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Salaün H, Djerroudi L, Haik L, Schnitzler A, Bataillon G, Deniziaut G, Bièche I, Vincent‐Salomon A, Debled M, Cottu P. The prognosis of patients treated with everolimus for advanced ER-positive, HER2-negative breast cancer is driven by molecular features. J Pathol Clin Res 2024; 10:e12372. [PMID: 38563252 PMCID: PMC10985771 DOI: 10.1002/2056-4538.12372] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
Everolimus is widely used in patients with advanced ER-positive, HER2-negative breast cancer. We looked at alterations in the PIK3CA/AKT/mTOR pathway in a multicenter cohort as potential biomarkers of efficacy. Patients with advanced ER-positive, HER2-negative breast cancer treated with everolimus and endocrine therapy between 2012 and 2014 in two cancer centers were included. Targeted sequencing examined mutations in PIK3CA, ESR1, and AKT1 genes. An immunochemical analysis was conducted to evaluate expression of PTEN, INPP4B, STK11, p4EBP1, and pS6. We analyzed 71 patients (44 primary tumors; 27 metastatic tissues). Median age was 63 years [58-69]. All patients had heavily pretreated advanced disease. A mutation in the PIK3CA pathway was observed in 32 samples (PIK3CA exons 10 and 21 and AKT1 exon 4 in 15.5%, 24.0%, and 5.6% of samples), and in ESR1 in 5 samples (7.0%), respectively. Most samples showed cytoplasmic expression of the PIK3CA pathway proteins. Progression-free survival was longer in patients with a pS6 or p4EBP1 histoscore ≥ median value (6.6 versus 3.7 months, p = 0.037), and in patients with a PTEN histoscore ≤ median value (7.1 versus 5.3 months, p = 0.02). Overall survival was longer in patients with pS6 ≥ 3rd quartile (27.6 versus 19.3 months, p = 0.038) and in patients with any mutation in the PIK3CA/AKT/mTOR pathway (27.6 versus 19.3 months, p = 0.011). The prognosis of patients treated with everolimus for advanced ER-positive, HER2-negative breast cancer appears primarily driven by molecular features associated with the activation of the PIK3CA/AKT/mTOR pathway.
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Affiliation(s)
- Hélène Salaün
- Department of Medical OncologyInstitut CurieParisFrance
| | - Lounes Djerroudi
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
| | - Laura Haik
- Department of Medical OncologyInstitut BergoniéBordeauxFrance
| | - Anne Schnitzler
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
| | - Guillaume Bataillon
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- Present address:
Department of PathologyIUCT OncopoleToulouseFrance
| | - Gabrielle Deniziaut
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- Present address:
Department of PathologyCHU Pitié‐SalpêtrièreParisFrance
| | - Ivan Bièche
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- Paris‐Cité UniversityParisFrance
| | - Anne Vincent‐Salomon
- Department of Pathology‐Genetics‐ImmunologyInstitut CurieParisFrance
- PSL Research UniversityParisFrance
| | - Marc Debled
- Department of Medical OncologyInstitut BergoniéBordeauxFrance
| | - Paul Cottu
- Department of Medical OncologyInstitut CurieParisFrance
- Paris‐Cité UniversityParisFrance
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Schubert L, Mbekwe-Yepnang AM, Wassermann J, Braik-Djellas Y, Jaffrelot L, Pani F, Deniziaut G, Lussey-Lepoutre C, Chereau N, Leenhardt L, Bernier MO, Buffet C. Clinico-pathological factors associated with radioiodine refractory differentiated thyroid carcinoma status. J Endocrinol Invest 2024:10.1007/s40618-024-02352-z. [PMID: 38578580 DOI: 10.1007/s40618-024-02352-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Risk factors for developing radioiodine refractory thyroid cancer (RAIR-TC) have rarely been analyzed. The purpose of the present study was to find clinical and pathological features associated with the occurrence of RAIR-disease in differentiated thyroid cancers (DTC) and to establish an effective predictive risk score. METHODS All cases of RAIR-DTC treated in our center from 1990 to 2020 were retrospectively reviewed. Each case was matched randomly with at least four RAI-avid DTC control patients based on histological and clinical criteria. Conditional logistic regression was used to examine the association between RAIR-disease and variables with univariate and multivariate analyses. A risk score was then developed from the multivariate conditional logistic regression model to predict the risk of refractory disease occurrence. The optimal cut-off value for predicting the occurrence of RAIR-TC was assessed by receiver operating characteristic (ROC) curves and Youden's statistic. RESULTS We analyzed 159 RAIR-TC cases for a total of 759 controls and found 7 independent risk factors for predicting RAIR-TC occurrence: age at diagnosis ≥ 55, vascular invasion, synchronous cervical, pulmonary and bone metastases at initial work-up, cervical and pulmonary recurrence during follow-up. The predictive score of RAIR-disease showed a high discrimination power with a cut-off value of 8.9 out of 10 providing 86% sensitivity and 92% specificity with an area under the curve (AUC) of 0.95. CONCLUSION Predicting the occurrence of RAIR-disease in DTC patients may allow clinicians to focus on systemic redifferentiating strategies and/or local treatments for metastatic lesions rather than pursuing with ineffective RAI-therapies.
