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Castaneda CA, Castillo M, Bernabe LA, Suarez N, Romero A, Sanchez J, Torres E, Enciso J, Tello K, Enciso N, Velarde M, De La Cruz M, Dunstan J, Cotrina JM, Abugattas J, Pinillos MA, Roque K, Fuentes H, Poquioma E, Guerra H, Gomez HL. Association between PIK3CA Mutations in Blood and Tumor-Infiltrating Lymphocytes in Peruvian Breast Cancer Patients. Asian Pac J Cancer Prev 2022; 23:3331-3337. [PMID: 36308356 PMCID: PMC9924322 DOI: 10.31557/apjcp.2022.23.10.3331] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between circulating tumor DNA (ctDNA) presence and tumor features including tumor-infiltrating lymphocyte (TIL) levels in Peruvian breast cancer patients. MATERIALS AND METHODS This was a prospective study conducted at the Instituto Nacional de Enfemedades Neoplasicas, Peru. We evaluated level of TIL and PIK3CA mutations in ctDNA. Clinical characteristics, including outcome data, were collected from the patient file. Survival was calculated from the date of blood sample drawn to the event time. Data collected were analyzed using SPSS software version 25. RESULTS We analyzed plasma samples from 183 breast cancer patients. most cases were of Luminal-B (44.8%) phenotype and stage II (41.5%), and median stromal TIL was 30%. PIK3CA mutation in ctDNA was detected in 35% cases (most with E545K) and was associated with lower TIL level (p=0.04). PIK3CA in ctDNA tended to be associated with advanced stages (p=0.09) in the whole series and with higher recurrence rates (p=0.053) in the non-metastatic setting. Patients with presence of PIK3CA in ctDNA tended to have shorter survival (p=0.083). CONCLUSION Presence of PIK3CA mutation in ctDNA was frequently found in our Peruvian breast cancer series, was associated with lower TIL levels and tended to predict poor outcomes.
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Affiliation(s)
- Carlos A. Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru. ,Faculty of Medical Sciences, Universidad Cientifica del Sur, Lima 15067, Peru. ,For Correspondence:
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Luis A. Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Nancy Suarez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Atocha Romero
- Department of Medical Oncology, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Ebert Torres
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Javier Enciso
- Laboratorio de Cultivo Celular e Inmunologia, Universidad Cientifica del Sur, Lima 15067, Peru.
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Nataly Enciso
- Laboratorio de Cultivo Celular e Inmunologia, Universidad Cientifica del Sur, Lima 15067, Peru.
| | - Marco Velarde
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Miguel De La Cruz
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Jorge Dunstan
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Jose M. Cotrina
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Julio Abugattas
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Miguel A. Pinillos
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Katia Roque
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Ebert Poquioma
- Department of Epidemiology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Henry L. Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
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Galagedera SK, Dao TP, Castaneda CA. Effects of Modulating Multivalent Ligand Binding Accessibility & Affinity on Liquid‐Liquid Phase Separation. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r6323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Thuy P. Dao
- Chemistry/ BiologySyracuse UniversitySyracuseNY
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Castaneda CA, Dao TP, Yang Y. Polyubiquitin effects on phase transitions of shuttle protein UBQLN2. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.0i195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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4
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Calderon G, Castaneda CA, Castillo M, Sanchez J, Bernabe L, Suarez N, Tello K, Torres E, Cotrina JM, Dunstan J, De-La-Cruz M, Abugattas J, Guerra H, Manrique JE, Aguayo F, Gomez HL. Human Papillomavirus, Cytomegalovirus Infection and P16 Staining in Breast Tumors from Peruvian Women. Asian Pac J Cancer Prev 2022; 23:1571-1576. [PMID: 35633540 PMCID: PMC9587888 DOI: 10.31557/apjcp.2022.23.5.1571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the frequency distribution of viral infections in Peruvian Breast Cancer (BC) lesions and its association with clinicopathological features. Additionally, a prospective evaluation of p16 and Tumor-infiltrating lymphocytes (TIL) levels were performed for developing a comprehensive analysis. Methods: Detection of high risk- human papillomavirus (HR- HPV) through qPCR was performed in 447 BC and 79 non-cancer frozen samples. Paired paraffin samples from 238 BC were stained with Human cytomegalovirus (HCMV) and p16 immunohistochemistry. TIL was calculated in 397 BC cases. Results: HCMV was positive in 72.5%. HR- HPV was detected in 2.9% of BC and 1.3% of non-malignant samples. P16+ was found in 28.15% and median TIL percentage was 30. HR- HPV infection was associated with non-ductal histology (p=0.003) and p16+ (p=0.017). Positive P16+ was associated with higher T stage (p=0.022), grade (p=0.009), TIL level (p=0.002), and triple-negative phenotype (p=0.021). Conclusion: HCMV is frequent, but HR- HPV infection is unusual in Peruvian BC. P16+ is associated with HR- PVH infection, high TIL and aggressive features.
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Affiliation(s)
- Gabriela Calderon
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.,Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Luis Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Nancy Suarez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Ebert Torres
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jose M Cotrina
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jorge Dunstan
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miguel De-La-Cruz
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Julio Abugattas
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Javier E Manrique
- Department of Health Promotion and Prevention, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Francisco Aguayo
- Laboratory of Oncovirology, Virology Program, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Santiago, Chile
| | - Henry L Gomez
- Laboratory of Oncovirology, Virology Program, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Santiago, Chile
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5
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Valencia GA, Rioja P, Morante Z, Ruiz R, Fuentes H, Castaneda CA, Vidaurre T, Neciosup S, Gomez HL. Immunotherapy in triple-negative breast cancer: A literature review and new advances. World J Clin Oncol 2022; 13:219-236. [PMID: 35433291 PMCID: PMC8966508 DOI: 10.5306/wjco.v13.i3.219] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/23/2021] [Accepted: 02/19/2022] [Indexed: 02/06/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is a highly complex, heterogeneous disease and historically has limited treatment options. It has a high probability of disease recurrence and rapid disease progression despite adequate systemic treatment. Immunotherapy has emerged as an important alternative in the management of this malignancy, showing an impact on progression-free survival and overall survival in selected populations. In this review we focused on immunotherapy and its current relevance in the management of TNBC, including various scenarios (metastatic and early -neoadjuvant, adjuvant-), new advances in this subtype and the research of potential predictive biomarkers of response to treatment.
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Affiliation(s)
| | - Patricia Rioja
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Zaida Morante
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Rossana Ruiz
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Tatiana Vidaurre
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Silvia Neciosup
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
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6
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Castaneda CA, Dao TP, Yang Y, Galagedera SK. Mechanistic insights into the promotion or inhibition of phase separation by polyubiquitin chains of different linkages. Biophys J 2022. [DOI: 10.1016/j.bpj.2021.11.1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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7
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Gomez HL, Castaneda CA, Castillo M, Reuben J, Gao H, Suarez N, Bernabe LA, Cotrina JM, Dunstan J, Velarde M, Abugattas J, Guerra H. Concurrent Detection of Circulating Tumor Cells and Circulating Tumor DNA in Triple-negative Breast Cancer. Asian Pac J Cancer Care 2021. [DOI: 10.31557/apjcc.2021.6.4.373-377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: Circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) provide tumor information in breast cancer. Our objective was to characterize CTCs, and contrasted them with ctDNA PIK3CA mutation in 24 triple-negative breast cancer (TNBC). Methods: CTCs genes were characterized by AdnaTest protocol and ctDNA by digital PCR. Results: We found CTCs genes in 37.5% and ctDNA PIK3CA mutations in 29.16%. Three cases with CTCs genes had concurrent ctDNA PIK3CA mutations. MUC1 or GA733-2 were found in 4 cases, and 3 of them had concurrent ctDNA PIK3CA. CTCs ALDH1/TWIST1 were found in 2 cases, AKT2 in one and PI3Kα in another, and none had concurrent ctDNA PIK3CA mutations. There was no correlation between CTCs and ctDNA detection. All 3 cases with CTC & cDNA concurrent finding underwent death during follow-up. Conclusion: Infrequent concurrent detection of CTC and ctDNA presence suggests that both represent independent processes in TNBC patients, and could identify worst prognosis cases.
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8
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Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Torres E, Suarez N, Tello K, Fuentes H, Dunstan J, De La Cruz M, Cotrina JM, Abugattas J, Guerra H, Gomez HL. A biomarker study in Peruvian males with breast cancer. World J Clin Oncol 2021; 12:926-934. [PMID: 34733614 PMCID: PMC8546657 DOI: 10.5306/wjco.v12.i10.926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/25/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast cancer (BC) frequency in males is extremely low and tumor features vary from its female counterpart. Breast cancer clinical and pathological features differ by race in women. Tumor infiltrating lymphocyte (TIL) levels, mismatch repair (MMR) protein loss, androgen receptor (AR) expression, and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC. There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.
AIM To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.
METHODS This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018. Standard pathological features, TIL levels, MMR proteins, AR immunohistochemistry staining, and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material. Percentage of AR and estrogen receptor (ER) positive cells was additionally calculated by software after slide scanning. Statistical analyses included association tests, intraclass correlation test and Kaplan Meier overall survival curves.
RESULTS The median age was 63 years and most cases were ER-positive (85.7%), HER2 negative (87.2%), Luminal-A phenotype (60%) and clinical stage II (41.5%) among our male breast tumors. Median TIL was 10% and higher levels tended to be associated with Luminal-B phenotype and higher grade. AR-positive was found in 85.3% and was correlated with ER (intraclass index of 0.835, P < 0.001). Loss of MMR proteins was found in 15.4% and PIK3CA mutation (H1047R) in 14.3% (belonged to the Luminal-A phenotype). Loss of MMR proteins was associated with AR-negative (P = 0.018) but not with ER (P = 0.43) or TIL (P = 0.84). Early stages (P < 0.001) and lower grade (P = 0.006) were associated with longer overall survival. ER status, phenotype, AR status, TIL level, MMR protein loss nor PIK3CA mutation was not associated with survival (P > 0.05).
CONCLUSION Male BC is usually ER and AR positive, and Luminal-A. MMR loss and PIK3CA mutations are infrequent. Stage and grade predicted overall survival in our South American country population.
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Affiliation(s)
- Carlos A Castaneda
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15067, Peru
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ebert Torres
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Nancy Suarez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jorge Dunstan
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miguel De La Cruz
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jose Manuel Cotrina
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Julio Abugattas
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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9
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Castillo M, Bernabe LA, Castaneda CA, Suarez N, Barreda F, Valdivia D, Ruiz E, Nieves J, Dias-Neto E, Landa-Baella M, Montano-Flores J, Chavez I. Prevalence of H. pylori Infection in Relatives of Peruvian Patients with Gastric Cancer. Asian Pac J Cancer Care 2021. [DOI: 10.31557/apjcc.2021.6.1.53-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: The aim of this study was to determine the relationship between Helicobacter pylori (H. pylori) infection in relatives and patients with gastric cancer (GC).Methods: H. pylori infection was evaluated by the breath urease test in 171 relatives and by qPCR technique in gastric tissue of 61 patients (n=45 for GC and n=16 for non-GC). Results: There were included 137 relatives of GC patients and 34 of non-GC. The median age of the relatives of patients with a gastric tissue sample was 39 years (10-86). Infection was found in 60.2% (n=103) relatives. There were no higher H. pylori infection rates in relatives of patients with gastric cancer (62% vs 62.9%, p=0.33), H. pylori infection (60% vs 60%, p=0.96), or metaplasia (58.8% vs 61.8%, p=0.71). Conclusion: The prevalence of infection in relatives of GC patients is high in our population but not associated with H. pylori presence in the paired case.
