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Kremer WW, Dick S, Heideman DA, Steenbergen RD, Bleeker MC, Verhoeve HR, van Baal WM, van Trommel N, Kenter GG, Meijer CJ, Berkhof J. Clinical Regression of High-Grade Cervical Intraepithelial Neoplasia Is Associated With Absence of FAM19A4/miR124-2 DNA Methylation (CONCERVE Study). J Clin Oncol 2022; 40:3037-3046. [PMID: 35512257 PMCID: PMC9462536 DOI: 10.1200/jco.21.02433] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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: 12/27/2022] Open
Abstract
PURPOSE Cervical screening can prevent cancer by detection and treatment of cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3). Screening also results in considerable overtreatment because many CIN2/3 lesions show spontaneous regression when left untreated. In this multicenter longitudinal cohort study of women with untreated CIN2/3, the prognostic value of FAM19A4/miR124-2 methylation was evaluated for clinical regression. PATIENTS AND METHODS Women with CIN2/3 were prospectively followed for 24 months. Surgical excision was replaced by a wait-and-see policy. FAM19A4/miR124-2 methylation was evaluated on all clinician-collected samples and self-collected samples collected at baseline. Every 6 months, human papillomavirus (HPV) testing and cytology were conducted on a clinician-collected sample, and a colposcopic examination was performed by a gynecologist to exclude progression. At the final study visit, two biopsies were taken. Clinical regression was defined as histologically confirmed absence of CIN2+ or an HPV-negative clinician-collected sample with normal cytology. Regression incidences were estimated using the Kaplan-Meier method. RESULTS One hundred fourteen women (median age, 30 years; range, 20-53 years) were included, 80 of whom were diagnosed with CIN2 and 34 with CIN3. During the study, 65.8% of women (75/114) did not receive surgical treatment. Women with a negative FAM19A4/miR124-2 result on the baseline clinician-collected sample showed more clinical regression (74.7%) than women with a positive methylation result (51.4%, P = .013). Regression in women with a negative FAM19A4/miR124-2 methylation test was highest when cytology was atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (88.4%) or HPV16 was negative (85.1%). CONCLUSION Most women with untreated CIN2/3 and a negative baseline FAM19A4/miR124-2 methylation test showed clinical regression. Methylation, in combination with cytology or HPV genotyping, can be used to support a wait-and-see policy in women with CIN2/3.
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Affiliation(s)
- Wieke W. Kremer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Stèfanie Dick
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Daniëlle A.M. Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Renske D.M. Steenbergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Maaike C.G. Bleeker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | | | | | - Nienke van Trommel
- Department of Gynecologic Oncology, Center of Gynecologic Oncology Amsterdam, Location Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Gemma G. Kenter
- Center of Gynaecologic Oncology Amsterdam, Location Amsterdam UMC, Amsterdam, the Netherlands
| | - Chris J.L.M. Meijer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Johannes Berkhof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Cancer Center Amsterdam, Amsterdam, the Netherlands,Johannes Berkhof, PhD, Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; e-mail:
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Vink FJ, Steenbergen RD, Kremer WW, Lissenberg-Witte BI, Heideman DA, Bleeker MC, van Zummeren M, Breytenbach E, Visser C, Lukhwareni A, Meijer CJ, Dreyer G. Posttreatment monitoring by ASCL1/LHX8 methylation analysis in women with HIV treated for cervical intraepithelial neoplasia grade 2/3. AIDS 2022; 36:953-961. [PMID: 35152224 DOI: 10.1097/qad.0000000000003197] [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]
Abstract
OBJECTIVE Women with HIV (WWH) have an increased risk to develop recurrent cervical intraepithelial neoplasia grade 2/3 (rCIN2/3) after treatment compared with HIV-negative women. Therefore, appropriate posttreatment monitoring of WWH is important. This study evaluates the performance of ASCL1 and LHX8 methylation analysis as posttreatment monitoring test in WWH treated for CIN2/3, as alternative to cytology or human papillomavirus (HPV) as follow-up test. DESIGN Prospective observational cohort study. METHODS WWH treated for CIN2/3 by large loop excision of the transformation zone (LLETZ) (n = 61) were invited for follow-up study visits at 1, 2.5 and 4 years after baseline. Baseline and follow-up cervical scrapes were tested for cytology, HPV and DNA methylation of ASCL1 and LHX8 genes. The performance of these strategies for the detection of rCIN2/3 was evaluated in the first follow-up cervical scrape. RESULTS Thirteen (21.3%) rCIN2/3 lesions were detected within 4 years of follow-up. In women without rCIN2/3 in follow-up, methylation levels of ASCL1 and LHX8 decreased significantly after LLETZ treatment (P = 0.02 and 0.007, respectively). In women with rCIN2/3, methylation levels remained high after LLETZ treatment. The 4-year rCIN2/3 risk was 4.9% (95% CI: 0.6-16.5) for ASCL1/LHX8-negative women, 8.1% (95% CI: 1.7-21.9) for HPV-negative women and 7.7% (95% CI: 2.1-18.5) for cytology-negative women. CONCLUSION A negative ASCL1/LHX8 methylation test in follow-up is associated with a low rCIN2/3 risk and could serve as an objective test of cure and well tolerated alternative for HPV and/or cytology screening in the posttreatment monitoring of WWH.
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Inturrisi F, Bogaards JA, Siebers AG, Meijer CJ, Heideman DA, Berkhof J. Women with a positive high-risk human papillomavirus (HPV) test remain at increased risk of HPV infection and cervical precancer ≥15 years later. Tumour Virus Res 2022; 14:200240. [PMID: 35640823 PMCID: PMC9190048 DOI: 10.1016/j.tvr.2022.200240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/02/2021] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 01/13/2023] Open
Abstract
Little is known about the long-term association between high-risk human papillomavirus (hrHPV) test results in women participating in a hrHPV-based cervical cancer screening program. To address this question, we collected data of 2217 women who participated in the POBASCAM hrHPV-based screening trial (enrolment 1999/2002) and also attended the Dutch hrHPV-based screening program between January 2017 and March 2018. Among 143 women who tested hrHPV-positive in 1999/2002, 45 (31.5%) had ≥ CIN2 or hysterectomy before 2017 and 17 (11.9%) tested hrHPV-positive at the 2017/2018 screen. In comparison, among 2074 women who tested hrHPV-negative in 1999/2002, 10 (0.5%) had ≥ CIN2 or hysterectomy before 2017 and 119 (5.7%) tested hrHPV-positive at the 2017/2018 screen. It follows that in the group of women who were not treated for ≥ CIN2 or had a hysterectomy in between the two screens 15 years apart (N = 2162), women who were hrHPV-positive in 1999/2002 had a higher risk of being hrHPV-positive in 2017/2018 than those who were hrHPV-negative in 1999/2002 (OR 3.4, 95% CI 1.8-6.1). A similar association was found at the genotype level for genotype-concordant results (5.1, 1.0-11.3) and for genotype non-concordant results (3.7, 1.6-6.7). Women who were hrHPV-positive in 2017/2018 had a higher risk of CIN3 after a hrHPV-positive result in 1999/2002 than after a hrHPV-negative result (5.8, 1.0-27.8). In conclusion, a positive hrHPV result in screening gives a long-term increased risk of a hrHPV-positive result, also for different genotypes, and a long-term increased risk of CIN3. This supports the concept of risk-stratification in hrHPV-based cervical cancer screening where previous hrHPV results are included in screening recommendations.