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Affiliation(s)
- L Schubert
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - A M Mbekwe-Yepnang
- Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire, BP 17, 92262, Fontenay aux Roses, France
| | - J Wassermann
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Y Braik-Djellas
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - L Jaffrelot
- Medical Oncology Department and Thyroid and Endocrine Tumors Department, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - F Pani
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - G Deniziaut
- Pathology Department, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - C Lussey-Lepoutre
- Nuclear Medicine Department, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
- PARCC-Inserm U970, 56 rue leblanc, 75015, Paris, France
| | - N Chereau
- Department of Endocrine Surgery, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - L Leenhardt
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M- O Bernier
- Laboratory of Epidemiology, Institut de Radioprotection et de Sureté Nucléaire, BP 17, 92262, Fontenay aux Roses, France
| | - C Buffet
- Service des pathologies thyroïdiennes et tumorales endocrines, Sorbonne Université, Groupe de Recherche Clinique n°16, GRC Tumeurs Thyroïdiennes, AP-HP, Hôpital Pitié-Salpêtrière, 45-83 boulevard de l'Hôpital, 75013, Paris, France.
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS UMR 7371, INSERM U1146, Paris, France.
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Theodon H, Guillerm E, Wassermann J, Deniziaut G, Jaffrelot L, Denis JA, Chereau N, Bigorgne C, Potonnier W, Coulet F, Leenhardt L, Buffet C. Next-Generation-Sequencing on fine needle aspirates in neck recurrence of thyroid cancers. Eur Thyroid J 2024; 13:ETJ-23-0164. [PMID: 38236745 PMCID: PMC10895307 DOI: 10.1530/etj-23-0164] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVES Tumor molecular genotyping plays a key role in improving the management of advanced thyroid cancers. Molecular tests are classically performed on Formalin-Fixed Paraffin-Embedded (FFPE) carcinoma tissue. However alternative molecular testing strategies are needed when FFPE tumoral tissue is unavailable. The objective of our study was to retrospectively assess the performance of targeted DNA and RNA-based Next Generation Sequencing (NGS) on the fine needle aspirate from thyroid cancer cervical recurrences to determine if this strategy is efficient in clinical practice. DESIGN/METHODS A retrospective study of 33 patients who had had DNA and/or RNA-based NGS on ultrasound (US)-guided fine needle aspirates of cervical thyroid cancer recurrences in our Department from July 2019 to September 2022. RESULTS In total, 34 DNA and 32 RNA-based NGS analyses were performed. Out of the 34 DNA-based NGS performed, 27 (79%) were conclusive allowing the identification of an oncogenic driver for 18 patients (53%). The most common mutation (n = 13) was BRAF c.1799T>A. Out of the 32 RNA-based NGS performed, 26 were interpretable (81%) and no gene fusion was found. The identification of a BRAFV600E mutation was decisive for one patient in our series, who was prescribed dabrafenib and trametinib. CONCLUSIONS NGS performed on fine needle aspirates of neck lymph node metastases enabled the identification of an oncogenic driver alteration in 53% of the cases in our series of advanced thyroid cancer patients and could significantly alter patient management.
