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Lopez-Beltran A, Cookson MS, Guercio BJ, Cheng L. Advances in diagnosis and treatment of bladder cancer. BMJ 2024; 384:e076743. [PMID: 38346808 DOI: 10.1136/bmj-2023-076743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Bladder cancer remains a leading cause of cancer death worldwide and is associated with substantial impacts on patient quality of life, morbidity, mortality, and cost to the healthcare system. Gross hematuria frequently precedes the diagnosis of bladder cancer. Non-muscle-invasive bladder cancer (NMIBC) is managed initially with transurethral resection of a bladder tumor (TURBT), followed by a risk stratified approach to adjuvant intravesical therapy (IVe), and is associated with an overall survival of 90%. However, cure rates remain lower for muscle invasive bladder cancer (MIBC) owing to a variety of factors. NMIBC and MIBC groupings are heterogeneous and have unique pathological and molecular characteristics. Indeed, The Cancer Genome Atlas project identified genetic drivers and luminal and basal molecular subtypes of MIBC with distinct treatment responses. For NMIBC, IVe immunotherapy (primarily BCG) is the gold standard treatment for high grade and high risk NMIBC to reduce or prevent both recurrence and progression after initial TURBT; novel trials incorporate immune checkpoint inhibitors. IVe gene therapy and combination IVe chemotherapy have recently been completed, with promising results. For localized MIBC, essential goals are improving care and reducing morbidity following cystectomy or bladder preserving strategies. In metastatic disease, advances in understanding of the genomic landscape and tumor microenvironment have led to the implementation of immune checkpoint inhibitors, targeted treatments, and antibody-drug conjugates. Defining better selection criteria to identify the patients most likely to benefit from a specific treatment is an urgent need.
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Affiliation(s)
- Antonio Lopez-Beltran
- Department of Morphological Sciences, Unit of Anatomic Pathology, University of Cordoba Medical School, Cordoba, Spain
| | - Michael S Cookson
- Department of Urology, University of Oklahoma Health Sciences Center and the Stephenson Cancer Center, Oklahoma City, OK, US
| | - Brendan J Guercio
- Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, US
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University, Providence, RI, US
- Legorreta Cancer Center, Brown University
- Lifespan Health Care System, Brown University
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Guercio BJ, Sarfaty M, Teo MY, Ratna N, Duzgol C, Funt SA, Lee CH, Aggen DH, Regazzi AM, Chen Z, Lattanzi M, Al-Ahmadie HA, Brannon AR, Shah R, Chu C, Lenis AT, Pietzak E, Bochner BH, Berger MF, Solit DB, Rosenberg JE, Bajorin DF, Iyer G. Clinical and Genomic Landscape of FGFR3-Altered Urothelial Carcinoma and Treatment Outcomes with Erdafitinib: A Real-World Experience. Clin Cancer Res 2023; 29:4586-4595. [PMID: 37682528 DOI: 10.1158/1078-0432.ccr-23-1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/02/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Erdafitinib is the only FDA-approved targeted therapy for FGFR2/3-altered metastatic urothelial cancer. We characterized the genetic landscape of FGFR-altered urothelial carcinoma and real-world clinical outcomes with erdafitinib, including on-treatment genomic evolution. EXPERIMENTAL DESIGN Prospectively collected clinical data were integrated with institutional genomic data to define the landscape of FGFR2/3-altered urothelial carcinoma. To identify mechanisms of erdafitinib resistance, a subset of patients underwent prospective cell-free (cf) DNA assessment. RESULTS FGFR3 alterations predictive of erdafitinib sensitivity were identified in 39% (199/504) of patients with non-muscle invasive, 14% (75/526) with muscle-invasive, 43% (81/187) with localized upper tract, and 26% (59/228) with metastatic specimens. One patient had a potentially sensitizing FGFR2 fusion. Among 27 FGFR3-altered cases with a primary tumor and metachronous metastasis, 7 paired specimens (26%) displayed discordant FGFR3 status. Erdafitinib achieved a response rate of 40% but median progression-free and overall survival of only 2.8 and 6.6 months, respectively (n = 32). Dose reductions (38%, 12/32) and interruptions (50%, 16/32) were common. Putative resistance mutations detected in cfDNA involved TP53 (n = 5), AKT1 (n = 1), and second-site FGFR3 mutations (n = 2). CONCLUSIONS FGFR3 mutations are common in urothelial carcinoma, whereas FGFR2 alterations are rare. Discordance of FGFR3 mutational status between primary and metastatic tumors occurs frequently and raises concern over sequencing archival primary tumors to guide patient selection for erdafitinib therapy. Erdafitinib responses were typically brief and dosing was limited by toxicity. FGFR3, AKT1, and TP53 mutations detected in cfDNA represent putative mechanisms of acquired erdafitinib resistance.
