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Jiagge E, Jin DX, Newberg JY, Perea-Chamblee T, Pekala KR, Fong C, Waters M, Ma D, Dei-Adomakoh Y, Erb G, Arora KS, Maund SL, Njiraini N, Ntekim A, Kim S, Bai X, Thomas M, van Eeden R, Hegde P, Jee J, Chakravarty D, Schultz N, Berger MF, Frampton GM, Sokol ES, Carrot-Zhang J. Tumor sequencing of African ancestry reveals differences in clinically relevant alterations across common cancers. Cancer Cell 2023; 41:1963-1971.e3. [PMID: 37890492 DOI: 10.1016/j.ccell.2023.10.003] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 08/02/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
Cancer genomes from patients with African (AFR) ancestry have been poorly studied in clinical research. We leverage two large genomic cohorts to investigate the relationship between genomic alterations and AFR ancestry in six common cancers. Cross-cancer type associations, such as an enrichment of MYC amplification with AFR ancestry in lung, breast, and prostate cancers, and depletion of BRAF alterations are observed in colorectal and pancreatic cancers. There are differences in actionable alterations, such as depletion of KRAS G12C and EGFR L858R, and enrichment of ROS1 fusion with AFR ancestry in lung cancers. Interestingly, in lung cancer, KRAS mutations are less common in both smokers and non-smokers with AFR ancestry, whereas the association of TP53 mutations with AFR ancestry is only seen in smokers, suggesting an ancestry-environment interaction that modifies driver rates. Our study highlights the need to increase representation of patients with AFR ancestry in drug development and biomarker discovery.
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Affiliation(s)
- Evelyn Jiagge
- Hematology/Oncology Division, Department of Medicine, Henry Ford Health System, Detroit, MI, USA.
| | - Dexter X Jin
- Computational Discovery, Foundation Medicine, Inc., Cambridge, MA, USA.
| | - Justin Y Newberg
- Computational Discovery, Foundation Medicine, Inc., Cambridge, MA, USA
| | - Tomin Perea-Chamblee
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kelly R Pekala
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christopher Fong
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michele Waters
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Ma
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Gilles Erb
- Global Product Development Medical Affairs - Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Kanika S Arora
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer, New York, NY, USA
| | - Sophia L Maund
- Computational Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - Njoki Njiraini
- Department of Oncology, Kenyatta University Teaching Research and Referral Hospital, Nairobi, Kenya
| | - Atara Ntekim
- Department of Radiation Oncology, University of Ibadan, Ibadan, Nigeria
| | - Susie Kim
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xuechun Bai
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marlene Thomas
- Global Product Development Medical Affairs - Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Ronwyn van Eeden
- Department of Medical Oncology, Chris Hani Academic Baragwanath Hospital, Johannesburg, South Africa
| | - Priti Hegde
- Computational Discovery, Foundation Medicine, Inc., Cambridge, MA, USA
| | - Justin Jee
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Debyani Chakravarty
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer, New York, NY, USA; Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nikolaus Schultz
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael F Berger
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer, New York, NY, USA; Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Ethan S Sokol
- Computational Discovery, Foundation Medicine, Inc., Cambridge, MA, USA
| | - Jian Carrot-Zhang
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Clinial Genetics, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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de Vries EGE, Rüschoff J, Lolkema M, Tabernero J, Gianni L, Voest E, de Groot DJA, Castellano D, Erb G, Naab J, Donica M, Deurloo R, van der Heijden MS, Viale G. Phase II study (KAMELEON) of single-agent T-DM1 in patients with HER2-positive advanced urothelial bladder cancer or pancreatic cancer/cholangiocarcinoma. Cancer Med 2023. [PMID: 37119523 DOI: 10.1002/cam4.5893] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/09/2023] [Accepted: 03/22/2023] [Indexed: 05/01/2023] Open
Abstract
The antibody-drug conjugate trastuzumab emtansine (T-DM1) is approved for human epidermal growth factor receptor 2 (HER2/ERBB2)-positive breast cancer. We aimed to study tumor HER2 expression and its effects on T-DM1 responses in patients with HER2-positive urothelial bladder cancer (UBC) or pancreatic cancer (PC)/cholangiocarcinoma (CC). In the phase II KAMELEON study (NCT02999672), HER2 status was centrally assessed by immunohistochemistry, with positivity defined as non-focal homogeneous or heterogeneous overexpression of HER2 in ≥30% of stained cells. We also performed exploratory biomarker analyses (e.g., gene-protein assay) on tissue samples collected from study participants and consenting patients who failed screening. Of the 284 patients successfully screened for HER2 status (UBC, n = 69; PC/CC, n = 215), 13 with UBC, four with PC, and three with CC fulfilled eligibility criteria. Due to recruitment difficulty, the sponsor terminated KAMELEON prematurely. Of the five responders in the UBC cohort (overall response rate, 38.5%), HER2 expression was heterogeneous in two and homogeneous in three. The one responder in the PC/CC cohort had PC, and the tumor displayed homogeneous expression. In the biomarker-evaluable population, composed of screen-failed and enrolled patients, 24.3% (9/37), 1.5% (1/66), and 8.2% (4/49) of those with UBC, PC, or CC, respectively, had HER2-positive tumors. In a gene-protein assay combining in situ hybridization with immunohistochemistry, greater HER2 homogeneity was associated with increased ERBB2 amplification ratio. In conclusion, KAMELEON showed that some patients with HER2-positive UBC or PC can respond to T-DM1 and provided insight into the prevalence of HER2 positivity and expression patterns in three non-breast tumor types.