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Affiliation(s)
- Helene Theodon
- H Theodon, Thyroïde et tumeurs endocrines, University Hospital Pitié Salpêtrière, Paris, 75013, France
| | | | - Johanna Wassermann
- J Wassermann, Oncolgy, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | | | - Loic Jaffrelot
- L Jaffrelot, Oncology, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | | | - Nathalie Chereau
- N Chereau, Surgery, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Claude Bigorgne
- C Bigorgne, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Wiame Potonnier
- W Potonnier, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Florence Coulet
- F Coulet, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Laurence Leenhardt
- L Leenhardt, Hopital Universitaire Pitie Salpetriere Bibliotheque de La Pitié, Paris, 75651, France
| | - Camille Buffet
- C Buffet, Thyroid and Endocrine Tumors Department, AP-HP, Paris, 75184, France
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Melot C, Deniziaut G, Menegaux F, Chereau N. Incidental parathyroidectomy during total thyroidectomy and functional parathyroid preservation: a retrospective cohort study. BMC Surg 2023; 23:269. [PMID: 37674156 PMCID: PMC10481605 DOI: 10.1186/s12893-023-02176-3] [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: 05/29/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND The published rate of incidental parathyroidectomy (IP) during thyroid surgery varies between 5.8% and 29%. The risk factors and clinical significance of postoperative transient hypocalcemia and permanent hypoparathyroidism are still debated. The aims of this study were to assess the clinical relevance of avoidable IP for transient hypocalcemia and permanent hypoparathyroidism, and to describe the risk factors for IP. METHODS This retrospective cohort study included 1,537 patients who had a one-step total thyroidectomy in a high-volume endocrine surgery center between 2018 and 2019. Pathology reports were reviewed for incidentally removed parathyroid glands. Intrathyroidal parathyroid glands were excluded from the study. Demographic characteristics, potential risk factors, and postoperative calcium and PTH levels were compared between IP and control groups. RESULTS Avoidable IP occurred in 234 (15.2%) patients. Patients with IP had a higher risk of transient hypocalcemia (17.9% vs. 11.5%, p = 0.006; odds ratio [OR] 1.68, 95% confidence interval [95% CI]1.16-2.45) and permanent hypoparathyroidism (4.7% vs. 1.6%, p = 0.002; OR 3.01, 95% CI 1.29-6.63) than patients without IP. Multivariate analysis showed that central lymph node dissection (CLND) and incidental removal of thymus tissue were independent risk factors for IP (OR 4.83, 95% CI 2.71-8.86, p < 0.001 and OR 1.72, 95% CI 1.02-2.82, p = 0.038). CONCLUSIONS Patients with IP were more likely to develop transient hypocalcemia and permanent hypoparathyroidism, indicating the clinical significance of avoidable IP for patients and the need for raising awareness among surgeons. Patients undergoing CLND are at a higher risk for IP, and should be adequately informed and treated. Any removal of thymus tissue should be avoided during CLND.
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Affiliation(s)
- Charlotte Melot
- Department of General and Endocrine Surgery, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 47-83 Boulevard de L'Hôpital, Paris, 75013, France.
