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Larrainzar-Garijo R, Fernández-Tormos E, Collado-Escudero CA, Alcantud Ibáñez M, Oñorbe-San Francisco F, Marin-Corral J, Casadevall D, Donaire-Gonzalez D, Martínez-Sanchez L, Cabal-Hierro L, Benavent D, Brañas F. Predictive model for a second hip fracture occurrence using natural language processing and machine learning on electronic health records. Sci Rep 2024; 14:532. [PMID: 38177650 PMCID: PMC10766963 DOI: 10.1038/s41598-023-50762-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024] Open
Abstract
Hip fractures (HFx) are associated with a higher morbidity and mortality rates, leading to a significant reduction in life quality and in limitation of patient´s mobility. The present study aimed to obtain real-world evidence on the clinical characteristics of patients with an initial and a second hip fracture (HFx) and develop a predictive model for second HFx using artificial intelligence. Electronic health records from one hospital centre in Spain from January 2011 to December 2019 were analysed using EHRead® technology, based on natural language processing and machine learning. A total of 1,960 patients with HFx were finally included during the study period after meeting all inclusion and exclusion criteria. From this total, 1835 (93.6%) patients were included in the HFx subgroup, while 124 (6.4%) were admitted to the second HFx (2HFx) subgroup. The mean age of the participants was 84 years and 75.5% were female. Most of comorbidities were more frequently identified in the HFx group, including hypertension (72.0% vs. 67.2%), cognitive impairment (33.0% vs. 31.2%), diabetes mellitus (28.7% vs. 24.8%), heart failure (27.6% vs. 22.4%) and chronic kidney disease (26.9% vs. 16.0%). Based on clinical criteria, 26 features were selected as potential prediction factors. From there, 16 demographics and clinical characteristics such as comorbidities, medications, measures of disabilities for ambulation and type of refracture were selected for development of a competitive risk model. Specifically, those predictors with different associated risk ratios, sorted from higher to lower risk relevance were visual deficit, malnutrition, walking assistance, hypothyroidism, female sex, osteoporosis treatment, pertrochanteric fracture, dementia, age at index, osteoporosis, renal failure, stroke, COPD, heart disease, anaemia, and asthma. This model showed good performance (dependent AUC: 0.69; apparent performance: 0.75) and could help the identification of patients with higher risk of developing a second HFx, allowing preventive measures. This study expands the current available information of HFx patients in Spain and identifies factors that exhibit potential in predicting a second HFx among older patients.
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Affiliation(s)
- Ricardo Larrainzar-Garijo
- Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, Medical School, Universidad Complutense, Madrid, Spain
| | | | | | - María Alcantud Ibáñez
- Geriatric Department, Hospital Universitario Infanta Leonor, Medical School, Universidad Complutense, Madrid, Spain
| | | | | | - David Casadevall
- Savana Research Group: Medsavana & Savana Research S.L., Madrid, Spain
| | | | | | | | - Diego Benavent
- Savana Research Group: Medsavana & Savana Research S.L., Madrid, Spain.
| | - Fátima Brañas
- Geriatric Department, Hospital Universitario Infanta Leonor, Medical School, Universidad Complutense, Madrid, Spain
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Gonzàlez-Farré M, Gibert J, Santiago-Díaz P, Menéndez S, Monzonis X, Olivares F, Riera X, López D, Torner A, Casado B, Bellosillo B, Lloveras B, Casadevall D, Rovira A, Servitja S, Albanell J, Vázquez I, Comerma L. Characterization and spatial distribution of the immune cell infiltrate in triple-negative breast cancer: a novel classification based on plasma cells and CD8+ T cells. Hum Pathol 2023; 139:91-105. [PMID: 37517596 DOI: 10.1016/j.humpath.2023.07.010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
Stromal tumor-infiltrating lymphocytes (sTILs) are a robust prognostic and predictive biomarker in triple-negative breast carcinoma. However, the sTIL compartment comprises different cell populations. The aim of the study is to characterize the distribution of T cells (CD3+ and CD8+), B cells, and plasma cells and explore their association with outcome in the surgical specimen of 62 patients. Furthermore, programmed death ligand 1 expression and the presence of tertiary lymphoid structures (TLSs) are explored. Patients with higher sTILs achieve better progression-free survival (PFS) (P = .0013), and tumors have more plasma cells in the infiltrate. Specifically, higher counts of T cells (both CD3+ and CD8+) have better PFS (P = .002 and P = .0086, respectively) as it is observed in tumors with higher infiltration of CD8+ T cells in the tumor core (P = .035). Higher infiltration by B cells and plasma cells shows a positive tendency toward increased PFS (P = .06 and P = .058). Programmed death ligand 1 (SP142) is positive in 56% of tumors. Tumors with at least 1 TLS (42%) show higher CD8+ T cell infiltration in the tumor core and the sTIL value doubles compared to tumors devoid of TLSs [sTIL mean: 36 ± 11% and 18 ± 5% (CI [Confidence Interval]: 95%), respectively]. Our study demonstrates that the characterization of the immune cell infiltration is as relevant as its distribution. Moreover, the importance of considering different immune cell types for classification is emphasized. Therefore, a new classification of triple-negative breast carcinoma immune infiltration with CD8+ T cell and plasma cell densities in the tumor core and infiltrative margin is proposed.
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Affiliation(s)
- Mònica Gonzàlez-Farré
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
| | - Joan Gibert
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | | | - Silvia Menéndez
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Xavier Monzonis
- Department of Medical Oncology, Hospital del Mar, 08003 Barcelona, Spain
| | | | - Xènia Riera
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain
| | - David López
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain
| | - Ariadna Torner
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain
| | - Beatriz Casado
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain
| | - Beatriz Bellosillo
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain; Department of Medicine and Life Sciences (MELIS), University Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Belén Lloveras
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain; Department of Medicine and Life Sciences (MELIS), University Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - David Casadevall
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain; Center for Biomedical Network Research on Cancer (CIBERONC), 28029 Madrid, Spain
| | - Sònia Servitja
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain; Department of Medical Oncology, Hospital del Mar, 08003 Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain; Department of Medical Oncology, Hospital del Mar, 08003 Barcelona, Spain; Center for Biomedical Network Research on Cancer (CIBERONC), 28029 Madrid, Spain; Department of Medicine and Life Sciences (MELIS), University Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Ivonne Vázquez
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain
| | - Laura Comerma
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
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Rocha P, Rodrigo M, Moliner L, Menendez S, Masfarré L, Navarro N, Del Rey-Vergara R, Galindo-Campos M, Taus Á, Giner M, Sanchez I, Rodríguez-Fuster A, Aguiló R, Chalela R, Sánchez-Font A, Belda J, Curull V, Pijuan L, Casadevall D, Clavé S, Bellosillo B, Perera-Bel J, Comerma L, Arriola E. Pre-existing tumor host immunity characterization in resected non-small cell lung cancer. Lung Cancer 2023; 181:107257. [PMID: 37263182 DOI: 10.1016/j.lungcan.2023.107257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/28/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Neoadjuvant and adjuvant immune checkpoint blockade (ICB) have recently become standard of care in resectable non-small cell lung cancer (NSCLC). Yet, biomarkers that inform patients who benefit from this approach remain largely unknown. Here, we interrogated the tumor immune microenvironment (TIME) in early-stage NSCLC patients that underwent up-front surgery. METHODS A total of 185 treatment-naïve patients with early-stage NSCLC, that underwent up-front surgical treatment between 2006 and 2018 at Hospital del Mar were included. 124 lung adenocarcinomas (LUADs), and 61 squamous cell carcinoma (LUSCs) were included in a tissue microarray. Immunohistochemistry for CD3, CD4, CD8, CD68, CD80, CD103, FOXP3, PD-1, PD-L1, PD-L2 and HLA class II were evaluated by digital image analysis (QuPath software). TIME was categorized into four groups using PD-L1 expression in tumor cells (<1 % or ≥1 %) and tumor resident memory (CD103+) immune cells (using the median as cut-off). We explored the association between different TIME dimensions and patient's clinicopathological features and outcomes. RESULTS We found increased levels of T cell markers (CD3+, CD4+, CD8+ cells), functional immune markers (FOXP3+ cells) as well as, higher HLA-II tumor membrane expression in LUADs compared to LUSCs (p < 0.05 for all). In contrast, LUSCs displayed higher percentage of intratumor macrophages (CD68+ cells) as well as, higher PD-L1 and PD-L2 tumor membrane expression (p < 0.05 for all). Unsupervised analysis revealed three different tumor subsets characterized by membrane tumor expression of PD-L1, PD-L2 and HLA-class II. Enrichment of T cells (CD3+, CD8+ cells), regulatory T cells (FOXP3+ cells) and macrophages (CD68+ cells) was observed in the CD103+/PD-L1+ group (p < 0.05 for all). Multivariate analysis showed that infiltration by CD103+ immune cells was associated with improved OS (p = 0.009). CONCLUSIONS TIME analysis in resected NSCLC highlighted differences by histology, PD-L1 expression and molecular subgroups. Biomarker studies using IHC might aid to individually tailor adjuvant treatment in early-stage NSCLC.
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Affiliation(s)
- Pedro Rocha
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain; IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Maite Rodrigo
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Laura Moliner
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain; Medical Oncology Department, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Silvia Menendez
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Laura Masfarré
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain
| | - Nil Navarro
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain
| | | | | | - Álvaro Taus
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain; IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Mario Giner
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | | | - Alberto Rodríguez-Fuster
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Thoracic Surgery Department, Hospital del Mar, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Rafael Aguiló
- Thoracic Surgery Department, Hospital del Mar, Barcelona, Spain
| | - Roberto Chalela
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Pulmonology Department, Hospital del Mar, Barcelona, Spain
| | - Albert Sánchez-Font
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain; Pulmonology Department, Hospital del Mar, Barcelona, Spain
| | - Josep Belda
- Thoracic Surgery Department, Hospital del Mar, Barcelona, Spain
| | - Victor Curull
- IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Thoracic Surgery Department, Hospital del Mar, Barcelona, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Lara Pijuan
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - David Casadevall
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain; IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Sergi Clavé
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | | | | | - Laura Comerma
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Edurne Arriola
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain; IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain.