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Affiliation(s)
- Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Martijn Lolkema
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Josep Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), UVic-UCC, IOB-Quiron, Barcelona, Spain
| | | | - Emile Voest
- Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oncode Institute, Amsterdam, The Netherlands
| | - Derk Jan A de Groot
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daniel Castellano
- Medical Oncology Department, Hospital Universitario 12 de Octubre, i + 12 Research Institute, Madrid, Spain
| | - Gilles Erb
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Julia Naab
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | | | | | | | - Giuseppe Viale
- IEO, European Institute of Oncology IRCCS, Milan, Italy
- University of Milan, Milan, Italy
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Dobritoiu F, Baltan A, Chefani A, Billingham K, Chenard MP, Vaziri R, Lacroix-Triki M, Waydelich A, Erb G, Andersson E, Cañamero M, Toro P, Wedden S, D’Arrigo C. Tissue Selection for PD-L1 Testing in Triple Negative Breast Cancer (TNBC). Appl Immunohistochem Mol Morphol 2022; 30:549-556. [PMID: 36036647 PMCID: PMC9444286 DOI: 10.1097/pai.0000000000001053] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
Atezolizumab in combination with nab-paclitaxel has been introduced for the treatment of locally advanced or recurrent triple negative breast cancer (TNBC). Patient selection relies on the use of immunohistochemistry using a specific monoclonal PD-L1 antibody (clone SP142) in a tightly controlled companion diagnostic test (CDx) with a defined interpretative algorithm. Currently there are no standardized recommendations for selecting the optimal tissue to be tested and there is limited data to support decision making, raising the possibility that tissue selection may bias test results. We compared PD-L1 SP142 assessment in a collection of 73 TNBC cases with matched core biopsies and excision samples. There was good correlation between PD-L1-positive core biopsy and subsequent excision, but we found considerable discrepancy between PD-L1 negative core biopsy and matched excision, with a third of cases found negative on core biopsies converting to positive upon examination of the excision tissue. In view of these findings, we developed a workflow for the clinical testing of TNBC for PD-L1 and implemented it in a central referral laboratory. We present audit data from the clinical PD-L1 testing relating to 2 years of activities, indicating that implementation of this workflow results in positivity rates in our population of TNBC similar to those of IMpassion130 clinical trial. We also developed an online atlas with a precise numerical annotation to aid pathologists in the interpretation of PD-L1 scoring in TNBC.
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Affiliation(s)
- Florin Dobritoiu
- Poundbury Cancer Institute
- Department of Pathology, University Emergency Hospital, Bucharest, Romania
| | | | | | - Kim Billingham
- Department of Pathology, Great Western Hospital, Swindon, UK
| | | | - Reza Vaziri
- Department of Pathology, Worcestershire Acute Hospitals, Worcester, UK
| | | | - Anne Waydelich
- Oncology Medical and Government Affairs Roche Diagnostics EMEA-LATAM Region, Rotkreuz, Switzerland
| | - Gilles Erb
- Global Medical Affairs/PDMA, Roche Basel, Switzerland
| | - Emilia Andersson
- Oncology Medical and Government Affairs Roche Diagnostics EMEA-LATAM Region, Rotkreuz, Switzerland
| | - Marta Cañamero
- Oncology Medical and Government Affairs Roche Diagnostics EMEA-LATAM Region, Rotkreuz, Switzerland
| | - Paula Toro
- Clinical Development & Medical Affairs, Roche Diagnostics Solutions, Tucson
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Rody A, Chaudhary N, Craggs C, Debiasi M, Erb G, Fisher V, McCusker M, Snow T, Losada MV, Luhn P. Abstract 437: Comprehensive genomic profiling (CGP) in breast cancer (BC): Patterns and results from a clinico-genomic database. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-437] [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
Genomic testing is an important part of personalized oncology. This study explored testing patterns and results, as well as patient (pt) characteristics, in the BC setting.
Data from the nationwide, de-identified Flatiron Health (FH)-Foundation Medicine, Inc. (FMI) BC clinico-genomic database were included; pts had to have been treated in a FH network oncology practice and tested with a FMI CGP test. Pts were >18 years old and had a primary or metastatic BC (mBC) diagnosis between 1/1/2011 and 3/30/2020. Only pts with solid-tumor tissue of origin and solid-tumor assay tests were considered; pts whose tests occurred >120 days after their last visit (based on report date) were excluded. Pt cohorts were classified by timing of test result receipt: cohort 1, between primary diagnosis and <60 days after primary surgery, or <120 days post-diagnosis if no surgery recorded; cohort 2, between 60 days post-primary surgery and 60 days prior to mBC diagnosis, or >120 days post-diagnosis if no surgery recorded; cohort 3a, within 60 days prior to/after mBC diagnosis; and cohort 3b, >60 days after mBC diagnosis. Pt characteristics and actionable mutations according to the FMI report only (associated with sensitivity or resistance to ≥1 therapy) were described by cohort and BC subtype, defined at primary diagnosis for cohorts 1/2 and at mBC diagnosis for cohorts 3a/3b. Pt characteristics were compared with those of the FH cohort (not tested with next-generation sequencing or received other next-generation sequencing tests).
Overall, 4183 pts were included: 285 in cohort 1, 412 in cohort 2, and 3486 in cohorts 3a/3b. There was an overrepresentation of triple-negative BC (TNBC) among pts tested in the early setting (cohorts 1/2) vs the underlying population (33%/32% vs 10%), and an underrepresentation of hormone receptor (HR)-positive/HER2-negative BC (45%/48% vs 71%). TNBC remained overrepresented among pts tested at mBC diagnosis (cohort 3a; 30% vs 11%), but not during mBC follow-up (cohort 3b; 14% vs 11%), which followed the underlying FH distribution. The majority of patients were tested using samples collected within their respective test windows: 100% in cohort 1, 63% in cohort 2, and 78% and 46% in cohorts 3a/3b. For pts tested in the mBC setting, 22% and 15% in cohorts 3a and 3b, respectively, were tested using tissue collected >60 days prior to mBC diagnosis. Percentages of pts with at least one FMI-report-actionable alteration ranged from 94% (n = 601) in HER2-positive samples to 75% (n = 668) in pts with TNBC.
Among this BC cohort, FMI-CGP predominantly occurred in the mBC setting, and use of archival tissue for CGP occurred in later lines of treatment. Testing, in particular prior to mBC diagnosis, reflected a disproportionately higher prevalence of pts with TNBC, potentially due to there being fewer satisfactory treatment options in this setting. The distribution of actionable alterations varied by HER2 and HR status.
Citation Format: Achim Rody, Nayan Chaudhary, Christopher Craggs, Marcio Debiasi, Gilles Erb, Virginia Fisher, Margaret McCusker, Tamara Snow, Maria Vidal Losada, Patricia Luhn. Comprehensive genomic profiling (CGP) in breast cancer (BC): Patterns and results from a clinico-genomic database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 437.