| | - Gabrielle Deniziaut
- Department of Pathology, Pitié Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France
| | - Fabrice Menegaux
- Department of General and Endocrine Surgery, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 47-83 Boulevard de L'Hôpital, Paris, 75013, France
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France
| | - Nathalie Chereau
- Department of General and Endocrine Surgery, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 47-83 Boulevard de L'Hôpital, Paris, 75013, France
- Groupe de Recherche Clinique N°16 Thyroid Tumors, Sorbonne University, Paris, France
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Scherman N, Wassermann J, Tlemsani C, Guillerm E, Deniziaut G, Cochand-Priollet B, Shan L, Chereau N, Gaujoux S, Simon JM, Leenhardt L, Groussin L, Buffet C. Possible Primary Thyroid Nuclear Protein in Testis Carcinomas with NSD3::NUTM1 Translocation Revealed by RNA Sequencing: A Report of Two Cases. Thyroid 2022; 32:1271-1276. [PMID: 35880417 DOI: 10.1089/thy.2022.0136] [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] [Indexed: 11/13/2022]
Abstract
Background: Nuclear protein in testis (NUT) carcinomas (NC) are a rare, highly aggressive, subset of squamous cell carcinomas, characterized by a translocation involving the NUTM1 gene. Thyroid location of NUT carcinomas has rarely been described. Methods: We report here two cases of thyroid NC with NSD3::NUTM1 translocation. Results: The first case presented as a very aggressive undifferentiated thyroid carcinoma in a 38-year-old man who died 21 months after the diagnosis. The second case was diagnosed after multiple lymphadenopathy recurrences mainly in the neck in a 37-year-old woman 7 years after total thyroidectomy for papillary thyroid carcinoma with a classic and a solid/trabecular component. Conclusions: Our case reports highlight the challenges in diagnosing these exceptional carcinomas. The therapeutic impact of the administration of pharmacological compounds with epigenetic action, in line with the physiopathology of these carcinomas, is also discussed.
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Affiliation(s)
- Noémie Scherman
- Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Johanna Wassermann
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Oncology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Camille Tlemsani
- Medical Oncology Department, Cochin Hospital, Paris Cancer Institute CARPEM, Université de Paris, Paris, France
| | - Erell Guillerm
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Oncogenetic Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Gabrielle Deniziaut
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Pathology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | | | - Larrys Shan
- Endocrine Department, Centre Hospitalier de Polynésie Française, Papeete, French Polynesia
| | - Nathalie Chereau
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Sébastien Gaujoux
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Jean-Marc Simon
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Radiotherapy Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Laurence Leenhardt
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Thyroid and Endocrine Tumors Department; Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Lionel Groussin
- Endocrine Department; Cochin Hospital, Université de Paris, Paris, France
| | - Camille Buffet
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Thyroid and Endocrine Tumors Department; Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
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Allard L, Denis JA, Godiris Petit G, Deniziaut G, Ghander C, Mathy E, Guillerm E, Lussey-Lepoutre C, Leenhardt L, Buffet C. Complete resection of ulcerating, infiltrative, voluminous differentiated thyroid carcinoma. Eur Thyroid J 2022; 11:e210091. [PMID: 35113038 PMCID: PMC8963168 DOI: 10.1530/etj-21-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
An 87-year-old woman was referred to our department for a 15 cm right-sided cervical tumor with bleeding and skin ulceration, developed on a 6 cm papillary thyroid carcinoma diagnosed two years earlier. Surprisingly, there were no other compressive symptoms. Unexpectedly, but successfully, total thyroidectomy and neck dissection were performed. There were no poorly differentiated or anaplastic components in the final histological analysis. Impressive dehiscence occurred shortly after surgery and was also successfully managed. Our case highlights the benefit of considering surgery in the context of a tertiary care center even for an apparent massive aggressive cervical mass and despite old age.