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Affiliation(s)
- Brendan J Guercio
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Michal Sarfaty
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Min Yuen Teo
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Neha Ratna
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cihan Duzgol
- Commonwealth Radiology Associates, Andover, Massachusetts
| | - Samuel A Funt
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Chung-Han Lee
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - David H Aggen
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Ashley M Regazzi
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ziyu Chen
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - A Rose Brannon
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ronak Shah
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Carissa Chu
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew T Lenis
- Department of Urology, Columbia University Irving Medical Center, New York, New York
| | - Eugene Pietzak
- Weill Cornell Medical College, New York, New York
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Bernard H Bochner
- Weill Cornell Medical College, New York, New York
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael F Berger
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David B Solit
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan E Rosenberg
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Dean F Bajorin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Gopa Iyer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
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Zhao J, Guercio BJ, Sahasrabudhe D. Current Trends in Chemotherapy in the Treatment of Metastatic Prostate Cancer. Cancers (Basel) 2023; 15:3969. [PMID: 37568784 PMCID: PMC10417637 DOI: 10.3390/cancers15153969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Prostate cancer is the second most common cancer among men. Despite advances in diagnosis and management, prostate cancer led to more than 300,000 deaths globally in 2020. Chemotherapy is a cornerstone of therapy for advanced prostate cancer and can prolong survival of patients with both castration-sensitive and castration-resistant disease. Herein, we present a comprehensive review of the data supporting implementation of chemotherapy in the modern treatment of advanced prostate cancer, with special attention to the use of chemotherapy for aggressive variant prostate cancer (e.g., neuroendocrine prostate cancer) and the combination of chemotherapy with androgen signaling inhibitors. As the field of prostate cancer research continues to rapidly evolve yielding novel agents and treatment modalities, chemotherapy continues to play an essential role in prolonging the survival of patients with advanced and metastatic prostate cancer.
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Affiliation(s)
| | | | - Deepak Sahasrabudhe
- James P. Wilmot Cancer Institute, University of Rochester, Rochester, NY 14642, USA; (J.Z.); (B.J.G.)
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Guercio BJ, Sarfaty M, Teo MY, Funt SA, Lee CH, Aggen DH, Ratna N, Regazzi AM, Chen Z, Lattanzi M, Al-Ahmadie HA, Brannon AR, Berger MF, Solit DB, Rosenberg JE, Bajorin DF, Iyer G. Abstract 3410: Identifying potential mechanisms of resistance to erdafitinib (erda) via longitudinal analysis of circulating tumor (ct)-DNA of patients (pts) with advanced/metastatic urothelial cancer (mUC). Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The fibroblast growth factor receptor (FGFR) inhibitor erda is the only FDA-approved targeted treatment (tx) for mUC with FGFR2/3 alterations (alt). Median progression-free survival on erda is 5.5 months and mechanisms of resistance remain poorly characterized. Analysis of ctDNA offers an opportunity to longitudinally and non-invasively assess for mechanisms of resistance.
Methods: Plasma was collected from mUC pts on erda at baseline, on-tx, and at disease progression (PD). Clinical characteristics were recorded. Pre-tx tumors were sequenced with MSK-IMPACT and plasma samples with MSK-ACCESS, a cell-free DNA assay sequencing 129 genes with unique molecular indexes to generate >15,000x coverage for detection of mutations to an allele frequency of 0.1%.
Results: Between 8/2019-9/2021, 18 pts received erda. Median progression-free survival was 4.2 months, range 1.4-10.8. Tx was discontinued in 14 pts for PD, 3 for toxicity, and 1 death unrelated to erda/PD. During tx, several pts acquired new alts in ctDNA compared to pre-tx tumor/ctDNA, most commonly in TP53 (n = 5) and FGFR3 (n = 4) (Table 1). Of 9 newly acquired FGFR2/3 alts observed in ctDNA on-tx, 3 were hotspots. Several acquired FGFR3 alts have been shown to impact binding of erda to FGFR3 in vitro (Table 1). Of 5 pts with primary refractoriness to erda, 3 had baseline activating alts of signaling downstream or parallel to FGFR, including alts of PIK3CA (n = 1), TSC1 (n = 1), and HER2 (n = 2). Of 3 pts with TP53 alts in baseline ctDNA, 2 had PD as best response to erda.