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A Castaneda C, Castillo M, Sanchez J, Casavilca S, Sanchez J, A Bernabe L, Suarez N, Chavez I, Ruiz E, Tello K, R Villa M, Zevallos R, Montenegro P, Dias-Neto E, Landa-Baella M, Taxa L. Detection of Helicobacter pylori in gastric cancer tissue through histopathology, immunohistochemistry and real-time reverse transcription-PCR. Future Microbiol 2020; 15:1131-1137. [PMID: 32954850 DOI: 10.2217/fmb-2019-0280] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: Helicobacter pylori is usually detected based on hematoxylin-eosin (H-E) features, but, immunohistochemistry (IHC) and real-time PCR (RT-PCR) are more precise in chronic-gastritis. We evaluated the relevance of these tests in Peruvian gastric cancer samples. Materials & methods: We performed and evaluated H-E, IHC staining and RT-PCR in 288 gastric tumors. Slides were independently evaluated by three pathologists. Results: H. pylori was detected in 167/287 through H-E, 140/288 through IHC and 175/288 through RT-PCR, and positive-status were associated (p < 0.001). H. pylori detection by H-E had a good concordance with IHC (kappa index = 0.632) but poor with RT-PCR (kappa index = 0.317). Higher median gene-copies were found in high H. pylori density through H-E or IHC (p < 0.001). Conclusion: H-E evaluation is accurate in gastric cancer, and IHC and RT-PCR can complement its results.
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Affiliation(s)
- Carlos A Castaneda
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru.,Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima 15067, Peru
| | - Miluska Castillo
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Sandro Casavilca
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Juvenal Sanchez
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Luis A Bernabe
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Nancy Suarez
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Ivan Chavez
- Departamento de Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Eloy Ruiz
- Departamento de Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Katherine Tello
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Maria R Villa
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Rocio Zevallos
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Paola Montenegro
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Emmanuel Dias-Neto
- Laboratory of Medical Genomics, CIPE, A.C. Camargo Cancer Center, São Paulo 04002-010, Brasil
| | - Maria Landa-Baella
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Luis Taxa
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
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Zavala V, Marker KM, Vidaurre T, Navarro-Vasquez J, Casavilca S, Calderon M, Abugattas J, Gómez H, Fuentes H, Liendo-Picoaga R, Cotrina JM, Neciosup SP, Castaneda CA, Morante Z, Valencia F, Serrano-Gomez SJ, Zabaleta J, Fejerman L. Abstract 4615: Admixture mapping and gene expression analysis to identify candidate genes associated with HER2 positive breast cancer in Latinas. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4615] [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
The incidence of Human Epidermal Growth Factor Receptor 2 positive (HER2+) breast cancer is higher in Latinas, both in the U.S. and in Latin America. Preliminary analyses of the Peruvian Genetics and Genomics of Breast Cancer (PEGEN-BC) study data set showed a strong association between the Indigenous American (IA) component of ancestry and HER2 status independently of stage at diagnosis and other factors. The aim of this study was to identify genetic loci associated with genetic ancestry and HER2+ breast cancer in patients with high IA ancestry. To achieve this aim we used admixture mapping and gene-expression guided fine mapping.
Breast cancer patients were recruited at the Instituto Nacional de Enfermedades Neoplásicas in Lima, Peru. A total of 1,850 patients have been recruited to date. DNA samples are currently available for a total of 1,380 patients. Genome wide genotypes were obtained with the Affymetrix Precision Medicine Research Array. After quality control, genome wide genotype data was available for 1,312 patients. After LD pruning and exclusion of SNPs with minor allele frequency <0.05, we estimated global ancestry with the program ADMIXTURE and locus-specific ancestry using RFMix. Tumor subtypes were classified using immunohistochemistry markers for estrogen, progesterone and HER2 receptors. Admixture mapping was conducted using logistic regression models. The outcome variable was HER2 status (HER2+ =1, HER2- =0). Global Individual IA ancestry and age at diagnosis were included as covariates. For transcriptomic analysis within regions of interest we used exome sequencing data (Illumina NextSeq500 system) for total RNA extracted from 79 FFPE tumor tissues from the same cohort. Genes within regions with suggestive admixture mapping signals were further analyzed by comparing normalized RNA read counts by HER2+ status using the DEseq2 R package.
Admixture mapping analysis revealed two regions associated with IA ancestry in two chromosomal regions: 2q11-2q12 (OR=0.6, p=0.00009) and 3p14 (OR=1.5, p= 0.0004). Of the 44 genes within the 2q region, TGFBRAP1, member of the heat shock protein 90 family, was the only gene with suggestive differential expression by HER2 status (p=0.032). Of the 28 genes within the 3p14 region, we found significant differential expression for FLNB (lower expression in HER2+ tumours, 5%FDR= 0.03), which has been shown to supress tumour growth and metastasis.
Combining admixture mapping and transcriptomics is a promising approach to discover candidate genes associated with subtype-specific breast cancer risk. We are currently working to replicate suggestive findings and expand our sample size to increase power.
Citation Format: Valentina Zavala, Katie M. Marker, Tatiana Vidaurre, Jeannie Navarro-Vasquez, Sandro Casavilca, Mónica Calderon, Julio Abugattas, Henry Gómez, Hugo Fuentes, Ruddy Liendo-Picoaga, Jose M. Cotrina, Silvia P. Neciosup, Carlos A. Castaneda, Zaida Morante, Fernando Valencia, Silvia J. Serrano-Gomez, Jovanny Zabaleta, Laura Fejerman. Admixture mapping and gene expression analysis to identify candidate genes associated with HER2 positive breast cancer in Latinas [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4615.
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Affiliation(s)
| | | | | | | | | | | | | | - Henry Gómez
- 2Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Hugo Fuentes
- 2Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | | | | | | | - Zaida Morante
- 2Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | | | - Jovanny Zabaleta
- 3The Louisiana State University Health Sciences Center, New Orleans, LA
| | - Laura Fejerman
- 1University of California San Francisco, San Francisco, CA
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12
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Kos Z, Roblin E, Kim RS, Michiels S, Gallas BD, Chen W, van de Vijver KK, Goel S, Adams S, Demaria S, Viale G, Nielsen TO, Badve SS, Symmans WF, Sotiriou C, Rimm DL, Hewitt S, Denkert C, Loibl S, Luen SJ, Bartlett JMS, Savas P, Pruneri G, Dillon DA, Cheang MCU, Tutt A, Hall JA, Kok M, Horlings HM, Madabhushi A, van der Laak J, Ciompi F, Laenkholm AV, Bellolio E, Gruosso T, Fox SB, Araya JC, Floris G, Hudeček J, Voorwerk L, Beck AH, Kerner J, Larsimont D, Declercq S, Van den Eynden G, Pusztai L, Ehinger A, Yang W, AbdulJabbar K, Yuan Y, Singh R, Hiley C, Bakir MA, Lazar AJ, Naber S, Wienert S, Castillo M, Curigliano G, Dieci MV, André F, Swanton C, Reis-Filho J, Sparano J, Balslev E, Chen IC, Stovgaard EIS, Pogue-Geile K, Blenman KRM, Penault-Llorca F, Schnitt S, Lakhani SR, Vincent-Salomon A, Rojo F, Braybrooke JP, Hanna MG, Soler-Monsó MT, Bethmann D, Castaneda CA, Willard-Gallo K, Sharma A, Lien HC, Fineberg S, Thagaard J, Comerma L, Gonzalez-Ericsson P, Brogi E, Loi S, Saltz J, Klaushen F, Cooper L, Amgad M, Moore DA, Salgado R. Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer. NPJ Breast Cancer 2020; 6:17. [PMID: 32411819 PMCID: PMC7217863 DOI: 10.1038/s41523-020-0156-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 03/02/2020] [Indexed: 02/08/2023] Open
Abstract
Stromal tumor-infiltrating lymphocytes (sTILs) are important prognostic and predictive biomarkers in triple-negative (TNBC) and HER2-positive breast cancer. Incorporating sTILs into clinical practice necessitates reproducible assessment. Previously developed standardized scoring guidelines have been widely embraced by the clinical and research communities. We evaluated sources of variability in sTIL assessment by pathologists in three previous sTIL ring studies. We identify common challenges and evaluate impact of discrepancies on outcome estimates in early TNBC using a newly-developed prognostic tool. Discordant sTIL assessment is driven by heterogeneity in lymphocyte distribution. Additional factors include: technical slide-related issues; scoring outside the tumor boundary; tumors with minimal assessable stroma; including lymphocytes associated with other structures; and including other inflammatory cells. Small variations in sTIL assessment modestly alter risk estimation in early TNBC but have the potential to affect treatment selection if cutpoints are employed. Scoring and averaging multiple areas, as well as use of reference images, improve consistency of sTIL evaluation. Moreover, to assist in avoiding the pitfalls identified in this analysis, we developed an educational resource available at www.tilsinbreastcancer.org/pitfalls.
