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Papadopoulou E, Rigas G, Fountzilas E, Boutis A, Giassas S, Mitsimponas N, Daliani D, Ziogas DC, Liontos M, Ramfidis V, Christophilakis C, Matthaios D, Floros T, Florou-Chatzigiannidou C, Agiannitopoulos K, Meintani A, Tsantikidi A, Katseli A, Potska K, Tsaousis G, Metaxa-Mariatou V, Nasioulas G. Microsatellite Instability Is Insufficiently Used as a Biomarker for Lynch Syndrome Testing in Clinical Practice. JCO Precis Oncol 2024; 8:e2300332. [PMID: 38271656 PMCID: PMC10830089 DOI: 10.1200/po.23.00332] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/06/2023] [Accepted: 11/15/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE The pan-cancer presence of microsatellite instability (MSI)-positive tumors demonstrates its clinical utility as an agnostic biomarker for identifying immunotherapy-eligible patients. Additionally, MSI is a hallmark of Lynch syndrome (LS), the most prevalent cancer susceptibility syndrome among patients with colorectal and endometrial cancer. Therefore, MSI-high results should inform germline genetic testing for cancer-predisposing genes. However, in clinical practice, such analysis is frequently disregarded. METHODS A next-generation sequencing (NGS)-based technique was used for MSI analysis in 4,553 patients with various tumor types. Upon request, somatic BRAF gene analysis was conducted. In addition, hereditary testing of cancer-associated genes was performed in MSI-high cases using a capture-based NGS protocol. MLH1 promoter methylation analysis was conducted retrospectively in patients with colorectal and endometrial cancer to further investigate the origin of MSI at the tumor level. RESULTS The MSI positivity rate for the entire cohort was 5.27%. Endometrial, gastric, colorectal, urinary tract, and prostate cancers showed the highest proportion of MSI-high cases (15.69%, 8.54%, 7.40%, 4.55%, and 3.19%, respectively). A minority of 45 patients (22.73%) among the MSI-high cases underwent germline testing to determine whether the mismatch repair pathway deficiency was inherited. 24.44% of those who performed the genetic test carried a pathogenic variant in an LS-associated gene. Three MSI-high individuals had non-LS gene alterations, including BRCA1, BRCA2, and CDKN2A pathogenic variants, indicating the presence of non-LS-associated gene alterations among MSI-high patients. CONCLUSION Although MSI analysis is routinely performed in clinical practice, as many as 77% of MSI-high patients do not undergo LS genetic testing, despite international guidelines strongly recommending it. BRAF and MLH1 methylation analysis could shed light on the somatic origin of MSI in 42.50% of the MSI-high patients; however, MLH1 analysis is barely ever requested in clinical practice.
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Affiliation(s)
| | - George Rigas
- Medical Oncology Unit, General Hospital of Volos, Volos, Greece
| | - Elena Fountzilas
- Second Department of Medical Oncology, Euromedica General Clinic, Thessaloniki, Greece
| | - Anastasios Boutis
- First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
| | - Stylianos Giassas
- Second Oncology Clinic IASO, General Maternity and Gynecology Clinic, Athens, Greece
| | | | - Danai Daliani
- Department of Medical Oncology, Euroclinic, Athens, Greece
| | - Dimitrios C Ziogas
- First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michalis Liontos
- Department of Clinical Therapeutics, Medical School of National and Kapodistrian University of Athens, “Alexandra” General Hospital of Athens, Athens, Greece
| | | | | | | | - Theofanis Floros
- Oncology Department, Athens Naval and Veterans Hospital, Athens, Greece
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Tsantikidi A, Papazisis K, Floros T, Gazouli M, Papadopoulou E, Tsaousis G, Nasioulas G, Mester A, Milan KP, Gozman B, Afrasanie V, Stanculeanu DL, Trifanescu O, Pescaru F, Militaru C, Papadimitriou C. RediScore: Prospective validation of a pipeline for homologous recombination deficiency analysis. Oncol Lett 2023; 26:480. [PMID: 37809048 PMCID: PMC10551864 DOI: 10.3892/ol.2023.14060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Tumors harboring homologous recombination deficiency (HRD) are considered optimal candidates for poly(ADP-ribose) polymerase 1 (PARP) inhibitor treatment. Such deficiency can be detected by analyzing breast cancer type (BRCA)1/2 gene mutations, as well as mutations in other genes of the homologous recombination pathway. The algorithmic measurement of the HRD effect by identifying genomic instability (GI) has been used as biomarker. As compared with the direct measurement of somatic gene alterations, this approach increases the number of patients who could benefit from PARP inhibitor treatment. In the present study, the performance of the Oncoscan CNV assay, accompanied by appropriate bioinformatic algorithms, was evaluated for its performance in GI calculation and was compared with that of a validated next-generation sequencing (NGS) test (myChoice HRD test). In addition, the clinical utility of the GI score (GIS) and BRCA1/2 tumor analysis were investigated in a cohort of 444 patients with ovarian cancer. For that reason, single nucleotide polymorphism (SNP) arrays and appropriate bioinformatics algorithms were used to calculate GIS in 29 patients with ovarian cancer with known GIS status using a validated NGS test. Furthermore, BRCA1/2 analysis results were compared between the aforementioned assay and the amplicon-based Oncomine™ BRCA Research Assay. BRCA1/2 analysis was performed in 444 patients with ovarian cancer, while GIS was calculated in 175 BRCA1/2-negative cases. The bioinformatics algorithm developed for GIS calculation in combination with NGS BRCA1/2 analysis (RediScore), and the OncoscanR pipeline exhibited a high overall agreement with the validated test (93.1%). In addition, the Oncomine NGS assay had a 100% agreement with the validated test. The BRCA1/2 mutation frequency was 26.5% in the examined patients with ovarian cancer. GIS was positive in 40% of the BRCA1/2-negative cases. The RediScore bioinformatics algorithm developed for GIS calculation in combination with NGS BRCA1/2 analysis is a viable and effective approach for HRD calculation in patients with ovarian cancer, offering a positive prediction for PARP inhibitor responsiveness in 55% of the patients.