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Affiliation(s)
- Federica Inturrisi
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands,Amsterdam Public Health, Methodology, Amsterdam, the Netherlands,Corresponding author. Department of Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
| | - Johannes A. Bogaards
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands,Amsterdam Public Health, Methodology, Amsterdam, the Netherlands
| | | | - Chris J.L.M. Meijer
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology, De Boelelaan, 1117, Amsterdam, the Netherlands,Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, the Netherlands
| | - Daniëlle A.M. Heideman
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology, De Boelelaan, 1117, Amsterdam, the Netherlands,Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, the Netherlands
| | - Johannes Berkhof
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands,Amsterdam Public Health, Methodology, Amsterdam, the Netherlands,Corresponding author. Department of Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
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4
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Inturrisi F, Aitken CA, Melchers WJ, van den Brule AJ, Molijn A, Hinrichs JW, Niesters HG, Siebers AG, Schuurman R, Heideman DA, de Kok IM, Bekkers RL, van Kemenade FJ, Berkhof J. Clinical performance of high-risk HPV testing on self-samples versus clinician samples in routine primary HPV screening in the Netherlands: An observational study. Lancet Reg Health Eur 2021; 11:100235. [PMID: 34918001 PMCID: PMC8642706 DOI: 10.1016/j.lanepe.2021.100235] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background High-risk human papillomavirus (hrHPV) testing on self-collected samples has potential as a primary screening tool in cervical screening, but real-world evidence on its accuracy in hrHPV-based screening programmes is lacking. Methods In the Netherlands, women aged 30–60 years invited for cervical screening can choose between sampling at the clinician's office (Cervex Brush) or self-sampling at home (Evalyn Brush). HrHPV testing is performed using Roche Cobas 4800. We collected screening test results between January 2017 and March 2018 and histological follow-up until August 2019. The main outcome measures were mean cycle threshold (Ct) value, cervical intraepithelial neoplasia (CIN) grade 3 or cancer (CIN3+) and CIN grade 2 or worse (CIN2+). Findings 30,808 women had a self-collected and 456,207 had a clinician-collected sample. In hrHPV-positive women with adequate cytology, Ct values were higher for self-collection than clinician-collection with a mean Ct difference of 1·25 (95% CI 0·98–1·52) in women without CIN2+, 2·73 (1·75–3·72) in CIN2 and 3·59 (3·03–4·15) in CIN3+. The relative sensitivity for detecting CIN3+ was 0·94 (0·90–0·97) for self-collection versus clinician-collection and the relative specificity was 1·02 (1·02–1·02). Interpretation The clinical accuracy of hrHPV testing on a self-collected sample for detection of CIN3+ is high and supports its use as a primary screening test for all invited women. Because of the slightly lower sensitivity of hrHPV testing on a self-collected compared to a clinician-collected sample, an evaluation of the workflow procedure to optimise clinical performance seems warranted. Funding National Institute for Public Health and the Environment (the Netherlands) and the European Commission.
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Affiliation(s)
- Federica Inturrisi
- Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health, 1081 HV Amsterdam, Netherlands
- Corresponding author at: Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Clare A. Aitken
- Erasmus MC University Medical Center, Public Health, 3015 GD Rotterdam, Netherlands
- Erasmus MC University Medical Center, Pathology, 3015 GD Rotterdam, Netherlands
| | - Willem J.G. Melchers
- Radboud University Medical Center, Medical Microbiology, 6525 GA Nijmegen, Netherlands
| | | | | | | | - Hubert G.M. Niesters
- University Medical Center Groningen, University of Groningen, Medical Microbiology, 9713 GZ Groningen, Netherlands
| | | | - Rob Schuurman
- University Medical Center Utrecht, Medical Microbiology, 3584 CX Utrecht, Netherlands
| | - Daniëlle A.M. Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, 1081 HV Amsterdam, Netherlands
| | - Inge M.C.M. de Kok
- Erasmus MC University Medical Center, Public Health, 3015 GD Rotterdam, Netherlands
| | - Ruud L.M. Bekkers
- GROW School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, Netherlands
- Catharina Hospital, 5623 EJ Eindhoven, Netherlands
| | | | - Johannes Berkhof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health, 1081 HV Amsterdam, Netherlands
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Koopman B, Groen HJ, Ligtenberg MJ, Grünberg K, Monkhorst K, de Langen AJ, Boelens MC, Paats MS, von der Thüsen JH, Dinjens WN, Solleveld N, van Wezel T, Gelderblom H, Hendriks LE, Speel EM, Theunissen TE, Kroeze LI, Mehra N, Piet B, van der Wekken AJ, ter Elst A, Timens W, Willems SM, Meijers RW, de Leng WW, van Lindert AS, Radonic T, Hashemi SM, Heideman DA, Schuuring E, van Kempen LC. Multicenter Comparison of Molecular Tumor Boards in The Netherlands: Definition, Composition, Methods, and Targeted Therapy Recommendations. Oncologist 2021; 26:e1347-e1358. [PMID: 33111480 PMCID: PMC8342588 DOI: 10.1002/onco.13580] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/25/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Molecular tumor boards (MTBs) provide rational, genomics-driven, patient-tailored treatment recommendations. Worldwide, MTBs differ in terms of scope, composition, methods, and recommendations. This study aimed to assess differences in methods and agreement in treatment recommendations among MTBs from tertiary cancer referral centers in The Netherlands. MATERIALS AND METHODS MTBs from all tertiary cancer referral centers in The Netherlands were invited to participate. A survey assessing scope, value, logistics, composition, decision-making method, reporting, and registration of the MTBs was completed through on-site interviews with members from each MTB. Targeted therapy recommendations were compared using 10 anonymized cases. Participating MTBs were asked to provide a treatment recommendation in accordance with their own methods. Agreement was based on which molecular alteration(s) was considered actionable with the next line of targeted therapy. RESULTS Interviews with 24 members of eight MTBs revealed that all participating MTBs focused on rare or complex mutational cancer profiles, operated independently of cancer type-specific multidisciplinary teams, and consisted of at least (thoracic and/or medical) oncologists, pathologists, and clinical scientists in molecular pathology. Differences were the types of cancer discussed and the methods used to achieve a recommendation. Nevertheless, agreement among MTB recommendations, based on identified actionable molecular alteration(s), was high for the 10 evaluated cases (86%). CONCLUSION MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational cancer profiles. We propose a "Dutch MTB model" for an optimal, collaborative, and nationally aligned MTB workflow. IMPLICATIONS FOR PRACTICE Interpretation of genomic analyses for optimal choice of target therapy for patients with cancer is becoming increasingly complex. A molecular tumor board (MTB) supports oncologists in rationalizing therapy options. However, there is no consensus on the most optimal setup for an MTB, which can affect the quality of recommendations. This study reveals that the eight MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational profiles. The Dutch MTB model is based on a collaborative and nationally aligned workflow with interinstitutional collaboration and data sharing.