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Vidal J, Fernández-Rodríguez MC, Casadevall D, García-Alfonso P, Páez D, Guix M, Alonso V, Cano MT, Santos C, Durán G, Elez E, Manzano JL, Garcia-Carbonero R, Ferreiro R, Losa F, Pineda E, Sastre J, Rivera F, Bellosillo B, Tabernero J, Aranda E, Salazar R, Montagut C. Liquid Biopsy Detects Early Molecular Response and Predicts Benefit to First-Line Chemotherapy plus Cetuximab in Metastatic Colorectal Cancer: PLATFORM-B Study. Clin Cancer Res 2023; 29:379-388. [PMID: 36074154 DOI: 10.1158/1078-0432.ccr-22-1696] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/22/2022] [Accepted: 09/02/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE Chemotherapy plus anti-EGFR is standard first-line therapy in RAS wild-type (wt) metastatic colorectal cancer (mCRC), but biomarkers of early response are clinically needed. We aimed to define the utility of ctDNA to assess early response in patients with mCRC receiving first-line anti-EGFR therapy. EXPERIMENTAL DESIGN Prospective multicentric study of tissue patients with RAS wt mCRC treated with first-line chemotherapy plus cetuximab undergoing sequential liquid biopsies. Baseline and early (C3) ctDNA were analyzed by NGS. Trunk mutations were assessed as surrogate marker of total tumor burden. RAS/BRAF/MEK/EGFR-ECD were considered mutations of resistance. ctDNA results were correlated with clinical outcome. RESULTS One hundred patients were included. ctDNA was detected in 72% of patients at baseline and 34% at C3. Decrease in ctDNA trunk mutations correlated with progression-free survival (PFS; HR, 0.23; P = 0.001). RAS/BRAF were the only resistant mutations detected at C3. An increase in the relative fraction of RAS/BRAF at C3 was followed by an expansion of the RAS clone until PD, and was associated with shorter PFS (HR, 10.5; P < 0.001). The best predictor of response was the combined analysis of trunk and resistant mutations at C3. Accordingly, patients with "early molecular response" (decrease in trunk and decrease in resistant mutations) had better response (77.5% vs. 25%, P = 0.008) and longer PFS (HR, 0.18; P < 0.001) compared with patients with "early molecular progression" (increase in trunk and/or increase in resistant mutations). CONCLUSIONS ctDNA detects early molecular response and predicts benefit to chemotherapy plus cetuximab. A comprehensive NGS-based approach is recommended to integrate information on total disease burden and resistant mutations. See related commentary by Eluri et al., p. 302.
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Affiliation(s)
- Joana Vidal
- Medical Oncology Department, Hospital del Mar, Institut Mar Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, CIBERONC, Barcelona, Spain
| | | | - David Casadevall
- Medical Oncology Department, Hospital del Mar, Institut Mar Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, CIBERONC, Barcelona, Spain
| | | | - David Páez
- Medical Oncology Department, H. Santa Creu i Sant Pau, Barcelona, Spain
| | - Marta Guix
- Medical Oncology Department, Hospital del Mar, Institut Mar Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, CIBERONC, Barcelona, Spain
| | - Vicente Alonso
- Medical Oncology Department, H. Miguel Servet, Zaragoza, Spain
| | - Maria Teresa Cano
- Medical Oncology Department, IMIBIC, Reina Sofía Hospital, University of Cordoba, CIBERONC, Cordoba, Spain
| | - Cristina Santos
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL)-CIBERONC, Barcelona, Spain
| | - Gema Durán
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - Elena Elez
- Medical Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, CIBERONC, Barcelona, Spain
| | - José Luís Manzano
- Medical Oncology Department, ICO, H. Germans Trias i Pujol, Barcelona, Spain
| | - Rocío Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), UCM, Madrid, Spain
| | - Reyes Ferreiro
- Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Ferran Losa
- Medical Oncology Department, Hospital Sant Joan Despí - Moisès Broggi, ICO-Hospitalet, Barcelona. Spain
| | - Estela Pineda
- Medical Oncology Department Hospital Clínic, Barcelona, Spain
| | - Javier Sastre
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, CIBERONC, Madrid, Spain
| | - Fernando Rivera
- Medical Oncology Department Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Enrique Aranda
- Medical Oncology Department, IMIBIC, Reina Sofía Hospital, University of Cordoba, CIBERONC, Cordoba, Spain
| | - Ramon Salazar
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL)-CIBERONC, Barcelona, Spain
| | - Clara Montagut
- Medical Oncology Department, Hospital del Mar, Institut Mar Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, CIBERONC, Barcelona, Spain
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Seguí E, Auclin E, Torres JM, Casadevall D, Aguilar-Company J, Rodríguez M, Epaillard N, Gavira J, Tapia JC, Tagliamento M, Pilotto S, Lopez R, Mielgo X, Blaquier JB, Bluthgen M, Minatta JN, Urbano C, Prat A, Vlagea A, Mezquita L. The FLARE score, circulating neutrophils, and association with COVID-19 outcomes in patients with solid tumors. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2551] [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: 11/20/2022] Open
Abstract
2551 Background: Inflammation and neutrophils play a central role in severe Covid-19 disease. In previous data, we showed that the FLARE score, combining both tumor and Covid-19-induced proinflammatory status (proinflam-status), predicts early mortality in cancer patients (pts) with Covid-19 infection. We aimed to assess the impact of this score in a larger cohort and characterize the immunophenotype (IF) of circulating neutrophils. Methods: Multicenter retrospective cohort (RC) of pts with cancer and Covid-19 infection across 14 international centers. Circulating inflammatory markers were collected at two timepoints: baseline (-15 to -45d before Covid-19 diagnosis) and Covid-19 diagnosis. Tumor-induced proinflam-status was defined by high dNLR (neutrophils/(leucocytes-neutrophils)>3) at baseline. Covid-19-induced proinflam-status was defined by +100% increase of dNLR between both timepoints. We built the FLARE score combining both Tumor and Infection-induced inflammation: T+/I+ (poor), if both proinflam-status; T+/I- (T-only), if inflammation only due to tumor; T-/I+ (I-only), if inflammation only due to Covid; T-/I- (favorable), if no proinflam-status. The IF of circulating neutrophils by flow cytometry was determined in a unicenter prospective cohort (PC) of pts with cancer during Covid-19 infection and in healthy volunteers (HV). Primary endpoint was 30-day mortality. Results: 524 pts were enrolled in the RC with a median follow-up of 84d (95%CI 78-90). Median age was 69 (range 35-98), 52% were male and 78% had baseline PS <1.Thoracic cancers were the most common (26%). 70% had active disease, 51% advanced stage and 57% were under systemic therapy. dNLR was high in 25% at baseline vs 55% at Covid-19 diagnosis. The median dNLR increase between both timepoints was +70% (IQR: 0-349%); 42% had +100% increase of dNLR. Pts distribution and mortality across FLARE groups is resumed in the Table. Overall mortality rate was 26%. In multivariate analysis, including gender, stage and PS, the FLARE poor group was independently associated with 30-day mortality [OR 5.27; 1.37-20.3]. 44 pts were enrolled in the PC. Median circulating neutrophils were higher in pts with cancer (n=10, 56.7% [IQR: 39-78.4%]) vs HV (n=6, 35.8% [IQR: 25.6-21%]), and particularly higher in pts with cancer and severe Covid-19 infection (n=7, 88.6% [IQR: 80.9-94%] (p=0.003). A more comprehensive characterization of the IF of circulating neutrophils, including Lox1/CD62/CD64, will be presented at ASCO. Conclusions: The FLARE score, combining tumor and Covid-19-induced proinflam-status, can identify the population at higher risk for mortality. A better characterization of circulating neutrophils may help improve the prediction of Covid-19 outcomes in pts with cancer. [Table: see text]
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Affiliation(s)
- Elia Seguí
- Medical Oncology, Hospital Clínic de Barcelona, Spain, Barcelona, Spain
| | - Edouard Auclin
- Oncology Department, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | | | | | - Juan Aguilar-Company
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Marta Rodríguez
- Parc Taulí University Hospital, Parc Taulí Institute of Research and Innovation I3PT, Barcelona Autonomous University, Sabadell, Spain
| | | | - Javier Gavira
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jose Carlos Tapia
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marco Tagliamento
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, Italy
| | - Sara Pilotto
- Azienda Ospedaliero Universitaria Integrata di Verona, Verona, Italy
| | - Rafael Lopez
- University Clinical Hospital and Health Research Institute (IDIS), CIBERONC, Santiago de Compostela University School of Medicine, Santiago De Compostela, Spain
| | | | | | | | | | - Cristina Urbano
- Medical Oncology, Hospital General de Granollers, Granollers, Spain
| | - Aleix Prat
- Medical Oncology Department, Hospital Clínic, Barcelona, Spain, Barcelona, Spain
| | - Alexandru Vlagea
- Immunology department, Hospital Clínic de Barcelona, Barcelona, Spain
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Muñoz Martín AJ, Huerga Domínguez S, Souto JC, Rogado Revuelta J, Sanchez A, Garcia-Palomo A, Aparicio J, Aguayo C, Gutierrez Abad D, Ortega L, Viñuela-Benéitez MC, Fanjul V, Casadevall D, Arumi D, Hernández-Presa MÁ. Predicting recurrence of venous thromboembolism in anticoagulated cancer patients using real-world data and machine learning. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18742] [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: 11/20/2022] Open
Abstract
e18742 Background: The clinical predictors of venous thromboembolism (VTE) recurrence in patients with cancer are not well known. Our objective was to develop a predictive model for risk of VTE recurrence in anticoagulant-treated cancer patients within the first 6 months following VTE diagnosis. Methods: Using the EHRead technology, based on Natural Language Processing (NLP) and machine learning (ML), the unstructured clinical data in EHRs from 9 Spanish hospitals between 2014 and 2018 was extracted and analyzed. The study population, comprising all adult anticoagulated cancer patients with VTE, was downsampled to prevent bias and class imbalance. A total of 94 patient characteristics were explored, and Random Forest (RF) feature selection was performed to identify the most relevant predictors for VTE recurrence. Multiple algorithms were used to train different prediction models, which were subsequently validated in a hold-out dataset. The model with the best performance metrics (i.e., ROC-AUC) was selected as the final model. Results: From a source population of 2,893,208 patients, 21,227 anticoagulant-treated patients with VTE and active cancer (53.9% male, median age of 70 years) were identified. Across the study period, yearly incidence of VTE remained relatively stable, ranging from 2.7 to 3.9%. The most common type of VTE was deep vein thrombosis (68.2% of patients), followed by pulmonary embolism (28.4%). Regarding primary cancer locations, the most frequent were colorectal (10.1%) and lung cancer (8.5%). Of all trained and validated models, the RF approach yielded the best performance, with a ROC-AUC = 0.72. The following predictors of VTE recurrence were identified: pulmonary embolism, deep vein thrombosis, metastasis, adenocarcinoma, hemoglobin values, serum creatinine values, platelet count, leukocyte count, family history of VTE, and patients’ age. Conclusions: Using NLP and ML, we were able to use the real-world data in EHRs to build a predictive model of VTE recurrence in cancer patients based on individual clinical features. These results may improve the clinical management of VTE recurrence in this population.