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Affiliation(s)
| | | | - Theofanis Floros
- Department of Oncology, Athens Naval and Veterans Hospital, 11521 Athens, Greece
| | - Maria Gazouli
- Department of Basic Medical Sciences National, Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | | | - Andra Mester
- Oncological Institute, 400015 Cluj-Napoca, Romania
| | | | - Bogdan Gozman
- Regional Institute of Oncology, 700483 Iasi, Romania
| | | | | | | | | | | | - Christos Papadimitriou
- Second Department of Surgery, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens 11528, Greece
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3
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Tsantikidi A, Papadopoulou E, Metaxa-Mariatou V, Kapetsis G, Tsaousis G, Meintani A, Florou-Chatzigiannidou C, Gazouli M, Papadimitriou C, Timotheadou E, Kotsakis A, Boutis A, Boukovinas I, Kampletsas E, Kontovinis L, Fountzilas E, Andreadis C, Karanikiotis C, Filippou D, Theodoropoulos G, Özdoğan M, Nasioulas G. The Utility of NGS Analysis in Homologous Recombination Deficiency Tracking. Diagnostics (Basel) 2023; 13:2962. [PMID: 37761329 PMCID: PMC10529941 DOI: 10.3390/diagnostics13182962] [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: 08/11/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Several tumor types have been efficiently treated with PARP inhibitors (PARPis), which are now approved for the treatment of ovarian, breast, prostate, and pancreatic cancers. The BRCA1/2 genes and mutations in many additional genes involved in the HR pathway may be responsible for the HRD phenomenon. The aim of the present study was to investigate the association between genomic loss of heterozygosity (gLOH) and alterations in 513 genes with targeted and immuno-oncology therapies in 406 samples using an NGS assay. In addition, the %gLOHs of 24 samples were calculated using the Affymetrix technology in order to compare the results obtained via the two methodologies. HR variations occurred in 20.93% of the malignancies, while BRCA1/2 gene alterations occurred in 5.17% of the malignancies. The %LOH was highly correlated with alterations in the BRCA1/2 genes, since 76.19% (16/21) of the BRCA1/2 positive tumors had a high %LOH value (p = 0.007). Moreover, the LOH status was highly correlated with the TP53 and KRAS statuses, but there was no association with the TMB value. Lin's concordance correlation coefficient for the 24 samples simultaneously examined via both assays was 0.87, indicating a nearly perfect agreement. In conclusion, the addition of gLOH analysis could assist in the detection of additional patients eligible for treatment with PARPis.
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Affiliation(s)
- Aikaterini Tsantikidi
- Genekor Medical S.A., 15344 Athens, Greece; (V.M.-M.); (G.K.); (G.T.); (A.M.); (C.F.-C.)
| | - Eirini Papadopoulou
- Genekor Medical S.A., 15344 Athens, Greece; (V.M.-M.); (G.K.); (G.T.); (A.M.); (C.F.-C.)
| | | | - George Kapetsis
- Genekor Medical S.A., 15344 Athens, Greece; (V.M.-M.); (G.K.); (G.T.); (A.M.); (C.F.-C.)
| | - Georgios Tsaousis
- Genekor Medical S.A., 15344 Athens, Greece; (V.M.-M.); (G.K.); (G.T.); (A.M.); (C.F.-C.)
| | - Angeliki Meintani
- Genekor Medical S.A., 15344 Athens, Greece; (V.M.-M.); (G.K.); (G.T.); (A.M.); (C.F.-C.)
| | | | - Maria Gazouli
- Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Christos Papadimitriou
- Second Department of Surgery, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Eleni Timotheadou
- Department of Medical Oncology, Papageorgiou Hospital, School of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece;
| | - Athanasios Kotsakis
- Oncology Department, University General Hospital of Larissa, 41334 Larissa, Greece;
| | - Anastasios Boutis
- First Department of Clinical Oncology, Theagenio Hospital, 54639 Thessaloniki, Greece;
| | - Ioannis Boukovinas
- Oncology Department, Bioclinic of Thessaloniki, 54622 Thessaloniki, Greece;
| | - Eleftherios Kampletsas
- Department of Medical, Oncology, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Loukas Kontovinis
- Oncology Department, “Euromedica” General Clinic, 54645 Thessaloniki, Greece;
| | - Elena Fountzilas
- Second Department of Medical Oncology, Euromedica General Clinic, 54645 Thessaloniki, Greece; (E.F.); (G.N.)
| | - Charalampos Andreadis
- Second Department of Clinical Oncology, Theagenio Hospital, 54639 Thessaloniki, Greece;
| | | | - Dimitrios Filippou
- Department of Anatomy, Faculty of Health Sciences, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Georgios Theodoropoulos
- Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, 15772 Athens, Greece;
| | - Mustafa Özdoğan
- Division of Medical Oncology, Memorial Hospital, Antalya 07025, Turkey;
| | - George Nasioulas
- Second Department of Medical Oncology, Euromedica General Clinic, 54645 Thessaloniki, Greece; (E.F.); (G.N.)
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Papadopoulou E, Pepe G, Konitsiotis S, Chondrogiorgi M, Grigoriadis N, Kimiskidis VK, Tsivgoulis G, Mitsikostas DD, Chroni E, Domouzoglou E, Tsaousis G, Nasioulas G. The evolution of comprehensive genetic analysis in neurology: Implications for precision medicine. J Neurol Sci 2023; 447:120609. [PMID: 36905813 DOI: 10.1016/j.jns.2023.120609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
Technological advancements have facilitated the availability of reliable and thorough genetic analysis in many medical fields, including neurology. In this review, we focus on the importance of selecting the appropriate genetic test to aid in the accurate identification of disease utilizing currently employed technologies for analyzing monogenic neurological disorders. Moreover, the applicability of comprehensive analysis via NGS for various genetically heterogeneous neurological disorders is reviewed, revealing its efficiency in clarifying a frequently cloudy diagnostic picture and delivering a conclusive and solid diagnosis that is essential for the proper management of the patient. The feasibility and effectiveness of medical genetics in neurology require interdisciplinary cooperation among several medical specialties and geneticists, to select and perform the most relevant test according to each patient's medical history, using the most appropriate technological tools. The prerequisites for a comprehensive genetic analysis are discussed, highlighting the utility of appropriate gene selection, variant annotation, and classification. Moreover, genetic counseling and interdisciplinary collaboration could improve diagnostic yield further. Additionally, a sub-analysis is conducted on the 1,502,769 variation records with submitted interpretations in the Clinical Variation (ClinVar) database, with a focus on neurology-related genes, to clarify the value of suitable variant categorization. Finally, we review the current applications of genetic analysis in the diagnosis and personalized management of neurological patients and the advances in the research and scientific knowledge of hereditary neurological disorders that are evolving the utility of genetic analysis towards the individualization of the treatment strategy.