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Affiliation(s)
- Achim Rody
- 1Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | | | | | | | - Gilles Erb
- 3F. Hoffmann-La Roche Ltd, Basel, Switzerland
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5
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Cabillic F, Hofman P, Ilie M, Peled N, Hochmair M, Dietel M, Von Laffert M, Gosney JR, Lopez-Rios F, Erb G, Schalles U, Barlesi F. ALK IHC and FISH discordant results in patients with NSCLC and treatment response: for discussion of the question-to treat or not to treat? ESMO Open 2018; 3:e000419. [PMID: 30245863 PMCID: PMC6144904 DOI: 10.1136/esmoopen-2018-000419] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/20/2018] [Accepted: 07/20/2018] [Indexed: 11/03/2022] Open
Abstract
Introduction Lung cancer is the most common cancer worldwide. Latest guidelines from the College of American Pathologist and the European society of medical oncologists indicate anaplastic lymphoma kinase (ALK) rearrangement testing is standard practice. Historically, diagnostics for ALK used fluorescence in situ hybridisation (FISH); however, immunohistochemical (IHC) assays are becoming common practice. Unfortunately, recent assessment of current practice indicated that not all patients who should be tested for ALK translocation are undergoing ALK testing. Methods From a series of European and Israeli labs, we collected patients with discordant IHC and FISH testing, which were subsequently treated with ALK-targeted therapy, for discussion of the question, to treat or not to treat? Results Our study may support ALK IHC testing as a better predictor of response to targeted therapy provided that the labs implement controlled preanalytical procedures, use correct clone, run protocols on automated staining platforms and validate using external quality assessments.
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Affiliation(s)
- Florian Cabillic
- Department of Cytogenetics and Cell Biology, CHU de Rennes, INSERM INRA, Université de Rennes 1, Université Bretagne Loire, Nutrition Metabolisms and Cancer, Rennes, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology and Hospital-Integrated Biobank, Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology and Hospital-Integrated Biobank, Nice, France
| | - Nir Peled
- Davidoff Cancer Center, Rabin Medical Center, Tel Aviv, Israel
| | | | | | | | - John R Gosney
- Department of Pathology, Royal Liverpool University Hospital, Liverpool, UK
| | | | | | - Uwe Schalles
- Roche Diagnostics Deutschland GmbH, Munich, Germany
| | - Fabrice Barlesi
- CNRS, INSERM, CRCM, APHM, Multidisciplinary Oncology & Therapeutic Innovations, Aix Marseille University, Marseille, France
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Ilié M, Beaulande M, Ben Hadj S, Chamorey E, Schiappa R, Long-Mira E, Lassalle S, Butori C, Cohen C, Leroy S, Guérin O, Mouroux J, Marquette CH, Pomerol JF, Erb G, Hofman V, Hofman P. Chromogenic Multiplex Immunohistochemistry Reveals Modulation of the Immune Microenvironment Associated with Survival in Elderly Patients with Lung Adenocarcinoma. Cancers (Basel) 2018; 10:cancers10090326. [PMID: 30216999 PMCID: PMC6162494 DOI: 10.3390/cancers10090326] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 08/04/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 01/01/2023] Open
Abstract
With underrepresentation of elderly patients with lung adenocarcinoma (LADC) in anti-PD-1/PD-L1 clinical trials, better understanding of the interplay of PD-L1 and tumor-associated immune cells (TAICs) could assist clinicians in stratifying these patients for immunotherapy. One hundred and one patients with LADCs, stratified by age, were included for analysis of PD-L1 expression and density of TAICs expressing CD4, CD8, and CD33, by using multiplex chromogenic immunohistochemistry (IHC) assays and automated digital quantification. The CD4+/CD8+ ratio was significantly higher in elderly patients. In patients <75 years, the density of CD4+, CD8+, and PD-L1 in TAICs showed a positive significant correlation with PD-L1 expression in tumor cells (TCs), while a lower correlation was observed in the elderly population. In the latter, a high CD4+/CD8+ ratio, and combined PD-L1 expression ≥1% TCs with a low CD8+ density, low CD33+ density, and a high CD4+ density correlated to worse overall survival. We identified differences according to age in the CD4+/CD8+ ratio and in correlation between PD-L1 expression and the density of TAICs in LADC patients. Distinct groups of tumor microenvironments had an impact on the OS of elderly patients with LADC.
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Affiliation(s)
- Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, FHU OncoAge, Pasteur Hospital, 06000 Nice, France.
- CNRS, INSERM, IRCAN, FHU OncoAge, Université Côte d'Azur, Team 4, 06000 Nice, France.
- Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | - Mélanie Beaulande
- EMEA-LATAM Division, Roche Diagnostics France, 38240 Meylan, France.
| | - Saima Ben Hadj
- Imaging Analysis, Tribvn Healthcare, 92320 Châtillon, France.
| | - Emmanuel Chamorey
- Biostatistics Unit, FHU OncoAge, Antoine Lacassagne Comprehensive Cancer Center, 06189 Nice, France.
| | - Renaud Schiappa
- Biostatistics Unit, FHU OncoAge, Antoine Lacassagne Comprehensive Cancer Center, 06189 Nice, France.
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, FHU OncoAge, Pasteur Hospital, 06000 Nice, France.
- CNRS, INSERM, IRCAN, FHU OncoAge, Université Côte d'Azur, Team 4, 06000 Nice, France.
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, FHU OncoAge, Pasteur Hospital, 06000 Nice, France.
- CNRS, INSERM, IRCAN, FHU OncoAge, Université Côte d'Azur, Team 4, 06000 Nice, France.
| | - Catherine Butori
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, FHU OncoAge, Pasteur Hospital, 06000 Nice, France.
| | - Charlotte Cohen
- Department of Thoracic Surgery, FHU OncoAge, CHU Nice, Université Côte d'Azur, 06000 Nice, France.
| | - Sylvie Leroy
- Department of Pulmonary Medicine and Thoracic Oncology, Pasteur Hospital, Université Côte d'Azur, CHU Nice, FHU OncoAge, 06000 Nice, France.
| | - Olivier Guérin
- Department of Geriatric Medicine, Cimiez Hospital, Université Côte d'Azur, CHU Nice, FHU OncoAge, 06000 Nice, France.
| | - Jérôme Mouroux
- Department of Thoracic Surgery, FHU OncoAge, CHU Nice, Université Côte d'Azur, 06000 Nice, France.
| | - Charles-Hugo Marquette
- Department of Pulmonary Medicine and Thoracic Oncology, Pasteur Hospital, Université Côte d'Azur, CHU Nice, FHU OncoAge, 06000 Nice, France.
| | | | - Gilles Erb
- EMEA-LATAM Division, Roche Diagnostics France, 38240 Meylan, France.
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, FHU OncoAge, Pasteur Hospital, 06000 Nice, France.
- CNRS, INSERM, IRCAN, FHU OncoAge, Université Côte d'Azur, Team 4, 06000 Nice, France.
- Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, FHU OncoAge, Pasteur Hospital, 06000 Nice, France.
- CNRS, INSERM, IRCAN, FHU OncoAge, Université Côte d'Azur, Team 4, 06000 Nice, France.
- Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
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Ilie M, Beaulande M, Hamila M, Erb G, Hofman V, Hofman P. Automated chromogenic multiplexed immunohistochemistry assay for diagnosis and predictive biomarker testing in non-small cell lung cancer. Lung Cancer 2018; 124:90-94. [PMID: 30268486 DOI: 10.1016/j.lungcan.2018.07.037] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The current challenge in the management of non-small cell lung cancer (NSCLC) in pathology laboratories is to combine immunohistochemistry (IHC) and molecular approaches on increasingly smaller biopsies and the need to reserve a fair amount of tumor material for molecular analyses with increasingly larger panels. The latest lung cancer classification, especially in the setting of poorly differentiated tumors, requires an IHC workup to allow for accurate diagnosis and also to preserve as much tissue as possible for molecular testing. Thus, it is recommended to reduce use of the term NSCLC not otherwise specified as much as possible and classify tumors according to their specific histologic subtype. This implies limiting the number of tissue slides despite the existence of specific and sensitive biomarkers (ALK, ROS1, BRAF V600E, PD-L1) and the obligation to distinguish lung adenocarcinoma (TTF-1 positive) from squamous cell carcinoma (p40 positive). MATERIALS AND METHODS Samples from 18 patients with NSCLC, previously characterized for histologic and genomic/immune features, were included. Two multiplexed IHC assays were developed, for diagnosis and immunophenotyping including TTF1, p40, PD-L1, and pan-Keratin antibodies, and for molecular profiling panel including ALK, ROS1 and BRAF V600E antibodies. RESULTS We developed two sensitive multiplexed IHC assays to comprehensively characterize major NSCLC histotypes and FDA-cleared predictive biomarkers, without antigenicity loss, steric interference or increased cross-reactivity. The assays rely on standard antigen retrieval and automated staining protocols, limiting the need for validation strategies. CONCLUSION Our multiplexed IHC approach provides a unique sample-sparing tool to characterize limited tissue samples in lung oncology and making it an alternative method in the clinical setting for therapeutic decision making of advanced NSCLC, provided that validation in a larger population is performed.
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Affiliation(s)
- Marius Ilie
- Laboratory of Clinical and Experimental Pathology/ Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.
| | | | - Marame Hamila
- Laboratory of Clinical and Experimental Pathology/ Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Gilles Erb
- EMEA-LATAM division, Roche Diagnostics France, Meylan, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology/ Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology/ Hospital-Integrated Biobank (BB-0033-00025), CHU Nice, FHU OncoAge, Université Côte d'Azur, Nice, France.
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8
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Hofman P, Beaulande M, Ben Hadj S, Erb G, Pomerol JF, Lassalle S, Butori C, Long E, Washetine K, Guerin O, Guigay J, Mouroux J, Leroy S, Marquette CH, Hofman V, Ilie M. Automated brightfield multiplex immunohistochemistry to quantify biomarkers related to immune senescence: Relationships with survival in non-small cell lung cancer patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20500 Background: Elderly patients have an eroded immune characterized by a progressive decline in immune surveillance that favors infection and cancer development. Tumor cells can escape immune surveillance by upregulating inhibitory immune checkpoint such as PD-L1. High expression of PD-L1 was reported in association with CD8+T-cell exhaustion and increased levels of CD33+ myeloid-derived suppressor cells. Although low CD4/CD8 ratio is associated with increased mortality, the status of the CD4+T-cells as a clinical marker of immunosenescence is less well characterized in the field of aging. The aim of this study was to determine the presence of immunosenescence biomarkers according to age in non-small cell lung cancer (NSCLC) patients and to evaluate them as predictive biomarkers of patients’ outcome. Methods: One hundred NSCLC patients, matched by age (50 patients < 70 years, 50 patients ≥70 years) were included. An automated 4-Plex optical IHC assay was developed on the Discovery ULTRA automated stainer using monoclonal antibodies PD-L1 (SP263), CD4, CD8, and CD33. The stained slides were scanned with Nanozoomer HT 2.0 Scanner, and analyzed with Calopix software. Results: The CD4/CD8 ratio and PD-L1 expression in tumor and immune cells were significantly lower in elderly NSCLC patients ≥70 years than in age-paired patients, while absolute count of CD33+ was increased. Patients with CD4/CD8 ratio higher than two, high PD-L1 density and low CD33+ frequency achieved increase in median disease-free survival. Conclusions: Distribution of PD-L1, CD4, CD8, and CD33 cells was influenced by age in NSCLC patients. The proportion of CD8 + CD28- T cells, CD4+ T cells and CD4/CD8 ratio may be used as predictive biomarkers of anti-PD-L1 therapy efficacy in NSCLC patients. The automated 4-Plex IHC assay together with its respective digital analysis could serve as a tool for further characterizing tumors and their microenvironment and provide a better understanding of which patients may benefit from immunotherapy.