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Affiliation(s)
- Lucie Allard
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, Pitié Salpêtrière, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gaëlle Godiris Petit
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Chirurgie Générale, Viscérale et Endocrinienne, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gabrielle Deniziaut
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service d’Anatomo-Pathologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cécile Ghander
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elise Mathy
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Erell Guillerm
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, UF d’Onco-Angiogénétique et Génomique des Tumeurs Solides, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Médecine Nucléaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Camille Buffet
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- Correspondence should be addressed to C Buffet:
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Moog S, Castinetti F, DoCao C, Amar L, Hadoux J, Lussey-Lepoutre C, Borson-Chazot F, Vezzosi D, Drui D, Laboureau S, Raffin Sanson ML, Lamartina L, Pierre P, Batisse Ligner M, Hescot S, Al Ghuzlan A, Renaudin K, Libé R, Laroche S, Deniziaut G, Gimenez-Roqueplo AP, Jannin A, Leboulleux S, Guerin C, Faron M, Baudin E. Recurrence-Free Survival Analysis in Locally Advanced Pheochromocytoma: First Appraisal. J Clin Endocrinol Metab 2021; 106:2726-2737. [PMID: 33782697 DOI: 10.1210/clinem/dgab202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Indexed: 12/30/2022]
Abstract
CONTEXT The behavior of locally advanced pheochromocytoma (LAP) remains unknown. OBJECTIVE We characterized the population with LAP and recurrence-free survival (RFS). METHODS This retrospective multicentric study was run within the ENDOCAN-COMETE network and French Group of Endocrine Tumors (GTE) from 2003 to 2018, including patients from 11 French referral centers with LAP as defined by capsular invasion, vascular invasion, adipose tissue invasion, and/or positive locoregional lymph nodes at diagnosis without evidence of distant metastasis. The main outcome measure was recurrence, defined as tumor reappearance, including local site and/or distant metastasis. The primary endpoint was RFS analysis; secondary endpoints were characterization, overall survival (OS), and prognostic factors of recurrence. RESULTS Among 950 patients, 90 (9%) exhibited LAP criteria and 55 met inclusion criteria (median age, 53 years; 61% males; 14% with germline mutation; 84% with catecholamine excess). LAP was defined by 31 (56%) capsular invasions, 27 (49%) fat invasions, 6 (11%) positive lymph nodes, and 22 (40%) vascular invasions. After median follow-up of 54 months (range, 6-180), 12 patients (22%) had recurrences and 3 (5%) died of metastatic disease. Median RFS was 115 months (range, 6-168). Recurrences were local in 2 patients, distant in 2, and both local and distant in 8 patients. Median OS of patients was not reached. Size above 6.5 cm (P = 0.019) and Ki-67 > 2% (P = 0.028) were identified as independent significant prognostic factors in multivariate analysis. CONCLUSION LAP represents 9% of pheochromocytoma's population and has a metastatic behavior. This study paves the way for future pathological TNM classification.
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Affiliation(s)
- Sophie Moog
- Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France
| | - Frédéric Castinetti
- Aix Marseille Université, INSERM, U1251, Department of Endocrinology, Marseille Medical Genetics (MMG), centre de référence des maladies rares de l'hypophyse (HYPO), hôpital de la Conception, France, Assistance Publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | | | - Laurence Amar
- Department of hypertension, AP-HP, Hôpital Européen Georges Pompidou, 75015 Paris, France
- Université de Paris, INSERM, PARCC, Equipe labellisée contre le cancer, F-75015 Paris, France
| | - Julien Hadoux
- Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France