Conclusions: Pts with mUC treated with erda demonstrated on-tx acquisition of ctDNA alts of FGFR2/3 and TP53 and activating alts downstream or parallel to FGFR signaling. Most pts with TP53 alts in baseline ctDNA were refractory to erda. Acquired FGFR2/3 alts on erda may drive resistance through interference with drug-target binding.
Case # Pre-tx FGFR2/3 alts Alts acquired on erda related to TP53 and FGFR signaling 1 FGFR3 Y373C TP53 K132M; TP53 R158L 2 FGFR3 S371C; FGFR3 R399C; FGFR3 R248C; FGFR3 S249C; FGFR3-TACC3 fusion FGFR3 R669G&; FGFR3 V553M&; FGFR3 N540S&; FGFR3 H673Y; FGFR3 K649_K650delinsIE; TP53 S241C; BRAF-CLIP2 fusion 3 FGFR3 S249C TP53 E287Q 4 FGFR3 S249C FGFR3 V553M&; FGFR3 K650M; FGFR2 R255W; AKT1 E17K 5 FGFR3 S249C FGFR3 R248C 6 FGFR3 S249C TP53 I195T 7 FGFR3 Y373C TP53 R248W; TP53 S241Y 8 FGFR3 S249C; FGFR3 L645V FGFR3 S424C & Alts likely to impact erda binding to FGFR3.
Citation Format: Brendan J. Guercio, Michal Sarfaty, Min Yuen Teo, Samuel A. Funt, Chung-Han Lee, David H. Aggen, Neha Ratna, Ashley M. Regazzi, Ziyu Chen, Michael Lattanzi, Hikmat A. Al-Ahmadie, A. Rose Brannon, Michael F. Berger, David B. Solit, Jonathan E. Rosenberg, Dean F. Bajorin, Gopa Iyer. Identifying potential mechanisms of resistance to erdafitinib (erda) via longitudinal analysis of circulating tumor (ct)-DNA of patients (pts) with advanced/metastatic urothelial cancer (mUC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3410.
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Affiliation(s)
| | | | - Min Yuen Teo
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Chung-Han Lee
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Neha Ratna
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Ziyu Chen
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | | | | | | | - Gopa Iyer
- 1Memorial Sloan Kettering Cancer Center, New York, NY
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Abstract
The hallmark of precision medicine involves tailoring the treatment to the patient and/or tumor-specific biomarkers. Candidate biomarkers in bladder cancer are abundant, but few have been validated in clinical practice. Significant obstacles to precision medicine in bladder cancer include the limited predictive value of candidate biomarkers, lack of standardization in biomarker assessment, heterogeneity in biomarker expression and function, and limited insight into the biologic factors that influence biomarker expression and predictive capacity. This review summarizes key biomarkers explored in bladder cancer and outlines innovative trial designs to approach these obstacles.
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Affiliation(s)
- Brendan J Guercio
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box #8, New York, NY 10065, USA.