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Affiliation(s)
- Bart Koopman
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Harry J.M. Groen
- Department of Pulmonary Diseases, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Marjolijn J.L. Ligtenberg
- Department of Pathology, Radboud University Medical CenterNijmegenThe Netherlands
- Department of Human Genetics, Radboud University Medical CenterNijmegenThe Netherlands
| | - Katrien Grünberg
- Department of Pathology, Radboud University Medical CenterNijmegenThe Netherlands
| | - Kim Monkhorst
- Department of Pathology, Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Adrianus J. de Langen
- Department of Thoracic Oncology, Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Mirjam C. Boelens
- Department of Pathology, Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Marthe S. Paats
- Department of Pulmonary Medicine, Erasmus Medical Center, University Medical Center RotterdamRotterdamThe Netherlands
| | - Jan H. von der Thüsen
- Department of Pathology, Erasmus Medical Center, University Medical Center RotterdamRotterdamThe Netherlands
| | - Winand N.M. Dinjens
- Department of Pathology, Erasmus Medical Center, University Medical Center RotterdamRotterdamThe Netherlands
| | - Nienke Solleveld
- Department of Pathology, Leiden University Medical CenterLeidenThe Netherlands
| | - Tom van Wezel
- Department of Pathology, Netherlands Cancer InstituteAmsterdamThe Netherlands
- Department of Pathology, Leiden University Medical CenterLeidenThe Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical CenterLeidenThe Netherlands
| | - Lizza E. Hendriks
- Department of Pulmonary Diseases, GROW‐School for Oncology and Developmental Biology, Maastricht University Medical CenterMaastrichtThe Netherlands
| | - Ernst‐Jan M. Speel
- Department of Pathology, GROW‐School for Oncology and Developmental Biology, Maastricht University Medical CenterMaastrichtThe Netherlands
| | - Tom E. Theunissen
- Department of Pathology, GROW‐School for Oncology and Developmental Biology, Maastricht University Medical CenterMaastrichtThe Netherlands
| | - Leonie I. Kroeze
- Department of Pathology, Radboud University Medical CenterNijmegenThe Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical CenterNijmegenThe Netherlands
| | - Berber Piet
- Department of Pulmonary Diseases, Radboud University Medical CenterNijmegenThe Netherlands
| | - Anthonie J. van der Wekken
- Department of Pulmonary Diseases, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Arja ter Elst
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Wim Timens
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Stefan M. Willems
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of Pathology, University Medical Center UtrechtUtrechtThe Netherlands
| | - Ruud W.J. Meijers
- Department of Pathology, University Medical Center UtrechtUtrechtThe Netherlands
| | - Wendy W.J. de Leng
- Department of Pathology, University Medical Center UtrechtUtrechtThe Netherlands
| | | | - Teodora Radonic
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Sayed M.S. Hashemi
- Department of Pulmonary Diseases, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Daniëlle A.M. Heideman
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ed Schuuring
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Léon C. van Kempen
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
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Nauta IH, Heideman DA, Brink A, van der Steen B, Bloemena E, Koljenovic S, de Jong RJB, Leemans CR, Brakenhoff RH. The unveiled reality of human papillomavirus as risk factor for oral cavity squamous cell carcinoma. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00267-0] [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: 10/21/2022]
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Vink FJ, Meijer CJ, Clifford GM, Poljak M, Oštrbenk A, Petry KU, Rothe B, Bonde J, Pedersen H, de Sanjosé S, Torres M, del Pino M, Quint WG, Cuschieri K, Boada EA, van Trommel NE, Lissenberg‐Witte BI, Floore AN, Hesselink AT, Steenbergen RD, Bleeker MC, Heideman DA. FAM19A4/miR124-2 methylation in invasive cervical cancer: A retrospective cross-sectional worldwide study. Int J Cancer 2020; 147:1215-1221. [PMID: 31390052 PMCID: PMC7383900 DOI: 10.1002/ijc.32614] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 12/17/2022]
Abstract
Widespread adoption of primary human papillomavirus (HPV)-based screening has encouraged the search for a triage test which retains high sensitivity for the detection of cervical cancer and precancer, but increases specificity to avoid overtreatment. Methylation analysis of FAM19A4 and miR124-2 genes has shown promise for the triage of high-risk (hr) HPV-positive women. In our study, we assessed the consistency of FAM19A4/miR124-2 methylation analysis in the detection of cervical cancer in a series of 519 invasive cervical carcinomas (n = 314 cervical scrapes, n = 205 tissue specimens) from over 25 countries, using a quantitative methylation-specific PCR (qMSP)-based assay (QIAsure Methylation Test®). Positivity rates stratified per histotype, FIGO stage, hrHPV status, hrHPV genotype, sample type and geographical region were calculated. In total, 510 of the 519 cervical carcinomas (98.3%; 95% CI: 96.7-99.2) tested FAM19A4/miR124-2 methylation-positive. Test positivity was consistent across the different subgroups based on cervical cancer histotype, FIGO stage, hrHPV status, hrHPV genotype, sample type and geographical region. In conclusion, FAM19A4/miR124-2 methylation analysis detects nearly all cervical carcinomas, including rare histotypes and hrHPV-negative carcinomas. These results indicate that a negative FAM19A4/miR124-2 methylation assay result is likely to rule out the presence of cervical cancer.