| | - Charlotte Lussey-Lepoutre
- Université de Paris, INSERM, PARCC, Equipe labellisée contre le cancer, F-75015 Paris, France
- Sorbonne University, Department of Nuclear Medicine, AP-HP, Pitié-Salpêtrière, 75013 Paris, France
| | - Françoise Borson-Chazot
- Fédération d'endocrinologie, Hôpital Louis Pradel, Hospices Civils de Lyon, EA 7425, Université Lyon1, 69500 Lyon, France
| | - Delphine Vezzosi
- Department of Endocrinology, CHU Toulouse, 40031 Toulouse, France
| | - Delphine Drui
- Department of Endocrinology, L'institut du thorax, 44200 CHU Nantes, France
| | | | - Marie-Laure Raffin Sanson
- Department of Endocrinology&Nutrition, AP-HP, Hôpital Ambroise Paré, 92100 Boulogne-Billancourt, France
| | - Livia Lamartina
- Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France
| | - Peggy Pierre
- Department of Endocrinology, CHU Tours, 37044 Tours, France
| | - Marie Batisse Ligner
- Department of Endocrinology, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Ségolène Hescot
- Médecine Nucléaire, Institut Curie, 35 rue Dailly, 92210 Saint Cloud, France
| | - Abir Al Ghuzlan
- Department of Anatomopathology, Gustave Roussy, 94805 Villejuif, France
| | - Karine Renaudin
- Department of Anatomopathology, CHU de Nantes, 44200 Nantes, France
| | - Rosella Libé
- Department of Endocrinology, AP-HP, Hôpital Cochin, 75014 Paris, France
| | - Suzanne Laroche
- Department of Endocrinology, AP-HP, Hôpital La Pitié Salpêtrière, 75013 Paris, France
| | - Gabrielle Deniziaut
- Department of Anatomopathology, AP-HP, Hôpital La Pitié-Salpêtrière, 75013 Paris, France
| | - Anne-Paule Gimenez-Roqueplo
- Université de Paris, INSERM, PARCC, Equipe labellisée contre le cancer, F-75015 Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital européen Georges Pompidou, Service de Génétique, F-75015 Paris, France
| | - Arnaud Jannin
- Department of Endocrinology, CHU Lille, 59000 Lille, France
| | | | - Carole Guerin
- Aix Marseille University, Assistance Publique-Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, 13005 Marseille, France
| | - Matthieu Faron
- Department of biostatistics and epidemiology and INSERM U1018 CESP équipe ONCOSTAT, Institut Gustave Roussy, 94805 Villejuif, France
| | - Eric Baudin
- Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France
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8
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Mohr A, Trésallet C, Monot N, Bauvois A, Abiven D, Atif M, Claër L, Malhotra R, Mayer G, Balderas R, Vaarala O, Deniziaut G, Brocheriou I, Buffet C, Leenhardt L, Gorochov G, Miyara M. Tissue Infiltrating LTi-Like Group 3 Innate Lymphoid Cells and T Follicular Helper Cells in Graves' and Hashimoto's Thyroiditis. Front Immunol 2020; 11:601. [PMID: 32328068 PMCID: PMC7160246 DOI: 10.3389/fimmu.2020.00601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/16/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Hashimoto's thyroiditis (HT) and Graves' disease (GD) are autoimmune thyroid disorders (AITDs). These conditions have been associated to abnormalities in circulating regulatory T cells (Tregs). We postulated that immune perturbations could be more pronounced at the thyroid tissue level. Methods: The phenotype of PBMCs and immune cells infiltrating thyroid tissue from 19 patients with HT, 21 patients with GD, and 30 controls has been analyzed by flow cytometry. Results: We report that blood and thyroid Treg cell subsets are similarly represented in all AITDs patients and controls. Increased Lymphoid tissue inducer (LTi)-like ILC3 and CXCR5+ PD-1hi CD4+ T follicular helper cells (Tfh) tissue-infiltrating cells, together with the prevalence of tertiary lymphoid structures (TLS) and germinal centers (GCs) represented a typical immune signature in all HT and 60% of GD patients. In the remaining group of GD patients, the absence of the aforementioned abnormalities was associated with a higher prevalence of ophthalmopathy. Conclusion: Tissue infiltrating Lymphoid Tissue inducer—like group 3 Innate Lymphoid cells and T follicular helper cells are increased in most thyroid autoimmune disease.