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Affiliation(s)
- Andrés J. Muñoz Martín
- Instituto Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | | | | | | | - Antonio Sanchez
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Jorge Aparicio
- Hospital Universitario y Politecnico de La Fe, Valencia, Spain
| | | | | | - Laura Ortega
- Instituto Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
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7
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Esteve-Palau E, Gonzalez-Cuevas A, Eugenia Guerrero M, Garcia-Terol C, Carmen Alvarez M, Garcia G, Moreno E, Medina F, Casadevall D, Diaz-Brito V. Quantification and progress over time of specific antibodies against SARS-CoV-2 in breast milk of lactating women vaccinated with BNT162b2 Pfizer-BioNTech COVID-19 vaccine (LacCOVID). Open Forum Infect Dis 2022; 9:ofac239. [PMID: 35783685 PMCID: PMC9129184 DOI: 10.1093/ofid/ofac239] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Several observational studies demonstrated the passage of postvaccine antibodies through breast milk in women vaccinated against coronavirus disease 2019 (COVID-19), mostly with messenger RNA (mRNA)–based vaccines, but lacked long-term data. Methods A 6-month prospective cohort study was performed to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine–induced antibody levels in the breast milk of 33 lactating healthcare workers at different timepoints after mRNA BNT162b2 Pfizer-BioNTech COVID-19 vaccination. Moreover, we examined the correlation of SARS-CoV-2 antibody levels between serum and breast milk, adverse events related to vaccination, and rate of SARS-CoV-2 infections. Results Mothers’ median age was 38 (interquartile range [IQR], 36–39) years and 15 (IQR, 10–22) months for infants. Median (IQR) SARS-CoV-2 immunoglobulin G (IgG) spike protein subunit S1 (S1) vaccine–induced levels at different timepoints for serum–milk pairs were 519 (234–937) to 1 (0–2.9) arbitrary units (AU)/mL at 2 weeks after first dose and 18 644 (9923–29 264) to 78 (33.7–128), 12 478 (6870–20 801) to 50.4 (24.3–104), 4094 (2413–8480) to 19.9 (10.8–51.9), 1350 (831–2298) to 8.9 (7.8–31.5) AU/mL at 2, 4, 12 and 24 weeks after second dose, respectively. We observed a positive correlation of antibody levels between serum and breast milk, no serious adverse events related to vaccination, and 2 (6%) COVID-19 vaccine breakthrough infections. Conclusions Women vaccinated with Pfizer-BioNTech transmit antibodies into breast milk with a positive correlation with serum levels. Both decreased over time in a 6-month follow-up.
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Affiliation(s)
- Erika Esteve-Palau
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | | | - M. Eugenia Guerrero
- Department of Microbiology, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Clara Garcia-Terol
- Department of Obstetrics and Gynecology, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - M. Carmen Alvarez
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Geneva Garcia
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Encarna Moreno
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Francisco Medina
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - David Casadevall
- Cancer Research Program, Hospital del Mar Research Institute, Barcelona, Spain
| | - Vicens Diaz-Brito
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
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8
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Marczyk M, Gunasekharan V, Casadevall D, Qing T, Foldi J, Sehgal R, Shan NL, Blenman KRM, O'Meara TA, Umlauf S, Surovtseva YV, Muthusamy V, Rinehart J, Perry RJ, Kibbey R, Hatzis C, Pusztai L. Comprehensive Analysis of Metabolic Isozyme Targets in Cancer. Cancer Res 2022; 82:1698-1711. [PMID: 35247885 PMCID: PMC10883296 DOI: 10.1158/0008-5472.can-21-3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/07/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022]
Abstract
Metabolic reprogramming is a hallmark of malignant transformation, and loss of isozyme diversity (LID) contributes to this process. Isozymes are distinct proteins that catalyze the same enzymatic reaction but can have different kinetic characteristics, subcellular localization, and tissue specificity. Cancer-dominant isozymes that catalyze rate-limiting reactions in critical metabolic processes represent potential therapeutic targets. Here, we examined the isozyme expression patterns of 1,319 enzymatic reactions in 14 cancer types and their matching normal tissues using The Cancer Genome Atlas mRNA expression data to identify isozymes that become cancer-dominant. Of the reactions analyzed, 357 demonstrated LID in at least one cancer type. Assessment of the expression patterns in over 600 cell lines in the Cancer Cell Line Encyclopedia showed that these reactions reflect cellular changes instead of differences in tissue composition; 50% of the LID-affected isozymes showed cancer-dominant expression in the corresponding cell lines. The functional importance of the cancer-dominant isozymes was assessed in genome-wide CRISPR and RNAi loss-of-function screens: 17% were critical for cell proliferation, indicating their potential as therapeutic targets. Lists of prioritized novel metabolic targets were developed for 14 cancer types; the most broadly shared and functionally validated target was acetyl-CoA carboxylase 1 (ACC1). Small molecule inhibition of ACC reduced breast cancer viability in vitro and suppressed tumor growth in cell line- and patient-derived xenografts in vivo. Evaluation of the effects of drug treatment revealed significant metabolic and transcriptional perturbations. Overall, this systematic analysis of isozyme expression patterns elucidates an important aspect of cancer metabolic plasticity and reveals putative metabolic vulnerabilities. SIGNIFICANCE This study exploits the loss of metabolic isozyme diversity common in cancer and reveals a rich pool of potential therapeutic targets that will allow the repurposing of existing inhibitors for anticancer therapy. See related commentary by Kehinde and Parker, p. 1695.
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Affiliation(s)
- Michal Marczyk
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
- Department of Data Science and Engineering, Silesian University of Technology, Gliwice, Poland
| | | | - David Casadevall
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Biomedical Research Networking Center on Oncology-CIBERONC, ISCIII, Madrid, Spain
| | - Tao Qing
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Julia Foldi
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Raghav Sehgal
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Naing Lin Shan
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Kim R M Blenman
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Tess A O'Meara
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Sheila Umlauf
- Yale Center for Molecular Discovery, Yale University, West Haven, Connecticut
| | - Yulia V Surovtseva
- Yale Center for Molecular Discovery, Yale University, West Haven, Connecticut
| | - Viswanathan Muthusamy
- Center for Precision Cancer Modeling, Yale School of Medicine, New Haven, Connecticut
| | - Jesse Rinehart
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Rachel J Perry
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Richard Kibbey
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Christos Hatzis
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
| | - Lajos Pusztai
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
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9
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Leis A, Casadevall D, Albanell J, Posso M, Macià F, Castells X, Ramírez-Anguita JM, Martínez Roldán J, Furlong LI, Sanz F, Ronzano F, Mayer MA. Exploring the Association of Cancer and Depression in Electronic Health Records: Combining Encoded Diagnosis and Mining Free Text Clinical Notes (Preprint). JMIR Cancer 2022; 8:e39003. [PMID: 35816382 PMCID: PMC9315897 DOI: 10.2196/39003] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/05/2022] Open
Abstract
Background A cancer diagnosis is a source of psychological and emotional stress, which are often maintained for sustained periods of time that may lead to depressive disorders. Depression is one of the most common psychological conditions in patients with cancer. According to the Global Cancer Observatory, breast and colorectal cancers are the most prevalent cancers in both sexes and across all age groups in Spain. Objective This study aimed to compare the prevalence of depression in patients before and after the diagnosis of breast or colorectal cancer, as well as to assess the usefulness of the analysis of free-text clinical notes in 2 languages (Spanish or Catalan) for detecting depression in combination with encoded diagnoses. Methods We carried out an analysis of the electronic health records from a general hospital by considering the different sources of clinical information related to depression in patients with breast and colorectal cancer. This analysis included ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis codes and unstructured information extracted by mining free-text clinical notes via natural language processing tools based on Systematized Nomenclature of Medicine Clinical Terms that mentions symptoms and drugs used for the treatment of depression. Results We observed that the percentage of patients diagnosed with depressive disorders significantly increased after cancer diagnosis in the 2 types of cancer considered—breast and colorectal cancers. We managed to identify a higher number of patients with depression by mining free-text clinical notes than the group selected exclusively on ICD-9-CM codes, increasing the number of patients diagnosed with depression by 34.8% (441/1269). In addition, the number of patients with depression who received chemotherapy was higher than those who did not receive this treatment, with significant differences (P<.001). Conclusions This study provides new clinical evidence of the depression-cancer comorbidity and supports the use of natural language processing for extracting and analyzing free-text clinical notes from electronic health records, contributing to the identification of additional clinical data that complements those provided by coded data to improve the management of these patients.
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Affiliation(s)
- Angela Leis
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - David Casadevall
- Cancer Research Program, Hospital del Mar Research Institute, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, Hospital del Mar Research Institute, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Margarita Posso
- Department of Epidemiology, Hospital del Mar Research Institute, Barcelona, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Francesc Macià
- Department of Epidemiology, Hospital del Mar Research Institute, Barcelona, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Xavier Castells
- Department of Epidemiology, Hospital del Mar Research Institute, Barcelona, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Juan Manuel Ramírez-Anguita
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Laura I Furlong
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ferran Sanz
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Francesco Ronzano
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Miguel A Mayer
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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10
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Casadevall D, Hernandez-Prat A, Garc A-Alonso S, Arpi-Llucia O, Menendez S, Qin M, Guardia C, Morancho B, Sanchez-Mart N FJ, Zazo S, Gavilan E, Sabbaghi M, Eroles P, Cejalvo JM, Lluch A, Rojo F, Pandiella A, Rovira A, Albanell J. mTOR inhibition and trastuzumab-emtansine (T-DM1) in HER2-positive breast cancer. Mol Cancer Res 2022; 20:1108-1121. [PMID: 35348729 DOI: 10.1158/1541-7786.mcr-21-0545] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/06/2022] [Accepted: 03/23/2022] [Indexed: 12/09/2022]
Abstract
In patients with trastuzumab-resistant HER2-positive breast cancer, the combination of everolimus (mTORC1 inhibitor) with trastuzumab failed to show a clinically significant benefit. However, the combination of mTOR inhibition and the antibody-drug conjugate (ADC) trastuzumab-emtansine (T-DM1) remains unexplored. We tested T-DM1 plus everolimus in a broad panel of HER2-positive breast cancer cell lines. The combination was superior to T-DM1 alone in four cell lines (HCC1954, SKBR3, EFM192A, and MDA-MB-36) and in two cultures from primary tumor cells derived from HER2-positive patient-derived xenografts (PDX), but not in BT474 cells. In the trastuzumab-resistant HCC1954 cell line, we characterized the effects of the combination using TAK-228 (mTORC1 and 2 inhibitor) and knockdown of the different mTOR complex components. T-DM1 did not affect mTOR downstream signaling nor induct autophagy. Importantly, mTOR inhibition increased intracellular T-DM1 levels, leading to increased lysosomal accumulation of the compound. The increased efficacy of mTOR inhibition plus T-DM1 was abrogated by lysosome inhibitors (chloroquine and bafilomycin A1). Our experiments suggest that BT474 are less sensitive to T-DM1 due to lack of optimal lysosomal processing and intrinsic resistance to the DM1 moiety. Finally, we performed several in vivo experiments that corroborated the superior activity of T-DM1 and everolimus in HCC1954 and PDX-derived mouse models. In summary, everolimus in combination with T-DM1 showed strong antitumor effects in HER2-positive breast cancer, both in vitro and in vivo. This effect might be related, at least partially, to mTOR-dependent lysosomal processing of T-DM1, a finding that might apply to other ADCs that require lysosomal processing. Implications: Inhibition of mTOR increases the anti-tumor activity of T-DM1, supporting that the combination of mTOR inhibitors and antibody-drug conjugates warrants clinical evaluation in patients with HER2-positive breast cancer.