| | - Gopa Iyer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA; Weill Cornell Medical College, New York, NY, USA
| | - Jonathan E Rosenberg
- Weill Cornell Medical College, New York, NY, USA; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; MSK Sidney Kimmel Center for Prostate and Urologic Cancers, 353 E 68th Street, New York, NY 10065, USA
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Guercio BJ, Zhang S, Ou FS, Venook AP, Niedzwiecki D, Lenz HJ, Innocenti F, Pollak MN, Nixon AB, Mullen BC, O'Neil BH, Shaw JE, Polite BN, Benson AB, Atkins JN, Goldberg RM, Brown JC, O'Reilly EM, Mayer RJ, Blanke CD, Fuchs CS, Meyerhardt JA. IGF-Binding Proteins, Adiponectin, and Survival in Metastatic Colorectal Cancer: Results From CALGB (Alliance)/SWOG 80405. JNCI Cancer Spectr 2020; 5:pkaa074. [PMID: 33426464 PMCID: PMC7785047 DOI: 10.1093/jncics/pkaa074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/07/2020] [Accepted: 08/14/2020] [Indexed: 12/16/2022] Open
Abstract
Background Energy balance-related biomarkers are associated with risk and prognosis of various malignancies. Their relationship to survival in metastatic colorectal cancer (mCRC) requires further study. Methods Baseline plasma insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, IGFBP-7, C-peptide, and adiponectin were measured at time of trial registration in a prospective cohort of patients with mCRC participating in a National Cancer Institute–sponsored trial of first-line systemic therapy. We used Cox proportional hazards regression to adjust for confounders and examine associations of each biomarker with overall survival (OS) and progression-free survival (PFS). P values are 2-sided. Results Median follow-up for 1086 patients was 6.2 years. Compared with patients in the lowest IGFBP-3 quintile, patients in the highest IGFBP-3 quintile experienced an adjusted hazard ratio (HR) for OS of 0.57 (95% confidence interval [CI] = 0.42 to 0.78; Pnonlinearity < .001) and for PFS of 0.61 (95% CI = 0.45 to 0.82; Ptrend = .003). Compared with patients in the lowest IGFBP-7 quintile, patients in the highest IGFBP-7 quintile experienced an adjusted hazard ratio for OS of 1.60 (95% CI = 1.30 to 1.97; Ptrend < .001) and for PFS of 1.38 (95% CI = 1.13 to 1.69; Ptrend < .001). Plasma C-peptide and IGF-1 were not associated with patient outcomes. Adiponectin was not associated with OS; there was a nonlinear U-shaped association between adiponectin and PFS (Pnonlinearity = .03). Conclusions Among patients with mCRC, high plasma IGFBP-3 and low IGFBP-7 were associated with longer OS and PFS. Extreme levels of adiponectin were associated with shorter PFS. These findings suggest potential avenues for prognostic and therapeutic innovation.
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Affiliation(s)
- Brendan J Guercio
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sui Zhang
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Alan P Venook
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Donna Niedzwiecki
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | | | | | - Michael N Pollak
- Department of Oncology, McGill University, Montreal, QC H3T 1E2, Canada
| | - Andrew B Nixon
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Brian C Mullen
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Bert H O'Neil
- Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James E Shaw
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Blase N Polite
- Pritzker School of Medicine, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Al Bowen Benson
- Department of Medicine, Northwestern University, Chicago, IL, USA
| | - James N Atkins
- Southeast Clinical Oncology Research (SCOR) Consortium, National Cancer Institute Community Oncology Research Program (NCORP), Winston-Salem, NC, USA
| | | | - Justin C Brown
- Department of Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eileen M O'Reilly
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert J Mayer
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Charles D Blanke
- SWOG Cancer Research Network and Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Charles S Fuchs
- Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
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Guercio BJ, Zhang S, Venook AP, Ou FS, Niedzwiecki D, Lenz HJ, Innocenti F, Mullen BC, O'Neil BH, Shaw JE, Polite BN, Hochster HS, Atkins JN, Goldberg RM, Brown JC, O'Reilly EM, Mayer RJ, Blanke CD, Fuchs CS, Meyerhardt JA. Body Mass Index and Weight Loss in Metastatic Colorectal Cancer in CALGB (Alliance)/SWOG 80405. JNCI Cancer Spectr 2020; 4:pkaa024. [PMID: 33134818 PMCID: PMC7590517 DOI: 10.1093/jncics/pkaa024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/01/2020] [Accepted: 03/25/2020] [Indexed: 12/12/2022] Open
Abstract
Background In nonmetastatic colorectal cancer, overweight and mild-to-moderately obese patients experience improved outcomes compared with other patients. Obesity’s influence on advanced or metastatic colorectal cancer (mCRC) is relatively unexplored. Methods We conducted a prospective body mass index (BMI) companion study in Cancer and Leukemia Group B (now Alliance)/SWOG 80405, a phase III metastatic colorectal cancer (mCRC) treatment trial. BMI was measured at trial registration. Primary and secondary endpoints were overall and progression-free survival, respectively. To minimize confounding by poor and rapidly declining health, we used Cox proportional hazards regression to adjust for known prognostic factors, comorbidities, physical activity, and weight loss during the 6 months prior to study entry. We also examined weight loss prior to enrollment as an independent predictor of patient outcome. All statistical tests were two-sided. Results Among 2323 patients with mCRC, there were no statistically significant associations between BMI and overall or progression-free survival (adjusted Ptrend = .12 and .40, respectively). Weight loss during the 6 months prior to study entry was associated with shorter overall and progression-free survival; compared with individuals with stable weight ±4.9%, individuals with weight loss greater than 15% experienced an adjusted hazard ratio of 1.52 for all-cause mortality (95% confidence interval [CI] = 1.26 to 1.84; Ptrend < .001) and of 1.23 for disease progression or death (95% CI = 1.02 to 1.47; Ptrend = .006). Conclusions In this prospective study of patients with mCRC, BMI at time of first-line chemotherapy initiation was not associated with patient outcome. Weight loss prior to study entry was associated with increased risk of patient mortality and disease progression.