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Affiliation(s)
- Audrey Mohr
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Christophe Trésallet
- Service de Chirurgie Digestive, Bariatrique et Endocrinienne, Hôpital Avicenne, Bobigny, France.,Université Paris Nord Seine St Denis Paris 13, Laboratoire d'imagerie Biomédicale (LIB) INSERM CNRS U678, CHU Pitié-Salpêtriẽre, Paris, France
| | - Natacha Monot
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Adeline Bauvois
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Delphine Abiven
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Muhammad Atif
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), Paris, France
| | - Laetitia Claër
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Rajneesh Malhotra
- Translational Science and Experimental Medicine, Early RIA, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Gaëll Mayer
- Clinical Development-Respiratory Inhalation and Oral Development, Global Medicines Development, AstraZeneca, Gothenburg, Sweden
| | | | - Outi Vaarala
- Respiratory, Inflammation, and Autoimmunity, Medimmune, Gaithersburg, MD, United States
| | - Gabrielle Deniziaut
- Sorbonne Université, Service d'Anatomie Pathologique, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Isabelle Brocheriou
- Sorbonne Université, Service d'Anatomie Pathologique, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Camille Buffet
- Sorbonne Université, Unité Thyroïde Tumeurs Endocrines, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, Unité Thyroïde Tumeurs Endocrines, AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Guy Gorochov
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
| | - Makoto Miyara
- Sorbonne Université, Inserm, Centre d'immunologie et des maladies infectieuses-Paris (CIMI-PARIS), AP-HP Hôpital Pitié-Salpêtrière, Paris, France
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9
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Romero P, Benhamo V, Deniziaut G, Fuhrmann L, Berger F, Manié E, Bhalshankar J, Vacher S, Laurent C, Marangoni E, Gruel N, MacGrogan G, Rouzier R, Delattre O, Popova T, Reyal F, Stern MH, Stoppa-Lyonnet D, Marchiò C, Bièche I, Vincent-Salomon A. Medullary Breast Carcinoma, a Triple-Negative Breast Cancer Associated with BCLG Overexpression. Am J Pathol 2018; 188:2378-2391. [PMID: 30075151 DOI: 10.1016/j.ajpath.2018.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/15/2018] [Accepted: 06/19/2018] [Indexed: 02/06/2023]
Abstract
Medullary breast carcinoma (MBC) is a rare subtype of triple-negative breast cancer with specific genomic features within the spectrum of basal-like carcinoma (BLC). In this study of 19 MBCs and 36 non-MBC BLCs, we refined the transcriptomic and genomic knowledge about this entity. Unsupervised and supervised analysis of transcriptomic profiles confirmed that MBC clearly differs from non-MBC BLC, with 92 genes overexpressed and 154 genes underexpressed in MBC compared with non-MBC BLC. Immunity-related pathways are the most differentially represented pathways in MBC compared with non-MBC BLC. The proapoptotic gene BCLG (official name BCL2L14) is by far the most intensely overexpressed gene in MBC. A quantitative RT-PCR validation study conducted in 526 breast tumors corresponding to all molecular subtypes documented the specificity of BCLG overexpression in MBC, which was confirmed at the protein level by immunohistochemistry. We also found that most MBCs belong to the immunomodulatory triple-negative breast cancer subtype. Using pan-genomic analysis, it was found that MBC harbors more losses of heterozygosity than non-MBC BLC. These observations corroborate the notion that MBC remains a distinct entity that could benefit from specific treatment strategies (such as deescalation or targeted therapy) adapted to this rare tumor type.
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Affiliation(s)
- Pierre Romero
- Department of Pathology, Institut Curie, PSL Research University, Paris, France.
| | - Vanessa Benhamo
- INSERM U934, Institut Curie, PSL Research University, Paris, France; Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Gabrielle Deniziaut
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - Laetitia Fuhrmann
- Department of Pathology, Institut Curie, PSL Research University, Paris, France; INSERM U934, Institut Curie, PSL Research University, Paris, France
| | - Frédérique Berger
- Unit of Biometry, INSERM U900, Institut Curie, PSL Research University, Paris, France
| | - Elodie Manié
- INSERM U934, Institut Curie, PSL Research University, Paris, France
| | | | - Sophie Vacher
- Pharmacogenomics Unit, Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - Cécile Laurent
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Elisabetta Marangoni
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Nadège Gruel
- INSERM U934, Institut Curie, PSL Research University, Paris, France; Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | | | - Roman Rouzier
- Department of Surgery, Institut Curie, PSL Research University, Paris, France
| | - Olivier Delattre
- INSERM U934, Institut Curie, PSL Research University, Paris, France
| | - Tatiana Popova
- INSERM U934, Institut Curie, PSL Research University, Paris, France
| | - Fabien Reyal