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Affiliation(s)
| | | | | | - Oriol Arpi-Llucia
- IMIM (Institut Hospital del Mar d'Investigacions M�diques), Barcelona, Barcelona, Spain
| | | | - Mengjuan Qin
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Cristina Guardia
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Barcelona, Spain
| | | | | | - Sandra Zazo
- IIS-Fundaci�n Jim�nez D�az-CIBERONC, UAM, Madrid, Spain
| | | | | | - Pilar Eroles
- INCLIVA Biomedical Research Institute - University of Valencia, Spain. CIBERONC, Valencia, Valencia, Spain
| | - Juan Miguel Cejalvo
- Biomedical Health Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - Ana Lluch
- University of Valencia - Biomedical Research Institute INCLIVA-Hospital Cl�nico de Valencia-CIBERONC, Valencia, Valencia, Spain
| | - Federico Rojo
- IIS-Fundaci�n Jim�nez D�az-CIBERONC, UAM, Madrid, Spain
| | - Atanasio Pandiella
- Centro de Investigaci�n del C�ncer, CIBERONC and IBSAL, Salamanca, Spain
| | | | - Joan Albanell
- Hospital Del Mar Medical Research Instiiute, Barcelona, Spain
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11
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Pérez-Núñez I, Rozalén C, Palomeque JÁ, Sangrador I, Dalmau M, Comerma L, Hernández-Prat A, Casadevall D, Menendez S, Liu DD, Shen M, Berenguer J, Ruiz IR, Peña R, Montañés JC, Albà MM, Bonnin S, Ponomarenko J, Gomis RR, Cejalvo JM, Servitja S, Marzese DM, Morey L, Voorwerk L, Arribas J, Bermejo B, Kok M, Pusztai L, Kang Y, Albanell J, Celià-Terrassa T. LCOR mediates interferon-independent tumor immunogenicity and responsiveness to immune-checkpoint blockade in triple-negative breast cancer. Nat Cancer 2022; 3:355-370. [PMID: 35301507 DOI: 10.1038/s43018-022-00339-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 01/21/2022] [Indexed: 01/05/2023]
Abstract
Ligand-dependent corepressor (LCOR) mediates normal and malignant breast stem cell differentiation. Cancer stem cells (CSCs) generate phenotypic heterogeneity and drive therapy resistance, yet their role in immunotherapy is poorly understood. Here we show that immune-checkpoint blockade (ICB) therapy selects for LCORlow CSCs with reduced antigen processing/presentation machinery (APM) driving immune escape and ICB resistance in triple-negative breast cancer (TNBC). We unveil an unexpected function of LCOR as a master transcriptional activator of APM genes binding to IFN-stimulated response elements (ISREs) in an IFN signaling-independent manner. Through genetic modification of LCOR expression, we demonstrate its central role in modulation of tumor immunogenicity and ICB responsiveness. In TNBC, LCOR associates with ICB clinical response. Importantly, extracellular vesicle (EV) Lcor-messenger RNA therapy in combination with anti-PD-L1 overcame resistance and eradicated breast cancer metastasis in preclinical models. Collectively, these data support LCOR as a promising target for enhancement of ICB efficacy in TNBC, by boosting of tumor APM independently of IFN.
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Affiliation(s)
- Iván Pérez-Núñez
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Catalina Rozalén
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - José Ángel Palomeque
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Irene Sangrador
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Mariona Dalmau
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Laura Comerma
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Anna Hernández-Prat
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - David Casadevall
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Silvia Menendez
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Daniel Dan Liu
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA, USA
| | - Minhong Shen
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
| | - Jordi Berenguer
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Irene Rius Ruiz
- Preclinical Research Program, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Raul Peña
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - José Carlos Montañés
- Research Program on Biomedical Informatics, Hospital del Mar Medical Research Institute and Universitat Pompeu Fabra, Barcelona, Spain
| | - M Mar Albà
- Research Program on Biomedical Informatics, Hospital del Mar Medical Research Institute and Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Sarah Bonnin
- Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Julia Ponomarenko
- Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Roger R Gomis
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
- Cancer Science Program, Institute for Research in Biomedicine, The Barcelona Institute of Science and Technology, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain
| | - Juan Miguel Cejalvo
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain
- Medical Oncology Department, Hospital Clínico Universitario; Medicine Department, Universidad de Valencia, Spain, INCLIVA, Valencia, Spain
| | - Sonia Servitja
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Diego M Marzese
- Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain
| | - Lluis Morey
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Leonie Voorwerk
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Joaquín Arribas
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Preclinical Research Program, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain
| | - Begoña Bermejo
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain
- Medical Oncology Department, Hospital Clínico Universitario; Medicine Department, Universidad de Valencia, Spain, INCLIVA, Valencia, Spain
| | - Marleen Kok
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lajos Pusztai
- Breast Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Yibin Kang
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
- Ludwig Institute for Cancer Research Princeton Branch, Princeton, NJ, USA
| | - Joan Albanell
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain.
- Universitat Pompeu Fabra, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain.
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain.
| | - Toni Celià-Terrassa
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Oncología, Madrid, Spain.
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12
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Corbera A, Rios-Hoyo A, Visa L, Casadevall D, Ilzarbe L, Barranco L, Radosevic A, Servitja S. Incidence of complications associated to bile duct stents, in patients with advanced cancer: a single-center experience. Support Care Cancer 2022; 30:4373-4378. [DOI: 10.1007/s00520-021-06737-1] [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] [Received: 07/01/2021] [Accepted: 12/03/2021] [Indexed: 12/09/2022]
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13
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Guardia C, Bianchini G, Arpí-LLucià O, Menendez S, Casadevall D, Galbardi B, Dugo M, Servitja S, Montero JC, Soria-Jiménez L, Sabbaghi M, Peña R, Madoz-Gúrpide J, Lloveras B, Lluch A, Eroles P, Arribas J, Pandiella A, Gianni L, Rojo F, Rovira A, Albanell J. Preclinical and Clinical Characterization of Fibroblast-derived Neuregulin-1 on Trastuzumab and Pertuzumab Activity in HER2-positive Breast Cancer. Clin Cancer Res 2021; 27:5096-5108. [PMID: 34385295 DOI: 10.1158/1078-0432.ccr-20-2915] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/29/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To characterize expression of neuregulin-1 (NRG1), an HER3 ligand, in HER2-positive breast cancer and its relation with the efficacy of trastuzumab with or without pertuzumab. EXPERIMENTAL DESIGN Characterization of NRG1 expression in tumor cell lines, in tumor specimens, and in cancer-associated fibroblasts (CAFs). Patient-derived CAFs were used to investigate NRG1 impact on the activity of trastuzumab with or without pertuzumab in HER2-positive breast cancer cells. The relationship between NRG1 expression and pathologic response to anti-HER2-based neoadjuvant therapy was assessed in a retrospective patient cohort and in the NeoSphere trial. RESULTS NRG1 was expressed in HER2-positive breast cancer-derived fibroblasts at significantly higher levels than in cancer cells. NRG1 and the conditioned media (CM) from CAFs phosphorylated HER3 and AKT in cancer cells and mediated trastuzumab resistance. Stable genetic depletion of NRG1 from CAFs overcame trastuzumab resistance. Pertuzumab effectively suppressed trastuzumab resistance mediated by either NRG1 or CAF's CM. NRG1 engaged an epithelial-to-mesenchymal transition that was prevented by trastuzumab and pertuzumab. In clinical samples, stromal and/or tumor cell expression of NRG1 determined by immunohistochemistry was uncommon (13.2%) yet significantly linked with residual disease following trastuzumab-based neoadjuvant therapy. In the NeoSphere trial, the magnitude of the difference of pathologic complete response rates favoring the pertuzumab arm was higher in the NRG1-high group. CONCLUSIONS CAF-derived NRG1 mediates trastuzumab resistance through HER3/AKT, which might be reverted by pertuzumab. In patients with HER2-positive breast cancer, high expression of NRG1 was associated to poor response to trastuzumab, but not in combination with pertuzumab.