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Affiliation(s)
- Zuzana Kos
- Department of Pathology, BC Cancer - Vancouver, Vancouver, BC Canada
| | - Elvire Roblin
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Rim S. Kim
- National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA USA
| | - Stefan Michiels
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Brandon D. Gallas
- Division of Imaging, Diagnostics, and Software Reliability (DIDSR); Office of Science and Engineering Laboratories (OSEL); Center for Devices and Radiological Health (CDRH), US Food and Drug Administration (US FDA), Silver Spring, MD USA
| | - Weijie Chen
- Division of Imaging, Diagnostics, and Software Reliability (DIDSR); Office of Science and Engineering Laboratories (OSEL); Center for Devices and Radiological Health (CDRH), US Food and Drug Administration (US FDA), Silver Spring, MD USA
| | - Koen K. van de Vijver
- Department of Pathology, University Hospital Antwerp, Antwerp, Belgium
- Department of Pathology, Ghent University Hospital, Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Shom Goel
- The Sir Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
| | - Sylvia Adams
- Perlmutter Cancer Center, New York University Medical School, New York, NY USA
| | - Sandra Demaria
- Departments of Radiation Oncology and Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY USA
| | - Giuseppe Viale
- Department of Pathology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Torsten O. Nielsen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Sunil S. Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, USA
| | - W. Fraser Symmans
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX USA
| | - Christos Sotiriou
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - David L. Rimm
- Department of Pathology, Yale School of Medicine, New Haven, CT USA
| | - Stephen Hewitt
- Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, MD USA
| | - Carsten Denkert
- Institute of Pathology, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg and Philipps-Universität Marburg, Marburg, Germany
| | | | - Stephen J. Luen
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
| | - John M. S. Bartlett
- Ontario Institute for Cancer Research, Toronto, ON Canada
- University of Edinburgh Cancer Research Centre, Edinburgh, UK
| | - Peter Savas
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
| | - Giancarlo Pruneri
- Department of Pathology, IRCCS Fondazione Instituto Nazionale Tumori and University of Milan, School of Medicine, Milan, Italy
| | - Deborah A. Dillon
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA
- Department of Pathology, Dana Farber Cancer Institute, Boston, MA USA
| | - Maggie Chon U. Cheang
- Institute of Cancer Research Clinical Trials and Statistics Unit, The Institute of Cancer Research, Surrey, UK
| | - Andrew Tutt
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - Marleen Kok
- Department of Medical Oncology and Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hugo M. Horlings
- Department of Pathology, University Hospital Antwerp, Antwerp, Belgium
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH USA
| | - Jeroen van der Laak
- Computational Pathology Group, Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Francesco Ciompi
- Computational Pathology Group, Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Enrique Bellolio
- Departamento de Anatomía Patológica, Universidad de La Frontera, Temuco, Chile
| | | | - Stephen B. Fox
- The Sir Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Department of Pathology, Peter MacCallum Cancer Centre Department of Pathology, Melbourne, VIC Australia
| | | | - Giuseppe Floris
- KU Leuven- Univerisity of Leuven, Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research and KU Leuven- University Hospitals Leuven, Department of Pathology, Leuven, Belgium
| | - Jan Hudeček
- Department of Research IT, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Leonie Voorwerk
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Denis Larsimont
- Department of Pathology, Jules Bordet Institute, Brussels, Belgium
| | | | | | - Lajos Pusztai
- Department of Internal Medicine, Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT USA
| | - Anna Ehinger
- Department of Clinical Genetics and Pathology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - Khalid AbdulJabbar
- Centre for Evolution and Cancer; Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Yinyin Yuan
- Centre for Evolution and Cancer; Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Rajendra Singh
- Icahn School of Medicine at Mt. Sinai, New York, NY 10029 USA
| | - Crispin Hiley
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK
| | - Maise al Bakir
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK
| | - Alexander J. Lazar
- Departments of Pathology, Genomic Medicine, Dermatology, and Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Stephen Naber
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, USA
| | - Stephan Wienert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Charitéplatz 1, 10117 Berlin, Germany
| | - Miluska Castillo
- Department of Medical Oncology and Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038 Peru
| | | | - Maria-Vittoria Dieci
- Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Fabrice André
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Charles Swanton
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK
- Francis Crick Institute, Midland Road, London, UK
| | - Jorge Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Joseph Sparano
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Eva Balslev
- Department of Pathology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - I-Chun Chen
- Department of Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Katherine Pogue-Geile
- National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA USA
| | - Kim R. M. Blenman
- Department of Internal Medicine, Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT USA
| | | | - Stuart Schnitt
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA
| | - Sunil R. Lakhani
- The University of Queensland Centre for Clinical Research and Pathology Queensland, Brisbane, QLD Australia
| | - Anne Vincent-Salomon
- Institut Curie, Paris Sciences Lettres Université, Inserm U934, Department of Pathology, Paris, France
| | - Federico Rojo
- Pathology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD) - CIBERONC, Madrid, Spain
- GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain
| | - Jeremy P. Braybrooke
- Nuffield Department of Population Health, University of Oxford, Oxford and Department of Medical Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Matthew G. Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - M. Teresa Soler-Monsó
- Department of Pathology, Bellvitge University Hospital, IDIBELL. Breast Unit. Catalan Institut of Oncology. L ‘Hospitalet del Llobregat’, Barcelona, 08908 Catalonia Spain
| | - Daniel Bethmann
- University Hospital Halle (Saale), Institute of Pathology, Halle (Saale), Germany
| | - Carlos A. Castaneda
- Department of Medical Oncology and Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038 Peru
| | - Karen Willard-Gallo
- Molecular Immunology Unit, Institut Jules Bordet, Universitè Libre de Bruxelles, Brussels, Belgium
| | - Ashish Sharma
- Department of Biomedical Informatics, Emory University, Atlanta, GA USA
| | - Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Susan Fineberg
- Department of Pathology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY USA
| | - Jeppe Thagaard
- DTU Compute, Department of Applied Mathematics, Technical University of Denmark; Visiopharm A/S, Hørsholm, Denmark
| | - Laura Comerma
- GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain
- Pathology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Paula Gonzalez-Ericsson
- Breast Cancer Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Sherene Loi
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
| | - Joel Saltz
- Biomedical Informatics Department, Stony Brook University, Stony Brook, NY USA
| | - Frederick Klaushen
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lee Cooper
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Mohamed Amgad
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA USA
| | - David A. Moore
- Department of Pathology, UCL Cancer Institute, UCL, London, UK
- University College Hospitals NHS Trust, London, UK
| | - Roberto Salgado
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
- Department of Pathology, GZA-ZNA, Antwerp, Belgium
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13
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Castaneda CA, Castillo M, Chavez I, Barreda F, Suarez N, Nieves J, Bernabe LA, Valdivia D, Ruiz E, Dias-Neto E, Landa-Baella MP, Bazan Y, Rengifo CA, Montenegro P. Prevalence of Helicobacter pylori Infection, Its Virulent Genotypes, and Epstein-Barr Virus in Peruvian Patients With Chronic Gastritis and Gastric Cancer. J Glob Oncol 2020; 5:1-9. [PMID: 31479342 PMCID: PMC6733198 DOI: 10.1200/jgo.19.00122] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Helicobacter pylori (HP) and Epstein Barr virus (EBV) infections induce chronic gastritis (CG) and are accepted carcinogenics of gastric cancer (GC). Our objective for this study was to determine the prevalence of these agents and clinicopathological features of GC and CG associated with the infection. PATIENTS AND METHODS A single-center cohort of 375 Peruvian patients with GC and 165 control subjects with CG were analyzed. Evaluation of HP and EBV genes was performed through quantitative polymerase chain reaction. RESULTS Prevalence of HP was 62.9% in the whole population and 60.8% in the GC subset. The cagA gene was detected in 79.9%; vacAs1 and vacAm1 alleles in 41.6% and 60.7%, respectively; and concurrent expression of vacAs1 and vacAm1 in 30.4% of infected patients in the whole series. The prevalence of EBV was 14.1% in the whole population and was higher in GC (P < .001). Coinfection of HP and EBV was found in 7.8% and was also higher in GC in univariate (P < .001) and multivariate (P = .011) analyses. Infection rates of HP and EBV were not associated with a geographic location in the whole series. Few clinicopathological features have been associated with infectious status. CONCLUSION Prevalence of HP infection and virulent strains are high in the Peruvian population. Infection by EBV was more frequent in patients with GC.
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Affiliation(s)
| | | | - Iván Chavez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Nancy Suarez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jais Nieves
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Luis A Bernabe
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Eloy Ruiz
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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14
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Gonzalez-Ericsson PI, Stovgaard ES, Sua LF, Reisenbichler E, Kos Z, Carter JM, Michiels S, Le Quesne J, Nielsen TO, Laenkholm AV, Fox SB, Adam J, Bartlett JM, Rimm DL, Quinn C, Peeters D, Dieci MV, Vincent-Salomon A, Cree I, Hida AI, Balko JM, Haynes HR, Frahm I, Acosta-Haab G, Balancin M, Bellolio E, Yang W, Kirtani P, Sugie T, Ehinger A, Castaneda CA, Kok M, McArthur H, Siziopikou K, Badve S, Fineberg S, Gown A, Viale G, Schnitt SJ, Pruneri G, Penault-Llorca F, Hewitt S, Thompson EA, Allison KH, Symmans WF, Bellizzi AM, Brogi E, Moore DA, Larsimont D, Dillon DA, Lazar A, Lien H, Goetz MP, Broeckx G, El Bairi K, Harbeck N, Cimino-Mathews A, Sotiriou C, Adams S, Liu SW, Loibl S, Chen IC, Lakhani SR, Juco JW, Denkert C, Blackley EF, Demaria S, Leon-Ferre R, Gluz O, Zardavas D, Emancipator K, Ely S, Loi S, Salgado R, Sanders M. The path to a better biomarker: application of a risk management framework for the implementation of PD-L1 and TILs as immuno-oncology biomarkers in breast cancer clinical trials and daily practice. J Pathol 2020; 250:667-684. [PMID: 32129476 DOI: 10.1002/path.5406] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 02/05/2023]
Abstract
Immune checkpoint inhibitor therapies targeting PD-1/PD-L1 are now the standard of care in oncology across several hematologic and solid tumor types, including triple negative breast cancer (TNBC). Patients with metastatic or locally advanced TNBC with PD-L1 expression on immune cells occupying ≥1% of tumor area demonstrated survival benefit with the addition of atezolizumab to nab-paclitaxel. However, concerns regarding variability between immunohistochemical PD-L1 assay performance and inter-reader reproducibility have been raised. High tumor-infiltrating lymphocytes (TILs) have also been associated with response to PD-1/PD-L1 inhibitors in patients with breast cancer (BC). TILs can be easily assessed on hematoxylin and eosin-stained slides and have shown reliable inter-reader reproducibility. As an established prognostic factor in early stage TNBC, TILs are soon anticipated to be reported in daily practice in many pathology laboratories worldwide. Because TILs and PD-L1 are parts of an immunological spectrum in BC, we propose the systematic implementation of combined PD-L1 and TIL analyses as a more comprehensive immuno-oncological biomarker for patient selection for PD-1/PD-L1 inhibition-based therapy in patients with BC. Although practical and regulatory considerations differ by jurisdiction, the pathology community has the responsibility to patients to implement assays that lead to optimal patient selection. We propose herewith a risk-management framework that may help mitigate the risks of suboptimal patient selection for immuno-therapeutic approaches in clinical trials and daily practice based on combined TILs/PD-L1 assessment in BC. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Elisabeth S Stovgaard
- Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Luz F Sua
- Department of Pathology and Laboratory Medicine, Fundación Valle del Lili, and Faculty of Health Sciences, Universidad ICESI, Cali, Colombia
| | | | - Zuzana Kos
- Department of Pathology, BC Cancer Agency, Vancouver, Canada
| | - Jodi M Carter
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Stefan Michiels
- Biostatistics and Epidemiology Service, Centre de Recherche en Epidémiologie et Santé des Populations, Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - John Le Quesne
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
- MRC Toxicology Unit, University of Cambridge, Leicester, UK
| | - Torsten O Nielsen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | | | - Stephen B Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Julien Adam
- Department of Pathology, Gustave Roussy, Grand Paris, France
| | - John Ms Bartlett
- Ontario Institute for Cancer Research, Toronto, Canada
- Edinburgh Cancer Research Centre, Institute of Genetics and Molecular Medicine, Edinburgh, UK
| | - David L Rimm
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Cecily Quinn
- Department of Pathology, St Vincent's University Hospital and University College Dublin, Dublin, Ireland
| | - Dieter Peeters
- HistoGeneX NV, Antwerp, Belgium
- AZ Sint-Maarten Hospital, Mechelen, Belgium
| | - Maria V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Medical Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | | | - Ian Cree
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Akira I Hida
- Department of Pathology, Matsuyama Shimin Hospital, Matsuyama, Japan
| | - Justin M Balko
- Breast Cancer Research Program, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Harry R Haynes
- Department of Cellular Pathology, North Bristol NHS Trust, Bristol, UK
- Translational Health Sciences, University of Bristol, Bristol, UK
| | - Isabel Frahm
- Department of Pathology, Sanatorio Mater Dei, Buenos Aires, Argentina
| | - Gabriela Acosta-Haab
- Department of Pathology, Hospital de Oncología Maria Curie, Buenos Aires, Argentina
| | - Marcelo Balancin
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Enrique Bellolio
- Department of Pathology, Universidad de La Frontera, Temuco, Chile
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, PR China
| | - Pawan Kirtani
- Department of Histopathology, Manipal Hospitals Dwarka, New Delhi, India
| | - Tomoharu Sugie
- Breast Surgery, Kansai Medical University Hospital, Hirakata, Japan
| | - Anna Ehinger
- Department of Clinical Genetics and Pathology, Skane University Hospital, Lund University, Lund, Sweden
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Marleen Kok
- Divisions of Medical Oncology, Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Heather McArthur
- Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kalliopi Siziopikou
- Department of Pathology, Breast Pathology Section, Northwestern University, Chicago, IL, USA
| | - Sunil Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Susan Fineberg
- Department of Pathology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA
| | - Allen Gown
- PhenoPath Laboratories, Seattle, WA, USA
| | - Giuseppe Viale
- Department of Pathology, Istituto Europeo di Oncologia IRCCS, Milan, Italy
- University of Milan, Milan, Italy
| | - Stuart J Schnitt
- Department of Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Giancarlo Pruneri
- University of Milan, Milan, Italy
- Department of Pathology, IRCCS Fondazione Instituto Nazionale Tumori, Milan, Italy
| | - Frederique Penault-Llorca
- Department of Biology and Pathology, Centre Jean Perrin, Clermont Ferrand, France
- UMR INSERM 1240, Université Clermont Auvergne, Clermont Ferrand, France
| | - Stephen Hewitt
- Experimental Pathology Laboratory, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | - William F Symmans
- Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew M Bellizzi
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David A Moore
- CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, and Department of Cellular Pathology, UCLH, London, UK
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Deborah A Dillon
- Department of Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alexander Lazar
- Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Huangchun Lien
- Graduate Institute of Pathology, National Taiwan University, Taipei, Taiwan
| | | | - Glenn Broeckx
- Department of Pathology, University Hospital Antwerp, Edegem, Belgium
| | - Khalid El Bairi
- Cancer Biomarkers Working Group, Faculty of Medicine and Pharmacy, Mohamed Ist University, Oujda, Morocco
| | - Nadia Harbeck
- Breast Center, Department of OB&GYN and CCC (LMU), University of Munich, Munich, Germany
| | - Ashley Cimino-Mathews
- Department of Pathology and Oncology, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Christos Sotiriou
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Sylvia Adams
- Perlmutter Cancer Center, New York University Medical School, New York, NY, USA
| | | | | | - I-Chun Chen
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Sunil R Lakhani
- The University of Queensland, Centre for Clinical Research, and Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Jonathan W Juco
- Translational Medicine, Merck & Co, Inc, Kenilworth, NJ, USA
| | - Carsten Denkert
- Institute of Pathology, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg and Philipps-Universität Marburg, Marburg, Germany
| | - Elizabeth F Blackley
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sandra Demaria
- Department of Radiation Oncology, Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Oleg Gluz
- Johanniter GmbH - Evangelisches Krankenhaus Bethesda Mönchengladbach, West German Study Group, Mönchengladbach, Germany
| | | | | | - Scott Ely
- Translational Medicine, Bristol-Myers Squibb, Princeton, NJ, USA
| | - Sherene Loi
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Roberto Salgado
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium
| | - Melinda Sanders
- Breast Cancer Research Program, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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15
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Castaneda CA, Castillo M, Aliaga K, Bernabe LA, Casavilca S, Sanchez J, Torres-Cabala CA, Gomez HL, Mas L, Dunstan J, Cotrina JM, Abugattas J, Chavez I, Ruiz E, Montenegro P, Rojas V, Orrego E, Galvez-Nino M, Felix B, Landa-Baella MP, Vidaurre T, Villa MR, Zevallos R, Taxa L, Guerra H. Level of tumor-infiltrating lymphocytes and density of infiltrating immune cells in different malignancies. Biomark Med 2019; 13:1481-1491. [DOI: 10.2217/bmm-2019-0178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: To correlate levels of tumor-infiltrating lymphocytes (TIL) evaluated using the International Immuno-Oncology Biomarker Working Group methodology, and both density of tumor-infiltrating immune cell and clinicopathological features in different malignancies. Methods: 209 pathological samples from gastric cancer, cervical cancer (CC), non-small-lung cancer, cutaneous melanoma (CM) and glioblastoma were tested for TIL in hematoxylin eosin, and density of CD3+, CD4+, CD8+, CD20+, CD68+ and CD163+ cells by digital analysis. Results: TIL levels were higher in invasive margin compartments (IMC). TIL in IMC, intratumoral and stromal compartments predicted survival. CC and gastric cancer had higher TIL in intratumoral; CC and CM had higher TIL in stromal compartment and IMC. CM had the highest density of lymphocyte and macrophage populations. CD20 density was associated with survival in the whole series. Conclusion: Standardized evaluation of TIL levels may provide valuable prognostic information in a spectrum of different malignancies.