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Affiliation(s)
- Frederique J. Vink
- Cancer Center AmsterdamAmsterdam UMC, Vrije Universiteit Amsterdam, PathologyAmsterdamThe Netherlands
| | - Chris J.L.M. Meijer
- Cancer Center AmsterdamAmsterdam UMC, Vrije Universiteit Amsterdam, PathologyAmsterdamThe Netherlands
| | | | - Mario Poljak
- Institute of Microbiology and ImmunologyUniversity of LjubljanaLjubljanaSlovenia
| | - Anja Oštrbenk
- Institute of Microbiology and ImmunologyUniversity of LjubljanaLjubljanaSlovenia
| | - Karl Ulrich Petry
- Department of Gynecologic OncologyKlinikum WolfsburgWolfsburgGermany
| | - Beate Rothe
- Institute for Clinical Chemistry, Laboratory and Transfusion MedicineWolfsburgGermany
| | - Jesper Bonde
- Molecular Pathology Laboratory, Department of PathologyHvidovre HospitalHvidovreDenmark
| | - Helle Pedersen
- Molecular Pathology Laboratory, Department of PathologyHvidovre HospitalHvidovreDenmark
| | | | - Montserrat Torres
- Infections and Cancer LaboratoryCatalan Institute of Oncology (ICO)BarcelonaSpain
| | - Marta del Pino
- Faculty of Medicine, Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic‐Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)University of BarcelonaBarcelonaSpain
| | | | - Kate Cuschieri
- Scottish HPV Reference LaboratoryRoyal Infirmary of EdinburghEdinburghUnited Kingdom
| | - Elia Alcañiz Boada
- HPV Research Group, Division of PathologyUniversity of EdinburghEdinburghUnited Kingdom
| | - Nienke E. van Trommel
- Department of Gynaecologic OncologyCentre of Gynaecologic Oncology Amsterdam, Antoni van Leeuwenhoek/Netherlands Cancer InstituteAmsterdamThe Netherlands
| | | | | | | | - Renske D.M. Steenbergen
- Cancer Center AmsterdamAmsterdam UMC, Vrije Universiteit Amsterdam, PathologyAmsterdamThe Netherlands
| | - Maaike C.G. Bleeker
- Cancer Center AmsterdamAmsterdam UMC, Vrije Universiteit Amsterdam, PathologyAmsterdamThe Netherlands
| | - Daniëlle A.M. Heideman
- Cancer Center AmsterdamAmsterdam UMC, Vrije Universiteit Amsterdam, PathologyAmsterdamThe Netherlands
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8
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Mpunga T, Chantal Umulisa M, Tenet V, Rugwizangoga B, Milner Jr DA, Munyanshongore C, Heideman DA, Bleeker MC, Tommasino M, Franceschi S, Baussano I, Gheit T, Sayinzoga F, Clifford GM. Human papillomavirus genotypes in cervical and other HPV-related anogenital cancer in Rwanda, according to HIV status. Int J Cancer 2020; 146:1514-1522. [PMID: 31173641 PMCID: PMC7003740 DOI: 10.1002/ijc.32491] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/22/2022]
Abstract
The study aim was to describe human papillomavirus (HPV)-attributable cancer burden in Rwanda, according to anogenital cancer site, HPV type, age and HIV status. Tissue specimens of cervical, vulvar, vaginal, penile and anal cancer diagnosed in 2012-2018 were retrieved from three cancer referral hospitals and tested for high-risk (HR) HPV DNA. Cervical cancer represented the majority of cases (598 of 738), of which 96.0% were HR-HPV positive. HPV-attributable fractions in other cancer sites varied from 53.1% in 81 penile, through 76.7% in 30 vulvar, 83.3% in 24 vaginal, up to 100% in 5 anal cases. HPV16 was the predominant HR-HPV type in cervical cancer (55.0%), followed by HPV18 (16.6%) and HPV45 (13.4%). HPV16 also predominated in other cancer sites (60-80% of HR-HPV-attributable fraction). For cervical cancer, type-specific prevalence varied significantly by histology (higher alpha-9 type prevalence in 509 squamous cell carcinoma vs. higher alpha-7 type prevalence in 80 adenocarcinoma), but not between 501 HIV-negative and 97 HIV-positive cases. With respect to types targeted, and/or cross-protected, by HPV vaccines, HPV16/18 accounted for 73%, HPV31/33/45/52/58 for an additional 22% and other HR-HPV types for 5%, of HPV-attributable cancer burden, with no significant difference by HIV status nor age. These data highlight the preventive potential of the ongoing national HPV vaccination program in Rwanda, and in sub-Saharan Africa as a whole. Importantly for this region, the impact of HIV on the distribution of causal HPV types was relatively minor, confirming type-specific relevance of HPV vaccines, irrespective of HIV status.
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Affiliation(s)
- Tharcisse Mpunga
- Butaro Cancer Centre of ExcellenceMinistry of HealthButaroRwanda
| | - Marie Chantal Umulisa
- Rwanda Biomedical CentreMinistry of Health of RwandaKigaliRwanda
- International Agency for Research on CancerLyonFrance
| | - Vanessa Tenet
- International Agency for Research on CancerLyonFrance
| | - Belson Rugwizangoga
- Department of PathologyUniversity Teaching Hospital of KigaliKigaliRwanda
- University of Rwanda School of Medicine and PharmacyKigaliRwanda
| | | | | | - Daniëlle A.M. Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center AmsterdamAmsterdamThe Netherlands
| | - Maaike C.G. Bleeker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center AmsterdamAmsterdamThe Netherlands
| | | | | | | | - Tarik Gheit
- International Agency for Research on CancerLyonFrance
| | - Felix Sayinzoga
- Rwanda Biomedical CentreMinistry of Health of RwandaKigaliRwanda
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9
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Dick S, Kremer WW, De Strooper LM, Lissenberg-Witte BI, Steenbergen RD, Meijer CJ, Berkhof J, Heideman DA. Long-term CIN3+ risk of HPV positive women after triage with FAM19A4/miR124-2 methylation analysis. Gynecol Oncol 2019; 154:368-373. [DOI: 10.1016/j.ygyno.2019.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 01/02/2023]
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10
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Tshomo U, Franceschi S, Tshokey T, Tobgay T, Baussano I, Tenet V, Heideman DA, Snijders PJ, Clifford GM. Evaluation of cytology versus human papillomavirus-based cervical cancer screening algorithms in Bhutan. Oncotarget 2017; 8:72438-72446. [PMID: 29069800 PMCID: PMC5641143 DOI: 10.18632/oncotarget.19783] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/25/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022] Open
Abstract
To evaluate the performance of existing versus alternative cervical cancer screening protocols in Bhutan, cervical exfoliated cells were collected for cytology and high-risk human papillomavirus (HR-HPV) testing among 1,048 women aged 30-69 years. Conventional smears were prepared and read locally. HR-HPV was tested by GP5+/6+ polymerase chain reaction, followed by genotyping and human DNA methylation analysis among HR-HPV-positives, in Europe. Test positivity was 7.5% for ASCUS or worse (ASCUS+) cytology and 14.0% for HR-HPV. All women with ASCUS+ and/or HR-HPV positivity (n=192) were recalled for colposcopy, among whom a total of 29 cases of histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were identified. An additional 7 CIN2+ cases were imputed among women without colposcopy. Corrected sensitivities for CIN2+ and CIN3+ were 61% and 74% for ASCUS+, 86% and 96% for HR-HPV, and 47% and 70% for ASCUS+ triage of HR-HPV. Specificity varied from 88% for HR-HPV up to 98% for ASCUS+ triage of HR-HPV, similarly for CIN2+ and CIN3+. Among HR-HPV-positive women with biopsies, methylation analysis offered similar discrimination of CIN2/3 and cervical cancer as ASCUS+, and better than HPV16/18 genotyping alone, but sample sizes were limited. In conclusion, the performance of cytology in Bhutan is in the mid-range of that reported in other screening settings. HR-HPV testing has the potential to improve detection of CIN2+, albeit with a higher referral rate for colposcopy. Cytological triage of HR-HPV-positives (performed in the absence of knowledge of HR-HPV status) reduced referral but missed more than one third of CIN2+.