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Affiliation(s)
- Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | | | | | - Gilles Erb
- Roche Diagnostics France, EMEA-LATAM division, Meylan, France
| | | | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | - Catherine Butori
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | - Elodie Long
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | - Kevin Washetine
- Hospital-Related Biobank (BB-0033-00025), FHU OncoAge, University Côte d’Azur, Nice, France
| | - Olivier Guerin
- Department of Geriatric Medicine, Cimiez Hospital, FHU Oncoage, University Côte d’Azur, Nice, France
| | - Joel Guigay
- Department of Medical Oncology, Antoine Lacassagne Comprehensive Cancer Centre, FHU Oncoage, Nice, France
| | | | - Sylvie Leroy
- Department of Pneumology, Pasteur Hospital, FHU Oncoage, Nice, France
| | | | - Veronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
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Doucet M, Becker KF, Björkman J, Bonnet J, Clément B, Daidone MG, Duyckaerts C, Erb G, Haslacher H, Hofman P, Huppertz B, Junot C, Lundeberg J, Metspalu A, Lavitrano M, Litton JE, Moore HM, Morente M, Naimi BY, Oelmueller U, Ollier B, Parodi B, Ruan L, Stanta G, Turano P, Vaught J, Watson P, Wichmann HE, Yuille M, Zaomi M, Zatloukal K, Dagher G. Quality Matters: 2016 Annual Conference of the National Infrastructures for Biobanking. Biopreserv Biobank 2016; 15:270-276. [PMID: 27992240 DOI: 10.1089/bio.2016.0053] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Marika Doucet
- 1 BIOBANQUES Infrastructure, Inserm US13, Hôpital de la Pitié Salpêtrière , Paris, France
| | | | | | - Jacques Bonnet
- 4 Inserm U916, Institut Bergonié, Université de Bordeaux , Bordeaux, France
| | - Bruno Clément
- 1 BIOBANQUES Infrastructure, Inserm US13, Hôpital de la Pitié Salpêtrière , Paris, France .,5 Inserm UMR991, Rennes, France
| | | | | | | | | | - Paul Hofman
- 1 BIOBANQUES Infrastructure, Inserm US13, Hôpital de la Pitié Salpêtrière , Paris, France .,10 Hospital-Integrated Biobank (BB-0033-00025), FHU OncoAge, University of Nice Sophia Antipolis , Nice, France
| | | | | | - Joakim Lundeberg
- 13 Science for Life Laboratory, KTH Royal Institute of Technology , Stockholm, Sweden
| | - Andres Metspalu
- 14 Estonian Genome Center, University of Tartu , Tartu, Estonia
| | | | | | - Helen M Moore
- 17 National Cancer Institute Biorepositories and Biospecimen Research Branch (BBRB) , Rockville, Maryland
| | - Manuel Morente
- 18 Biobank Unit of the Spanish national cancer center (CNIO) , Madrid, Spain
| | | | | | - Bill Ollier
- 21 University of Manchester , Manchester, United Kingdom
| | - Barbara Parodi
- 22 Biological Resource Center of the National Institute for Cancer Research (IRCCS AOU San Martino-IST) , Genoa, Italy
| | | | | | | | - Jim Vaught
- 26 International Society for Biological and Environmental Repositories (ISBER) , Bethesda, Maryland
| | - Peter Watson
- 27 British Columbia Cancer Agency's Vancouver Island Cancer Center , Victoria, Canada
| | - H-Erich Wichmann
- 28 Helmholtz Zentrum München, Institute of Epidemiology II , Munich, Germany
| | - Martin Yuille
- 21 University of Manchester , Manchester, United Kingdom
| | - Myriam Zaomi
- 1 BIOBANQUES Infrastructure, Inserm US13, Hôpital de la Pitié Salpêtrière , Paris, France
| | | | - Georges Dagher
- 1 BIOBANQUES Infrastructure, Inserm US13, Hôpital de la Pitié Salpêtrière , Paris, France
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10
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Gerigk L, Kristen M, Hielscher T, Nagel AM, Essig M, Erb G, Weber MA. Moderne MRT-Techniken im Management von WHO Grad II Astrozytomen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Schunck T, Mathis A, Erb G, Namer IJ, Hode Y, Demazières A, Luthringer R. One milligram of lorazepam does not decrease anxiety induced by CCK-4 in healthy volunteers: investigation of neural correlates with BOLD MRI. J Psychopharmacol 2011; 25:52-9. [PMID: 20498136 DOI: 10.1177/0269881110367449] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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] [Indexed: 11/17/2022]
Abstract
Benzodiazepine effects on cholecystokinin tetrapeptide (CCK-4)-induced panic attack (PA) in humans are incompletely characterized, in particular on the neurofunctional level. This work explores the effects of lorazepam on brain activity and behavioral and physiological symptoms related to CCK-4-induced PA in healthy volunteers. Twenty-one male volunteers received 1 mg of lorazepam or placebo orally, 2 hours before an injection of 0.9% saline solution followed by 50 µg of CCK-4 during functional magnetic resonance imaging (fMRI) and heart rate recording. Panic attacks were defined using the panic symptom scale (PSS). In addition, the Y1-STAI (state anxiety) and the Bond & Lader Visual Analogue Scale (VAS) were used. Eleven subjects were classified as panickers. CCK-4 induced behavioral anxiety and cardiovascular effects along with cerebral activation in anxiety-related brain regions. Overall, lorazepam did not significantly modify the anxiogenic and cardiovascular effects of CCK-4. Regarding CCK-4-induced brain activation, lorazepam did not reduce activity in the insulae and cingulate gyrus of panickers. One milligram of lorazepam was not sufficient to reverse strong panicogenic effects, but decreased brain activity in the case of mild anxiety.
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12
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Schunck T, Mathis A, Erb G, Namer IJ, Demazières A, Luthringer R. Effects of lorazepam on brain activity pattern during an anxiety symptom provocation challenge. J Psychopharmacol 2010; 24:701-8. [PMID: 19460871 DOI: 10.1177/0269881109104864] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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] [Indexed: 01/16/2023]
Abstract
Human models of anxiety are useful to develop new effective anxiolytics. The objective of this study was to use functional magnetic resonance imaging (fMRI) to test the hypothesis that a single dose of lorazepam modifies brain activation during an anxiety challenge. Eighteen healthy male subjects underwent fMRI associated with a challenge based on the anticipation of aversive electrical stimulations after pretreatment, either with placebo or with 1.0 mg of oral lorazepam. Anxiety was rated before fMRI and after, referring to the threat condition periods, using State Trait Anxiety Inventory (STAI) and Hamilton scales. The conditioning procedure induced anxiety, as indicated by clinical rating score changes. Lorazepam did not modify anxiety rating as compared to placebo. Lorazepam reduced cerebral activity in superior frontal gyrus, anterior insula/inferior frontal gyrus and cingulate gyrus. The current finding provides the first evidence of the modulatory effects of an established anxiolytic agent on brain activation related to anticipatory anxiety.
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Affiliation(s)
- T Schunck
- FORENAP-FRP - MR Department, Rouffach, France.
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13
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Mathis A, Schunck T, Erb G, Namer IJ, Luthringer R. The effect of aging on the inhibitory function in middle-aged subjects: a functional MRI study coupled with a color-matched Stroop task. Int J Geriatr Psychiatry 2009; 24:1062-71. [PMID: 19418476 DOI: 10.1002/gps.2222] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [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] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The effects of aging on the inhibitory function are largely described in the neuroimaging literature but little data is available on the beginning of this age-related impairment. METHODS In this study, we described the cortical activation of middle-aged (mean age +/- standard error to the mean, 51.7 +/- 3.1) subjects compared to young (26.8 +/- 3.4) and elderly subjects (62.8 +/- 3) while they performed a color-matched Stroop task during functional magnetic resonance imaging. The task consisted in identifying the printing color of a word regardless of its meaning. Three conditions were defined depending on the meaning of this word; neutral (no meaning), congruent (color name matching the printing color), incongruent (color name mismatching the printing color), with interference effect in the latter. RESULTS Middle-aged subjects were as slow as elderly compared to young for all conditions and both were less accurate than young subjects during interference condition. Elderly showed an activity more bilateral and greater in the parietal lobule, the dorsolateral and ventrolateral prefrontal cortex (DLPFC, VLPFC) during both congruent and incongruent conditions compared to young. Middle-aged showed an intermediary level of activity between those of elderly and young subjects in the left DLPFC, VLPFC and parietal lobule only during incongruent condition. CONCLUSION These results suggested that the age-related impairment of the inhibitory process could already occur around the age of 50 years and consist in an increase of the activity in the left prefrontal and parietal cortex before increasing more and becoming bilateral around the age of 60 years.
