankerst
- Department of Life Sciences of the Technical University Munich, Liesel-Beckmann-Str. 2, 85354 Freising, Germany; Department of Urology of the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA; Department of Mathematics of the Technical University Munich, Boltzmannstr. 3, 85748 Garching b. München, Germany; Department of Epidemiology and Biostatistics of the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| |
Collapse
|
14
|
Verma M. Molecular profiling and companion diagnostics: where is personalized medicine in cancer heading? Per Med 2014; 11:761-771. [PMID: 29764045 DOI: 10.2217/pme.14.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The goal of personalized medicine is to use the right drug at the right dose - with minimal or no toxicity - for the right patient at the right time. Recent advances in understanding cell biology and pathways, and in using molecular 'omics' technologies to diagnose cancer, offer a strategic bridge to personalized medicine in cancer. Modern personalized medicine takes into account an individual's genetic makeup and disease history before developing a treatment regimen. The future of clinical oncology will be based on the use of predictive and prognostic biomarkers in patient management. Once implemented widely, personalized medicine will benefit patients and the healthcare system greatly.
Collapse
|
15
|
Demichelis F, Stanford JL. Genetic predisposition to prostate cancer: Update and future perspectives. Urol Oncol 2014; 33:75-84. [PMID: 24996773 DOI: 10.1016/j.urolonc.2014.04.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/27/2014] [Accepted: 04/28/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Prostate cancer is the second most frequent cancer in men worldwide and kills over 250,000 men worldwide every year. Prostate cancer is a heterogeneous disease at the clinical and the molecular level. The Scandinavian Twin Registry Study demonstrated that in contrast to most malignancies where environment was the overriding influence, heritable factors account for more than fifty percent of prostate cancers. METHODS AND MATERIALS We review the literature on prostate cancer risk variants (rare and common) including SNPs and Copy Number Variants (CNVs) and discuss the potential implications of significant variants for prostate cancer patient care. RESULTS The search for prostate cancer susceptibility genes has included both family-based studies and case-control studies utilizing a variety of approaches from array-based to sequencing-based studies. A major challenge is to identify genetic variants associated with more aggressive, potentially lethal prostate cancer and to understand their role in the progression of the disease. CONCLUSION Future risk models useful in the clinical setting will likely incorporate several risk loci rather than single variants and may be dependent on an individual patient's ethnic background.
Collapse
Affiliation(s)
- Francesca Demichelis
- Centre for Integrative Biology, University of Trento, Trento, Italy; Institute for Computational Biomedicine, Weill Medical College of Cornell University, New York, NY; Institute for Precision Medicine, Weill Medical College of Cornell University and New York Presbyterian Hospital, New York, NY.
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| |
Collapse
|
16
|
Mekhail SM, Yousef PG, Jackinsky SW, Pasic M, Yousef GM. miRNA in Prostate Cancer: New Prospects for Old Challenges. EJIFCC 2014; 25:79-98. [PMID: 27683458 PMCID: PMC4975192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Prostate cancer (PCa) is one of the most commonly diagnosed cancers among men but has limited prognostic biomarkers available for follow up. MicroRNAs (miRNAs) are small non-coding RNAs that regulate expression of their target genes. Accumulating experimental evidence reports differential miRNA expression in PCa, and that miRNAs are actively involved in the pathogenesis and progression of PCa. miRNA and androgen receptor signaling cross-talk is an established factor in PCa pathogenesis. Differential miRNA expression was found between patients with high versus low Gleason scores, and was also observed in patients with biochemical failure, hormone-resistant cancer and in metastasis. Metastasis requires epithelial-mesenchymal transition which shares many cancer stem cell biological characteristics and both are associated with miRNA dysregulation. In the era of personalized medicine, there is a broad spectrum of potential clinical applications of miRNAs. These applications can significantly improve PCa management including their use as diagnostic and/or prognostic markers, or as predictive markers for treatment efficiency. Preliminary evidence demonstrates that miRNAs can also be used for risk stratification. Circulatory miRNAs can serve as non-invasive biomarkers in urine and/or serum of PCa patients. More recently, analysis of miRNAs and circulating tumor cells are gaining significant attention. Moreover, miRNAs represent an attractive new class of therapeutic targets for PCa. Here, we summarize the current knowledge and the future prospects of miRNAs in PCa, their advantages, and potential challenges as tissue and circulating biomarkers. Prostate cancer (PCa) is the most commonly diagnosed cancer among men in western populations. The American Cancer Society estimated 239, 590 new cases and 29, 720 expected deaths in the USA in 2013. One in every six men are at risk of developing PCa during their lifetime (1). Currently, the standard biomarker for PCa diagnosis is prostate-specific antigen (PSA), which has its limitations, leading to the risks of PCa over diagnosis and harmful overtreatment. The prognostic value of PSA is also questionable (2). Stepping into the new epoch of personalized medicine, molecular markers are urgently needed to improve the different aspects of PCa management (3). miRNAs represent an attractive class of emerging biomarkers that can help in this regard (4;5).
Collapse
Affiliation(s)
- Samy M Mekhail
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada, Department of Laboratory Medicine, and the Keenan Research Centre for Biomedical Science at the Li KaShing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Peter G Yousef
- American International College of Arts and Sciences, Antigua
| | | | - Maria Pasic
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada, Department of Laboratory Medicine, St. Joseph’s Health Centre, Toronto, Canada
| | - George M Yousef
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada, Department of Laboratory Medicine, and the Keenan Research Centre for Biomedical Science at the Li KaShing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada,*Department of Laboratory Medicine St. Michael’s Hospital 30 Bond Street Toronto, ON M5B 1W8, Canada 416-864-6060 ext. 77605416-864-5648
| |
Collapse
|