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Affiliation(s)
| | - Georgia Pepe
- GeneKor Medical SA, Spaton 52, Gerakas 15344, Greece
| | - Spiridon Konitsiotis
- Department of Neurology, University of Ioannina, Stavrou Niarchou Avenue, Ioannina 45500, Greece
| | - Maria Chondrogiorgi
- Department of Neurology, University of Ioannina, Stavrou Niarchou Avenue, Ioannina 45500, Greece
| | - Nikolaos Grigoriadis
- Second Department of Neurology, "AHEPA" University Hospital, Aristotle University of Thessaloniki, St. Kiriakidis 1, Thessaloniki 54636, Greece
| | - Vasilios K Kimiskidis
- First Department of Neurology, "AHEPA" University hospital, Aristotle University of Thessaloniki, St. Kiriakidis 1, Thessaloniki 54636, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimos D Mitsikostas
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Chroni
- Department of Neurology, School of Medicine, University of Patras, Rio-Patras, Greece
| | - Eleni Domouzoglou
- Department of Pediatrics, University Hospital of Ioannina, Stavrou Niarchou Avenue, Ioannina 45500, Greece
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Ziogas D, Agiannitopoulos K, Pepe G, Potska K, Tsaousis G, Apostolopoulou D, Tsoulos N, Venizelos V, Markopoulos C, Iosifidou R, Karageorgopoulou S, Giassas S, Natsiopoulos I, Papazisis K, Vasilaki-Antonatou M, Psyrri A, Koumarianou A, Papadimitriou C, Papadopoulou E, Nasioulas G. 1709P Cascade genetic testing utilized only in 31% of initial families with pathogenic variants in breast cancer genes. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1787] [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: 11/01/2022] Open
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Papadopoulou E, Tsoulos N, Metaxa-Mariatou V, Tsantikidi A, Kapetsis G, Florou-Chatzigiannidou C, Maravelaki S, Bourkoula E, Fotiou D, Tsaousis G, Touroutoglou N, Trafalis D, Boukovinas I, Varthalitis I, Saridaki Z, Zoublios C, Galani E, Papatsibas G, Papadimitriou C, Zlatintsi T, Iorga P, Orhan B, Tansan S, Özatlı T, Nasioulas G. Abstract P5-13-01: Comprehensive tumor analysis by NGS in metastatic breast cancer patients. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p5-13-01] [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: Comprehensive tumor analysis by Next Generation Sequencing (NGS) is imperative for targeted and immunotherapy related biomarkers’ analysis in metastatic breast cancer enabling personalization of cancer treatment in these patients. In parallel with targeted therapies, immunotherapies are also evolving, revolutionizing cancer therapy. Thus, biomarkers such as. Microsatellite Instability (MSI), and Tumor Mutational Burden (TMB) are commonly employed in NGS analysis due to their correlation to Immune Checkpoint inhibitors treatment.Methods: In the present study, tumor molecular profile analysis was performed in 73 metastatic breast cancer patients using a broad NGS assay, which analyzes more than 500 unique cancer related genes and is able to detect relevant single nucleotide variations (SNVs), indels, copy number variations (CNVs) and gene fusions, in addition to TMB and MS) simultaneously. Results: An actionable alteration was detected in 79.45% of the patients. 35.62% of them had at least one alteration with an on label treatment associated and 10.96% received information related to an off-label treatment (Tiers 1A.1 and 2C.1 respectively). Additionally, 31.51% of the tumors harbored an alteration that could be used for clinical trial inclusion (Table 1). The most prevalent altered gene in these patients was the PIK3CA gene, with 27.40% mutation rate. Moreover, in 11 cases (15.07%) the mutation detected was in a gene involved in the Homologous recombination (HR) pathway, with evidence of response to PARP inhibitors. BRCA1/2 genes were as expected the most prominent HR mutated genes (5 out of 11 HR mutations), while the remaining HR mutations involved other HR genes (ATM, BLM, CHEK2, FANCM, RAD50). 24.66% of the tumors had a TMB value >10muts/MB and thus were eligible for ICI treatment. The addition of TMB to targeted biomarkers’ analysis increased the number of patients with an on-label treatment recommendation by 8.22%. Conclusions: Tumor molecular profile analysis using NGS, in real world samples, is a first-tier method for metastatic breast cancer and provides important information for decision making in the treatment of such patients. Importantly, simultaneous analysis for targeted therapy and immunotherapy biomarkers could lead to better tumor characterization and offered actionable information in 9 out of 10 patients tested. However, appropriate interpretation of results from such analysis is essential for implementation in clinical practice and accurate refinement of the treatment strategy..