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14
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Erb G, Elbayed K, Piotto M, Raya J, Neuville A, Mohr M, Maitrot D, Kehrli P, Namer I. Toward improved grading of malignancy in oligodendrogliomas using metabolomics. Magn Reson Med 2008; 59:959-65. [DOI: 10.1002/mrm.21486] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Aschoff P, Plathow C, Lichy MP, Öksüz MÖ, Erb G, Claussen CD, Pfannenberg C. FDG-PET/CT zur Beurteilung von Leberläsionen: Klinisch relevante Beeinflussung der CT-basierten Schwächungskorrektur durch Gabe von intravenösem Kontrastmittel mit hoher Jodkonzentration? ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Schunck T, Erb G, Mathis A, Jacob N, Gilles C, Namer IJ, Meier D, Luthringer R. Test–retest reliability of a functional MRI anticipatory anxiety paradigm in healthy volunteers. J Magn Reson Imaging 2008; 27:459-68. [DOI: 10.1002/jmri.21237] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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17
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Schunck T, Erb G, Mathis A, Gilles C, Namer IJ, Hode Y, Demaziere A, Luthringer R, Macher JP. Functional magnetic resonance imaging characterization of CCK-4-induced panic attack and subsequent anticipatory anxiety. Neuroimage 2006; 31:1197-208. [PMID: 16600640 DOI: 10.1016/j.neuroimage.2006.01.035] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2005] [Revised: 01/13/2006] [Accepted: 01/20/2006] [Indexed: 11/24/2022] Open
Abstract
The main objective of this work was to study the functional markers of the clinical response to cholecystokinin tetrapeptide (CCK-4). Twelve healthy male subjects were challenged with CCK-4 and simultaneously underwent functional magnetic resonance imaging (fMRI) recording. Since anticipatory anxiety (AA) is an intrinsic part of panic disorder, a behavioral paradigm, using the threat of being administered a second injection of CCK-4, has been developed to investigate induced AA. The study was composed of three fMRI scans according to an open design. During first and second scan, subjects were injected with placebo and CCK-4, respectively. The third scan was the AA challenge. CCK-4 administration induced physiological and psychological symptoms of anxiety that met the criteria for a panic attack in 8 subjects, as well as cerebral activation in anxiety-related brain regions. Clinical and physiological response intensity was consistent with cerebral activity extent and robustness. fMRI proved more sensitive than clinical assessment in evidencing the effects of the AA challenge. The latter induced brain activation, different from that obtained on CCK-4 and during placebo injection, that was likely related to anxiety. The method applied in this study is suitable for the study of anxiety using fMRI.
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Affiliation(s)
- Thérèse Schunck
- Forenap-Unité RMN, 27, rue du 4ème RSM, 68250 Rouffach, France.
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18
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Schick F, Pintaske J, Martirosian P, Graf H, Erb G, Lodemann KP, Claussen C. CMR 2005: 13.03: Relaxivity of gadopentetate dimeglumine, gadobutrol and gadobenate dimeglumine in human blood plasma at 0.2, 1.5 and 3 T. Contrast Media Mol Imaging 2006. [DOI: 10.1002/cmmi.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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Bültmann E, Erb G, Klose U, Ernemann U, Voigt K, Nägele T. Intraindividueller Vergleich von Gd-BOPTA (Multihance®) und Gd-DTPA (Magnevist®) in der kontrastangehobenen MR-Angiographie der Halsgefäße bei 3T. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Abstract
Regional brain iron levels of two patients with haemochromatosis and severe restless legs syndrome (RLS) were assessed using R2' magnetic resonance imaging (MRI) sequences in both patients and in nine healthy controls. R2' relaxation rates in the patients were decreased in the substantia nigra, red nucleus, and pallidum when compared with the controls. These results indicate that local brain iron deficiency may occur in patients with haemochromatosis and suggest a role for brain iron metabolism in the pathophysiology of RLS.
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Affiliation(s)
- J Haba-Rubio
- Institute for Research in Neurosciences and Neuropsychiatry, Rouffach, France.
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21
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Pintaske JP, Martirosian P, Graf H, Erb G, Lodemann KP, Schick F, Claussen CD. Vergleich konzentrationsabhängiger Relaxivitäten von Gadopentetate Dimeglumine (Magnevist), Gadobutrol (Gadovist) und Gadobenate Dimeglumine (MultiHance) im Blutplasma bei 0.2T, 1.5T und 3T. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Hansmann JH, Floßdorf P, Erb G, Grüber-Hoffmann B, Kauffmann GW. MRT des Morbus Crohn – Vergleich Histologie, Endoskopie und OP-Befund. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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23
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Schunck T, Erb G, Gilles C, Hode Y, Namer IJ, Fuder H, Luthringer R. fMRI in anxiety. Dialogues Clin Neurosci 2003. [PMID: 22033750 PMCID: PMC3181634 DOI: 10.31887/dcns.2003.5.3/tschunck] [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] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Thérèse Schunck
- FORENAP, Institute for Research in Neuroscience and Neuropsychiatry, BP 29, 68250 Rouffach, France
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Abstract
PURPOSE Evaluation of typical MRI-findings in patients with Crohn's disease receiving therapy. Correlation with the course of disease. PATIENTS AND METHODS 81 follow-up MRI-studies in 25 patients conducted within a period of 3 weeks to 4 years were evaluated retrospectively. Therapy consisted in various combinations of antibiotics and immunosuppressive agents and if necessary operation. The findings of the MRI-studies were correlated with clinical data (e.g.operation of Crohn's complications) and the subjective perception during therapy. RESULTS The morphological substrate of Crohn's disease in the Hydro-MRI images is reliably detected. Especially in a delineation of extraluminal changes MRI is superior to endoscopy and enteroclysis. Independent from clinical symptoms short- and mid-term follow-up showed inflammatory changes of the intestinal wall in all 25 patients. In 24/81 studies there was persistence or even progression of Crohn's disease in the MRI-studies, although patients were free of symptoms by the time of image acquisition. CONCLUSION Hydro-MRI is a modality for the evaluation of inflammatory changes in patients with Crohn's disease. Independent from clinical symptoms persistence of Crohn's disease is detectable.
