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Marchiò C, Mariani S, Bertero L, Di Bello C, Francia Di Celle P, Papotti M, Rudà R, Soffietti R, Cassoni P. Liquoral liquid biopsy in neoplastic meningitis enables molecular diagnosis and mutation tracking: a proof of concept. Neuro Oncol 2019; 19:451-453. [PMID: 27838647 PMCID: PMC5464358 DOI: 10.1093/neuonc/now244] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 09/29/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Caterina Marchiò
- Department of Medical Sciences, University of Turin, Turin, Italy.,Pathology Division, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Sara Mariani
- Department of Medical Sciences, University of Turin, Turin, Italy.,Pathology Division, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Cristiana Di Bello
- Pathology Division, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Paola Francia Di Celle
- Pathology Division, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Mauro Papotti
- Pathology Division, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Roberta Rudà
- Department of Neuro-Oncology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Riccardo Soffietti
- Department of Neuro-Oncology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Neurosciences, University of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy.,Pathology Division, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
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Mariani S, Bertero L, Osella-Abate S, Di Bello C, Francia di Celle P, Coppola V, Sapino A, Cassoni P, Marchiò C. Extreme assay sensitivity in molecular diagnostics further unveils intratumour heterogeneity in metastatic colorectal cancer as well as artifactual low-frequency mutations in the KRAS gene. Br J Cancer 2017; 117:358-366. [PMID: 28618430 PMCID: PMC5537488 DOI: 10.1038/bjc.2017.170] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 12/16/2022] Open
Abstract
Background: Gene mutations in the RAS family rule out metastatic colorectal carcinomas (mCRCs) from anti-EGFR therapies. Methods: We report a retrospective analysis by Sequenom Massarray and fast COLD-PCR followed by Sanger sequencing on 240 mCRCs. Results: By Sequenom, KRAS and NRAS exons 2-3-4 were mutated in 52.9% (127/240) of tumours, while BRAF codon 600 mutations reached 5% (12/240). Fast COLD-PCR found extra mutations at KRAS exon 2 in 15/166 (9%) of samples, previously diagnosed by Sequenom as wild-type or mutated at RAS (exons 3-4) or BRAF genes. After UDG digestion results were reproduced in 2/12 analysable subclonally mutated samples leading to a frequency of true subclonal KRAS mutations of 1.2% (2.1% of the previous Sequenom wild-type subgroup). In 10 out of 12 samples, the subclonal KRAS mutations disappeared (9 out of 12) or turned to a different sequence variant (1 out of 12). Conclusions: mCRC can harbour coexisting multiple gene mutations. High sensitivity assays allow the detection of a small subset of patients harbouring true subclonal KRAS mutations. However, DNA changes with mutant allele frequencies <3% detected in formalin-fixed paraffin-embedded samples may be artifactual in a non-negligible fraction of cases. UDG pre-treatment of DNA is mandatory to identify true DNA changes in archival samples and avoid misinterpretation due to artifacts.
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Affiliation(s)
- Sara Mariani
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy
| | - Cristiana Di Bello
- Department of Molecular Biotechnology and Health Sciences, University of Turin, via Nizza 52, Turin 10126, Italy
| | - Paola Francia di Celle
- Pathology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, via Santena 7, Turin 10126, Italy
| | - Vittoria Coppola
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy.,Pathology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, via Santena 7, Turin 10126, Italy
| | - Caterina Marchiò
- Department of Medical Sciences, University of Turin, via Santena 7, Turin 10126, Italy.,Pathology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, via Santena 7, Turin 10126, Italy
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Mariani S, Di Bello C, Bonello L, Tondat F, Pacchioni D, Molinaro L, Barreca A, Macrì L, Chiusa L, di Celle PF, Cassoni P, Sapino A. Flexible lab-tailored cut-offs for suitability of formalin-fixed tumor samples for diagnostic mutational analyses. PLoS One 2015; 10:e0121815. [PMID: 25844806 PMCID: PMC4386759 DOI: 10.1371/journal.pone.0121815] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/04/2015] [Indexed: 11/18/2022] Open
Abstract
The selection of proper tissues from formalin-fixed and paraffin-embedded tumors before diagnostic molecular testing is responsibility of the pathologist and represents a crucial step to produce reliable test results. The international guidelines suggest two cut-offs, one for the percentage and one for the number of tumor cells, in order to enrich the tumor content before DNA extraction. The aim of the present work was two-fold: to evaluate to what extent a low percentage or absolute number of tumor cells can be qualified for somatic mutation testing; and to determine how assay sensitivities can guide pathologists towards a better definition of morphology-based adequacy cut-offs. We tested 1797 tumor specimens from melanomas, colorectal and lung adenocarcinomas. Respectively, their BRAF, K-RAS and EGFR genes were analyzed at specific exons by mutation-enriched PCR, pyrosequencing, direct sequencing and real-time PCR methods. We demonstrate that poorly cellular specimens do not modify the frequency distribution of either mutated or wild-type DNA samples nor that of specific mutations. This observation suggests that currently recommended cut-offs for adequacy of specimens to be processed for molecular assays seem to be too much stringent in a laboratory context that performs highly sensitive routine analytical methods. In conclusion, new cut-offs are needed based on test sensitivities and documented tumor heterogeneity.