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Affiliation(s)
- Carlos A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Health Sciences, Universidad Científica del Sur, Lima 15067, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Karina Aliaga
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Carlos A Torres-Cabala
- Departments of Pathology & Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis Mas
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jorge Dunstan
- Department of Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jose M Cotrina
- Department of Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Julio Abugattas
- Department of Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ivan Chavez
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Eloy Ruiz
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Paola Montenegro
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Victor Rojas
- Department of Chest Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Marco Galvez-Nino
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Brayam Felix
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Maria P Landa-Baella
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Tatiana Vidaurre
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Maria R Villa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Rocio Zevallos
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis Taxa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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16
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Castillo M, Bernabe L, Castaneda CA, Chavez I, Ruiz E, Barreda F, Valdivia D, Suarez N, Nieves J, Dias-Neto E, Boehnke K, Landa-Baella MP, Montenegro P. Helicobacter Pylori Detected in Tap Water of Peruvian Patients with Gastric Cancer. Asian Pac J Cancer Prev 2019; 20:3193-3196. [PMID: 31759341 PMCID: PMC7062988 DOI: 10.31557/apjcp.2019.20.11.3193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the correlation between the presence of H. pylori in paired samples of tap water and gastric cancer (GC) lesion in Lima city (Peru). MATERIAL AND METHODS Gastric tissue and tap-water samples were prospectively collected from 82 Gastric Cancer who lived in Lima. HspA and ureA genes were evaluated by qPCR in the samples. Results: The median age of patients with GC was 63 years, 52.4% were men and stage-II in 36.6%. A home-living time> 10 years was reported in 84.1% of patients. Boiling water treatment was indicated in 85.4% of cases. H. pylori was detected in 69.5% of gastric tissues and in 12.2% of analyzed tap-water. There was no differences in gastric infection rates among those with or without water contamination (70% vs. 69.4%, p=0.971). Conclusion & Impact: H. pylori was found in tap-water samples, however, detection rates were lower than in gastric cancer samples. Other sources of infection transmission should be investigated.
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Affiliation(s)
- Miluska Castillo
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.,Universidad Científica del Sur, Peru
| | - Luis Bernabe
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Carlos A Castaneda
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.,Universidad Científica del Sur, Peru
| | - Ivan Chavez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Eloy Ruiz
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | | | - Nancy Suarez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jais Nieves
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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17
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Castaneda CA, Castillo M, Torres-Cabala C, Bernabe LA, Casavilca S, Villegas V, Sanchez J, de la Cruz M, Dunstan J, Cotrina JM, Gomez HL, Chavez C, Landa-Baella MP, Tello K, Felix BF, Abugattas J. Relationship between tumor-associated immune infiltrate and p16 staining over clinicopathological features in acral lentiginous melanoma. Clin Transl Oncol 2019; 21:1127-1134. [PMID: 30778854 DOI: 10.1007/s12094-019-02033-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/01/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE This study aims to evaluate the association between composition of tumor-infiltrating lymphocytes (TIL) and expression of p16 in acral lentiginous melanoma (ALM), and their impact on prognosis. MATERIALS AND METHODS A cohort of 148 surgical pathology specimens of ALM was studied. TIL were evaluated by immunohistochemical detection of CD3 and CD8, along with CD20, CD4, CD68, and CD163 in a subset of 43 cases. p16 protein expression was also investigated in all the cases. RESULTS The median age was 66 years, median Breslow thickness was 6.0 mm, grade III TIL was found in 28.4% and lymph nodes were involved in 54.2%. Breslow thickness (p < 0.001), stage I-II (p < 0.001), negative lymph nodes (p < 0.001) and < 10% p16 (p = 0.01) were associated with longer survival. Grade III of TIL was associated with thinner Breslow thickness (p = 0.008) and lower mitosis (p = 0.047). A higher density of CD3 TIL was associated with male gender (p = 0.008), thinner Breslow thickness (p = 0.047), negative lymph node (p = 0.031), early stage (p = 0.046), and p16 nuclear expression of > 10% (p = 0.045). Higher CD8 TIL was associated with > p16 (p = 0.03). Survival analysis found that longer survival had a trend to be associated with high TIL (p = 0.090). Levels of CD3+ and CD8+ cells were correlated with those of CD4+, CD20+, CD68+ and CD163+ immune cells. CONCLUSIONS Higher levels of TIL tend to be associated with better overall survival in ALM. Loss of expression of p16 is associated with lower levels of CD3+ and CD8+ TIL, indicating a probable relationship between p16 and TIL immune response in ALM .
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Affiliation(s)
- C A Castaneda
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru.
- Faculty of Medicine, Universidad Privada San Juan Bautista, 15067, Lima, Peru.
| | - M Castillo
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - C Torres-Cabala
- Departments of Pathology and Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - L A Bernabe
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - S Casavilca
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas., Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - V Villegas
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J Sanchez
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - M de la Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J M Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - H L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - C Chavez
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - M P Landa-Baella
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - K Tello
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - B F Felix
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
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Saura C, Hlauschek D, Oliveira M, Zardavas D, Jallitsch-Halper A, de la Peña L, Nuciforo P, Ballestrero A, Dubsky P, Lombard JM, Vuylsteke P, Castaneda CA, Colleoni M, Santos Borges G, Ciruelos E, Fornier M, Boer K, Bardia A, Wilson TR, Stout TJ, Hsu JY, Shi Y, Piccart M, Gnant M, Baselga J, de Azambuja E. Neoadjuvant letrozole plus taselisib versus letrozole plus placebo in postmenopausal women with oestrogen receptor-positive, HER2-negative, early-stage breast cancer (LORELEI): a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Oncol 2019; 20:1226-1238. [PMID: 31402321 DOI: 10.1016/s1470-2045(19)30334-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Endocrine therapy-based neoadjuvant treatment for luminal breast cancer allows efficient testing of new combinations before surgery. The activation of the phosphatidylinositol-3-kinase (PI3K) pathway is a known mechanism of resistance to endocrine therapy. Taselisib is an oral, selective PI3K inhibitor with enhanced activity against PIK3CA-mutant cancer cells. The LORELEI trial tested whether taselisib in combination with letrozole would result in an increased proportion of objective responses and pathological complete responses. METHODS In this multicentre, randomised, double-blind, parallel-cohort, placebo-controlled phase 2, study, we enrolled postmenopausal women (aged ≥18 years) with histologically confirmed, oestrogen receptor (ER)-positive, HER2-negative, stage I-III, operable breast cancer, from 85 hospitals in 22 countries worldwide. To be eligible, patients had have an Eastern Cooperative Oncology Group (ECOG) performance status 0-1, adequate organ function, and had to have evaluable tumour tissue for PIK3CA genotyping. Patients were randomly assigned (1:1) by means of a permuted block algorithm (block size of four) via an interactive voice or web-based response system, to receive letrozole (2·5 mg/day orally, continuously) with either 4 mg of oral taselisib or placebo (on a 5 days-on, 2 days-off schedule) for 16 weeks, followed by surgery. Randomisation was stratified by tumour size and nodal status. Site staff, patients, and the sponsor were masked to treatment assignment. Coprimary endpoints were the proportion of patients who achieved an objective response by centrally assessed breast MRI and a locally assessed pathological complete response in the breast and axilla (ypT0/Tis, ypN0) at surgery in all randomly assigned patients and in patients with PIK3CA-mutant tumours. Analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT02273973, and is closed to accrual. FINDINGS Between Nov 12, 2014, and Aug 12, 2016, 334 participants were enrolled and randomly assigned to receive letrozole and placebo (n=168) or letrozole and taselisib (n=166). Median follow-up was 4·9 months (IQR 4·7-5·1). The study met one of its primary endpoints: the addition of taselisib to letrozole was associated with a higher proportion of patients achieving an objective response in all randomly assigned patients (66 [39%] of 168 patients in the placebo group vs 83 [50%] of 166 in the taselisib group; odds ratio [OR] 1·55, 95% CI 1·00-2·38; p=0·049) and in the PIK3CA-mutant subset (30 [38%] of 79 vs 41 [56%] of 73; OR 2·03, 95% CI 1·06-3·88; p=0·033). No significant differences were observed in pathological complete response between the two groups, either in the overall population (three [2%] of 166 in the taselisib group vs one [1%] of 168 in the placebo group; OR 3·07 [95% CI 0·32-29·85], p=0·37) or in the PIK3CA-mutant cohort (one patient [1%) vs none [0%]; OR not estimable, p=0·48). The most common grade 3-4 adverse events in the taselisib group were gastrointestinal (13 [8%] of 167 patients), infections (eight [5%]), and skin-subcutaneous tissue disorders (eight [5%]). In the placebo group, four (2%) of 167 patients had grade 3 or worse vascular disorders, two (1%) had gastrointestinal disorders, and two (1%) patients had grade 3 or worse infections and infestations. There was no grade 4 hyperglycaemia and grade 3 cases were asymptomatic. Serious adverse events were more common in the taselisib group (eight [5%] patients with infections and seven [4%] with gastrointestinal effects) than in the placebo group (one [1%] patient each with grade 3 postoperative wound and haematoma infection, grade 4 hypertensive encephalopathy, grade 3 acute cardiac failure, and grade 3 breast pain). One death occurred in the taselisib group, which was not considered to be treatment-related. INTERPRETATION The increase in the proportion of patients who achieved an objective response from the addition of taselisib to endocrine therapy in a neoadjuvant setting is consistent with the clinical benefit observed in hormone receptor-positive, HER2-negative, metastatic breast cancer. FUNDING Genentech and F Hoffmann-La Roche.