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Affiliation(s)
- Brendan J Guercio
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sui Zhang
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Alan P Venook
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Rochester, MN, USA
| | - Donna Niedzwiecki
- Alliance Statistics and Data Center, Duke University, Durham, NC, USA
| | | | | | - Brian C Mullen
- Alliance Statistics and Data Management Center, Rochester, MN, USA
| | - Bert H O'Neil
- Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James E Shaw
- Medstar Washington Hospital Center, Washington, DC, USA
| | - Blase N Polite
- Pritzker School of Medicine, University of Chicago Comprehensive Cancer Center, Chicago, IL USA
| | | | - James N Atkins
- Southeast Clinical Oncology Research Consortium, NCORP, Winston-Salem, NC, USA
| | | | - Justin C Brown
- Department of Population and Public Health Science, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Eileen M O'Reilly
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert J Mayer
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Charles D Blanke
- SWOG Cancer Research Network and Oregon Health & Science University, Portland, OR, USA
| | - Charles S Fuchs
- Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
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Guercio BJ, Zhang S, Ou FS, Venook AP, Niedzwiecki D, Lenz HJ, Innocenti F, O'Neil BH, Shaw JE, Polite BN, Hochster HS, Atkins JN, Goldberg RM, Sato K, Ng K, Van Blarigan E, Mayer RJ, Blanke CD, O'Reilly EM, Fuchs CS, Meyerhardt JA. Associations of Physical Activity With Survival and Progression in Metastatic Colorectal Cancer: Results From Cancer and Leukemia Group B (Alliance)/SWOG 80405. J Clin Oncol 2019; 37:2620-2631. [PMID: 31408415 DOI: 10.1200/jco.19.01019] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Regular physical activity is associated with reduced risk of recurrence and mortality in patients with nonmetastatic colorectal cancer. Its influence on patients with advanced/metastatic colorectal cancer (mCRC) has been largely unexplored. PATIENTS AND METHODS We conducted a prospective cohort study nested in Cancer and Leukemia Group B (Alliance)/SWOG 80405 (ClinicalTrials.gov identifier: NCT00265850), a National Cancer Institute-sponsored phase III trial of systemic therapy for mCRC. Within 1 month after therapy initiation, patients were invited to complete a validated questionnaire that reported average physical activity over the previous 2 months. On the basis of responses, we calculated metabolic equivalent task (MET) hours per week to quantify physical activity. The primary end point of the clinical trial and this companion study was overall survival (OS). Secondary end points included progression-free survival (PFS) and first grade 3 or greater treatment-related adverse events. To minimize confounding by poor and declining health, we excluded patients who experienced progression or died within 60 days of activity assessment and used Cox proportional hazards regression analysis to adjust for known prognostic factors, comorbidities, and weight loss. RESULTS The final cohort included 1,218 patients. Compared with patients engaged in less than 3 MET hours per week of physical activity, patients engaged in 18 or more MET hours per week experienced an adjusted hazard ratio for OS of 0.85 (95% CI, 0.71 to 1.02; PTrend = .06) and for PFS of 0.83 (95% CI, 0.70 to 0.99; PTrend = .01). Compared with patients engaging in less than 9 MET hours per week, patients engaging in 9 or more MET hours per week experienced an adjusted hazard ratio for grade 3 or greater treatment-related adverse events of 0.73 (95% CI, 0.62 to 0.86; PTrend < .001). CONCLUSION Among patients with mCRC in Cancer and Leukemia Group B (Alliance)/SWOG 80405, association of physical activity with OS was not statistically significant. Greater physical activity was associated with longer PFS and lower adjusted risk for first grade 3 or greater treatment-related adverse events.