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Affiliation(s)
- Ugyen Tshomo
- Department of Obstetrics & Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | | | - Tshokey Tshokey
- Department of Pathology & Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tashi Tobgay
- Department of Pathology & Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | | | - Vanessa Tenet
- International Agency for Research on Cancer, Lyon, France
| | | | - Peter J.F. Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
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11
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Galvani E, Sun J, Leon LG, Sciarrillo R, Narayan RS, Tjin Tham Sjin R, Lee K, Ohashi K, Heideman DA, Alfieri RR, Heynen GJ, Bernards R, Smit EF, Pao W, Peters GJ, Giovannetti E. NF-κB drives acquired resistance to a novel mutant-selective EGFR inhibitor. Oncotarget 2015; 6:42717-32. [PMID: 26015408 PMCID: PMC4767465 DOI: 10.18632/oncotarget.3956] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 04/08/2015] [Indexed: 01/22/2023] Open
Abstract
The clinical efficacy of EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC) harbouring activating EGFR mutations is limited by the emergence of acquired resistance, mostly ascribed to the secondary EGFR-T790M mutation. Selective EGFR-T790M inhibitors have been proposed as a new, extremely relevant therapeutic approach. Here, we demonstrate that the novel irreversible EGFR-TKI CNX-2006, a structural analog of CO-1686, currently tested in a phase-1/2 trial, is active against in vitro and in vivo NSCLC models expressing mutant EGFR, with minimal effect on the wild-type receptor. By integration of genetic and functional analyses in isogenic cell pairs we provide evidence of the crucial role played by NF-κB1 in driving CNX-2006 acquired resistance and show that NF-κB activation may replace the oncogenic EGFR signaling in NSCLC when effective and persistent inhibition of the target is achieved in the presence of the T790M mutation. In this context, we demonstrate that the sole, either genetic or pharmacologic, inhibition of NF-κB is sufficient to reduce the viability of cells that adapted to EGFR-TKIs. Overall, our findings support the rational inhibition of members of the NF-κB pathway as a promising therapeutic option for patients who progress after treatment with novel mutant-selective EGFR-TKIs.
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Affiliation(s)
- Elena Galvani
- Department Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | - Jing Sun
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University School of Medicine and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Leticia G. Leon
- Instituto de Tecnologias Biomedicas, Center for Biomedical Research of the Canary Islands, University of La Laguna, Tenerife, Spain
| | - Rocco Sciarrillo
- Department Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
- Department Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - Ravi S. Narayan
- Department Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Kwangho Lee
- Celgene Avilomics Research, Bedford, MA, USA
| | - Kadoaki Ohashi
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University School of Medicine and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | | | - Roberta R. Alfieri
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Guus J. Heynen
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - René Bernards
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Egbert F. Smit
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
| | - William Pao
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University School of Medicine and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Godefridus J. Peters
- Department Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisa Giovannetti
- Department Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
- Cancer Pharmacology Lab, AIRC Start-Up Unit, DIPINT, University of Pisa, Pisa, Italy
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12
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Kuiper JL, Hendriks LE, van der Wekken AJ, de Langen AJ, Bahce I, Thunnissen E, Heideman DA, Berk Y, Buijs EJ, Speel EJM, Krouwels FH, Smit HJ, Groen HJ, Dingemans AMC, Smit EF. Treatment and survival of patients with EGFR -mutated non-small cell lung cancer and leptomeningeal metastasis: A retrospective cohort analysis. Lung Cancer 2015; 89:255-61. [DOI: 10.1016/j.lungcan.2015.05.023] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/19/2015] [Accepted: 05/28/2015] [Indexed: 11/16/2022]
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13
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Luttmer R, Berkhof J, Dijkstra MG, van Kemenade FJ, Snijders PJ, Heideman DA, Meijer CJ. Comparing triage algorithms using HPV DNA genotyping, HPV E7 mRNA detection and cytology in high-risk HPV DNA-positive women. J Clin Virol 2015; 67:59-66. [DOI: 10.1016/j.jcv.2015.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 03/26/2015] [Accepted: 04/05/2015] [Indexed: 11/25/2022]
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14
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de Bruin EC, Cowell C, Warne PH, Jiang M, Saunders RE, Melnick MA, Gettinger S, Walther Z, Wurtz A, Heynen GJ, Heideman DA, Gómez-Román J, García-Castaño A, Gong Y, Ladanyi M, Varmus H, Bernards R, Smit EF, Politi K, Downward J. Reduced NF1 expression confers resistance to EGFR inhibition in lung cancer. Cancer Discov 2014; 4:606-19. [PMID: 24535670 PMCID: PMC4011693 DOI: 10.1158/2159-8290.cd-13-0741] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [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] [Indexed: 12/27/2022]
Abstract
Activating mutations in the EGF receptor (EGFR) are associated with clinical responsiveness to EGFR tyrosine kinase inhibitors (TKI), such as erlotinib and gefitinib. However, resistance eventually arises, often due to a second EGFR mutation, most commonly T790M. Through a genome-wide siRNA screen in a human lung cancer cell line and analyses of murine mutant EGFR-driven lung adenocarcinomas, we found that erlotinib resistance was associated with reduced expression of neurofibromin, the RAS GTPase-activating protein encoded by the NF1 gene. Erlotinib failed to fully inhibit RAS-ERK signaling when neurofibromin levels were reduced. Treatment of neurofibromin-deficient lung cancers with a MAP-ERK kinase (MEK) inhibitor restored sensitivity to erlotinib. Low levels of NF1 expression were associated with primary and acquired resistance of lung adenocarcinomas to EGFR TKIs in patients. These findings identify a subgroup of patients with EGFR-mutant lung adenocarcinoma who might benefit from combination therapy with EGFR and MEK inhibitors.