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Affiliation(s)
- M Ganten
- Abt.Radiodiagnostik, Radiologische Uniklinik Heidelberg
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25
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Abstract
Chronic inflammatory bowel disease is diagnosed and monitored by the combination of colonoscopy and small bowel enteroklysis. Magnetic resonance imaging has become the gold standard for the imaging of perirectal and pelvic fistulas. With the advent of ultrafast MRI small and large bowel imaging has become highly attractive and is being advocated more and more in the diagnostic work up of inflammatory bowel disease. Imaging protocols include fast T1-weighted gradient echo and T2-weighted TSE sequences and oral or rectal bowel distension. Furthermore, dedicated imaging protocols are based on breath-hold imaging under pharmacological bowel paralysis and gastrointestinal MR contrast agents (Hydro-MRI). High diagnostic accuracy can be achieved in Crohn's disease with special reference to the pattern of disease, depth of inflammation, mesenteric reaction, sinus tract depiction and formation of abscess. In ulcerative colitis, the mucosa-related inflammation causes significantly less bowel wall thickening compared to Crohn's disease. Therefore with MRI, the extent of inflammatory changes is always underestimated compared to colonoscopy. According to our experience in more than 200 patients as well as the results in other centers, Hydro-MRI possesses the potential to replace enteroklysis in the diagnosis of chronic inflammatory bowel disease and most of the follow-up colonoscopies in Crohn's disease. Further technical improvements in 3D imaging will allow interactive postprocessing of the MR data.
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Affiliation(s)
- H J Hansmann
- Radiologische Klinik, Abteilung Röntgendiagnostik, Ruprecht-Karls-Universität, Heidelberg.
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26
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Benner T, Reimer P, Erb G, Schuierer G, Heiland S, Fischer C, Geens V, Sartor K, Forsting M. Cerebral MR perfusion imaging: first clinical application of a 1 M gadolinium chelate (Gadovist 1.0) in a double-blinded randomized dose-finding study. J Magn Reson Imaging 2000; 12:371-80. [PMID: 10992303 DOI: 10.1002/1522-2586(200009)12:3<371::aid-jmri1>3.0.co;2-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The purpose of this study was to evaluate efficacy and safety of the 1 M gadolinium chelate Gadovist 1.0 for assessment of cerebral hemodynamics with dynamic susceptibility contrast-enhanced magnetic resonance (MR) imaging. Eighty-nine patients with carotid artery stenosis or cerebral infarcts were included in this multicenter, double-blinded study using five dose groups from 0.1 to 0.5 mmol/kg. Imaging was performed with 1-T scanners using a T2*-weighted fast low-angle shot (FLASH) sequence. Dose-dependent changes in quantitative and qualitative parameters describing signal-time curves and relative regional cerebral blood volume maps were investigated. For safety evaluation, vital signs, clinical and laboratory tests, and adverse events were assessed. The quantitative measurements revealed an optimal dose of 0.4 mmol/kg. The qualitative evaluation revealed that the required qualitative assessment for clinical purposes was already reached at a dose of 0. 3 mmol/kg. No significant changes in vital signs and laboratory tests were found. No serious adverse events were observed. The combined results revealed the dose of 0.3 mmol/kg as the diagnostically adequate dose given the gradient-echo sequence and field strength used. Gadovist 1.0 has been shown to be a safe and well-tolerated contrast agent. J. Magn. Reson. Imaging 2000;12:371-380.
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Affiliation(s)
- T Benner
- Department of Neuroradiology, University of Heidelberg Medical School, D-69120 Heidelberg, Germany.
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27
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Abstract
PURPOSE In this study we investigated, whether increasing the dosage of a paramagnetic contrast agent results in a stronger signal decrease in T2*-weighted perfusion sequences and therefore more meaningful parameter maps. MATERIAL AND METHODS In a prospective study bolus injection of gadolinium-DTPA was performed at dosages of 0.1, 0.2, and 0.3 mmol/kg body weight (BW) in 10 patients each. Before, during and after bolus injection 40 T2*-weighted images of a reference brain slice were acquired within 65.6 seconds on a 1.0 T clinical scanner and perfusion parameters were calculated. RESULTS Due to the limited signal decrease during bolus passage and the resulting low signal-difference-to-noise ratio (delta S/N) no reliable differentiation of gray and white matter was possible at a contrast agent dosage of 0.1 mmol/kg BW. Only at higher dosages, both, signal decrease and delta S/N were strong enough to allow differentiation of gray and white matter and to yield reliable parameter maps. CONCLUSION For meaningful MR perfusion imaging at 1.0 T and with the given sequence a contrast agent dosage of at least 0.2 mmol/kg BW is necessary, if a 0.5-molar contrast agent is used.
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Affiliation(s)
- G Erb
- Abteilung Neuroradiologie, Universität Heidelberg
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28
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Reith W, Heiland S, Erb G, Benner T, Forsting M, Sartor K. Dynamic contrast-enhanced T2*-weighted MRI in patients with cerebrovascular disease. Neuroradiology 1997; 39:250-7. [PMID: 9144671 DOI: 10.1007/s002340050403] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Our purpose was to investigate the potential of dynamic susceptibility contrast-enhanced MRI in assessing regional haemodynamics in patients with cerebrovascular disease. T2*-weighted FLASH sequences were performed on a control group of 10 healthy subjects, 13 patients with unilateral stenosis or occlusion of the internal carotid artery and 6 patients with acute onset of neurological symptoms, the observed signal intensities being converted into concentration-time curves. A gamma-variate function was fitted to the measured concentration-time curves to eliminate effects of tracer recirculation. In each patient the two cerebral hemispheres were compared and the difference between the mean transit times and the percental change of the regional cerebral blood volume, calculated for each side. Patients with haemodynamically significant unilateral carotid obstruction can be divided into two subgroups: those with good and those with poor collateral supply. Patients with good collateral supply had a slight but not statistically significant increase in mean transit time and cerebral blood volume on the diseased side, whereas those with poor collaterals had a significant increase compared with the control group. In patients with acute onset of neurological symptoms perfusion maps clearly demonstrated the disturbed perfusion at a time when T2-weighted images were still normal. Perfusion imaging is a reliable and noninvasive method of assessing changes in cerebral perfusion in patients with unilateral carotid stenosis. This MR technique permits monitoring of haemodynamic changes during therapy and thus may become an alternative to SPECT and PET scanning. In patients with acute occlusion of a cerebral artery, perfusion imaging reveals the entire, perfusion deficit before conventional MRI and thus allows early intervention.