Table 1.Biomarker's summary in the 73 patients included in the studyPercentage of patients with Tier1 variantsPercentage of patients with 2C.1 variantsPercentage of patients with 2C.2/2D variantsPercentage of patients with Tier 3 variantsPercentage of patients with TMB>10muts/MBMEDIAN TMBPercentage of MSI-High patients35.62% (26/73)10.96% (8/73)12.33% (9/73)0% (0/73)24.66% (18/73)5.050% (0/73)
Citation Format: Eirini Papadopoulou, Nikolaos Tsoulos, Vasiliki Metaxa-Mariatou, Aikaterini Tsantikidi, Georgios Kapetsis, Chrysiida Florou-Chatzigiannidou, Sonia Maravelaki, Evgenia Bourkoula, Dimitrios Fotiou, Georgios Tsaousis, Nikolaos Touroutoglou, Dimitrios Trafalis, Ioannis Boukovinas, Ioannis Varthalitis, Zacharenia Saridaki, Charalampos Zoublios, Eleni Galani, George Papatsibas, Christos Papadimitriou, Tania Zlatintsi, Polixenia Iorga, Bülent Orhan, Sualp Tansan, Tahsin Özatlı, George Nasioulas. Comprehensive tumor analysis by NGS in metastatic breast cancer patients [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-13-01.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Zacharenia Saridaki
- Asklepios Oncology Department and “Asklepion Crete” Clinic, Heraklion, Greece
| | | | - Eleni Galani
- Second Department of Medical Oncology, "Metropolitan" Hospital,, Piraeus, Greece
| | - George Papatsibas
- Oncology Department, University General Hospital of Larissa, Larissa, Greece
| | - Christos Papadimitriou
- Oncology Unit, Aretaieion Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | | | | | - Bülent Orhan
- Department of Medical Oncology, Ceylan International Hospital,, Bursa, Turkey
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Ozmen V, Caglayan A, Yararbas K, Ordu C, Aktepe F, Ozmen T, Ilgun A, Soybir G, Alco G, Tsaousis G, Papadopoulou E, Agiannitopoulos K, Pepe G, Kampouri S, Nasioulas G, Sezgin E, Soran A. Importance of multigene panel test in patients with consanguineous marriage and family history of breast cancer. Oncol Lett 2022; 23:118. [PMID: 35261632 PMCID: PMC8855161 DOI: 10.3892/ol.2022.13238] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 01/06/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Vahit Ozmen
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey
| | - Ahmet Caglayan
- Department of Medical Genetics, Dokuz Eylul University, Izmir 35330, Turkey
| | - Kanay Yararbas
- Department of Medical Genetics, Demiroglu Bilim University, Istanbul 34403, Turkey
| | - Cetin Ordu
- Medical Oncology, Demiroglu Bilim University, Istanbul 34403, Turkey
| | - Fatma Aktepe
- Department of Pathology, Memorial Hospital, Istanbul 34385, Turkey
| | - Tolga Ozmen
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33127, USA
| | - Ahmet Ilgun
- Department of Surgery, Demiroglu Bilim University, Istanbul 34403, Turkey
| | - Gursel Soybir
- Department of Surgery, Memorial Hospital, Istanbul 34385, Turkey
| | - Gul Alco
- Department of Radiation Oncology, Demiroglu Bilim University, Istanbul 34403, Turkey
| | | | | | | | | | | | | | - Efe Sezgin
- Department of Food Engineering, Faculty of Engineering, Izmir Institute of Technology, Izmir 35430, Turkey
| | - Atilla Soran
- Department of Surgical Oncology, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Özdoğan M, Papadopoulou E, Tsoulos N, Tsantikidi A, Mariatou VM, Tsaousis G, Kapeni E, Bourkoula E, Fotiou D, Kapetsis G, Boukovinas I, Touroutoglou N, Fassas A, Adamidis A, Kosmidis P, Trafalis D, Galani E, Lypas G, Orhan B, Tansan S, Özatlı T, Kırca O, Çakır O, Nasioulas G. Comprehensive tumor molecular profile analysis in clinical practice. BMC Med Genomics 2021; 14:105. [PMID: 33853586 PMCID: PMC8045191 DOI: 10.1186/s12920-021-00952-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 10/25/2020] [Accepted: 03/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background Tumor molecular profile analysis by Next Generation Sequencing technology is currently widely applied in clinical practice and has enabled the detection of predictive biomarkers of response to targeted treatment. In parallel with targeted therapies, immunotherapies are also evolving, revolutionizing cancer therapy, with Programmed Death-ligand 1 (PD-L1), Microsatellite instability (MSI), and Tumor Mutational Burden (TMB) analysis being the biomarkers employed most commonly. Methods In the present study, tumor molecular profile analysis was performed using a 161 gene NGS panel, containing the majority of clinically significant genes for cancer treatment selection. A variety of tumor types have been analyzed, including aggressive and hard to treat cancers such as pancreatic cancer. Besides, the clinical utility of immunotherapy biomarkers (TMB, MSI, PD-L1), was also studied.
Results Molecular profile analysis was conducted in 610 cancer patients, while in 393 of them a at least one biomarker for immunotherapy response was requested. An actionable alteration was detected in 77.87% of the patients. 54.75% of them received information related to on-label or off-label treatment (Tiers 1A.1, 1A.2, 2B, and 2C.1) and 21.31% received a variant that could be used for clinical trial inclusion. The addition to immunotherapy biomarker to targeted biomarkers’ analysis in 191 cases increased the number of patients with an on-label treatment recommendation by 22.92%, while an option for on-label or off-label treatment was provided in 71.35% of the cases. Conclusions Tumor molecular profile analysis using NGS is a first-tier method for a variety of tumor types and provides important information for decision making in the treatment of cancer patients. Importantly, simultaneous analysis for targeted therapy and immunotherapy biomarkers could lead to better tumor characterization and offer actionable information in the majority of patients. Furthermore, our data suggest that one in two patients may be eligible for on-label ICI treatment based on biomarker analysis. However, appropriate interpretation of results from such analysis is essential for implementation in clinical practice and accurate refinement of treatment strategy. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-00952-9.
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Affiliation(s)
- Mustafa Özdoğan
- Division of Medical Oncology, Memorial Hospital, Antalya, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Eleni Galani
- Second Department of Medical Oncology, "Metropolitan" Hospital, Piraeus, Greece
| | - George Lypas
- Department of Genetic Oncology/Medical Oncology, Hygeia Hospital, Athens, Greece
| | - Bülent Orhan
- Department of Medical Oncology, Ceylan International Hospital, Bursa, Turkey
| | | | | | - Onder Kırca
- Division of Medical Oncology, Memorial Hospital, Antalya, Turkey
| | - Okan Çakır
- Applied Health Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland, UK
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Gourgouli K, Gourgouli I, Tsaousis G, Spai S, Niskopoulou M, Efthimiopoulos S, Lamnissou K. Investigation of genetic base in the treatment of age-related macular degeneration. Int Ophthalmol 2020; 40:985-997. [PMID: 31916060 DOI: 10.1007/s10792-019-01274-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 08/03/2019] [Accepted: 12/30/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE To determine whether gene polymorphisms which are associated with age-related macular degeneration (AMD) influence treatments' response and specifically the antioxidant supplementation in dry AMD patients, as well as the anti-vascular endothelial growth factor (anti-VEGF) therapy in neovascular AMD patients. METHODS A total of 170 patients with dry AMD and 52 neovascular AMD patients were genotyped for the following single nucleotide polymorphisms (SNPs): rs1061170/Y402H in CFH gene, rs10490924/A69S in ARMS2 gene, rs9332739/E318D and rs547154/IVS10 in C2 gene, and rs4151667/L9H and rs2072633/IVS17 in CFB gene. Treatment response was evaluated by comparing visual acuity and optical coherence tomography between baseline and at the end of the treatment. RESULTS Τhe CFH/Y402H variant was associated with the response to antioxidants in dry AMD patients. Carriers of one or two CFH risk alleles displayed a lower chance of responding compared to those with no risk allele. No association of antioxidants' response and ARMS2/A69S genotype was identified. The analysis of the C2 and CFB genetic variants (protective SNPs) revealed that antioxidant supplementation was much more effective in protective SNP carriers. In neovascular AMD patients, the analysis indicated that Y402H homozygous patients were less likely to respond to anti-VEGF therapy compared to heterozygous. Regarding the ARMS2/A69S genotype, carriers of the risk variant experienced significantly worse treatment outcome compared to wild-type patients. CONCLUSION In AMD patients, the efficacy of the antioxidant supplementation and the anti-VEGF therapy appears to differ by genotype. The detection of genetic variants, associated with treatment responsiveness, could lead to improved visual outcomes through genotype-directed therapy.