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Affiliation(s)
- Elza C. de Bruin
- Signal Transduction, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK
| | - Catherine Cowell
- Signal Transduction, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK
| | - Patricia H. Warne
- Signal Transduction, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK
| | - Ming Jiang
- High Throughput Screening Laboratories, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK
| | - Rebecca E. Saunders
- High Throughput Screening Laboratories, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK
| | - Mary Ann Melnick
- Yale Cancer Center, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Scott Gettinger
- Yale Cancer Center, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
- Department of Medicine (Medical Oncology), Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Zenta Walther
- Yale Cancer Center, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
- Department of Pathology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Anna Wurtz
- Yale Cancer Center, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Guus J. Heynen
- Division of Molecular Carcinogenesis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Daniëlle A.M. Heideman
- Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | | | - Almudena García-Castaño
- Oncology Service Hospital Universitario Marques de Valdecilla, IFIMAV, Avda Valdecilla s/n, E39008 Santander, Spain
| | - Yixuan Gong
- Dept of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Marc Ladanyi
- Dept of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Harold Varmus
- Cancer Genetics Branch, National Human Genome Research Institute, 50 South Drive, Bethesda, MD 20892, USA
| | - René Bernards
- Division of Molecular Carcinogenesis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Egbert F. Smit
- Department of Pulmonary Diseases, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Katerina Politi
- Yale Cancer Center, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
- Department of Medicine (Medical Oncology), Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
- Department of Pathology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Julian Downward
- Signal Transduction, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK
- The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, UK
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15
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Rietbergen MM, Snijders PJ, Beekzada D, Braakhuis BJ, Brink A, Heideman DA, Hesselink AT, Witte BI, Bloemena E, Baatenburg-De Jong RJ, René Leemans C, Brakenhoff RH. Molecular characterization of p16-immunopositive but HPV DNA-negative oropharyngeal carcinomas. Int J Cancer 2013; 134:2366-72. [DOI: 10.1002/ijc.28580] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 10/10/2013] [Indexed: 01/15/2023]
Affiliation(s)
- Michelle M. Rietbergen
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Peter J.F. Snijders
- Department of Pathology; VU University Medical Center; Amsterdam The Netherlands
| | - Derakshan Beekzada
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Boudewijn J.M. Braakhuis
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Arjen Brink
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | | | | | - Birgit I. Witte
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam The Netherlands
| | - Elisabeth Bloemena
- Department of Pathology; VU University Medical Center; Amsterdam The Netherlands
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | | | - C. René Leemans
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Ruud H. Brakenhoff
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
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16
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Hubers AJ, Heideman DA, Yatabe Y, Wood MD, Tull J, Tarón M, Molina MA, Mayo C, Bertran-Alamillo J, Herder GJ, Koning R, Sie D, Ylstra B, Meijer GA, Snijders PJ, Witte BI, Postmus PE, Smit EF, Thunnissen E. EGFR mutation analysis in sputum of lung cancer patients: A multitechnique study. Lung Cancer 2013; 82:38-43. [DOI: 10.1016/j.lungcan.2013.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/11/2013] [Accepted: 07/13/2013] [Indexed: 12/01/2022]
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17
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Rietbergen MM, Brakenhoff RH, Bloemena E, Witte BI, Snijders PJ, Heideman DA, Boon D, Koljenović S, Baatenburg de Jong RJ, Leemans CR. OP028. Oral Oncol 2013. [DOI: 10.1016/j.oraloncology.2013.03.036] [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: 11/28/2022]
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18
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Gök M, Heideman DA, van Kemenade FJ, de Vries AL, Berkhof J, Rozendaal L, Beliën JA, Overbeek L, Babović M, Snijders PJ, Meijer CJ. Offering self-sampling for human papillomavirus testing to non-attendees of the cervical screening programme: Characteristics of the responders. Eur J Cancer 2012; 48:1799-808. [DOI: 10.1016/j.ejca.2011.11.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 11/03/2011] [Accepted: 11/18/2011] [Indexed: 12/30/2022]
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19
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Dijkstra MG, Heideman DA, van Kemenade FJ, Hogewoning KJ, Hesselink AT, Verkuijten MC, van Baal WM, Boer GMND, Snijders PJ, Meijer CJ. Brush-based self-sampling in combination with GP5+/6+-PCR-based hrHPV testing: High concordance with physician-taken cervical scrapes for HPV genotyping and detection of high-grade CIN. J Clin Virol 2012; 54:147-51. [DOI: 10.1016/j.jcv.2012.02.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 02/14/2012] [Accepted: 02/25/2012] [Indexed: 12/12/2022]
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20
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Heideman DA, Lurkin I, Doeleman M, Smit EF, Verheul HM, Meijer GA, Snijders PJ, Thunnissen E, Zwarthoff EC. KRAS and BRAF Mutation Analysis in Routine Molecular Diagnostics. J Mol Diagn 2012; 14:247-55. [DOI: 10.1016/j.jmoldx.2012.01.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 12/15/2011] [Accepted: 01/20/2012] [Indexed: 10/28/2022] Open
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21
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Mellema WW, Dingemans AMC, Groen HJ, van Wijk A, Burgers S, Kunst PW, Thunnissen FB, Heideman DA, Smit EF. Abstract PR5: A phase II study of sorafenib in patients with stage IV non-small cell lung cancer (NSCLC) with a K-Ras mutation. Clin Cancer Res 2012. [DOI: 10.1158/1078-0432.12aacriaslc-pr5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: In a pilot study (1) we found sorafenib to display clinical activity against patients with K-Ras positive NSCLC, sufficient for formal phase II testing. Methods: Patients with K-Ras mutated NSCLC that progressed after at least 1 platinum containing regimen with adequate organ reserve, ECOG 0–2, who provided written informed consent according to local IRB regulations were eligible. A tumor biopsy confirming the presence of a K-Ras mutation was mandatory. Treatment consisted of sorafenib 400 mg BID until disease progression or unacceptable toxicity. Dose reductions and delays were specified per protocol in the face of CTC toxicities grade 3 and 4. Primary endpoint: Rate of No Progression (NPR) at 6 weeks. Secondary endpoints: duration of response, progression free survival (PFS), overall survival and treatment related toxicities. A 2-stage design was implemented (Simon's optimal design; p0=40%, p1=60%, alpha=0.05, beta=0.20) for a total number of 48 pts. Results: 59 patients were entered between May 1st 2010 and February 18 2011. Median age was 58 (range 46–79) years, 17 Male/42 Female, ECOG PS 0/1/2 23/32/4. 57 patients started treatment. At 6 weeks 5 PR, 25 SD, 27 PD were observed; NPR 52.6%. Fifteen patients stopped treatment before 6 weeks, of which 10 patients stopped due to (clinical) progression. Median duration of treatment was 9 (range 0–62) weeks, 2 patients are still on treatment. Median duration of response was 32 (range 5–58) weeks. Median PFS was 2.3 months, median OS was 4.9 months, 14 patients still alive. Dose modifications were realized in 21 patients, of whom 4 discontinued treatment. Most reported adverse events were fatigue (6.4%), hand-foot reaction (5.7%), dyspnea (5.6%), anorexia (3.7%) diarrhea (3.6%) and cough (3.6%). Sorafenib related grade 3-4 toxicity was reported in 10 patients. Five patients with grade 3 skin toxicity, 4 patients with grade 3 gastrointestinal toxicity and 1 patient with both grade 3 metabolic abnormalities and a grade 3 pneumonitis. Conclusion: Treatment with sorafenib has relevant clinical activity in patients with K-Ras mutational status. Further randomized study with this agent is warranted.