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Affiliation(s)
- Cristina Saura
- Vall d'Hebrón University Hospital, Vall d'Hebrón Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain.
| | | | - Mafalda Oliveira
- Vall d'Hebrón University Hospital, Vall d'Hebrón Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | | | | | - Paolo Nuciforo
- Vall d'Hebrón University Hospital, Vall d'Hebrón Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Alberto Ballestrero
- University of Genoa - Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova; Gruppo Oncologico Italiano di Ricerca Clinica, Genova, Italy
| | - Peter Dubsky
- Medical University of Vienna, Vienna, Austria; Hirslanden Klinik St Anna, Breast Centre, Lucerne, Switzerland
| | - Janine M Lombard
- Breast Cancer Trials Australia New Zealand, University of Newcastle, Newcastle, NSW, Australia
| | - Peter Vuylsteke
- European Organisation for Research and Treatment of Cancer, Breast Cancer Group, CHU Namur, Université Catholique de Louvain, Ottignies-Nouvain-la-Neuve, Belgium
| | | | - Marco Colleoni
- Division of Medical Senology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico and International Breast Cancer Study Group, Milan, Italy
| | | | - Eva Ciruelos
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Monica Fornier
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | | | - Aditya Bardia
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Yi Shi
- Genentech Inc, South San Francisco, CA, USA
| | - Martine Piccart
- Breast International Group, Brussels, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Michael Gnant
- Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Medical University of Vienna, Vienna, Austria
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Castaneda CA, Castillo M, Enciso JA, Enciso N, Bernabe LA, Sanchez J, Guerra H, Chavez C, Landa-Baella M, De-La-Cruz M, Villa-Robles M, Tello K, Gomez HL. Role of undifferentiation markers and androgen receptor expression in triple-negative breast cancer. Breast J 2019; 25:1316-1319. [PMID: 31332870 DOI: 10.1111/tbj.13464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Carlos A Castaneda
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.,Universidad Cientifica del Sur, Lima, Peru
| | - Miluska Castillo
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.,Universidad Cientifica del Sur, Lima, Peru
| | | | | | - Luis A Bernabe
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Joselyn Sanchez
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Henry Guerra
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Carlos Chavez
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | | | | | | | - Katherine Tello
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
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Castaneda CA, Dao TP, Yang Y, Jones H, Lei Y, Martyniak B. Hydrophobic Mutations Promote UBQLN2 Oligomerization And Phase Separation. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.464.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Castaneda CA, Dao TP, Martyniak B, Lei Y, Canning A, Colicino E, Cosgrove MS, Hehnly H. Disease-Linked Mutations in UBQLN2 Proline-Rich Region Promote Phase Separation and Liquid-To-Solid Phase Transitions. Biophys J 2019. [DOI: 10.1016/j.bpj.2018.11.1895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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22
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Orrego E, Castaneda CA, Castillo M, Bernabe LA, Casavilca S, Chakravarti A, Meng W, Garcia-Corrochano P, Villa-Robles MR, Zevallos R, Mejia O, Deza P, Belmar-Lopez C, Ojeda L. Distribution of tumor-infiltrating immune cells in glioblastoma. CNS Oncol 2018; 7:CNS21. [PMID: 30299157 PMCID: PMC6331699 DOI: 10.2217/cns-2017-0037] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: Evaluation of features related to infiltrating immune cell level in glioblastoma. Methods: Tumor-infiltrating lymphocytes (TILs) through H&E staining, and TILs (CD3, CD4, CD8 and CD20) and macrophage (CD68 and CD163) levels through immunohistochemistry were evaluated through digital analysis. Results: CD68 (9.1%), CD163 (2.2%), CD3 (1.6%) and CD8 (1.6%) had the highest density. Higher CD4+ was associated with unmethylated MGMT (p = 0.016). Higher CD8+ was associated with larger tumoral size (p = 0.027). Higher CD163+ was associated with higher age (p = 0.044) and recursive partitioning analysis = 4. Women (p < 0.05), total resection (p < 0.05), MGMT-methylation (p < 0.001), radiotherapy (p < 0.001), chemotherapy (p < 0.001) and lower CD4+ (p < 0.05) were associated with longer overall survival. Conclusion: Macrophages are more frequent than TILs. Some subsets are associated with clinical features.
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Affiliation(s)
- Enrique Orrego
- Neurosurgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru.,Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima, 15067, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Luis A Bernabe
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Sandro Casavilca
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Arnab Chakravarti
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital, Columbus, OH, 43210, USA
| | - Wei Meng
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital, Columbus, OH, 43210, USA
| | | | - Maria R Villa-Robles
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Rocio Zevallos
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Omar Mejia
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Pedro Deza
- Neurosurgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Carolina Belmar-Lopez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
| | - Luis Ojeda
- Neurosurgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038, Peru
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Castaneda CA, Rebaza P, Castillo M, Gomez HL, De La Cruz M, Calderon G, Dunstan J, Cotrina JM, Abugattas J, Vidaurre T. Critical review of axillary recurrence in early breast cancer. Crit Rev Oncol Hematol 2018; 129:146-152. [PMID: 30097233 DOI: 10.1016/j.critrevonc.2018.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/07/2016] [Revised: 05/20/2018] [Accepted: 06/18/2018] [Indexed: 01/07/2023] Open
Abstract
Around 2% of early breast cancer cases treated with axillary lymph node dissection (ALND) underwent axillary recurrence (AR) and it has a deleterious effect in prognosis. Different scenarios have incorporated Sentinel Lymph Node (SLN) Biopsy (SLNB) instead of ALND as part of the standard treatment and more effective systemic treatment has also been incorporated in routine management after first curative surgery and after regional recurrence. However, there is concern about the effect of SLNB alone over AR risk and how to predict and treat AR. SLN biopsy (SLNB) has been largely accepted as a valid option for SLN-negative cases, and recent prospective studies have demonstrated that it is also safe for some SLN-positive cases and both scenarios carry low AR rates. Different studies have identified clinicopathological factors related to aggressiveness as well as high-risk molecular signatures can predict the development of locoregional recurrence. Other publications have evaluated factors affecting prognosis after AR and find that time between initial treatment and AR as well as tumor aggressive behavior influence patient survival. Retrospective and prospective studies indicate that treatment of AR should include local and systemic treatment for a limited time.
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Affiliation(s)
- Carlos A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
| | - Pamela Rebaza
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miguel De La Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Gabriela Calderon
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jorge Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jose Manuel Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Julio Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Tatiana Vidaurre
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Casavilca S, García-Corrochano P, Ponce J, Villa-Robles MR, Lopez CB, Orrego E. Impact of pathological features of brain metastases in prognosis. Biomark Med 2018; 12:475-485. [PMID: 29697273 DOI: 10.2217/bmm-2017-0161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To evaluate the prognostic value of tumor-infiltrating lymphocytes (TILs) and Ki67 in brain metastasis lesions, and the effect of adding them to variables of graded prognostic assessment score. PATIENTS & METHODS Clinicopathological information from 111 medical charts of brain metastasis patients was obtained, and TIL distribution (n = 84), Ki67 index (n = 79) and CD3 TIL (n = 64) were prospectively evaluated. RESULTS Most frequent TIL pattern was perivascular (67.8%), and median Ki67 and CD3 TIL percents were 30 and 4.8%, respectively. Ki67 ≥15 was associated with shorter survival (p = 0.018) but CD3 TIL was not (p = 0.870). The highest graded prognostic assessment score was not associated with survival (p = 0.648), however, those with low Ki67 and high score was associated with better outcome (p = 0.007). CONCLUSION High Ki67 index in brain metastasis carries a worse prognosis.
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Affiliation(s)
- Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.,Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Jaime Ponce
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Maria R Villa-Robles
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Galvez M, Castaneda CA, Sanchez J, Castillo M, Rebaza LP, Calderon G, Cruz MDL, Cotrina JM, Abugattas J, Dunstan J, Guerra H, Mejia O, Gomez HL. Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy. World J Clin Oncol 2018; 9:33-41. [PMID: 29651385 PMCID: PMC5893995 DOI: 10.5306/wjco.v9.i2.33] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/19/2017] [Accepted: 02/05/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the survival impact of clinicopathological factors, including pathological complete response (pCR) and tumor-infiltrating lymphocytes (sTIL) levels according to subtypes, in breast cancer (BC) patients who received neo-adjuvant chemotherapy (NAC).
METHODS We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. sTIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preNAC core biopsy. pCR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, sTIL, pCR and survival were carried out using SPSSvs19.
RESULTS Median age was 49 years (range 24-84 years) and the most frequent clinical stage was IIIB (58.3%). Luminal A, Luminal B, HER2-enriched and (triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. pCR was observed in 11% and median percentage of sTIL was 40% (2%-95%) in the whole population. pCR was associated to Ct1-2 (P = 0.045) and to high sTIL (P = 0.029) in the whole population. There was a slight trend towards significance for sTIL (P = 0.054) in Luminal A. sTIL was associated with grade III (P < 0.001), no-Luminal A subtype (P < 0.001), RE-negative (P < 0.001), PgR-negative (P < 0.001), HER2-positive (P = 0.002) and pCR (P = 0.029) in the whole population. Longer disease-free survival was associated with grade I-II (P = 0.006), cN0 (P < 0.001), clinical stage II (P = 0.004), ER-positive (P < 0.001), PgR-positive (P < 0.001), luminal A (P < 0.001) and pCR (P = 0.002). Longer disease-free survival was associated with grade I-II in Luminal A (P < 0.001), N0-1 in Luminal A (P = 0.045) and TNBC (P = 0.01), clinical stage II in Luminal A (P = 0.003) and TNBC (P = 0.038), and pCR in TNBC (P < 0.001). Longer overall survival was associated with grade I-II (P < 0.001), ER-positive (P < 0.001), PgR-positive (P < 0.001), Luminal A (P < 0.001), cN0 (P = 0.002) and pCR (P = 0.002) in the whole population. Overall survival was associated with clinical stage II (P = 0.017) in Luminal A, older age (P = 0.042) in Luminal B, and pCR in TNBC (P = 0.005).