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Affiliation(s)
- Kalliopi Gourgouli
- Division of Genetics and Biotechnology, Department of Biology, National and Kapodistrian University of Athens, Panepistimiopolis, Ilissia, 15701, Athens, Greece.
| | - Ioanna Gourgouli
- Department of Ophthalmology, Sismanoglio General Hospital of Attica, Athens, Greece
| | - Georgios Tsaousis
- Division of Cell Biology and Biophysics, Department of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Spai
- Department of Ophthalmology, Sismanoglio General Hospital of Attica, Athens, Greece
| | - Maria Niskopoulou
- Consultant Ophthalmic Surgeon, Agias Paraskevis 118, Chalandri, 15232, Athens, Greece
| | - Spiros Efthimiopoulos
- Division of Animal and Human Physiology, Department of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Klea Lamnissou
- Division of Genetics and Biotechnology, Department of Biology, National and Kapodistrian University of Athens, Panepistimiopolis, Ilissia, 15701, Athens, Greece
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Papadopoulou E, Tsoulos N, Tsantikidi K, Metaxa-Mariatou V, Stamou PE, Kladi-Skandali A, Kapeni E, Tsaousis G, Pentheroudakis G, Petrakis D, Lampropoulou DI, Aravantinos G, Varthalitis I, Kesisis G, Boukovinas I, Papakotoulas P, Katirtzoglou N, Athanasiadis E, Stavridi F, Christodoulou C, Koumarianou A, Eralp Y, Nasioulas G. Clinical feasibility of NGS liquid biopsy analysis in NSCLC patients. PLoS One 2019; 14:e0226853. [PMID: 31860648 PMCID: PMC6924668 DOI: 10.1371/journal.pone.0226853] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background Analysis of circulating tumor nucleic acids in plasma of Non-Small Cell Lung Cancer (NSCLC) patients is the most widespread and documented form of "liquid biopsy" and provides real-time information on the molecular profile of the tumor without an invasive tissue biopsy. Methods Liquid biopsy analysis was requested by the referral physician in 121 NSCLC patients at diagnosis and was performed using a sensitive Next Generation Sequencing assay. Additionally, a comparative analysis of NSCLC patients at relapse following EGFR Tyrosine Kinase Inhibitor (TKIs) treatment was performed in 50 patients by both the cobas and NGS platforms. Results At least one mutation was identified in almost 49% of the cases by the NGS approach in NSCLC patients analyzed at diagnosis. In 36 cases with paired tissue available a high concordance of 86.11% was observed for clinically relevant mutations, with a Positive Predictive Value (PPV) of 88.89%. Furthermore, a concordance rate of 82% between cobas and the NGS approach for the EGFR sensitizing mutations (in exons 18, 19, 21) was observed in patients with acquired resistance to EGFR TKIs, while this concordance was 94% for the p.T790M mutation, with NGS being able to detect this mutation in three 3 additional patients. Conclusions This study indicates the feasibility of circulating tumor nucleic acids (ctNA) analysis as a tumor biopsy surrogate in clinical practice for NSCLC personalized treatment decision making. The use of new sensitive NGS techniques can reliably detect tumor-derived mutations in liquid biopsy and provide clinically relevant information both before and after targeted treatment in patients with NSCLC. Thus, it could aid physicians in treatment decision making in clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | - George Pentheroudakis
- Department of Medical Oncology, School of Medicine, Ioannina, Greece
- Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), Ioannina, Greece
| | - Dimitrios Petrakis
- Department of Medical Oncology, School of Medicine, Ioannina, Greece
- Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), Ioannina, Greece
| | | | - Gerasimos Aravantinos
- Second Department of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Greece
| | | | - George Kesisis
- Oncology Department, Saint Luke Private Hospital, Thessaloniki, Greece
| | | | - Pavlos Papakotoulas
- First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
| | | | | | - Flora Stavridi
- Fourth Department of Medical Oncology, Hygeia Hospital, Athens, Greece
| | | | - Anna Koumarianou
- Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Yeşim Eralp
- Department of Medical Oncology, Istanbul University School of Medicine, İstanbul, Turkey
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Tsoulos N, Apessos A, Agiannitopoulos K, Pepe G, Tsaousis G, Kambouri S, Eniu DT, Ungureanu A, Banu E, Ciule L, Blidaru A, Chiorean A, Stanculeanu DL, Mateescu D, Nasioulas G. Abstract P3-03-03: Analysis of hereditary cancer syndromes by use of a panel of genes: More answers than questions. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-03-03] [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
Hereditary breast cancer is estimated to account for approximately 10% of all breast cancer cases. In addition, an estimated 15-20% of those affected by breast cancer have a positive family history.
Despite the fact that BRCA1 and BRCA2 are the two most significant genes in hereditary breast cancer predisposition, twenty years of analysis has highlighted the fact, that mutations in these two highly penetrant genes, are only present in approximately 20% of high risk families.
Other genes, mutations in which are associated with high risk of breast cancer, were identified because of the strong association with familial cancer syndromes, in which breast cancer is one of the defining components.
Technological advances in molecular biology and especially DNA sequencing, commonly designated as “Next Generation Sequencing – NGS” have aided in the concentrated efforts to identify new genes responsible for the missing heritability, allowing the application of this knowledge in the diagnostic setting.
AIM
The aim of this study was to investigate the extent and nature of mutations in 26 genes implicated in hereditary cancer predisposition in families of Romanian descent.
MATERIALS & METHODS
In total, 297 Romanian families have been analyzed by our group in the past three years.