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Affiliation(s)
| | - Sui Zhang
- Dana-Farber/Partners CancerCare, Boston, MA
| | | | - Alan P Venook
- University of California, San Francisco, San Francisco, CA
| | | | - Heinz-Josef Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | - Bert H O'Neil
- Indiana University School of Medicine, Indianapolis, IN
| | - James E Shaw
- Medstar Washington Hospital Center, Washington, DC
| | | | | | - James N Atkins
- Southeast Clinical Oncology Research Consortium, National Cancer Institute Community Oncology Research Program, Winston-Salem, NC
| | | | - Kaori Sato
- Dana-Farber/Partners CancerCare, Boston, MA
| | - Kimmie Ng
- Dana-Farber/Partners CancerCare, Boston, MA
| | | | | | - Charles D Blanke
- SWOG, Portland, OR.,Oregon Health & Science University, Portland, OR
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Guercio BJ, Zhang S, Niedzwiecki D, Li Y, Babic A, Morales-Oyarvide V, Saltz LB, Mayer RJ, Mowat RB, Whittom R, Hantel A, Benson A, Atienza D, Messino M, Kindler H, Venook A, Ogino S, Zoltick ES, Stampfer M, Ng K, Wu K, Willett WC, Giovannucci EL, Meyerhardt JA, Fuchs CS. Associations of artificially sweetened beverage intake with disease recurrence and mortality in stage III colon cancer: Results from CALGB 89803 (Alliance). PLoS One 2018; 13:e0199244. [PMID: 30024889 PMCID: PMC6053135 DOI: 10.1371/journal.pone.0199244] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 06/01/2018] [Indexed: 12/16/2022] Open
Abstract
Purpose Observational studies have demonstrated increased colon cancer recurrence and mortality in states of excess energy balance, as denoted by factors including sedentary lifestyle, diabetes, increased dietary glycemic load, and increased intake of sugar-sweetened beverages. Nonetheless, the relation between artificially sweetened beverages, a popular alternative for sugar-sweetened beverages, and colon cancer recurrence and survival is unknown. Methods We analyzed data from 1,018 patients with stage III colon cancer who prospectively reported dietary intake during and after chemotherapy while enrolled in a National Cancer Institute-sponsored trial of adjuvant chemotherapy. Using Cox proportional hazards regressions, we assessed associations of artificially sweetened beverage intake with cancer recurrence and mortality. Results Patients consuming one or more 12-ounce servings of artificially sweetened beverages per day experienced an adjusted hazard ratio for cancer recurrence or mortality of 0.54 (95% confidence interval, 0.36 to 0.80) when compared to those who largely abstained (Ptrend = .004). Similarly, increasing artificially sweetened beverage intake was also associated with a significant improvement in both recurrence-free survival (Ptrend = .005) and overall survival (Ptrend = .02). Substitution models demonstrated that replacing a 12-ounce serving of a sugar-sweetened beverage with an isovolumetric serving of an artificially sweetened beverage per day was associated with a 23% lower risk of cancer recurrence and mortality (relative risk, 0.77; 95% confidence interval, 0.63 to 0.95; P = .02). Conclusion Higher artificially sweetened beverage consumption may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer. This association may be mediated by substitution for sugar-sweetened alternatives. Further studies are needed to confirm these findings.