CONCLUSION Predictive and prognostic values of clinicopathological features, like pCR and sTIL, differ depending on the evaluated molecular subtype
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Affiliation(s)
- Marco Galvez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima 15067, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Lia Pamela Rebaza
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Gabriela Calderon
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miguel De La Cruz
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jose Manuel Cotrina
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Julio Abugattas
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jorge Dunstan
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Omar Mejia
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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Salas E, Sanchez P, Postigo J, Castaneda CA, Castillo M, Villegas V, Cano L, Casavilca S, Bernabe LA, Belmar C, Villa-Robles MR, Mantilla R, Guerra H. Nodal involvement and p16-staining in upper alveolar ridge and hard palate cancer. ACTA ACUST UNITED AC 2018. [DOI: 10.20517/2394-4722.2017.66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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27
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Belmar-Lopez C, Castaneda CA, Castillo M, García-Corrochano P, Orrego E, Meléndez B, Casavilca S, Flores C, Orrego E. MGMT promoter methylation in Peruvian patients with glioblastoma. Ecancermedicalscience 2018. [PMID: 29515653 PMCID: PMC5834313 DOI: 10.3332/ecancer.2018.812] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose O6-methylguanine–DNA methyltransferase (MGMT) promoter methylation predicts the outcome and response to alkylating chemotherapy in glioblastoma. The aim of this study is to evaluate the prevalence of MGMT methylation in Peruvian glioblastoma cases. Patients and methods We evaluated retrospectively 50 cases of resected glioblastoma during the period 2008–2013 at Instituto Nacional de Enfermedades Neoplasicas in Peru. Samples consisted of paraffin embedded and frozen tumour tissue. MGMT-promoter methylation status and the expression level of MGMT gene were evaluated by methylation-specific PCR and real-time PCR, respectively. Results Unmethylated, methylated and partially methylated statuses were found in 54%, 20% and 26% of paraffin-embedded samples, respectively. Methylation status was confirmed in the Virgen de la Salud Hospital and frozen samples. There was an association between the status of MGMT-promoter methylation and the level of gene expression (p = 0.001). Methylation was associated with increased progression-free survival (p = 0.002) and overall survival (OS) (p < 0.001). Conclusion MGMT-promoter methylation frequency in Peruvian glioblastoma is similar to that reported in other populations and the detection test has been standardised.
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Affiliation(s)
- Carolina Belmar-Lopez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas. Av Angamos Este 2520, Surquillo, Lima 15038, Peru
| | - Carlos A Castaneda
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas. Av Angamos Este 2520, Surquillo, Lima 15038, Peru.,Faculty of Medicine, Universidad Peruana San Juan Bautista. Av Jose Antonio Lavalle s/n, Chorrillos, Lima 15067, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas. Av Angamos Este 2520, Surquillo, Lima 15038, Peru
| | | | - Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Barbara Meléndez
- Molecular Pathology Research Unit, Department of Pathology, Virgen de la Salud Hospital. Av De Barber s/n, Toledo 45005, Spain
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas. Av Angamos Este 2520, Surquillo, Lima 15038, Peru
| | - Claudio Flores
- Department of Research, Oncosalud. Av Guardia Civil 571, San Borja, Lima 15036, Peru
| | - Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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Rebaza LP, Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Calderon G, Dunstan J, la Cruz MD, Cotrina JM, Abugattas J, Guerra H, Villa-Robles MR, Poma N, Mejia O, Gomez HL. Androgen expression & clinicopathological features in male breast cancer. Breast Cancer Management 2018. [DOI: 10.2217/bmt-2017-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To investigate prognostic features in male breast cancer (MBC). Methods: Clinicopathological information from 40 MBC patients was retrospectively reviewed. Androgen receptor (AR) and estrogen receptor (ER) were prospectively stained out in 22 cases and counted through software program analysis. Results: Median age was 65.5 years; most cases were Stage II (40%), Grade II (37.5%), ER ≥10% (72.5%) and PgR ≥10% (75%). AR >10% was found in 17 of 22 cases. Although AR expression was correlated with ER, there are some cells without coexpression. Axillary node involvement was associated with DFS (p = 0.001) and age (p = 0.002) was associated with overall survival. Conclusion: ER is expressed in most MBC cases and is correlated with AR. Axillary involvement and age were associated with survival.
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Affiliation(s)
- Lia P Rebaza
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima 15067, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Luis A Bernabe
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Joselyn Sanchez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Gabriela Calderon
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Jorge Dunstan
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Miguel de la Cruz
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Jose M Cotrina
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Julio Abugattas
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Henry Guerra
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Maria R Villa-Robles
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Nathaly Poma
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Omar Mejia
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
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29
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Castaneda CA, Castillo M, Villarreal-Garza C, Rabanal C, Dunstan J, Calderon G, La Cruz MD, Guerra H, Cotrina JM, Abugattas J, Gomez HL. Genetics, tumor features and treatment response of breast cancer in Latinas. Breast Cancer Management 2018. [DOI: 10.2217/bmt-2017-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Breast cancer is a heterogeneous and genetic disease that has variability according to ethnicity and race with respect to incidence, clinical characteristics and prognosis. The incidence of breast cancer is lower but mortality is higher in Latinas than Caucasians in the US series. Risk factors appear to have different prevalence and impact in Latinas. Breast cancer in Latinas has particular clinic-pathological features including younger age, higher rates of triple-negative subtype and advanced stages. Molecular studies find that Latinas from every region have a specific BRCA incidence and a recurrent mutation, as well as differences in activity of molecular pathways. Treatment response rates and toxicity have also been compared, and no difference was found between Latinas and other ethnic groups.
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Affiliation(s)
- Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico
- Breast Cancer Clinic & Research Department, Instituto Nacional de Cancerologia, Tlalplan, Mexico
| | - Connie Rabanal
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jorge Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Gabriela Calderon
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miguel De La Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry Guerra
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jose M Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Julio Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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30
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Castaneda CA, Torres-Cabala C, Castillo M, Villegas V, Casavilca S, Cano L, Sanchez J, Dunstan J, Calderon G, De La Cruz M, Cotrina JM, Gomez HL, Galvez R, Abugattas J. Tumor infiltrating lymphocytes in acral lentiginous melanoma: a study of a large cohort of cases from Latin America. Clin Transl Oncol 2017; 19:1478-1488. [PMID: 28577153 DOI: 10.1007/s12094-017-1685-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/24/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Acral lentiginous melanoma (ALM) is a poor prognosis subtype and is the most prevalent in non-Caucasian populations. The presence of tumor infiltrating lymphocytes (TILs) has been associated with poor prognosis in melanoma. A large cohort of ALM cases was studied to determine status of TIL and its association with outcome. METHODS All patients with cutaneous melanoma presenting from 2005 to 2012 at Instituto Nacional de Enfermedades Neoplasicas in Peru were retrospectively identified. Clinicopathological information was obtained from the medical charts. A prospective evaluation of TIL was performed. Analysis of association between ALM and clinicopathological features including TIL as well as survival analysis compared the outcome of ALM to whole group and extremity NALM was performed. RESULTS 537 ALM from a total of 824 cutaneous melanoma cases were studied. Older age (p = 0.022), higher Breslow (p = 0.008) and ulceration (p < 0.001) were found to be more frequent in ALM. Acral had worse overall survival (OS) compared with the whole group (p = 0.04). Clinical stage (CS) I-II patients had a median OS of 5.3 (95% CI 4.3-6.2) for ALM and 9.2 (95% CI 5.0-7.0) for extremity NALM (p = 0.016). Grade 0 (absence of TIL), I, II and III were found in 7.5, 34.5, 32.1, and 25.9%, respectively. Lower TIL grade was associated with larger tumor size (p = 0.003), higher Breslow (p = 0.001), higher Clark level (p = 0.007), higher CS (p = 0.002), extremity location (p = 0.048), histological subtype ALM (p = 0.024) and better OS (p = 0.001). CONCLUSIONS ALM is highly prevalent in Peru and carries poor outcome. Lower TIL levels were associated with poor outcome and ALM.
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Affiliation(s)
- C A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru.
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru.
| | - C Torres-Cabala
- Departments of Pathology and Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - M Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - V Villegas
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - S Casavilca
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - L Cano
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J Sanchez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - G Calderon
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - M De La Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J M Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - H L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - R Galvez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
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Orrego E, Casavilca S, Garcia-Corrochano P, Rojas-Meza S, Castillo M, Castaneda CA. Glioblastoma of pineal region: report of four cases and literature review. CNS Oncol 2017; 6:251-259. [PMID: 28990813 DOI: 10.2217/cns-2016-0047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report four cases of glioblastoma in the pineal region. The patients presented a severe headache and vomiting. Brain imaging showed a heterogeneously enhanced tumor in the pineal region with obstructive hydrocephalus. Case 3 developed a subependymal dissemination. The patient went to ventricular-peritoneal shunt and subtotal or total resection and radiotherapy with/without chemotherapy. Cases 1 and 2 received radiation and died 8 and 11 later months. Cases 3 and 4 completed radiotherapy and chemotherapy, and survived 28 and 31 months after the initial diagnosis. Glioblastoma in the pineal region carry a poor prognosis and require neurooncology teams.
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Affiliation(s)
- Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | | | - Sugey Rojas-Meza
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | - Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
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Castaneda CA, Castillo M, Sanchez J, Casavilca S, Gonzalez C, Flores C, Cano L, Belmar-Lopez C, Villa-Robles R, Rios-Martini G, Wu Y. Factors influencing Ki67 calculation in neuroendocrine neoplasia. International Journal of Endocrine Oncology 2017. [DOI: 10.2217/ije-2016-0011] [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: 11/21/2022] Open
Abstract
Aim: We compared different methodologies to evaluate Ki67 in neuroendocrine neoplasia (NEN). Patients & methods: ki67 was evaluated using three methods in 70 NEN cases: manual-count, eyeballed estimate made by three pathologists and ImmunoRatio-software. Manual-count was the standard method and agreement with it was evaluated through intraclass correlation (ICC). Results: Agreement between manual-count and eyeballed estimate had ICC: 0.887–0.929. Eyeballed estimate by three pathologists produced upgradation in 5.7–32.9% and downgradation in 5.7% of NEN cases. Agreement for ImmunoRatio-count had ICC: 0.989. Immunoratio produced upgradation in 17.1% and downgradation in 8.5% cases. Agreement between all methods was higher at low-Ki67. Cellularity, immune-cell infiltration, staining and sample quality did not affect agreement. Conclusion: Eyeballed estimate and ImmunoRatio showed good accuracy, especially at low-Ki67.
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Affiliation(s)
- Carlos A Castaneda
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Juvenal Sanchez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Carlos Gonzalez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Luis Cano
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Rosario Villa-Robles
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Yun Wu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Castaneda CA, Mittendorf E, Casavilca S, Wu Y, Castillo M, Arboleda P, Nunez T, Guerra H, Barrionuevo C, Dolores-Cerna K, Belmar-Lopez C, Abugattas J, Calderon G, De La Cruz M, Cotrina M, Dunstan J, Gomez HL, Vidaurre T. Tumor infiltrating lymphocytes in triple negative breast cancer receiving neoadjuvant chemotherapy. World J Clin Oncol 2016; 7:387-394. [PMID: 27777881 PMCID: PMC5056330 DOI: 10.5306/wjco.v7.i5.387] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/22/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To determine influence of neoadjuvant-chemotherapy (NAC) over tumor-infiltrating-lymphocytes (TIL) in triple-negative-breast-cancer (TNBC).
METHODS TILs were evaluated in 98 TNBC cases who came to Instituto Nacional de Enfermedades Neoplasicas from 2005 to 2010. Immunohistochemistry staining for CD3, CD4, CD8 and FOXP3 was performed in tissue microarrays (TMA) sections. Evaluation of H/E in full-face and immunohistochemistry in TMA sections was performed in pre and post-NAC samples. STATA software was used and P value < 0.05 was considered statistically significant.
RESULTS Higher TIL evaluated in full-face sections from pre-NAC tumors was associated to pathologic-complete-response (pCR) (P = 0.0251) and outcome (P = 0.0334). TIL evaluated in TMA sections showed low level of agreement with full-face sections (ICC = 0.017-0.20) and was not associated to pCR or outcome. TIL in post-NAC samples were not associated to response or outcome. Post-NAC lesions with pCR had similar TIL levels than those without pCR (P = 0.6331). NAC produced a TIL decrease in full-face sections (P < 0.0001). Percentage of TIL subpopulations was correlated with their absolute counts. Higher counts of CD3, CD4, CD8 and FOXP3 in pre-NAC samples had longer disease-free-survival (DFS). Higher counts of CD3 in pre-NAC samples had longer overall-survival. Higher ratio of CD8/CD4 counts in pre-NAC was associated with pCR. Higher ratio of CD4/FOXP3 counts in pre-NAC was associated with longer DFS. Higher counts of CD4 in post-NAC samples were associated with pCR.