Genomic DNA was enriched for targeted regions of 26 genes involved in hereditary predisposition to cancer (ATM, BARD1, BLM, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, EPCAM (only intron 8, exon 9 and 3'UTR), FAM175A, MEN1, MLH1, MRE11A, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2, PTEN, RAD50, RAD51C, RAD51D, STK11, TP53, XRCC2). Sequencing was carried out using the Illumina NGS technology. Reads were aligned to the reference sequence (GRCh38), and sequence changes were identified and interpreted in the context of a single clinically relevant transcript. The presence of large genomic rearrangements was investigated by use of MLPA. All clinically significant observations were confirmed by orthogonal technologies.
RESULTS
In total, a pathogenic mutation was identified in 79 of the 297 families (26.6%) analyzed. Clinically significant mutations were identified in 17 of the genes included in the panel. The most commonly mutated genes in the Romanian population were BRCA1 and BRCA2, accounting for 50% of the mutations identified, followed by PALB2 (12%), CHEK2 (9.4%) and ATM, NBN and RAD50 which accounted for 3.5% of the mutations each. Of note is that 7 of the 79 affected families (8.8%) carried clinically significant mutations in two different genes.
CONCLUSIONS
Our results support the clinical significance of analysis of a panel of genes involved in hereditary cancer predisposition. In this series of patients, analysis of this panel allowed for the identification of 14% additional pathogenic variants. This is especially true in those cases where more than one pathogenic variant was identified.
Citation Format: Tsoulos N, Apessos A, Agiannitopoulos K, Pepe G, Tsaousis G, Kambouri S, Eniu DT, Ungureanu A, Banu E, Ciule L, Blidaru A, Chiorean A, Stanculeanu DL, Mateescu D, Nasioulas G. Analysis of hereditary cancer syndromes by use of a panel of genes: More answers than questions [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-03-03.
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Affiliation(s)
- N Tsoulos
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - A Apessos
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - K Agiannitopoulos
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - G Pepe
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - G Tsaousis
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - S Kambouri
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - DT Eniu
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - A Ungureanu
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - E Banu
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - L Ciule
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - A Blidaru
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - A Chiorean
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - DL Stanculeanu
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - D Mateescu
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
| | - G Nasioulas
- GeneKor M.S.A, Athens, Attiki, Greece; Institutul Oncologic Prof. Dr. I. Chiricuta, CLUJ, Romania; Amethyst Radiotherapy, Cluj-Napoca, Romania; Spitalul Sfantul Constantin, Brasov, Romania; Spitalul Clinic Judetean de Urgenta, Cluj-Napoca, Romania; Institutul Oncologic Bucuresti, Bucuresti, Romania; Regina Maria, Bucuresti, Romania
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Tsoulos N, Papadopoulou E, Metaxa-Mariatou V, Tsaousis G, Efstathiadou C, Tounta G, Scapeti A, Bourkoula E, Zarogoulidis P, Pentheroudakis G, Kakolyris S, Boukovinas I, Papakotoulas P, Athanasiadis E, Floros T, Koumarianou A, Barbounis V, Dinischiotu A, Nasioulas G. Tumor molecular profiling of NSCLC patients using next generation sequencing. Oncol Rep 2017; 38:3419-3429. [PMID: 29130105 PMCID: PMC5783588 DOI: 10.3892/or.2017.6051] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 10/05/2017] [Indexed: 01/10/2023] Open
Abstract
Non‑small cell lung cancer (NSCLC) is the most common type of lung cancer and a tumor with a broad spectrum of targeted therapies already available or in clinical trials. Thus, molecular characterization of the tumor using next generation sequencing (NGS) technology, has become a key tool for facilitating treatment decisions and the clinical management of NSCLC patients. The performance of a custom 23 gene multiplex amplification hot spot panel, based on Ion AmpliSeq™ technology, was evaluated for the analysis of tumor DNA extracted from formalin-fixed and paraffin-embedded (FFPE) tissues. Furthermore, the Ion AmpliSeq™ RNA Fusion Lung Cancer Research Panel was used for fusion RNA transcript analysis. The mutation spectrum of the tumors was determined in a cohort of 502 patients with NSCLC using the aforementioned targeted gene panels. The panel used for tumor DNA analysis in this study exhibited high rates (100%) of sensitivity, specificity and reproducibility at a mutation allelic frequency of 3%. At least one DNA mutation was detected in 374 patients (74.5%) and an RNA fusion was identified in 16 patients, (3.2%). In total, alterations in a cancer-driver gene were identified (including point mutations, gene rearrangements and MET amplifications) in 77.6% of the tumors tested. Among the NSCLC patients, 23% presented a mutation in a gene associated with approved or emerging targeted therapy. More specifically, 13.5% (68/502) presented a mutation in a gene with approved targeted therapy (EGFR, ALK, ROS1) and 9.4% (47/502) had an alteration in a gene related to emerging targeted therapies (ERBB2, BRAF, MET and RET). Furthermore, 51.6% of the patients had a mutation in a gene that could be related to an off label therapy or indicative for access to a clinical trial. Thus, the targeted NGS panel used in this study is a reliable approach for tumor molecular profiling and can be applied in personalized treatment decision making for NSCLC patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Pavlos Zarogoulidis
- Pulmonary Department, Oncology Unit, ‘G. Papanikolaou’ General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - George Pentheroudakis
- Department of Medical Oncology, University Hospital of Ioannina, Ioannina 45500, Greece
| | - Stylianos Kakolyris
- Department of Medical Oncology, University General Hospital of Alexandroupoli, Alexandroupoli 68100, Greece
| | - Ioannis Boukovinas