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Affiliation(s)
- Sara Mariani
- Department of Medical Sciences; University of Torino, Torino, Italy
| | - Cristiana Di Bello
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza; Presidio Ospedaliero Molinette of Torino, Torino, Italy
| | - Lisa Bonello
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Fabrizio Tondat
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Donatella Pacchioni
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza; Presidio Ospedaliero Molinette of Torino, Torino, Italy
| | - Luca Molinaro
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza; Presidio Ospedaliero Molinette of Torino, Torino, Italy
| | | | - Luigia Macrì
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza; Presidio Ospedaliero Molinette of Torino, Torino, Italy
| | - Luigi Chiusa
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza; Presidio Ospedaliero Molinette of Torino, Torino, Italy
| | - Paola Francia di Celle
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza; Presidio Ospedaliero Molinette of Torino, Torino, Italy
| | - Paola Cassoni
- Department of Medical Sciences; University of Torino, Torino, Italy
| | - Anna Sapino
- Department of Medical Sciences; University of Torino, Torino, Italy
- * E-mail:
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Riera L, Lasorsa E, Bonello L, Sismondi F, Tondat F, Di Bello C, Di Celle PF, Chiarle R, Godio L, Pich A, Facchetti F, Ponzoni M, Marmont F, Zanon C, Bardelli A, Inghirami G. Description of a novel Janus kinase 3 P132A mutation in acute megakaryoblastic leukemia and demonstration of previously reported Janus kinase 3 mutations in normal subjects. Leuk Lymphoma 2011; 52:1742-50. [DOI: 10.3109/10428194.2011.574757] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Curti A, Tosi P, Comoli P, Terragna C, Ferri E, Cellini C, Massaia M, D'Addio A, Giudice V, Di Bello C, Cavo M, Conte R, Gugliotta G, Baccarani M, Lemoli RM. Phase I/II clinical trial of sequential subcutaneous and intravenous delivery of dendritic cell vaccination for refractory multiple myeloma using patient-specific tumour idiotype protein or idiotype (VDJ)-derived class I-restricted peptides. Br J Haematol 2008; 139:415-24. [PMID: 17910631 DOI: 10.1111/j.1365-2141.2007.06832.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Fifteen multiple myeloma (MM) patients who had failed maintenance therapy after tandem autologous stem cell transplantation underwent anti-idiotype (Id) vaccination with dendritic cells (DCs). CD14(+)-derived DCs were loaded with the autologous Id as whole protein (=6) or Id-derived class I-restricted peptides (=9) and keyhole limpet hemocyanin (KLH). Vaccination consisted of three subcutaneous (sc) and two intravenous injections of increasing DC doses at 2 weeks interval. DC therapy was well tolerated. Most patients developed both humoral and T-cell responses to KLH, suggesting immunocompetence. Eight of 15 patients developed an Id-specific T-cell proliferative response, 8/15 increased interferon-gamma-secreting T cells and 4/15 showed an Id-positive delayed-type hypersensitivity test. Anti-Id cytotoxic T-lymphocyte precursors increased after DC vaccination in 2/2 evaluable patients. A more robust T-cell response was observed after sc DC injections and increased Id-specific T-cell proliferation was found up to 1 year after vaccination. VDJ-derived peptides were as effective as the whole protein in stimulating T-cell responses. Clinically, 7/15 patients have stable disease after a median follow-up of 26 months, one patient achieved durable partial remission after 40 months, and seven patients progressed. In conclusion, sc injections of cryopreserved Id-pulsed DCs were safe and, in contrast with intravenous administrations, induced anti-MM T-cell responses.
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Affiliation(s)
- Antonio Curti
- Institute of Haematology and Medical Oncology 'L. & A. Seràgnoli', University of Bologna, Bologna, Italy
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