CONCLUSION TIL in pre-NAC full-face sections in TNBC are correlated to longer survival. TIL in full-face differ from TMA sections, absolute count and percentage analysis of TIL subpopulation closely related.
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Swisher SK, Wu Y, Castaneda CA, Lyons GR, Yang F, Tapia C, Wang X, Casavilca SAA, Bassett R, Castillo M, Sahin A, Mittendorf EA. Interobserver Agreement Between Pathologists Assessing Tumor-Infiltrating Lymphocytes (TILs) in Breast Cancer Using Methodology Proposed by the International TILs Working Group. Ann Surg Oncol 2016; 23:2242-8. [PMID: 26965699 DOI: 10.1245/s10434-016-5173-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND The presence of tumor-infiltrating lymphocytes (TILs) in breast tumors is prognostic and predictive, suggesting that TILs may be an important biomarker. Recently, an international TILs working group formulated consensus recommendations for TIL evaluation. The current study was performed to determine interobserver agreement using that methodology. METHODS Tumor-infiltrating lymphocytes were assessed on a single hematoxylin and eosin (H&E)-stained slide obtained from the core biopsy of 75 triple-negative breast cancers. Four pathologists independently reviewed each slide and evaluated stromal TILs (sTILs) and intratumoral TIL (iTILs). The kappa statistic was used to estimate interobserver agreement for identification of sTILs, and the intraclass correlation coefficient (ICC) was used to estimate the agreement among observers for iTILs. Cases with poor agreement were reviewed to identify pathologic factors that may contribute to the lack of agreement. RESULTS The kappa statistic for sTIL evaluation was 0.57 (standard error, 0.04). For iTILs, the ICC calculated to determine internal consistency within raters was 0.65 (95 % confidence interval [CI] 0.56-0.74; p < 0.0001), and the ICC calculated to determine agreement among raters was 0.62 (95 % CI 0.50-0.72; p < 0.0001). In 10 cases (13 %), there was not agreement between three of four pathologists. The pathologic features contributing to difficulty in TIL enumeration included marked individual tumor cell necrosis or apoptosis, the presence of reactive plasma cells mimicking tumor cells, plasmatoid tumor cells, and accurate quantification of TILs in specimens with focal areas of heavy immune infiltrate. CONCLUSION Acceptable agreement in TIL enumeration was observed, suggesting that the proposed methodology can be used to facilitate the use of TILs as a biomarker in research and clinical trial settings.
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Affiliation(s)
- Shannon K Swisher
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yun Wu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos A Castaneda
- Department of Clinical Medicine, Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Genvieve R Lyons
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fei Yang
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Coya Tapia
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiuhong Wang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sandro A A Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Miluska Castillo
- Department of Clinical Medicine, Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Aysegul Sahin
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth A Mittendorf
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Abstract
Unexpected tryptic cleavage has been characterized at modified K48 residues in polyubiquitins. In particular, the tryptic products of all seven of the lysine-linked dimers of ubiquitin and of three trimers-linear Ub-(48)Ub-(48)Ub, linear Ub-(63)Ub-(63)Ub, and the branched trimer [Ub]2-(6,48)Ub-have been analyzed. In addition to the peptide products expected under commonly used tryptic conditions, we observe that peptides are formed with an unexpected ε-glycinylglycinyl-Lys carboxyl terminus when the site of linkage is Lys48. Trypsin from three different commercial sources exhibited this aberration. Initial cleavage at R74 is proposed in a distal ubiquitin to produce a glycinylglycinyl-lysine residue which is bound by trypsin.
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Sullcahuaman-Allende Y, Castro-Mujica MDC, Mejía Farro R, Castaneda CA, Castillo M, Dolores-Cerna K, Poquioma E. [Demographic characteristics of human papillomavirus detected by PCR-RFLP in peruvian women]. Rev Peru Med Exp Salud Publica 2015; 32:509-514. [PMID: 26580934] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 06/17/2015] [Indexed: 06/05/2023] Open
Abstract
In order to determine the sociodemographic characteristics of human papillomavirus (HPV) in patients referred to the National Institute of Neoplastic Diseases (INEN) between 2012-2014, the detection of HPV in cervical cells was performed by polymerase chain reaction (PCR). In 465 cervical samples, 151 (32.5%) cases were HPV positive. The most common genotypes were HPV-16 (23.8%) and HPV-6 (11.9%). The presence of HPV was higher in women aged 17-29 years (OR = 2.64, 95% CI 1.14 to 6.13) and single women (OR = 2.31, 95% CI 1.37 to 3.91). The presence of genotypes of high-risk HPV was higher in single women (OR = 2.19, 95% CI 1.04 to 4.62). In conclusion, young and single women had a higher frequency of HPV-positive cases. Therefore participation by these groups should be emphasized in screening programs with combined molecular and cytological methods in order to detect the risk of developing cervical cancer in a timely manner.
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Affiliation(s)
| | | | | | | | | | | | - Ebert Poquioma
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
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Castaneda CA, Flores R, Rojas KY, Castillo M, Dolores-Cerna K, Flores C, Belmar-Lopez C, Milla E, Gomez H. Prognostic factors for patients with newly diagnosed brain metastasis from breast cancer. CNS Oncol 2015; 4:137-45. [PMID: 25906174 DOI: 10.2217/cns.15.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 11/21/2022] Open
Abstract
AIM This retrospective study determined features associated with brain metastasis (BM) in women with breast cancer. PATIENTS & METHODS A total of 215 initially early breast cancer cases were included. We reviewed files and CT scan images of BM. RESULTS Median age was 47 years and most of our cases were stage III (58.6%), grade III (62.8%), ER negative (62.3%) and nonluminal (59.1%). Median survival after BM was 4 months. Nonluminal, extracranial disease, time to CNS shorter than 15 months, >three brain lesions and poor breast-graded prognostic assessment and recursive partitioning analysis scores were associated with shorter survival. Adding extracranial disease to breast-graded prognostic assessment score also predicted survival after BM. Radiation response was assessed in 57 patients and response tended to be associated with nonluminal phenotype but not with survival. CONCLUSION Factors associated with both initial tumor and clinical features at BM time are associated with shorter survival in our Latinas population.
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Affiliation(s)
- Carlos A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Gámez-Pozo A, Berges-Soria J, Arevalillo JM, Nanni P, López-Vacas R, Navarro H, Grossmann J, Castaneda CA, Main P, Díaz-Almirón M, Espinosa E, Ciruelos E, Fresno Vara JÁ. Combined Label-Free Quantitative Proteomics and microRNA Expression Analysis of Breast Cancer Unravel Molecular Differences with Clinical Implications. Cancer Res 2015; 75:2243-53. [PMID: 25883093 DOI: 10.1158/0008-5472.can-14-1937] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 03/12/2015] [Indexed: 11/16/2022]
Abstract
Better knowledge of the biology of breast cancer has allowed the use of new targeted therapies, leading to improved outcome. High-throughput technologies allow deepening into the molecular architecture of breast cancer, integrating different levels of information, which is important if it helps in making clinical decisions. microRNA (miRNA) and protein expression profiles were obtained from 71 estrogen receptor-positive (ER(+)) and 25 triple-negative breast cancer (TNBC) samples. RNA and proteins obtained from formalin-fixed, paraffin-embedded tumors were analyzed by RT-qPCR and LC/MS-MS, respectively. We applied probabilistic graphical models representing complex biologic systems as networks, confirming that ER(+) and TNBC subtypes are distinct biologic entities. The integration of miRNA and protein expression data unravels molecular processes that can be related to differences in the genesis and clinical evolution of these types of breast cancer. Our results confirm that TNBC has a unique metabolic profile that may be exploited for therapeutic intervention.
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Affiliation(s)
- Angelo Gámez-Pozo
- Molecular Oncology and Pathology Lab, Instituto de Genética Médica y Molecular-INGEMM, Instituto de Investigación Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Julia Berges-Soria
- Molecular Oncology and Pathology Lab, Instituto de Genética Médica y Molecular-INGEMM, Instituto de Investigación Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Jorge M Arevalillo
- Department of Statistics, Operational Research and Numerical Analysis, University Nacional Educacion a Distancia (UNED), Madrid, Spain
| | - Paolo Nanni
- Functional Genomics Centre Zurich, University of Zurich/ETH Zurich, Zurich, Switzerland
| | - Rocío López-Vacas
- Molecular Oncology and Pathology Lab, Instituto de Genética Médica y Molecular-INGEMM, Instituto de Investigación Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Hilario Navarro
- Department of Statistics, Operational Research and Numerical Analysis, University Nacional Educacion a Distancia (UNED), Madrid, Spain
| | - Jonas Grossmann
- Functional Genomics Centre Zurich, University of Zurich/ETH Zurich, Zurich, Switzerland
| | - Carlos A Castaneda
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima, Surquillo-Lima, Peru
| | - Paloma Main
- Department of Statistics and Operations Research, Faculty of Mathematics, Complutense University of Madrid, Madrid, Spain
| | - Mariana Díaz-Almirón
- Biostatistics Unit, Instituto de Investigación Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Enrique Espinosa
- Medical Oncology Service, Instituto de Investigación Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Eva Ciruelos
- Medical Oncology Service, Instituto de Investigación Hospital Universitario Doce de Octubre-i+12, Madrid, Spain
| | - Juan Ángel Fresno Vara
- Molecular Oncology and Pathology Lab, Instituto de Genética Médica y Molecular-INGEMM, Instituto de Investigación Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.
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Castaneda CA, Flores R, Rojas K, Flores C, Castillo M, Milla E. Association between mammographic features and response to neoadjuvant chemotherapy in locally advanced breast carcinoma. Hematol Oncol Stem Cell Ther 2014; 7:149-56. [PMID: 25300565 DOI: 10.1016/j.hemonc.2014.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 08/07/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Mammography is the cornerstone of breast cancer (BC) evaluation. This report investigates whether breast density (BD) and mammographic features of the tumor can provide information on both BC susceptibility to chemotherapy and other clinicopathologic features of locally advanced BC (LA BC). MATERIALS AND METHODS We evaluated mammography films and clinicopathological information of patients with LA BC who received neoadjuvant chemotherapy (NAC) followed by tumor resection at the Instituto Nacional de Enfermedades Neoplásicas (INEN) from 2000 to 2011. RESULTS We selected 494 LA BC cases. Most cases were at clinical tumor stage 4 (48.5%), node stage 1 (58.8%) and had high histologic grade (53.3%). BI-RADS 1, 2, 3, and 4 BD were found in 16.9%, 22%, 35.7% and 25.1% of patients, respectively. High BD has been associated with younger age (p<0.001), obesity (p=0.017) and no skin infiltration (T3 vs T4) (p=0.018). An association between dusty microcalcifications and HER2 group, as well as between casting microcalcifications and TN BC group (p=0.05) was found. NAC included anthracyclines and taxanes in 422 (85.5%) cases. Miller-Payne pathologic responses 4 and 5 (pCR) in the primary lesion and absence of axillary lymph nodes involvement were found in 15.3% of cases and were associated with younger age (p<0.001) and HG-3 lesions (p<0.001), but not with mammographic images. CONCLUSION Mammographic features are associated with specific clinicopathological features of pre-NAC BC lesions but do not predict pCR. The implications and biological reasons for these findings require further study.