- Medical Oncology, ‘Bioclinic’ of Thessaloniki, Thessaloniki 54622, Greece
| | - Pavlos Papakotoulas
- Second Department of Medical Oncology, Theagenion Anticancer Hospital of Thessaloniki, Thessaloniki 54639, Greece
| | | | | | - Anna Koumarianou
- Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon Hospital, National and Kapodistrian University of Athens, Athens 12462, Greece
| | - Vasileios Barbounis
- Third Medical Oncology Department, ‘Metropolitan’ Hospital, Pireas 18547, Greece
| | - Anca Dinischiotu
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest 0050095, Romania
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Tsoulos N, Papadopoulou E, Metaxa-Mariatou V, Tsaousis G, Efstathiadou C, Tounta G, Skapeti K, Bourkoula J, Zarogoulidis P, Pentheroudakis GE, Kakolyris S, Boukovinas I, Papakotoulas P, Athanasiadis I, Floros T, Koumarianou A, Vassilios B, Nasioulas G. Molecular profiling of 502 patient cohort with NSCLC using a 27 somatic gene panel. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e23193] [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
e23193 Background: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and a tumor with broad spectrum of targeted therapies already available or in clinical trials. Thus, molecular characterization of the tumor using the Next Generation Sequencing (NGS) technology, has become a key tool for NSCLC patients’ treatment decision and clinical management. Methods: The performance of a custom 23 gene multiplex amplification hot spot panel, based on Ion AmpliSeq Technology, was evaluated for the analysis of tumor DNA extracted from FFPE (Formalin Fixed Parraffin Embedded) tissue. Furthermore the Ion AmpliSeq™ RNA Fusion Lung Cancer Research Panel was used for fusion RNA transcript analysis. Tumors’ mutation spectrum was determined in a cohort of 502 patients with NSCLC using the aforementioned targeted gene panels. Results: The panel used for tumor DNA analysis in this study exhibit high rates (100%) of sensitivity, specificity and reproducibility at a mutation frequency of 3%. At least one DNA mutation was detected in 374 patients (74.5%) and an RNA fusion was identified in 16 patients, (3.2%). In total, alterations in a cancer driver gene were identified (including point mutations, gene rearrangements and MET amplifications) in 77.6% of the tumors tested. Among the NSCLC patients, 13.5% (68/502) presented a mutation in a gene with approved targeted therapy (EGFR, ALK ROS1) and 9.4% had an alteration in a gene related to emerging targeted therapies according the NCCN guidelines. These alterations include ERBB2, BRAF and MET mutations, MET amplification and RET rearrangements. The remaining 51.6% of the patients had a mutation in a gene that could be related to an off label therapy or give them access to a clinical trial. Conclusions: Thus the NGS panel validated is a reliable approach of clinical applicability for tumor molecular profile detection in NSCLC patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Paul Zarogoulidis
- G Papanikolaou General Hospital Aristotle University of Thessaloniki, Thessaloniki, Greece
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Papadopoulou E, Metaxa-Mariatou V, Tsaousis G, Tsoulos N, Tsirigoti A, Efstathiadou C, Apessos A, Agiannitopoulos K, Pepe G, Bourkoula E, Nasioulas G. Molecular predictive markers in tumors of the gastrointestinal tract. World J Gastrointest Oncol 2016; 8:772-785. [PMID: 27895815 PMCID: PMC5108979 DOI: 10.4251/wjgo.v8.i11.772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 03/28/2016] [Revised: 07/11/2016] [Accepted: 08/31/2016] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal malignancies are among the leading causes of cancer-related deaths worldwide. Like all human malignancies they are characterized by accumulation of mutations which lead to inactivation of tumor suppressor genes or activation of oncogenes. Advances in Molecular Biology techniques have allowed for more accurate analysis of tumors’ genetic profiling using new breakthrough technologies such as next generation sequencing (NGS), leading to the development of targeted therapeutical approaches based upon biomarker-selection. During the last 10 years tremendous advances in the development of targeted therapies for patients with advanced cancer have been made, thus various targeted agents, associated with predictive biomarkers, have been developed or are in development for the treatment of patients with gastrointestinal cancer patients. This review summarizes the advances in the field of molecular biomarkers in tumors of the gastrointestinal tract, with focus on the available NGS platforms that enable comprehensive tumor molecular profile analysis.
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Ntostis P, Agiannitopoulos K, Tsaousis G, Pantos K, Lamnissou K. Evidence for association of the rs605059 polymorphism of HSD17B1 gene with recurrent spontaneous abortions. J Matern Fetal Neonatal Med 2014; 28:2250-3. [PMID: 25394609 DOI: 10.3109/14767058.2014.984289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate whether the missense rs605059 polymorphism of HSD17B1 gene, which is expressed mainly in the placenta, is associated with recurrent spontaneous abortions (RSA). METHODS This study group consisted of 138 women with three or more unexplained spontaneous abortions, before the 20th week of gestation, with the same partner, while 140 healthy women served as controls. To genotype the individuals, we used the polymerase chain reaction-restriction fragment length polymorphism method. RESULTS The genotyping of the rs605059 polymorphism revealed the frequencies 0.22, 0.45 and 0.33, for AA, GA and GG genotypes, respectively, for the patient group and 0.37, 0.41 and 0.22, respectively, for the control group. The A allele frequencies were 0.44 and 0.57 for the patient and control group, respectively, and the G allele frequencies were 0.56 and 0.43 for the patient and control group, respectively. Statistical analysis of the results indicated the existence of significant differences in genotype and allele frequencies between the two groups. CONCLUSION The rs605059 polymorphism of the HSD17B1 gene is associated with increased risk of RSA in our Caucasian Greek population. Thus it could be used as a prognostic genetic marker for RSA.