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Affiliation(s)
- Cristina Guardia
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | | | - Oriol Arpí-LLucià
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Silvia Menendez
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - David Casadevall
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Barbara Galbardi
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Matteo Dugo
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Sonia Servitja
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | | | - Luis Soria-Jiménez
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - MohammadA Sabbaghi
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Raul Peña
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Juan Madoz-Gúrpide
- Department of Pathology, IIS-Fundación Jiménez Díaz-CIBERONC, Madrid, Spain
| | - Belen Lloveras
- Department of Pathology, Hospital del Mar, Barcelona, Spain
| | - Ana Lluch
- INCLIVA Biomedical Research Institute, Hospital Clínico de Valencia-CIBERONC, Universitat de València, Barcelona, Spain
| | - Pilar Eroles
- INCLIVA Biomedical Research Institute, Hospital Clínico de Valencia-CIBERONC, Universitat de València, Barcelona, Spain.,INCLIVA, Biomedical Research Institute, Valencia, Spain
| | - Joaquin Arribas
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Preclinical Research Program, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Atanasio Pandiella
- Centro de Investigación del Cáncer, IBSAL-CSIC-CIBERONC, Salamanca, Spain
| | | | - Federico Rojo
- Department of Pathology, IIS-Fundación Jiménez Díaz-CIBERONC, Madrid, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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Esteve-Palau E, Gonzalez-Cuevas A, Guerrero ME, Garcia-Terol C, Alvarez MC, Casadevall D, Diaz-Brito V. Quantification of Specific Antibodies Against SARS-CoV-2 in Breast Milk of Lactating Women Vaccinated With an mRNA Vaccine. JAMA Netw Open 2021; 4:e2120575. [PMID: 34379127 PMCID: PMC8358734 DOI: 10.1001/jamanetworkopen.2021.20575] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/08/2021] [Indexed: 01/04/2023] Open
Affiliation(s)
- Erika Esteve-Palau
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu, Sant Boi, Barcelona, Spain
| | | | - M. Eugenia Guerrero
- Department of Microbiology, Parc Sanitari Sant Joan de Déu, Sant Boi, Barcelona, Spain
| | - Clara Garcia-Terol
- Department of Obstetrics and Gynecology, Parc Sanitari Sant Joan de Déu, Sant Boi, Barcelona, Spain
| | - M. Carmen Alvarez
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu, Sant Boi, Barcelona, Spain
| | - David Casadevall
- Cancer Research Program, Hospital del Mar Research Institute, Barcelona, Spain
| | - Vicens Diaz-Brito
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu, Sant Boi, Barcelona, Spain
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15
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Casadevall D, Marczyk M, Monzonis X, Pusztai L, Albanell J. Abstract 423: Pooled analysis of matching score and patient outcome in I-PREDICT and WINTHER studies. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-423] [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: Comprehensive genomic profiling (CGP) of tumors is available at many specialized cancer centers, potentially allowing oncologists to individualize patient therapy based on tumor molecular features. However, clinicians still lack a systematic approach to deal with the wealth of information provided by CGP. The proportion of plausible drug-matched alterations over the total number of alterations detected by CGP (Matching Score, MS) has been postulated to predict the likelihood of patient benefit. We performed a systematic analysis of MS and its association with the outcome of patients treated according to tumor DNA alterations within two recent precision oncology trials.
Materials and Methods: We downloaded the supplementary data from WINTHER (NCT01856296) and I-PREDICT (NCT02534675) studies. We included patients who received treatment for one or more single-gene alterations, excluding eight patients that received immunotherapy due to high tumor mutational burden, PD-L1 positivity or microsatellite instability. We used MS cut-offs of 0.25 (as in WINTHER) and 0.5 (as in I-PREDICT) and also MS as a continuous variable to study its association with clinical variables such as age, sex, tumor type, and number of previous treatment lines (Kruskall-Wallis and Wilcoxon-rank tests), as well as disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) (Cox proportional hazards models).
Results: The pooled analysis included 144 patients. Median age was 60 years (range 21-86) and 64% had received ≥ 2 lines of therapy. Most patients had colorectal (37%), lung (14%), or breast (11%) tumors, and 58% were treated with 2 or more drugs. MS was not associated with any clinical variable nor with DCR. MS > 0.25 (n=98; 68%) was associated with longer PFS (median 3.5 vs. 1.9 months, HR [95%CI]: 0.60 [0.41-0.87]) but not with OS. In contrast, MS > 0.5 (n=41; 28%) was associated with longer OS (median 14.1 vs. 6.5 months, HR [95%CI]: 0.50 [0.29-0.54]) but not with PFS. As a continuous variable, increasing MS values were associated with better OS (HR [95% CI]: 0.43 [0.20-0.95]) and with a non-significant trend towards better PFS (HR [95% CI]: 0.54 [0.21-1.05]). In a multivariable model adjusted for Age and study, PFS/OS probabilities improved consistently with increasing MS values from 0 to 0.5. With MS values > 0.5, OS probabilities kept increasing while PFS probabilities plateaued.
Conclusions: The significant and consistent relationship between MS and OS (in contrast with PFS) may be explained by patients with higher MS values having more targeted therapies available for successive treatment lines, although we cannot exclude the existence of other confounding prognostic variables. We note that, as better drugs are developed and new knowledge is incorporated into the clinic, the value of CGP will probably increase over time, improving the number of patients with actionable alterations and their outcome.
Citation Format: David Casadevall, Michal Marczyk, Xavier Monzonis, Lajos Pusztai, Joan Albanell. Pooled analysis of matching score and patient outcome in I-PREDICT and WINTHER studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 423.
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16
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Vidal J, Casadevall D, Bellosillo B, Pericay C, Garcia-Carbonero R, Losa F, Layos L, Alonso V, Capdevila J, Gallego J, Vera R, Salud A, Martin-Richard M, Nogué M, Cillán E, Maurel J, Faull I, Raymond V, Fernández-Martos C, Montagut C. Clinical Impact of Presurgery Circulating Tumor DNA after Total Neoadjuvant Treatment in Locally Advanced Rectal Cancer: A Biomarker Study from the GEMCAD 1402 Trial. Clin Cancer Res 2021; 27:2890-2898. [PMID: 33727257 DOI: 10.1158/1078-0432.ccr-20-4769] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/06/2021] [Accepted: 03/10/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Total neoadjuvant treatment (TNT) is a valid strategy for patients with high-risk locally advanced rectal cancer (LARC). Biomarkers of response to TNT are an unmet clinical need. We aimed to determine the value of circulating tumor DNA (ctDNA) to predict tumor response, recurrence, and survival in patients with LARC treated with TNT. EXPERIMENTAL DESIGN The GEMCAD 1402 was a phase II randomized, multicentric clinical trial that randomized 180 patients with LARC to modified schedule of fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) +/- aflibercept, followed by chemoradiation and surgery. Plasma samples were collected at baseline and after TNT within 48 hours before surgery (presurgery). An ultrasensitive assay that integrates genomic and epigenomic cancer signatures was used to assess ctDNA status. ctDNA results were correlated with variables of local tumor response in the surgery sample, local/systemic recurrence, and survival. RESULTS A total of 144 paired plasma samples from 72 patients were included. ctDNA was detectable in 83% of patients at baseline and in 15% following TNT (presurgery). No association was found between ctDNA status and pathologic response. Detectable presurgery ctDNA was significantly associated with systemic recurrence, shorter disease-free survival (HR, 4; P = 0.033), and shorter overall survival (HR, 23; P < 0.0001). CONCLUSIONS In patients with LARC treated with TNT, presurgery ctDNA detected minimal metastatic disease identifying patients at high risk of distant recurrence and death. This study sets the basis for prospective clinical trials that use liquid biopsy to personalize the therapeutic approach following TNT.
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Affiliation(s)
- Joana Vidal
- Department of Medical Oncology, Hospital del Mar - IMIM, CIBERONC, Barcelona, Spain
| | - David Casadevall
- Department of Medical Oncology, Hospital del Mar - IMIM, CIBERONC, Barcelona, Spain
| | | | - Carles Pericay
- Department of Medical Oncology, Complex Sanitari Parc Tauli, Sabadell, Spain
| | - Rocio Garcia-Carbonero
- Department of Medical Oncology, Hospital Universitario Doce de Octubre, Imas12, UCM, CNIO, CIBERONC, Madrid, Spain
| | - Ferran Losa
- Department of Medical Oncology, Hospital, Sant Joan Despí-Moises Broggi, Sant Joan Despí, Spain
| | - Laia Layos
- Department of Medical Oncology, Hospital Universitari Germans Trias i Pujol, Institut Català d'Oncologia, Badalona, Spain
| | - Vicente Alonso
- Department of Medical Oncology, Hospital Universitario Miguel Servet, IISA, CIBERONC, Zaragoza, Spain
| | - Jaume Capdevila
- Department of Medical Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Javier Gallego
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Spain
| | - Ruth Vera
- Department of Medical Oncology, Complejo Hospitalario de Navarra, Instituto de investigaciones Sanitarias de Navarra (IdISNA), Pamplona, Navarra, Spain
| | - Antonieta Salud
- Department of Medical Oncology, Hospital Arnau de Vilanova de Lleida, Lleida, Spain
| | - Marta Martin-Richard
- Department of Medical Oncology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Miguel Nogué
- Department of Medical Oncology, Hospital de Granollers, Granollers, Spain
| | - Elena Cillán
- Department of Medical Oncology, Hospital Sant Joan de Déu Fundació Althaia, Manresa, Spain
| | - Joan Maurel
- Department of Medical Oncology, Hospital Clìnic i Provincial de Barcelona, Barcelona, Spain
| | - Iris Faull
- Guardant Health, Redwood City, California
| | | | | | - Clara Montagut
- Department of Medical Oncology, Hospital del Mar - IMIM, CIBERONC, Barcelona, Spain.