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Affiliation(s)
- Carlos A Castaneda
- Instituto Nacional de Enfermedades Neoplasicas, Medical Oncology Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru.
| | - Raymundo Flores
- Instituto Nacional de Enfermedades Neoplasicas, Radiology Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru
| | - Katerin Rojas
- Instituto Nacional de Enfermedades Neoplasicas, Medical Oncology Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru
| | - Claudio Flores
- Oncosalud- AUNA, Av. Guardia Civil 571, San Borja, Lima, Peru
| | - Miluska Castillo
- Instituto Nacional de Enfermedades Neoplasicas, Research Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru
| | - Esperanza Milla
- Instituto Nacional de Enfermedades Neoplasicas, Pathology Department. Av. Angamos Este, 2520 Surquillo, Lima, Peru
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Espinosa E, Berges-Soria J, Gamez-Pozo A, Nanni P, Grossmann J, Lopez-Vacas R, Castaneda CA, Diaz-Almiron M, Madero R, Zamora P, Ciruelos E, Fresno-Vara JA. Abstract P4-05-04: Proteomic patterns unravel a new luminal-A breast cancer molecular subgroup with prognostic value. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-05-04] [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: Breast cancer is a heterogeneous disease including a variety of entities with different genetic background. Estrogen receptor-positive, HER2 negative tumors (ER+) usually have a favorable outcome, although some patients eventually relapse, which suggests some heterogeneity within this category.
In the last years, proteomic approaches have been incorporated to the study of clinical samples as a way to complement the information provided by gene analysis. Shotgun proteomics allows measuring over 1,000 proteins in clinical samples. In the present study, we combined genomic and proteomic techniques to characterize a set of breast tumors.
Methods: The study population consisted of 102 patients with lymph-node positive breast cancer who had received anthracycline-based adjuvant chemotherapy. Protein extracts from FFPE samples were prepared in 2% SDS buffer and digested with trypsin. SDS was removed from digested lysates, and resulting peptides were analyzed in an Orbitrap Velos. Protein abundance was calculated on the basis of the normalized spectral protein intensity (LFQ intensity) using MaxQuant. A prognostic protein signature was built. Findings were verified using whole genome gene expression data from 1,141 patients included in public repositories. To this purpose, the protein signature was converted to a gene signature. Data analysis was done using MeV, BRBArray Tools, R and Cytoscape software suites and Uniprot (http://www.uniprot.org/) and DAVID (http://david.abcc.ncifcrf.gov) webtools.
Results: We identified 3,000 protein groups in FFPE breast cancer samples and selected 1,000 that were identified at least in 75% of the samples. Significance Analysis for Microarrays analysis revealed 224 protein groups differentially expressed between ER+ and triple-negative (TN) samples (False Discovery Rate set at <0.001). Hierarchical clustering analyses of protein expression showed that some ER+ samples had a protein expression profile similar to that of TN samples: patients with TN-like tumors had a clinical outcome similar to those with TN disease. Gene ontology analyses unraveled a reduced expression of proteins related with cellular adhesion in the TN-like and the TN groups. A TN-like predictive protein signature was built, converted to a gene signature and evaluated in the whole-genome expression data. The signature had prognostic value in patients with luminal-A breast cancer. This prognostic information was independent from that provided by standard genomic tests for breast cancer, such as MammaPrint, OncoType Dx and the 8-gene Score.
Conclusions: Proteomic profiling showed that cellular adhesion is a differential process between ER+ and TN breast cancer, and is reduced in the TN tumors. A group of ER+ breast tumors with reduced cellular adhesion was identified (TN-like). Patients with this luminal-A, TN-like breast cancer type had a poor outcome. This prognostic information was complementary to that offered by genomic tests such as OncoType.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-05-04.
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Affiliation(s)
- E Espinosa
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - J Berges-Soria
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - A Gamez-Pozo
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - P Nanni
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - J Grossmann
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - R Lopez-Vacas
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - CA Castaneda
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - M Diaz-Almiron
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - R Madero
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - P Zamora
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - E Ciruelos
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
| | - JA Fresno-Vara
- Hospital La Paz - IdiPAZ, Madrid, Spain; Laboratory of Molecular Oncology & Pathology, INGEMM - IdiPAZ, Madrid, Spain; Functional Genomics Centre, Zürich, Switzerland; Hospital Doce de Octubre - i+12, Madrid, Spain; IdiPAZ, Madrid, Spain
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Castaneda CA, Dixon E, Chaturvedi A, Krueger S, Cropp TA, Fushman D. Effect of Different Lysine Linkages on Polyubiquitin Chain Structure and Function. Biophys J 2013. [DOI: 10.1016/j.bpj.2012.11.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ciruelos EM, Castaneda CA, Andrés E, Gomez HL, Castellano D, Mendiola C, Manso L, Ghanem I, Farfan C, Cortes-Funes H. P3-05-06: Progression of Breast Cancer Molecular Subtypes through Different Clinical Stages. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p3-05-06] [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
Purpose : Molecular classification of breast cancer (BC) through immunohistochemistry classifies patients globally in 4 subtypes with similar features and prognosis. The present study was designed to compare features of BC subtypes in early versus locally advanced clinical stages. A secondary objective was compare molecular subtypes of the primary vs recurrences.
Methods : The study included 1621 patients with non-metastatic invasive BC that were consecutively diagnosed at Hospital Universitario 12 de Octubre, Madrid, between 1997 and 2007. Luminal A was defined as ER+ and PR+, HER2−negative and Ki67 < 14%. Luminal B was defined as PR-negative, HER2−positive or ki67≥14%. HER2 was defined as ER and PR-negative, and HER2−positive.Triple negative (TN) were tumors with ER, PR and HER2 -negativity. Clinicopathological characteristics and outcomes were retrospectively reviewed. Variables were compared with the X2 test, and survival curves were evaluated with Kaplan-Meier method.
Results : Most patients were diagnosed as T1 (48%) and T2 (39.7%) clinical stages, and classified as Luminal B (49%) and Luminal A (29%). GIII frequency increased from T1 to T3-4 in Luminal A (p=0.002), and Luminal B (p=0.051) subtypes, but not in HER2 (p=0.867) or TN (p=0.53).
Molecular subtypes carry significant different prognosis (DFS and OS) in all T stages except for T1a cases. When T3-4 and T1 stages of the same molecular subtype were compared, a significant shorter DFS were found for more advanced stages in the Luminal A (p=0.0002), Luminal B (0.0001) and TN (0.0017), but not for HER2 (p=0.54) subtype. And, similar results were found for OS.
We compared molecular subtypes in the primary tumor and in the metastatic site in 83 cases (excluding contralateral recurrences) and found change of phenotype in 54% of the cases. Changes from Luminal A to a more aggressive phenotype were more frequent than in the opposite situation (14 vs 2 cases).
Conclusion : Despite the molecular classification of early-stage BC that classifies patients in well-defined prognostic subgroups, tumors are continuously changing and tumor behavior becomes more aggressive through progression. Therefore, even tumors with favorable phenotype could loss their good prognosis in locally advanced stages. Obtention of tumor tissue at metastatic sites is also mandatory to a better selection of systemic therapies in relapsed patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-05-06.
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Affiliation(s)
- EM Ciruelos
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - CA Castaneda
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - E Andrés
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - HL Gomez
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - D Castellano
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - C Mendiola
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - L Manso
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - I Ghanem
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - C Farfan
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - H Cortes-Funes
- 1Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
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Castaneda CA, Gomez HL, Vallejos C, Cortes-Funes H, Castellano D, Andrés E, Cruz W, Ciruelos EM. P2-14-09: Comparison between Spanish and Peruvian Patients with Early Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-14-09] [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
Purpose : Breast Cancer (BC) is a genetic, heterogeneous disease and has a remarkable variability according to racial factors. Hypothetic explanations for these disparities include differences in tumor biology. The present study was designed to compare clinical and pathological features between Peruvian Latinas and Spanish women with BC; interest of this analysis increases if we take into account the relationship among historic ancestries of both ethnic groups (Incas emporium and Spanish conquers).
Methods : Information was retrospectively reviewed from patients files and pathologic reports from Instituto Nacional de Enfermedades Neoplasicas (INEN) in Lima- Peru, and Hospital Universitario 12 de Octubre in Madrid- Spain. In order to produce comparative information and avoid subjective clinical measurements we selected only non-metastatic and non-bilateral invasive BC cases that underwent surgery as initial therapy. BC cases were classified as molecular subtypes: Luminal A [RE+ and/or RP+, HER2−], Lum B [RE+ and/or RP+, HER2+], triple negative (TN) [RE-, RP-, HER2−] and HER2 [RE-, RP-, HER2+]. Variables were compared with the X2 test and survival curves were evaluated with Kaplan-Meier method. Results: The study included 3765 BC cases. The Spanish cohort involved 1539 (40.9%) women consecutively diagnosed between 1997 and 2007 (median follow-up of 7.9 years). The Peruvian cohort involved 2226 (59.1%) women consecutively diagnosed between 2000 and 2006 (median follow-up of 6.3 years).
In terms of pathological features, grade I tumors were more frequent in Spanish (16.2%) than Peruvian women (9.6%) (p<0.001). Higher rates of lobular histology were also found in Spanish (12.5%) than Peruvian (6.0%) women (p<0.001). Spanish cases presented at earlier stages when evaluated by lymph node status (N0 in 58.9% vs 47.1%) (p<0.001) or by tumor size (T1 in 37.9% vs 17-2%). Conservative surgery were more frequent among Spanish cases (50.6% vs 16.8%) (p<0.001). TN molecular subtype were more frequent among Peruvian cases (22.5% vs 12.4%) (p<0.001).
Brain (10.4% vs5.3%), and skin and subcutaneous (7.1% vs 2.4%) metastases were more frequently found in Peruvian patients. On the other hand, contralateral breast cancer was more frequent among Spanish patients (12.2% vs 2.8%).
And when evaluated by molecular subtypes, bone metastases in TN were more frequent among Spanish (25.4%) than Peruvian (18.5%) cases.
Disease-free survival rates at 7 years were similar between Spanish and Peruvian patients (80,3% vs 79,6%, p=0.197). However, overall survival at 7 years was better in Spanish women (90.4% vs 82.6%, p<0.001).
Conclusion : Epidemiologic differences in terms of histological features, clinical stage at diagnosis, molecular subtypes distribution, recurrence patterns and prognosis were found among Spanish and Peruvian BC patients in this retrospective analysis.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-14-09.
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Affiliation(s)
- CA Castaneda
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - HL Gomez
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Vallejos
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - H Cortes-Funes
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - D Castellano
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - E Andrés
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - W Cruz
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - EM Ciruelos
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital Universitario 12 de Octubre, Madrid, Spain
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Abstract
The phosphatidyl inositol 3-kinase (PI3K)/Akt pathway mediates the effects of a variety of extracellular signals in a number of cellular processes including cell growth, proliferation, and survival. The alteration of integrants of this pathway through mutation of its coding genes increases the activation status of the signaling and can thus lead to cellular transformation. The frequent dysregulation of the PI3K/Akt pathway in breast cancer (BC) and the mediation of this pathway in different processes characteristically implicated in tumorigenesis have attracted the interest of this pathway in BC; however, a more comprehensive understanding of the signaling intricacies is necessary to develop clinical applications of the modulation of this pathway in this pathology. We review a series of experiments examining the contribution of alteration of integrants of this signaling network to human BC and we make an update of the information about the effect of the modulation of this pathway in this cancer.
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Castaneda CA, Kashyap T, Fushman D. K11-linked Diubiquitin Exhibits Significant Interdomain Dynamics. Biophys J 2011. [DOI: 10.1016/j.bpj.2010.12.2233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Pazopanib, a tyrosine kinase inhibitor targeted to angiogenesis, has been tested in preclinical and clinical trials and has shown promising activity against a variety of solid tumors, such as renal cancer, all of which are related to the angiogenic pathway. It has a safety profile related to this mechanism of action. Diarrhea, hypertension, hair depigmentation and nausea are the most common side effects. Pazopanib is currently under evaluation as monotherapy and in combination with some potentially synergistic agents of proven activity.
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Abstract
Resistance to chemotherapy is a complex and very frequent problem in the treatment of breast cancer. It is associated with a poor prognosis and short overall survival. We report a patient with advanced breast cancer without response to anthracyclines or taxanes but who controlled the disease for 15 months with the combination of ixabepilone and capecitabine.
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