This abstract is also presented as Poster B18.
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Affiliation(s)
- Wouter W. Mellema
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Anne-Marie C. Dingemans
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Harry J.M. Groen
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Atie van Wijk
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Sjaak Burgers
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Peter W.A. Kunst
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Frederik B. Thunnissen
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Daniëlle A.M. Heideman
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
| | - Egbert F. Smit
- 1Maastricht University Medical Center, Maastricht, The Netherlands, 2VU University Medical Center, Amsterdam, The Netherlands, 3University Medical Center Groningen, Groningen, The Netherlands, 4Netherlands Cancer Institute, Amsterdam, The Netherlands, 5Academic Medical Center, Amsterdam, The Netherlands
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22
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Mellema WW, Dingemans AMC, Smit EF, Derks J, Heideman DA, van Suylen R, Thunnissen FB. Abstract A31: Predictive and prognostic value of KRAS mutations in advanced non-small cell lung cancer (NSCLC) patients treated with chemotherapy. Clin Cancer Res 2012. [DOI: 10.1158/1078-0432.12aacriaslc-a31] [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
Introduction: K-Ras mutation is thought to be related with poor outcome of NSCLC patients with an advanced stage of disease. The role of K-Ras mutation as a predictor of response for these patients treated only with chemotherapy is poorly understood.
Patients and methods: From a retrospective database from 2 university hospitals all patients with advanced stage, nonsquamous, NSCLC treated with palliative platinum containing chemotherapy were selected. Patients were included when archive tumour tissue was available for DNA extraction. High resolution melting followed by PCR sequencing was performed for KRAS exon1 and 2. Response to treatment was assessed by RECIST. The databases were matched by treatment.
Results: A total of 179 patients were included in this study. All patients were treated with chemotherapy and were no candidate for treatment with curative intent. There were 59 patients with a K-Ras mutation (32.9%). There was no significant difference in basic characteristics between the group with a K-Ras mutation and the group with K-Ras wild-type. Mean age 59 years (range 32–83 years), 108 males and 71 females. ECOG performance score 0/1/2/3 73/77/13/2. Thirty patients with stage IIIb disease, 149 patients with stage IV disease. Progression as best response to treatment was reported in 21/59 patients with a K-ras mutation (35.6%) and 34/120 patients (28.3%) with a K-Ras wild type, this was not significant (p=0.611). The median progression free survival (PFS) in the group with a K-Ras mutation was 4.1 months (95% CI 3.12–5.0 months) compared to 5.4 months (95% CI 4.4–6.4 months) in patients with K-Ras wild type (p=0.202). The overall survival (OS) in the group with a K-Ras mutation, was 8.3 months (95% CI 5.2–11.4 months) compared to 12.5 months (95% CI 10.2–14–7 months) in patients with K-Ras wild type (p=0.037).
Conclusion: In our series K-Ras mutation was not predictive for response to platinum containing chemotherapy in patients with advanced NSCLC. K-Ras mutational status was prognostic for overall survival.
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Affiliation(s)
- Wouter W. Mellema
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
| | - Anne-Marie C. Dingemans
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
| | - Egbert F. Smit
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jules Derks
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
| | - Daniëlle A.M. Heideman
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robertjan van Suylen
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frederik B. Thunnissen
- 1VU University Medical Center, Amsterdam, The Netherlands, 2Maastricht University Medical Center, Maastricht, The Netherlands
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23
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Liu Y, Wang T, Yan J, Jiagbogu N, Heideman DA, Canfield AE, Alexander MY. HGF/c-Met signalling promotes Notch3 activation and human vascular smooth muscle cell osteogenic differentiation in vitro. Atherosclerosis 2011; 219:440-7. [PMID: 21920521 PMCID: PMC3925803 DOI: 10.1016/j.atherosclerosis.2011.08.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 07/21/2011] [Accepted: 08/18/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Vascular calcification is a major clinical problem and elucidating the underlying mechanism is important to improve the prognosis of patients with cardiovascular disease. We aimed to elucidate the role and mechanism of action of Hepatocyte Growth Factor (HGF)/c-Met signalling in vascular calcification and establish whether blocking this pathway could prevent mineralisation of vascular smooth muscle cells (VSMCs) in vitro. METHODS AND RESULTS We demonstrate increased HGF secretion and c-Met up-regulation and phosphorylation during VSMC osteogenic differentiation. Adenoviral-mediated over-expression of HGF (AdHGF) in VSMCs accelerated mineralisation, shown by alizarin red staining, and significantly increased (45)Calcium incorporation (1.96 ± 0.54-fold [P < 0.05]) and alkaline phosphatase (ALP) activity (3.01 ± 0.8-fold [P < 0.05]) compared to controls. AdHGF also significantly elevated mRNA expression of bone-related proteins, Runx2, osteocalcin, BMP2 and osterix in VSMCs. AdHGF-accelerated mineralisation correlated with increased Akt phosphorylation, nuclear translocation of Notch3 intracellular domain (N3IC) and up-regulation of the Notch3 target protein, HES1. In contrast, adenoviral-mediated over-expression of the HGF antagonist, NK4, markedly attenuated VSMC mineralisation, and reduced c-Met phosphorylation, Akt activation and HES1 protein expression compared to AdHGF-treated cells. Furthermore, the Notch inhibitor, DAPT, attenuated N3IC nuclear translocation and AdHGF-induced mineralisation. CONCLUSION We demonstrate HGF induces VSMC osteogenic differentiation via c-Met/Akt/Notch3 signalling, highlighting these pathways as potential targets for intervention of vascular calcification.