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17
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Seguí E, García de Herreros M, Auclin E, Mirallas O, Casadevall D, Rodriguez M, Epaillard N, Tagliamento M, Pilotto S, López-Castro R, Mielgo X, Urbano C, Pesántez D, Saoudi N, Bluthgen M, Masfarré L, Minatta J, Cruz C, Mezquita L, Prat A. 1681P First results of the COCO study: COVID-19 outcomes in patients with cancer. Ann Oncol 2020. [PMCID: PMC7506441 DOI: 10.1016/j.annonc.2020.08.1745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Seguí E, Auclin E, Casadevall D, Aguilar-Company J, Rodriguez M, Epaillard N, Tagliamento M, Pilotto S, López-Castro R, Mielgo X, Urbano C, Rodríguez A, García-Illescas D, Bluthgen M, Masfarré L, Oliveres H, Minatta J, Marco-Hernández J, Prat A, Mezquita L. 1714P Change of circulating pro-inflammatory markers between pre-COVID-19 condition and COVID-19 diagnosis predicts early death in cancer patients: The FLARE score. Ann Oncol 2020. [PMCID: PMC7506416 DOI: 10.1016/j.annonc.2020.08.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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19
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Casadevall D, Mestres JA, Rojo F, Bellosillo B, González A, Serra V, Bellet M, Gil MA, Pujana MA, Gámez A, Espinosa E, Schmid P, Gligorov J, Marmé F, Arteaga CL, Mina L, Malfettone A, Sampayo M, Pérez-García JM, Cortés J, Llombart-Cussac A. Abstract P4-10-17: Baseline and pharmacodynamic changes of circulating exosomal microRNAs predict early versus late progression to palbociclib plus endocrine therapy in patients with metastatic breast cancer. A sub-analysis of the PARSIFAL-1 trial. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p4-10-17] [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: Palbociclib in combination with endocrine therapy (ET) is the first- or second-line standard of care for patients (pts) with hormone receptor (HR)-positive (+)/human epidermal growth factor receptor 2 (HER2)-negative (-) metastatic breast cancer (MBC). No clinically validated markers of long-term benefit from palbociclib have been established and the clinically relevant resistance mechanisms to cyclin-dependent kinases 4 and 6 inhibitors remain undefined. In the present study, we explored candidate circulating exosomal microRNAs (miRNAs) as putative predictors of benefit and/or resistance to palbociclib in combination with ET in pts included in the PARSIFAL-1 trial (ClinicalTrials.gov identifier: NCT02491983). MATERIALS AND METHODS: PARSIFAL-1 was a randomized, open-label, phase II trial aimed at evaluating the efficacy and safety of palbociclib plus either fulvestrant or letrozole in HR+/HER2- MBC pts. For the study of exosomal miRNAs, forty-five consenting pts were selected based on primary endocrine resistance according to the ABC-4 criteria. Nine pts who progressed within the first six months after treatment initiation in the absence of an objective response were considered Resistant and thirty-six pts who progressed more than six months after starting therapy were classified as Sensitive. Exosomes were isolated from plasma samples collected at study entry (baseline) and after 12 weeks of treatment initiation. Differences in miRNA expression between Resistant and Sensitive pts as well as miRNA pharmacodynamic changes between baseline and 12-week samples were assessed. Ribonucleic acid (RNA) was isolated using the miRNeasy plasma kit and the library preparation was done using the QIAseq miRNA library kit according to manufacturer’s instructions. All experiments were conducted at QIAGEN Genomic Services in Germany. Differential expression of miRNA between different conditions was studied using EdgeR statistical software package from Bioconductor. Estimated p-values for significantly differentially expressed miRNAs were adjusted using Benjamini-Hochberg’s False Discovery Rate (FDR). Differences in expression of miRNA with an FDR below 0.05 were considered significant. RESULTS: Sequencing of exosomal RNA and preparation of miRNA libraries were successful for all included samples, with good technical performance. On average, 2.8 million Unique Molecular Index-corrected reads were obtained for each sample and the average percentage of mappable reads was 34.5%. Overall, expression of miRNAs was higher in Resistant compared with Sensitive pts. Eight miRNAs were called as differentially expressed between the two groups. Four miRNAs (miR-1246; miR-375; miR-193a-5p; miR-181d-5p) were differentially expressed at baseline, three (miR-196a-5p, miR-200a-3p, miR-320d) were differentially expressed at 12 weeks, and expression of one miRNA (miR-141-3p) was consistently higher across both time points in Resistant pts. Significant pharmacodynamic changes in miRNA expression were observed both in Resistant and Sensitive pts. Seven miRNAs (miR-224-5p, miR-16-5p, let-7a-5p, miR-381-3p, miR-200c-3p, miR-493-3p, let-7b-5p) in Sensitive pts and three miRNAs (miR-223-3p, miR-126-3p, miR-320b) in Resistant pts were differentially expressed between baseline and 12-week samples. CONCLUSIONS: Circulating exosomal miRNA profiling is feasible in liquid biopsies from MBC pts. Differential expression of selected miRNAs at baseline or their pharmacodynamic modulation may predict benefit from palbociclib combined with ET in pts with HR+/HER2- MBC. Validation of the most promising miRNAs by custom quantitative PCR is warranted.
Citation Format: David Casadevall, Joan Albanell Mestres, Federico Rojo, Beatríz Bellosillo, Abel González, Violeta Serra, Meritxell Bellet, Miguel Angel Gil, Miquel Angel Pujana, Angelo Gámez, Enrique Espinosa, Peter Schmid, Joseph Gligorov, Frederik Marmé, Carlos L. Arteaga, Leonardo Mina, Andrea Malfettone, Miguel Sampayo, José Manuel Pérez-García, Javier Cortés, Antonio Llombart-Cussac. Baseline and pharmacodynamic changes of circulating exosomal microRNAs predict early versus late progression to palbociclib plus endocrine therapy in patients with metastatic breast cancer. A sub-analysis of the PARSIFAL-1 trial [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-10-17.
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Affiliation(s)
- David Casadevall
- 1Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joan Albanell Mestres
- 2Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
| | - Federico Rojo
- 3Pathology Department, IIS-Fundacion Jimenez Diaz, UAM, CIBERONC, Madrid, Spain
| | | | - Abel González
- 5Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Research Program on Biomedical Informatics, Universitat Pompeu Fabra, Barcelona, Spain
| | - Violeta Serra
- 6Experimental Therapeutics Group, Vall d'Hebron Institut d'Oncologia, Barcelona, Spain
| | - Meritxell Bellet
- 7Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Miguel Angel Gil
- 8Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - Miquel Angel Pujana
- 9ProCURE, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - Angelo Gámez
- 10Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Enrique Espinosa
- 11Servicio de Oncología Médica, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain; Biomedical Research Networking Center on Oncology-CIBERONC, ISCIII, Madrid, Spain
| | - Peter Schmid
- 12Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Joseph Gligorov
- 13Medical Oncology Dept Tenon Hospital, Inserm U938, Institut Universitaire de Cancérologie APHP-Sorbonne Université, Paris, France
| | - Frederik Marmé
- 14Center for Gynecological Oncology at University Women's Hospital, Heidelberg, Germany
| | | | - Leonardo Mina
- 16Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Andrea Malfettone
- 16Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Miguel Sampayo
- 16Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - José Manuel Pérez-García
- 17IOB, Institute of Oncology, QuironSalud Group, Barcelona, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Javier Cortés
- 18IOB, Institute of Oncology, QuironSalud Group, Madrid & Barcelona, Spain; Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Antonio Llombart-Cussac
- 19Hospital Arnau de Vilanova, FISABIO, Valencia, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
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Abstract
Breast cancer is the most common malignancy among women. Most of breast cancer patients are diagnosed in early stages and will be treated with curative intent. Despite this, some patients will relapse. The identification of patients at high risk remains an important challenge. CTCs can be useful to identify this patients, to assess tumor dynamics and to monitoring therapy. There is definitive evidence on the prognostic role of CTCs in early breast cancer (eBC) but its clinical utility in daily practice is still lacking. We have to take into consideration that the studies published to date mainly evaluated the presence of CTC based on the expression of epithelial surface markers. Future studies need to overcome this limitation and important advances in technical methods can assess CTCs and capture the heterogeneity of the tumor landscape. It is also tempting to speculate that CTCs may also provide complementary information on the interplay of tumor cells with the immune system. The combination of different methods to detect tumoral disease by liquid biopsy may provide new ways to personalize in an unprecedented manner the management of patients with eBC.
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Affiliation(s)
- Tamara Martos
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - David Casadevall
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joan Albanell
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain. .,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,CEXS Department, Pompeu Fabra University, Barcelona, Spain. .,CIOCC HM Delfos, Barcelona, Spain.
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21
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Albanell J, Casadevall D, Sokol E, Albacker L, Elvin J, Vergilio JA, Killian J, Ngo N, Lin D, Ramkissoon S, Severson E, Ali S, Schrock A, Chung J, Reddy P, Miller V, Alexander B, McGregor K, Ross J, Leyland-Jones B. PIK3CA alterations in metastatic breast cancer (mBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.001] [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: 11/13/2022] Open
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22
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Barrull JV, Casadevall D, Fernandez M, Castro-Henriques M, García-Alfonso P, Martin-Cullell B, Alonso-Orduna V, Alonso RMR, Benavides M, Vivas CS, Fernández EE, Garcia-Carbonero R, Ferreiro R, Manzano J, Losa F, Salazar R, Tabernero J, Aguilar EA, Bellosillo B, Viladot CM. Clinical relevance of circulating tumour (ct)DNA genotyping for first-line cetuximab-based treatment monitoring in metastatic colorectal cancer (mCRC): A prospective multicentric study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.102] [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: 11/12/2022] Open
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23
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Lluch A, González-Angulo AM, Casadevall D, Eterovic AK, Martínez de Dueñas E, Zheng X, Guerrero-Zotano Á, Liu S, Pérez R, Chen K, Chacón JI, Mills GB, Antolín S, Blancas I, López-Serra P, Carrasco E, Caballero R, Prat A, Rojo F, Gonzalez-Perez A, Meric-Bernstam F, Albanell J. Dynamic clonal remodelling in breast cancer metastases is associated with subtype conversion. Eur J Cancer 2019; 120:54-64. [PMID: 31491604 DOI: 10.1016/j.ejca.2019.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 02/07/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Changes in the clinical subtype (CS) and intrinsic subtype (IS) between breast cancer (BC) metastases and corresponding primary tumours have been reported. However, their relationship with tumour genomic changes remains poorly characterised. Here, we analysed the association between genomic remodelling and subtype conversion in paired primary and metastatic BC samples. METHODS A total of 57 paired primary and metastatic tumours from GEICAM/2009-03 (ConvertHER, NCT01377363) study participants with centrally assessed CS (n = 57) and IS (n = 46) were analysed. Targeted capture and next-generation sequencing of 202 genes on formalin-fixed paraffin-embedded samples was performed. The cancer cell fraction (CCF) of mutations in primary and metastatic pairs was estimated as a surrogate of tumour clonal architecture. Changes in mutation CCF between matched primary and metastatic tumours were analysed in the presence or absence of subtype conversion. FINDINGS CS conversion occurred in 24.6% and IS conversion occurred in 36.9% of metastases. Primary tumours and metastases had a median of 11 (range, 3-29) and 9 (range, 1-38) mutations, respectively (P = 0.05). Overall, mutations in metastases showed a higher estimated CCF than in primary tumours (median CCF, 0.51 and 0.47, respectively; P = 0.042), consistent with increased clonal homogeneity. The increase in mutation CCF was significant in CS-converted (P = 0.04) but not in IS-converted (P = 0.48) metastases. Clonal remodelling was highest in metastases from hormone receptor-positive and human epidermal growth factor 2 (HER2)-positive tumours (P = 0.006). CONCLUSIONS Mutations in BC metastases showed significantly higher estimated CCF than primary tumours. CCF changes were more prominent in metastases with CS conversion. Our findings suggest that changes in BC subtypes are linked to clonal remodelling during BC evolution.