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Affiliation(s)
- Brendan J. Guercio
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Sui Zhang
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | - Donna Niedzwiecki
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina, United States of America
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ana Babic
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | | | - Leonard B. Saltz
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Robert J. Mayer
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | - Rex B. Mowat
- Toledo Community Hospital Oncology Program, Toledo, Ohio, United States of America
| | | | - Alexander Hantel
- Edward-Elmhurst Healthcare, Naperville, Illinois, United States of America
| | - Al Benson
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, United States of America
| | - Daniel Atienza
- Virginia Oncology Associates, Norfolk, Virginia, United States of America
| | - Michael Messino
- Southeast Clinical Oncology Research (SCOR) Consortium, Mission Hospitals, Incorporated, Asheville, North Carolina, United States of America
| | - Hedy Kindler
- University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States of America
| | - Alan Venook
- University of California at San Francisco Comprehensive Cancer Center, San Francisco, California, United States of America
| | - Shuji Ogino
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Molecular Pathological Epidemiology (MPE), Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Department of Pathology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Emilie S. Zoltick
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Meir Stampfer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kimmie Ng
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Charles S. Fuchs
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, United States of America
- * E-mail:
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10
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Guercio BJ, Donovan NJ, Munro CE, Aghjayan SL, Wigman SE, Locascio JJ, Amariglio RE, Rentz DM, Johnson KA, Sperling RA, Marshall GA. The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment. J Alzheimers Dis 2016; 47:421-32. [PMID: 26401564 DOI: 10.3233/jad-150146] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Apathy is a common neuropsychiatric symptom in Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). Detecting apathy accurately may facilitate earlier diagnosis of AD. The Apathy Evaluation Scale (AES) is a promising tool for measurement of apathy in prodromal and possibly preclinical AD. OBJECTIVE To compare the three AES sub-scales - subject-reported (AES-S), informant-reported (AES-I), and clinician-reported (AES-C) - over time in individuals at risk for AD due to MCI and advanced age (cognitively normal [CN] elderly). METHODS Mixed effects longitudinal models were used to assess predictors of score for each AES sub-scale. Cox proportional hazards models were used to assess which AES sub-scales predict progression from MCI to AD dementia. RESULTS Fifty-seven MCI and 18 CN subjects (ages 53-86) were followed for 1.4 ± 1.2 years and 0.7 ± 0.7 years, respectively. Across the three mixed effects longitudinal models, the common findings were associations between greater apathy and greater years in study, a baseline diagnosis of MCI (compared to CN), and male gender. CN elderly self-reported greater apathy compared to that reported by informants and clinicians, while individuals with MCI under-reported their apathy compared to informants and clinicians. Of the three sub-scales, the AES-C best predicted transition from MCI to AD dementia. CONCLUSION In a sample of CN elderly and elderly with MCI, apathy increased over time, particularly in men and those with MCI. AES-S scores may be more sensitive than AES-I and AES-C scores in CN elderly, but less reliable if subjects have MCI. Moreover, the AES-C sub-scale predicted progression from MCI to AD dementia.
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Affiliation(s)
- Brendan J Guercio
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA
| | - Nancy J Donovan
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine E Munro
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah L Aghjayan
- Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah E Wigman
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Joseph J Locascio
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Rebecca E Amariglio
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Dorene M Rentz
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Keith A Johnson
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Reisa A Sperling
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Gad A Marshall
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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11
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Munro CE, Donovan NJ, Guercio BJ, Wigman SE, Schultz AP, Amariglio RE, Rentz DM, Johnson KA, Sperling RA, Marshall GA. Neuropsychiatric Symptoms and Functional Connectivity in Mild Cognitive Impairment. J Alzheimers Dis 2016; 46:727-35. [PMID: 25854929 DOI: 10.3233/jad-150017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS), such as apathy and depression, commonly accompany cognitive and functional decline in early Alzheimer's disease (AD). Prior studies have shown associations between affective NPS and neurodegeneration of medial frontal and inferior temporal regions in mild cognitive impairment (MCI) and AD dementia. OBJECTIVE To investigate the association between functional connectivity in four brain networks and NPS in elderly with MCI. METHODS NPS were assessed using the Neuropsychiatric Inventory in 42 subjects with MCI. Resting-state functional connectivity in four networks (default mode network, fronto-parietal control network (FPCN), dorsal attention network, and ventral attention network) was assessed using seed-based magnetic resonance imaging. Factor analysis was used to identify two factors of NPS: Affective and Hyperactivity. Linear regression models were utilized with the neuropsychiatric factors as the dependent variable and the four networks as the predictors of interest. Covariates included age, gender, premorbid intelligence, processing speed, memory, head movement, and signal-to-noise ratio. These analyses were repeated with the individual items of the affective factor, using the same predictors. RESULTS There was a significant association between greater Affective factor symptoms and reduced FPCN connectivity (p = 0.03). There was no association between the Hyperactivity factor and any of the networks. Secondary analyses revealed an association between greater apathy and reduced FPCN connectivity (p = 0.005), but none in other networks. CONCLUSIONS Decreased connectivity in the FPCN may be associated with greater affective symptoms, particularly apathy, early in AD. These findings extend prior studies, using different functional imaging modalities in individuals with greater disease severity.