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France; Department of Surgery, Institut Curie, PSL Research University, Paris, France
| | - Marc-Henri Stern
- Department of Pathology, Institut Curie, PSL Research University, Paris, France; INSERM U934, Institut Curie, PSL Research University, Paris, France
| | - Dominique Stoppa-Lyonnet
- Department of Pathology, Institut Curie, PSL Research University, Paris, France; INSERM U934, Institut Curie, PSL Research University, Paris, France; Sorbonne Paris Cité, University Paris Descartes, Paris, France
| | - Caterina Marchiò
- Department of Pathology, Institut Curie, PSL Research University, Paris, France; Institute of Pathology at the Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ivan Bièche
- Pharmacogenomics Unit, Department of Genetics, Institut Curie, PSL Research University, Paris, France; EA 7331, University Paris Descartes, Paris, France
| | - Anne Vincent-Salomon
- Department of Pathology, Institut Curie, PSL Research University, Paris, France; INSERM U934, Institut Curie, PSL Research University, Paris, France
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10
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Romero P, Deniziaut G, Benhamo V, Fuhrmann L, Berger F, Bhalshankar J, Gruel N, MacGrogan G, Popova T, Manié E, Stern MH, Stoppa-Lyonnet D, Rouzier R, Delattre O, Bieche I, Vincent-Salomon A. Abstract P1-03-05: A comprehensive molecular analysis of medullary breast carcinoma: A model of immunomodulatory triple negative breast cancer subtype. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-03-05] [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
Medullary breast carcinoma (MBC) is a rare subtype of triple negative breast cancer (TNBC)with specific genomic features within the spectrum of basal-like carcinoma. The frequent association between BRCA constitutive mutation and MBC phenotype has been reported previously. In this study including 19 MBC and 36 non-MMB basal-like carcinoma (BLC), we refine the genomic and transcriptomic knowledge about this entity. Using pan genomic Affymetrix genome-wide human SNP6.0 array, we show that i/ MBC harbour more copy number alterations and losses of heterozygocity than BLC and that ii/ the high frequency of BRCAness genomic trait among MBC. Unsupervised and supervised analysis of GeneChip Uman Genome U133 Plus 2.0 Array transcriptomic generated data confirmed that MBC clearly differ from BLC in terms of gene expression level, with 92 genes overexpressed and 154 genes underexpressed in MBC over BLC. Immune response and inflammatory response are the most differentially represented pathways in MBC over BLC. Pro apoptotic gene BCLG is by far the more overexpressed gene in MBC. A validation study conducted with RT-QPCR among 526 breast tumors form all molecular subtype confirmed the specificity of BCLG overexpression in MBC, which was confirmed at protein level using immunohistochemisytry. Moreover, we show that a vast majority of MBC belong o the immunomodulatory TNBC subtype according to Lehman et al. Finally, we confirm the better prognosis of MBC toward BLC. Our observations epitomize the importance of developing DNA repair targeting drugs and immunotherapy based trials in order to improve the outcome of such a specific entity.
Citation Format: Romero P, Deniziaut G, Benhamo V, Fuhrmann L, Berger F, Bhalshankar J, Gruel N, MacGrogan G, Popova T, Manié E, Stern M-H, Stoppa-Lyonnet D, Rouzier R, Delattre O, Bieche I, Vincent-Salomon A. A comprehensive molecular analysis of medullary breast carcinoma: A model of immunomodulatory triple negative breast cancer subtype [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-03-05.
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Affiliation(s)
- P Romero
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - G Deniziaut
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - V Benhamo
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - L Fuhrmann
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - F Berger
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - J Bhalshankar
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - N Gruel
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - G MacGrogan
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - T Popova
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - E Manié
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - M-H Stern
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - D Stoppa-Lyonnet
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - R Rouzier
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - O Delattre
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
| | - I Bieche
- Institut Curie, Paris, France; Institut Bergonié, Bordeaux, France
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11
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Deniziaut G, Ballot E, Johanet C. Antineutrophil cytoplasmic auto-antibodies (ANCA) in autoimmune hepatitis and primary sclerosing cholangitis. Clin Res Hepatol Gastroenterol 2013; 37:105-7. [PMID: 22998811 DOI: 10.1016/j.clinre.2012.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 07/06/2012] [Accepted: 07/10/2012] [Indexed: 02/04/2023]
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