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Affiliation(s)
- Ana Lluch
- Hospital Clínico Universitario de Valencia, Valencia, Spain; GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; Universidad de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | | | - David Casadevall
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; IMIM Hospital del Mar Medical Research Institute; Barcelona, Spain; Medical Oncology Department Hospital del Mar, Barcelona, Barcelona, Spain
| | | | - Eduardo Martínez de Dueñas
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Hospital Provincial de Castellón, Castellón, Spain
| | | | - Ángel Guerrero-Zotano
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Instituto Valenciano de Oncología, Valencia, Spain
| | - Shuying Liu
- MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ramón Pérez
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain
| | - Ken Chen
- MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jose Ignacio Chacón
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain
| | - Gordon B Mills
- MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Systems Biology and Institute of Personalized Cancer Therapy, The University of Texas, USA
| | - Silvia Antolín
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Isabel Blancas
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Hospital Clínico San Cecilio, Granada, Spain
| | - Paula López-Serra
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain
| | - Eva Carrasco
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain
| | - Rosalía Caballero
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain
| | - Aleix Prat
- Medical Oncology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Federico Rojo
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; Fundación Jiménez Díaz, Madrid, Spain
| | - Abel Gonzalez-Perez
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Institut de Recerca Biomedica Barcelona, Spain.
| | | | - Joan Albanell
- GEICAM (Grupo GEICAM de Investigación en Cáncer de Mama), Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; IMIM Hospital del Mar Medical Research Institute; Barcelona, Spain; Medical Oncology Department Hospital del Mar, Barcelona, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
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Casadevall D, Li X, Powles RL, Wali VB, Buza N, Pelekanou V, Dhawan A, Foldi J, Szekely B, Lopez-Giraldez F, Hatzis C, Pusztai L. Genomic and Immune Profiling of a Patient With Triple-Negative Breast Cancer That Progressed During Neoadjuvant Chemotherapy Plus PD-L1 Blockade. JCO Precis Oncol 2019; 3:1800335. [PMID: 32914041 PMCID: PMC7450962 DOI: 10.1200/po.18.00335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2019] [Indexed: 01/26/2023] Open
Affiliation(s)
- David Casadevall
- Yale School of Medicine, New Haven, CT.,Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | | | | | | | | | | | | | | | - Borbala Szekely
- Yale School of Medicine, New Haven, CT.,National Institute of Oncology, Budapest, Hungary
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O'Meara T, Safonov A, Casadevall D, Qing T, Silber A, Killelea B, Hatzis C, Pusztai L. Immune microenvironment of triple-negative breast cancer in African-American and Caucasian women. Breast Cancer Res Treat 2019; 175:247-259. [PMID: 30725384 DOI: 10.1007/s10549-019-05156-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE African-American (AA) patients with triple-negative breast cancer (TNBC) are less likely to achieve pathologic complete response from neoadjuvant chemotherapy and have poorer prognosis than Caucasian patients with TNBC, suggesting potential biological differences by race. Immune infiltration is the most consistent predictive marker for chemotherapy response and improved prognosis in TNBC. In this study, we test the hypothesis that the immune microenvironment differs between AA and Caucasian patients. METHODS RNA-seq expression data were obtained from The Cancer Genome Atlas (TCGA) database for 162 AA and 697 Caucasian breast cancers. Estrogen receptor (ER)-positive, human epidermal growth factor receptor-2 (HER2)-positive, and TNBC subtypes were included in the analyses. Tumor infiltrating lymphocyte (TIL) counts, immunomodulatory scores, and molecular subtypes were obtained from prior publications for a subset of the TNBC cases. Differences in immune cell distributions and immune functions, measured through gene expression and TIL counts, as well as neoantigen, somatic mutation, amplification, and deletion loads, were compared by race and tumor subtype. RESULTS Immune metagene analysis demonstrated marginal immune attenuation in AA TNBC relative to Caucasian TNBC that did not reach statistical significance. The distributions of immune cell populations, lymphocyte infiltration, molecular subtypes, and genomic aberrations between AA and Caucasian subtypes were also not significantly different. The MHC1 metagene demonstrated increased expression in AA ER-positive cancers relative to Caucasian ER-positive cancers. CONCLUSIONS This study suggests that the immunological differences between AA and Caucasian breast cancers represented by TCGA data are subtle, if they exist at all. We observed no consistent racial differences in immune gene expression or TIL counts in TNBC by race. However, this study cannot rule out small differences in immune cell subtype distribution and activity status that may not be apparent in bulk RNA analysis.
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Affiliation(s)
- Tess O'Meara
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA
| | - Anton Safonov
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - David Casadevall
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA.,Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Tao Qing
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA
| | - Andrea Silber
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA
| | - Brigid Killelea
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA
| | - Christos Hatzis
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA
| | - Lajos Pusztai
- Breast Medical Oncology, Yale School of Medicine, Yale Cancer Center, 300 George St, Suite 120, Rm 133, New Haven, CT, 06520, USA.
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26
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Casadevall D, Kilian AY, Bellmunt J. The prognostic role of epigenetic dysregulation in bladder cancer: A systematic review. Cancer Treat Rev 2017; 61:82-93. [PMID: 29121502 DOI: 10.1016/j.ctrv.2017.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/14/2017] [Accepted: 10/16/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Despite adequate treatment and follow-up, around one fifth of patients with localized bladder cancer will present with disease progression. Adequate prognostic biomarkers are lacking to define patients who are at risk. Mutations in chromatin remodeling genes are more frequently found in bladder cancer than in any other solid tumor. However, the prognostic relevance of epigenetic dysregulation has not been established and may offer an opportunity for biomarker discovery. METHODS Looking for prognostic epigenetic factors, we performed a comprehensive PubMed search using keywords such as "bladder cancer", "chromatin remodeling", "gene methylation" and "epigenetics". We only included studies reporting on the association of epigenetic markers with prognostic outcomes such as recurrence, progression or survival. RESULTS Of 1113 results, 87 studies met the inclusion criteria, which represented a total of 85 epigenetic markers with potential prognostic relevance. No prospective studies were identified. Seventy-three percent (64/87) of the studies involved mixed cohorts of muscle invasive and non-muscle invasive bladder cancer. Promoter methylation of genes with putative prognostic value affected cellular processes such as cell cycle, apoptosis, cell-adhesion or migration, as well as critical pathways such as MAP-kinase or Wnt. Alteration of chromatin regulatory elements suggest a prognostic relevance alterations leading to a predominantly silenced chromatin state. CONCLUSIONS The prognostic impact of epigenetic alterations in bladder cancer is still unclear. Prospective evaluation of methylation marks and chromatin remodeling gene alterations using consistent methods and criteria is warranted.
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Affiliation(s)
- David Casadevall
- Cancer Research Program, PSMAR-IMIM (Hospital del Mar Medical Research Institute), Carrer Dr. Aiguader 88, 08003 Barcelona, Spain.
| | | | - Joaquim Bellmunt
- Cancer Research Program, PSMAR-IMIM (Hospital del Mar Medical Research Institute), Carrer Dr. Aiguader 88, 08003 Barcelona, Spain; Dana-Farber Cancer Institute, 450 Brookline Ave, DANA 1230, Boston, MA 02215, USA.
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Clavé S, Pijuan L, Casadevall D, Taus Á, Gimeno J, Hernández-Llodrà S, Rodríguez-Rivera M, Lorenzo M, Menéndez S, Albanell J, Espinet B, Arriola E, Salido M. CD274 (PDL1) and JAK2 genomic amplifications in pulmonary squamous-cell and adenocarcinoma patients. Histopathology 2017; 72:259-269. [PMID: 28795418 DOI: 10.1111/his.13339] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 08/05/2017] [Indexed: 12/20/2022]
Abstract
AIMS CD274 (PDL1) and JAK2 (9p24.1) gene amplifications have been recently described in pulmonary carcinomas in association with programmed death-ligand 1 (PD-L1) expression. Furthermore, PTEN loss has been explored preclinically in relation to PD-L1 expression. Our aim was to determine whether these genomic alterations affect PD-L1 expression levels in non-small-cell lung cancer. METHODS AND RESULTS PD-L1 and PTEN expression determined by immunohistochemistry (IHC), and CD274, JAK2 and PTEN copy number alterations (CNAs) determined by fluorescence in-situ hybridisation, were studied in 171 pulmonary carcinoma specimens. PD-L1 expression was positive in 40 cases (23.3%), and CD274 amplification was present in 14 tumours (8.8%). Concordance between both events was found in 12 of 14 amplified cases (P = 0.0001). We found nine JAK2-amplified cases (5.7%), seven with PD-L1 expression (P = 0.0006). Moreover, six of the seven cases had JAK2 and CD274 coamplification (9p24.1 genomic amplification). Remarkably, the average PD-L1 IHC score was higher in these amplified cases (230 versus 80; P = 0.001). Non-statistical associations were observed between PD-L1 expression and PTEN loss and PTEN deletions. CONCLUSIONS We describe a subset of patients (8.2%) who had 9p24.1 amplifications resulting in high expression of PD-L1. Our results provide evidence for genomic up-regulation of PD-L1 expression in non-small-cell lung cancer.