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Affiliation(s)
- Catherine E Munro
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Nancy J Donovan
- Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Sarah E Wigman
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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12
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Guercio BJ, Sato K, Niedzwiecki D, Ye X, Saltz LB, Mayer RJ, Mowat RB, Whittom R, Hantel A, Benson A, Atienza D, Messino M, Kindler H, Venook A, Hu FB, Ogino S, Wu K, Willett WC, Giovannucci EL, Meyerhardt JA, Fuchs CS. Coffee Intake, Recurrence, and Mortality in Stage III Colon Cancer: Results From CALGB 89803 (Alliance). J Clin Oncol 2015; 33:3598-607. [PMID: 26282659 DOI: 10.1200/jco.2015.61.5062] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Observational studies have demonstrated increased colon cancer recurrence in states of relative hyperinsulinemia, including sedentary lifestyle, obesity, and increased dietary glycemic load. Greater coffee consumption has been associated with decreased risk of type 2 diabetes and increased insulin sensitivity. The effect of coffee on colon cancer recurrence and survival is unknown. PATIENTS AND METHODS During and 6 months after adjuvant chemotherapy, 953 patients with stage III colon cancer prospectively reported dietary intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items. We examined the influence of coffee, nonherbal tea, and caffeine on cancer recurrence and mortality using Cox proportional hazards regression. RESULTS Patients consuming 4 cups/d or more of total coffee experienced an adjusted hazard ratio (HR) for colon cancer recurrence or mortality of 0.58 (95% CI, 0.34 to 0.99), compared with never drinkers (Ptrend = .002). Patients consuming 4 cups/d or more of caffeinated coffee experienced significantly reduced cancer recurrence or mortality risk compared with abstainers (HR, 0.48; 95% CI, 0.25 to 0.91; Ptrend = .002), and increasing caffeine intake also conferred a significant reduction in cancer recurrence or mortality (HR, 0.66 across extreme quintiles; 95% CI, 0.47 to 0.93; Ptrend = .006). Nonherbal tea and decaffeinated coffee were not associated with patient outcome. The association of total coffee intake with improved outcomes seemed consistent across other predictors of cancer recurrence and mortality. CONCLUSION Higher coffee intake may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer.
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Affiliation(s)
- Brendan J Guercio
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Kaori Sato
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Donna Niedzwiecki
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Xing Ye
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Leonard B Saltz
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Robert J Mayer
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Rex B Mowat
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Renaud Whittom
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Alexander Hantel
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Al Benson
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Daniel Atienza
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Michael Messino
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Hedy Kindler
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Alan Venook
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Frank B Hu
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Shuji Ogino
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Kana Wu
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Walter C Willett
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Edward L Giovannucci
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Jeffrey A Meyerhardt
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Charles S Fuchs
- Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA.
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Desai MK, Guercio BJ, Narrow WC, Bowers WJ. An Alzheimer's disease-relevant presenilin-1 mutation augments amyloid-beta-induced oligodendrocyte dysfunction. Glia 2011; 59:627-40. [PMID: 21294162 DOI: 10.1002/glia.21131] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 11/30/2010] [Indexed: 11/10/2022]
Abstract
White matter pathology has been documented in the brains of familial Alzheimer's disease (FAD)-afflicted individuals during presymptomatic and preclinical stages of AD. How these defects in myelination integrity arise and what roles they may play in AD pathophysiology have yet to be fully elucidated. We previously demonstrated that triple-transgenic AD (3xTg-AD) mice, which harbor the human amyloid precursor Swedish mutation, presenilin-1 M146V (PS1(M146V) ) knock-in mutation, and tau(P301L) mutation, exhibit myelin abnormalities analogous to FAD patients and that Aβ(1-42) contributes to these white matter deficits. Herein, we demonstrate that the PS1(M146V) mutation predisposes mouse oligodendrocyte precursor (mOP) cells to Aβ(1-42) -induced alterations in cell differentiation in vitro. Furthermore, PS1(M146V) expression compromised mOP cell function and MBP protein distribution, a process that is further aggravated with exposure to Aβ(1-42) . We found that the myelination defect and MBP subcellular mislocalization triggered by PS1(M146V) and Aβ(1-42) can be effectively prevented by treatment with the GSK-3β inhibitor, TWS119, thereby implicating GSK-3β kinase activity in this pathogenic cascade. Overall, this work provides further mechanistic insights into PS1(M146V) and Aβ(1-42) -driven oligodendrocyte dysfunction andmyelin damage during early presymptomatic stages of AD, and provides a new target in oligodendrocytes for developing therapies designed to avert AD-related white matter pathology.
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Affiliation(s)
- Maya K Desai
- Department of Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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