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Affiliation(s)
- Panagiotis Ntostis
- a Department of Genetics and Biotechnology, Faculty of Biology , University of Athens , Athens , Greece
| | | | - Georgios Tsaousis
- b Department of Cell Biology and Biophysics, Faculty of Biology , University of Athens , Athens , Greece , and
| | | | - Klea Lamnissou
- a Department of Genetics and Biotechnology, Faculty of Biology , University of Athens , Athens , Greece
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Chorianopoulos D, Samitas K, Vittorakis S, Kiriazi V, Rondoyianni D, Tsaousis G, Skoutelis A. Extranodal natural killer/T-cell lymphoma, nasal-type. Skinmed 2010; 8:56-58. [PMID: 20839428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A 51-year-old previously healthy man, an ex-smoker, was admitted to the authors' medical department with a 3-month history of dry cough; intermittent fever; painless, ulcerated cutaneous lesions over the trunk and limbs (Figure 1); and progressive weight loss. He was of Greek descent. His medical history was remarkable for nasal polyps, which were surgically removed 15 years earlier. Initially, he had been treated with antibiotics, without improvement. Several days before admission, chest radiography revealed pulmonary infiltrates in the left lower lobe. On admission, physical examination revealed a well-orientated man in mild distress, with inspiratory rhonchi at the lower part of the left lung and scattered erythematous nodules of variable size, some of which were ulcerated. Laboratory values were notable for leukopenia, 3.3 x 10(9)/L; total protein, 5.9 g/dL; globulin, 2.2 g/dL; serum glutamic oxaloacetic transaminase, 86 IU/L; serum glutamic pyruvic transaminase, 71 IU/L; and lactate dehydrogenase, 519 U/L. Computed tomograph (CT) of the chest showed multiple alveolar opacities bilaterally (Figure 2). Fiberoptic bronchoscopy did not reveal any important pathologic findings. Results of bronchial biopsy, cytology of bronchoalveolar lavage, washing, brushing, and sputum following bronchoscopy were negative. CT of the brai and sinonasal area revealed an abnormal low-density mass in the left nasal area. CT findings of the abdomen were negative, as were results of a bone marrow biopsy. There was no evidence of immunosuppression. The differential diagnosis, considering the evidence described, included granulomatous or infectious diseases, angiocentric lymphoproliferative lesions, and lymphomas. Biopsy of a skin lesion showed lymphoproliferative infiltration of the dermis with a follicular and angiocentric growth pattern and regional epidermal necrosis. Immunohistochemical stains showed that the tumor cell were positive for CD56 and CD3 (cytoplasmic positivity) and expressed the cytotoxic proteins T-cell intracellular antigen and granzyme B (Figure 3) They lacked TdT, CD34, CD7, CD8, TCL-1, and CD123. Findings from an in situ hybridization study for Epstein-Barr virus were negative. Give this result, molecular analysis ofT-cell receptor (TCR) gene rearrangements was performed using polymerase chain reaction-based TCR-gamma gene, wit negative results. The morphology and the immunophenotype were consistent with natural killer/T-cell lymphoma, nasal-type. Nasal involvement must be first excluded to proceed to the diagnosis of nasal-type natural killer-cell lymphoma. Indeed, histologic examination of the nasal mass revealed its polypoid nature. Thus, the authors were led to the diagnosis of extranodal extranasal natural killer/T-cell lymphoma, nasal-type, CD56-positive, Ep stein-Barr virus-negative, TCR-negative. The patient received combination chemotherapy and completed 4 cycles of cyclophosphamide, doxorubicin vincristine, and prednisone every 14 days for 2 months. Skin lesions improved, and there was no fever soon after the initiation of therapy. Reevaluatio after the fourth cycle, however, disclosed pulmonary infiltrations as well as leukemic infiltration of the central nervous system. The patient had receive systemic salvage chemotherapy and intrathecal infusions of methotrexate. Although the lung lesions had diminished at that time, the patient develope paraplegia, his clinical course rapidly deteriorated, and he eventually died.
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Affiliation(s)
- Dimitrios Chorianopoulos
- Department of Pulmonary Medicine, Athens Medical School, Sotiria General Hospital, Athens, Greece.
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Skemperis V, Tsaousis G, Darilis E, Tsigarida E. P.2.7 High degree atrioventicular block in a femele patient 11 years of age due to enstein Barr virus. The usefulness of holter monitoring. Europace 2003. [DOI: 10.1016/eupace/4.supplement_1.a41-b] [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: 11/15/2022] Open
Affiliation(s)
- V. Skemperis
- 2nd Prop University Clinic Oof Internal Medicine, Thessaloniki
| | - G. Tsaousis
- Cardiology Pediatric Clinic Hospital ‘Agia Sophia’, Athens
| | - E. Darilis
- 3rd Paediatric Univerity Clinic, Thessaloniki, Greece
| | - E. Tsigarida
- 2nd Prop University Clinic Oof Internal Medicine, Thessaloniki
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Tsaousis G, Koutsouri A, Gatsiou C, Paniara O, Peppas C, Chalevelakis G. Liver and brain mucormycosis in a diabetic patient type II successfully treated with liposomial amphotericin B. Scand J Infect Dis 2000; 32:335-7. [PMID: 10879616 DOI: 10.1080/00365540050166090] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A case of liver and brain mucormycosis in a 73-y-old diabetic patient is described. The patient presented with fever and a moderate, tender hepatomegaly and a C/T scan examination of the abdomen and brain showed multiple hepatic and cerebral nodular lesions. The largest of the liver lesions was aspirated and broad hyphae of mucor were demonstrated in the purulent material obtained. The patient was treated successfully (for 40 d) with intravenous liposomal amphotericin B and then with itraconazole for 3 months. To our knowledge, this is the first case of a diabetic patient with both liver and brain mucormycosis who has been treated successfully.
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Affiliation(s)
- G Tsaousis
- 5th Medical Department of Internal Medicine, Evangelismos Hospital, Athens, Greece
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19
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Dhillon R, Thanopoulos B, Tsaousis G, Triposkiadis F, Kyriakidis M, Redington A. Transcatheter closure of atrial septal defects in adults with the Amplatzer septal occluder. Heart 1999; 82:559-62. [PMID: 10525508 PMCID: PMC1760778 DOI: 10.1136/hrt.82.5.559] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the efficacy and complications of device occlusion of atrial septal defects in adults, using the Amplatzer septal occluder (ASO). DESIGN A prospective interventional study. SETTING Paediatric cardiology departments in two European teaching hospitals. PATIENTS The first 20 patients accepted for atrial septal defect device occlusion, on the basis of transoesophageal echocardiography. Sixteen patients had larger defects with right heart dilatation, while the primary indication for closure in four was a history of early paradoxical embolism. INTERVENTIONS Transcatheter atrial septal defect occlusions performed under transoesophageal echocardiography and fluoroscopic guidance between December 1996 and June 1998. OUTCOME MEASURES Success of deployment of ASO devices, procedure and fluoroscopic times, complications, and symptoms. RESULTS The ASO device was successfully implanted in all 20 patients (14 female), median age 44.2 years, with no complications. Of the 16 patients with right heart dilatation, the median Qp:Qs was 2.5:1. Defects measured 11-22 mm (median 18) on transoesophageal echocardiography, with balloon sized diameter (and device size) of 13-28 mm (median 20). For all 20 patients, the procedure time ranged from 38-78 minutes (median 61), and fluoroscopy 8.4-24.7 minutes (median 15.2). There were residual shunts in three patients at the end of the procedure, which were trivial (</= 1 mm) as assessed by transoesophageal echocardiography, and persisted for more than six months in only one patient. Follow up ranged from 0.1-1.5 years (median 0.7). There have been no late complications. CONCLUSIONS The ASO device can be used successfully to close selected oval fossa defects in adults, with minimal procedural morbidity and excellent early results.
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Affiliation(s)
- R Dhillon
- Department of Paediatric Cardiology, Royal Brompton and Harefield Hospital NHS Trust, London, UK
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