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Affiliation(s)
- Sergi Clavé
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Lara Pijuan
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - David Casadevall
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Álvaro Taus
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Javier Gimeno
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | - María Rodríguez-Rivera
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Marta Lorenzo
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - Silvia Menéndez
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Joan Albanell
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Blanca Espinet
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Edurne Arriola
- Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain.,Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Marta Salido
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Programa de Recerca en Càncer, IMIM (Institut Mar d'Investigacions Mèdiques), Barcelona, Spain
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Casadevall D, Clavé S, Taus Á, Hardy-Werbin M, Rocha P, Lorenzo M, Menéndez S, Salido M, Albanell J, Pijuan L, Arriola E. Heterogeneity of Tumor and Immune Cell PD-L1 Expression and Lymphocyte Counts in Surgical NSCLC Samples. Clin Lung Cancer 2017; 18:682-691.e5. [PMID: 28549836 DOI: 10.1016/j.cllc.2017.04.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [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: 01/09/2017] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Immune-checkpoint inhibitors against programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) have shown remarkable therapeutic activity in non-small-cell lung cancer (NSCLC). However, biomarker-based patient selection remains a challenge. Our aim was to assess the heterogeneity of various immune markers between different tumor areas of surgically resected NSCLC specimens. MATERIALS AND METHODS We included 94 adenocarcinoma (ADC) and 50 squamous cell carcinoma (SCC) specimens. Two distinct tumor areas of each tumor sample were selected and incorporated into tissue microarrays. PD-L1 expression in tumor cells (TCs) and immune cells (ICs) was assessed using clone SP142 (Ventana). PDL1 gene amplification was assessed using fluorescence in situ hybridization. CD3 and CD8 densities were quantified using digital image-based analysis. Heterogeneity was assessed using kappa agreement index (KI) and intraclass correlation coefficient. RESULTS Prevalence of PD-L1 expression was 16.8% in TCs and 27.8% in ICs. Eleven tumors (7.6%) showed PDL1 amplification. In ADC, KI of PD-L1 TC and IC expression between cores was 0.465 and 0.260, compared with 0.274 and 0.124 in SCC, respectively. Higher concordance was observed for PDL1 amplification (KI, 0.647 in ADC and KI, 1 in SCC). Eleven (61.1%) of 18 amplified cores showed PD-L1 staining in < 5% of TCs. Intraclass correlation coefficients for CD3 and CD8 were 0.293 and 0.186 in ADC and 0.489 and 0.610 in SCC samples, respectively. CONCLUSIONS We found significant heterogeneity of PD-L1 expression in both ADC and SCC samples, especially in the IC compartment. Heterogeneous expression of PD-L1 could misclassify patients for PD-1/PD-L1-directed therapies.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Adult
- Aged
- Aged, 80 and over
- B7-H1 Antigen/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Non-Small-Cell Lung/surgery
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Female
- Gene Amplification
- Gene Expression Regulation, Neoplastic
- Humans
- In Situ Hybridization, Fluorescence
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lung Neoplasms/surgery
- Lymphocyte Count
- Male
- Middle Aged
- Patient Selection
- Retrospective Studies
- Tissue Array Analysis
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Affiliation(s)
- David Casadevall
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Clavé
- Servei de Patologia, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Álvaro Taus
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Max Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Pedro Rocha
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Marta Lorenzo
- Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | - Marta Salido
- Servei de Patologia, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joan Albanell
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lara Pijuan
- Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - Edurne Arriola
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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Clavé S, Pijuan L, Casadevall D, Taus Á, Rodríguez-Rivera M, Menéndez S, Albanell J, Espinet B, Arriola E, Salido M. P2.01-063 PDL1, JAK2 and PTEN Copy Number Alterations Synergistically Upregulate PD-L1 Expression in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1115] [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: 10/20/2022]
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Clavé S, Dalmases A, Longarón R, Pijuan L, Casadevall D, Taus Á, Albanell J, Espinet B, Arriola E, Bellosillo B, Salido M. P1.02-048 MET Exon 14 Skipping Mutations and Gene Amplifications Are Not Simultaneous Events in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.632] [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: 11/28/2022]
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31
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Taus Á, Camacho L, Hernández A, Piquer G, López E, Dalmases A, Casadevall D, Pijuan L, Hardy M, Longarón R, Rocha P, Zafra A, Albanell J, Bellosillo B, Arriola E. P1.02-039 Assessment of KRAS mutations (by Digital PCR) in Circulating Tumoral DNA from Lung Adenocarcinoma Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.622] [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]
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32
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Casadevall D, Vidal J, Gallardo F, Zuccarino F, Arumí-Uría M, Dalmases A, Bellosillo B, Montagut C. Dabrafenib in an elderly patient with metastatic melanoma and BRAF V600R mutation: a case report. J Med Case Rep 2016; 10:158. [PMID: 27255157 PMCID: PMC4890269 DOI: 10.1186/s13256-016-0953-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 01/06/2016] [Accepted: 05/13/2016] [Indexed: 12/17/2022] Open
Abstract
Background Approximately 50 % of malignant melanomas harbor activating point mutations in the BRAF gene. Typically, these mutations result in the substitution of the amino acid valine at codon 600 of the gene, and 90–95 % of mutations are either BRAFV600E or BRAFV600K. Specific BRAF inhibitors such as dabrafenib and vemurafenib are the mainstays of treatment in patients with metastatic BRAF-mutant malignant melanomas. The third most common BRAF mutation is V600R, which also leads to increased BRAF signaling. Although evidence exists about the activity of dabrafenib and vemurafenib in patients with the BRAFV600R mutation, these patients have been systematically excluded from recent trials with targeted therapies. Case presentation Here, we report the positive results in terms of survival and quality of life obtained with dabrafenib in an 80-year-old Caucasian male patient with a Charlson Comorbidity Index of 8 diagnosed with metastatic malignant melanoma harboring the BRAFV600R mutation. Our patient was treated with dabrafenib for 7 months with minimal toxicity. We also report exploratory analyses of circulating tumor DNA during targeted treatment. Interestingly, the mutation was not detected after starting treatment and became detectable before radiological disease progression. Conclusions Our report suggests that (1) a relevant benefit can be obtained with a BRAF inhibitor in real-world patients with a malignant melanoma harboring a BRAFV600R mutation, and that (2) circulating tumor DNA detection might be of help in assessing tumor burden in everyday clinical practice. The results reported here should encourage the inclusion of patients with BRAFV600R-mutated malignant melanomas in future prospective clinical trials with BRAF inhibitors.
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Affiliation(s)
- David Casadevall
- Medical Oncology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain. .,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Joana Vidal
- Medical Oncology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | - Montserrat Arumí-Uría
- Pathology Department, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Alba Dalmases
- Pathology Department, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Beatriz Bellosillo
- Pathology Department, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Clara Montagut
- Medical Oncology Department, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Casadevall D, Pijuan L, Clave S, Taus A, Hernandez A, Lorenzo M, Espinet B, Salido M, Albanell J, Arriola E. Evaluation of tumor- and stromal immune marker heterogeneity in lung adenocarcinoma. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e20029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Lara Pijuan
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Sergi Clave
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Alvaro Taus
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | | | - Marta Lorenzo
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Blanca Espinet
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Marta Salido
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Albanell
- Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain
| | - Edurne Arriola
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
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Casadevall D, Gimeno J, Clavé S, Taus Á, Pijuan L, Arumí M, Lorenzo M, Menéndez S, Cañadas I, Albanell J, Serrano S, Espinet B, Salido M, Arriola E. MET expression and copy number heterogeneity in nonsquamous non-small cell lung cancer (nsNSCLC). Oncotarget 2016; 6:16215-26. [PMID: 26041880 PMCID: PMC4599265 DOI: 10.18632/oncotarget.3976] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 02/25/2015] [Accepted: 05/05/2015] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE We aimed to assess MET intratumoral heterogeneity and its potential impact on biomarker-based patient selection as well as potential surrogate biomarkers of MET activation. METHODS Our study included 120 patients with non-squamous Non-small-cell Lung Cancer (nsNSCLC), of which 47 were incorporated in tissue microarrays (TMA). Four morphologically distinct tumor areas were selected to assess MET heterogeneity. MET positivity by immunohistochemistry (IHC) was defined as an above-median H-score and by +2/+3 staining intensity in >50% of tumor cells (Metmab criteria). MET FISH positivity was defined by MET/CEP7 ratio ≥ 2.0 and/or MET ≥ 5.0. MET staining pattern (cytoplasmic vs. membranous) and mesenchymal markers were investigated as surrogates of MET activation. RESULTS Median MET H-score was 140 (range 0-400) and 47.8% of patients were MET positive by Metmab criteria. Eight cases (6.8%) were MET FISH positive and showed higher H-scores (p = 0.021). MET positivity by IHC changed in up to 40% of cases among different tumor areas, and MET amplification in 25-50%. Cytoplasmic MET staining and positivity for vimentin predicted poor survival (p = 0.042 and 0.047, respectively). CONCLUSIONS MET status is highly heterogeneous among different nsNSCLC tumor areas, hindering adequate patient selection for MET-targeted therapies. MET cytoplasmic staining and vimentin might represent surrogate markers for MET activation.
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Affiliation(s)
- David Casadevall
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Javier Gimeno
- Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - Sergi Clavé
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Álvaro Taus
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Lara Pijuan
- Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - Miriam Arumí
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Marta Lorenzo
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Silvia Menéndez
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Israel Cañadas
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joan Albanell
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Blanca Espinet
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Marta Salido
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Edurne Arriola
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Arriola E, Taus &A, Casadevall D. Is there a role for epidermal growth factor receptor tyrosine kinase inhibitors in epidermal growth factor receptor wild-type non-small cell lung cancer? World J Clin Oncol 2015; 6:45-56. [PMID: 26266101 PMCID: PMC4530378 DOI: 10.5306/wjco.v6.i4.45] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 02/20/2015] [Revised: 05/08/2015] [Accepted: 06/04/2015] [Indexed: 02/06/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer with a world-wide annual incidence of around 1.3 million. The majority of patients are diagnosed with advanced disease and survival remains poor. However, relevant advances have occurred in recent years through the identification of biomarkers that predict for benefit of therapeutic agents. This is exemplified by the efficacy of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for the treatment of EGFR mutant patients. These drugs have also shown efficacy in unselected populations but this point remains controversial. Here we have reviewed the clinical data that demonstrate a small but consistent subgroup of EGFR wild-type patients with NSCLC that obtain a clinical benefit from these drugs. Moreover, we review the biological rationale that may explain this benefit observed in the clinical setting.
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36
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Taus A, Hernandez A, Vela MDC, Martinez G, Piquer G, Correa R, Longaron R, Vidal J, Casadevall D, Pijuan L, Montagut C, Serrano S, Albanell J, Arriola E, Bellosillo B. Monitoring treatment response in EGFR mutant non-small cell lung cancer patients using mutational load in circulating cell-free tumour DNA. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e19089] [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: 11/20/2022] Open
Affiliation(s)
- Alvaro Taus
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | | | | | - Gemma Martinez
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Gabriel Piquer
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Roser Correa
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | | | - Joana Vidal
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | | | - Lara Pijuan
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Clara Montagut
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Sergi Serrano
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Albanell
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
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Casadevall D, Gimeno J, Clavé S, Taus A, Pijuan L, Luque A, Lorenzo M, Menendez S, Espinet B, Albanell J, Arriola E. Heterogeneity of Met Assessed By Immunohistochemistry (Ihc) and Fluorescence-In-Situ Hybridization (Fish) in Nonsquamous Non-Small Cell Lung Cancer (Nsnsclc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.27] [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: 11/13/2022] Open
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38
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Arriola E, Casadevall D, Gimeno J, Clave S, Taus A, Lorenzo M, Menendez S, Albanell J, Espinet B, Salido M. Met heterogeneity evaluation by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in nonsquamous non-small cell lung cancer (nsNSCLC). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.11005] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Alvaro Taus
- Medical Oncology, Hospital del Mar, Barcelona, Spain
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