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MESH Headings
- Adenoviridae/genetics
- Alkaline Phosphatase/metabolism
- Basic Helix-Loop-Helix Transcription Factors/metabolism
- Bone Morphogenetic Protein 2/genetics
- Calcium/metabolism
- Cell Differentiation
- Cells, Cultured
- Core Binding Factor Alpha 1 Subunit/genetics
- Genetic Vectors
- Hepatocyte Growth Factor/genetics
- Hepatocyte Growth Factor/metabolism
- Homeodomain Proteins/metabolism
- Humans
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Osteogenesis
- Phosphorylation
- Proto-Oncogene Proteins c-akt/metabolism
- Proto-Oncogene Proteins c-met/metabolism
- RNA, Messenger/metabolism
- Receptor, Notch3
- Receptors, Notch/metabolism
- Signal Transduction
- Sp7 Transcription Factor
- Time Factors
- Transcription Factor HES-1
- Transcription Factors/genetics
- Transfection
- Up-Regulation
- Vascular Calcification/genetics
- Vascular Calcification/metabolism
- Vascular Calcification/pathology
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Affiliation(s)
- Yiwen Liu
- Cardiovascular Research Group, University of Manchester, UK
| | - Tao Wang
- Medical Genetics Research Group, University of Manchester, UK
| | - Jianyun Yan
- Cardiovascular Research Group, University of Manchester, UK
| | - Naomi Jiagbogu
- Cardiovascular Research Group, University of Manchester, UK
| | | | - Ann E. Canfield
- Cardiovascular Research Group, University of Manchester, UK
- Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, UK
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24
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Khodakarami N, Clifford GM, Yavari P, Farzaneh F, Salehpour S, Broutet N, Bathija H, Heideman DA, van Kemenade FJ, Meijer CJ, Hosseini SJ, Franceschi S. Human papillomavirus infection in women with and without cervical cancer in Tehran, Iran. Int J Cancer 2011; 131:E156-61. [DOI: 10.1002/ijc.26488] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 09/13/2011] [Indexed: 11/07/2022]
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25
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Gök M, van Kemenade FJ, Heideman DA, Berkhof J, Rozendaal L, Spruyt JW, Beliën JA, Babovic M, Snijders PJ, Meijer CJ. Experience with high-risk human papillomavirus testing on vaginal brush-based self-samples of non-attendees of the cervical screening program. Int J Cancer 2011; 130:1128-35. [DOI: 10.1002/ijc.26128] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 03/21/2011] [Indexed: 12/24/2022]
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26
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27
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Heideman DA, Snijders PJ, Bloemena E, Meijer CJ, Offerhaus GJ, Meuwissen SG, Gerritsen WR, Craanen ME. Absence of tpr-met and expression of c-met in human gastric mucosa and carcinoma. J Pathol 2001; 194:428-35. [PMID: 11523050 DOI: 10.1002/path.934] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [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: 11/05/2022]
Abstract
The c-met proto-oncogene, encoding the hepatocyte growth factor receptor, can be activated by various mechanisms. These include, among others, gene amplification with concomitant overexpression and the tpr-met oncogenic rearrangement. In the case of gastric cancer, contradictory results on the presence of the tpr-met oncogenic rearrangement have been published. The current study aimed therefore to assess the prevalence of tpr-met expression in Caucasian gastric adenocarcinomas, to evaluate the importance of this oncogene in their carcinogenesis. In addition, the level of c-met expression was determined, to evaluate the role of this alternative mode of activation of the proto-oncogene. A series of Caucasian gastric adenocarcinomas (n=43) and normal gastric mucosal samples (n=14) was analysed for tpr-met and c-met expression. Expression of tpr-met mRNA in the samples was performed by two reverse transcriptase polymerase chain reaction (RT-PCR) assays, with excellent correlation. The specificity of both methods was confirmed by direct sequencing of the PCR products of the MNNG-HOS cell line, which is known to contain the rearrangement. The level of c-met expression was assessed using semi-quantitative RT-PCR assays and immunohistochemistry (IHC). None of the normal gastric mucosal or gastric adenocarcinoma samples expressed tpr-met mRNA, as determined by both RT-PCR assays. Seventy per cent of the adenocarcinomas showed overexpression of c-met, according to elevated c-met mRNA levels, compared with the expression level of normal gastric mucosa. A significant correlation was found between the level of c-met mRNA and protein expression. In conclusion, these results strongly suggest that tpr-met activation does not play a role in Caucasian gastric carcinogenesis, while overexpression of the c-met gene occurs in the majority of Caucasian gastric adenocarcinomas.
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Affiliation(s)
- D A Heideman
- Department of Gastroenterology, University Hospital Vrije Universiteit, 1081 HV Amsterdam, The Netherlands.
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28
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Heideman DA, Gerritsen WR, Craanen ME. Gene therapy for gastrointestinal tract cancer: a review. Scand J Gastroenterol Suppl 2001:93-100. [PMID: 11232500] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Carcinomas of the gastrointestinal tract count as one of the most common causes of cancer-related death in the world. Despite improvement of conventional treatment modalities, the prognosis of patients with gastrointestinal tract cancer remains poor. Progress in understanding the molecular mechanism of gastrointestinal carcinogenesis may facilitate development of gene therapy strategies for the treatment of gastrointestinal tumors. This review describes new developments in vectors (tools for gene transfer) for gene therapy, possible therapeutic genes and the early clinical results of gastrointestinal tract cancer gene therapy. Results of current preclinical studies are promising for the future clinical application of gene therapy for gastrointestinal cancer. The first clinical trials have been initiated recently, the preliminary results reflecting low toxicity and clinical responses. Further clinical studies will be required to confirm the feasibility of gene therapy in the treatment of gastrointestinal cancer. In future, the greatest potential will probably lie in the field of combination strategies of gene therapy and existing treatment modalities, such as surgery combined with molecular chemotherapy.
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Affiliation(s)
- D A Heideman
- Dept. of Gastroenterology, University Hospital Vrije Universiteit, P. O. Box 7057, 1081 HV Amsterdam, The Netherlands
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29
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Heideman DA, Snijders PJ, Craanen ME, Bloemena E, Meijer CJ, Meuwissen SG, van Beusechem VW, Pinedo HM, Curiel DT, Haisma HJ, Gerritsen WR. Selective gene delivery toward gastric and esophageal adenocarcinoma cells via EpCAM-targeted adenoviral vectors. Cancer Gene Ther 2001; 8:342-51. [PMID: 11477454 DOI: 10.1038/sj.cgt.7700313] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2001] [Indexed: 11/08/2022]
Abstract
Application of recombinant adenoviral vectors for cancer gene therapy is currently limited due to lack of specificity for tumor cells. For gastric and esophageal adenocarcinoma, we present here that the relative abundant expression of the primary adenovirus receptor, coxsackie/adenovirus receptor (CAR), on normal epithelium compared to carcinoma favors the transduction of the epithelium. As such, to achieve specific transduction of cancer cells, targeting approaches are required that ablate the binding of the virus to CAR and redirect the virus to tumor-specific receptors. By immunohistochemistry and reverse transcriptase polymerase chain reaction assays, we demonstrate a marked difference in expression of the human epithelial cell adhesion molecule (EpCAM) between normal and (pre)malignant lesions of the stomach and esophagus. Based on this, we explored the feasibility of using EpCAM to achieve gastric and esophageal adenocarcinoma selective gene transfer. Adenoviral vectors redirected to EpCAM using bispecific antibodies against the adenovirus fiber-knob protein and EpCAM specifically infected gastric and esophageal cancer cell lines. Using primary human cells, an improved ratio of tumor transduction over normal epithelium transduction was accomplished by the EpCAM-targeted vectors. This study thus indicates that EpCAM-targeted adenoviral vectors may be useful for gastric and esophageal cancer-specific gene therapy in patients.
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Affiliation(s)
- D A Heideman
- Department of Gastroenterology, University Hospital Vrije Universiteit, Amsterdam.
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