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Affiliation(s)
- W Reith
- Department of Neuroradiology, University of Heidelberg Medical School, Germany
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Morano I, Koehlen S, Haase H, Erb G, Baltas LG, Rimbach S, Wallwiener D, Bastert G. Alternative splicing and cycling kinetics of myosin change during hypertrophy of human smooth muscle cells. J Cell Biochem 1997; 64:171-81. [PMID: 9027578 DOI: 10.1002/(sici)1097-4644(199702)64:2<171::aid-jcb1>3.0.co;2-u] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We investigated in vivo expression of myosin heavy chain (MHC) isoforms, 17 kDa myosin light chain (MLC17), and phosphorylation of the 20 kDa MLC (MLC20) as well as mechanical performance of chemically skinned fibers of normal and hypertrophied smooth muscle (SM) of human myometrium. According to their immunological reactivity, we identified three MHC isoenzymes in the human myometrium: two SM-MHC (SM1 with 204 kDa and SM2 with 200 kDa), and one non-muscle specific MHC (NM with 196 kDa). No cross-reactivity was detected with an antibody raised against a peptide corresponding to a seven amino acid insert at the 25K/50K junction of the myosin head (a-25K/50K) in both normal and hypertrophied myometrium. In contrast, SM-MHC of human myomatous tissue strongly reacted with a-25K/50K. Expression of SM1/SM2/NM (%) in normal myometrium was 31.7/34.7/33.6 and 35.1/40.9/24 in hypertrophied myometrium. The increased SM2 and decreased NM expression in the hypertrophied state was statistically significant (P < 0.05). MHC isoform distribution in myomatous tissue was similar to normal myometrium (36.3/35.3/29.4). In vivo expression of MLC17a increased from 25.5% in normal to 44.2% in hypertrophied (P < 0.001) myometrium. Phosphorylation levels of MLC20 upon maximal Ca(2+)-calmodulin activation of skinned myometrial fibers were the same in normal and hypertrophied myometrial fibers. Maximal force of isometric contraction of skinned fibers (pCa 4.5, slack-length) was 2.85 mN/mm2 and 5.6 mN/mm2 in the normal and hypertrophied state, respectively (P < 0.001). Apparent maximal shortening velocity (Vmax(appt), extrapolated from the force-velocity relation) of myometrium rose from 0.13 muscle length s-1 (ML/s) in normal to 0.24 ML/s in hypertrophied fibers (P < 0.001).
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Affiliation(s)
- I Morano
- Max-Delbrück-Center for Molecular Medicine, Berlin-Buch, Germany
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Benner T, Heiland S, Erb G, Forsting M, Sartor K. Accuracy of gamma-variate fits to concentration-time curves from dynamic susceptibility-contrast enhanced MRI: influence of time resolution, maximal signal drop and signal-to-noise. Magn Reson Imaging 1997; 15:307-17. [PMID: 9201678 DOI: 10.1016/s0730-725x(96)00392-x] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Concentration-time curves derived from dynamic susceptibility-contrast enhanced magnetic resonance imaging are widely used to calculate cerebrovascular parameters. To exclude effects of recirculation, a non-linear regression method is used to fit a gamma-variate function to the concentration-time course. In previous studies the errors arising from the fitting procedure have not been quantified. In a computer simulation we investigate the uncertainties of parameters calculated from the fitted gamma-variate function, exploring the dependencies on signal-to-noise (SNR), time resolution (delta t), and maximal signal drop (MSD). Our study was performed to give a framework on how to design MR-sequences and choose contrast media and their application in order to yield concentration-time curves which allow a reliable performance of the gamma-variate fitting procedure. We recorded 396 concentration-time curves from regions of interest of 40 patients. The gamma-variate fitting procedure was applied to these curves resulting in 396 parameter sets. Ideal concentration-time curves as gamma-variate functions were generated from these sets with a given delta t, MSD, and SNR. Recirculation effect was simulated. Then the gamma-variate fitting was performed again. From ideal and simulated gamma-variate function the area and the normalized first moment were calculated. The uncertainties of the values calculated from the simulated curve relating to the values of the original one were determined. Increase of SNR decreases the involved errors. With SNR values of 100 and more there is only minor influence of delta t and MSD and the fitted curve approximates the original data very well. Smaller values of SNR lead to a stronger influence of delta t and MSD and a higher number of fitting failures. With increasing delta t the uncertainties also increase. Intermediate values of MSD (30% to 70%) yield the smallest errors while increasing or decreasing MSD yields an increase of uncertainty. To achieve low uncertainties in the calculation of cerebrovascular parameters from gamma-variate fits, delta t of the imaging sequence and MSD must be considered. This is more important the lower SNR is. The shown dependencies should be taken into account when choosing MR sequence parameters and application of contrast media.
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Affiliation(s)
- T Benner
- Department of Neuroradiology, University of Heidelberg Medical School, Germany.
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Abstract
We investigated the in vivo expression of myosin heavy chains (MHC) and myosin light chains (MLC) in the rat uterus during pregnancy and post partum (p. p.). According to their antigenic reactivity, we observed two smooth-muscle-specific MHC (SM-MHC) of 204 kDa and 200 kDa (SM1 and SM2 respectively) and one non-muscle-specific MHC band of 198 kDa (NM-MHC). Adult virgin female rats expressed SM1 and NM-MHC (65/35) but no SM2. During the first pregnancy NM-MHC expression decreased in favour of the SM1 form, the SM1/NM-MHC ratio being 82/12 after 20 days of pregnancy. SM2 is newly expressed in the first p. p. state, the SM1/SM2/NM-MHC ratio being 58/28/14 between 3 and 33 days p. p. During the second pregnancy, starting 34 days p. p., both SM2 and NM-MHC expression decreased, the SM1/SM2/NM-MHC ratio being 85/0/15 after 20 days of pregnancy. Two protein bands of approximately 154 kDa and 145 kDa (sodium dodecylsulphate electrophoresis), designated SMP1 and SMP2 respectively, with the same immunoreactivity as the SM-MHC were observed in vivo in the pregnant but not in the non-pregnant uterus. In addition, a Ca(2+)-independent protease, which uses MHC as substrate, is expressed in the pregnant but not in the non-pregnant rat uterus. Two isoforms of the 17-kDa MLC (LC17a and LC17b) exist in the rat uterus. Expression of the LC17a isoform increased during the first pregnancy from 46% in virgin rats to 65% in uteri of rats 20 days pregnant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- I Morano
- Department of Physiology II, University of Heidelberg, Germany
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