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Giaccherini M, Rende M, Gentiluomo M, Corradi C, Archibugi L, Ermini S, Maiello E, Morelli L, van Eijck CHJ, Cavestro GM, Schneider M, Mickevicius A, Adamonis K, Basso D, Hlavac V, Gioffreda D, Talar-Wojnarowska R, Schöttker B, Lovecek M, Vanella G, Gazouli M, Uno M, Malecka-Wojciesko E, Vodicka P, Goetz M, Bijlsma MF, Petrone MC, Bazzocchi F, Kiudelis M, Szentesi A, Carrara S, Nappo G, Brenner H, Milanetto AC, Soucek P, Katzke V, Peduzzi G, Rizzato C, Pasquali C, Chen X, Capurso G, Hackert T, Bueno-de-Mesquita B, Uzunoglu FGG, Hegyi P, Greenhalf W, Theodoropoulos GEE, Sperti C, Perri F, Oliverius M, Mambrini A, Tavano F, Farinella R, Arcidiacono PG, Lucchesi M, Bunduc S, Kupcinskas J, Di Franco G, Stocker S, Neoptolemos JP, Bambi F, Jamroziak K, Testoni SGG, Aoki MN, Mohelnikova-Duchonova B, Izbicki JR, Pezzilli R, Lawlor RT, Kauffmann EF, López de Maturana E, Malats N, Canzian F, Campa D. A pleiotropy scan to discover new susceptibility loci for pancreatic ductal adenocarcinoma. Mutagenesis 2024:geae012. [PMID: 38606763 DOI: 10.1093/mutage/geae012] [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: 01/25/2024] [Indexed: 04/13/2024] Open
Abstract
Pleiotropic variants (i.e., genetic polymorphisms influencing more than one phenotype) are often associated with cancer risk. A scan of pleiotropic variants was successfully conducted ten years ago in relation to pancreatic ductal adenocarcinoma susceptibility. However, in the last decade, genetic association studies performed on several human traits have greatly increased the number of known pleiotropic variants. Based on the hypothesis that variants already associated with a least one trait have a higher probability of association with other traits, 61,052 variants reported to be associated by at least one genome wide association study (GWAS) with at least one human trait were tested in the present study consisting of two phases (discovery and validation), comprising a total of 16,055 pancreatic ductal adenocarcinoma (PDAC) cases and 212,149 controls. The meta-analysis of the two phases showed two loci (10q21.1-rs4948550 (P=6.52×10-5) and 7q36.3-rs288762 (P=3.03×10-5) potentially associated with PDAC risk. 10q21.1-rs4948550 shows a high degree of pleiotropy and it is also associated with colorectal cancer risk while 7q36.3-rs288762 is situated 28,558 base pairs upstream of the Sonic Hedgehog (SHH) gene, which is involved in the cell differentiation process and PDAC etiopathogenesis. In conclusion, none of the single nucleotide polymorphisms (SNPs) showed a formally statistically significant association after correction for multiple testing. However, given their pleiotropic nature and association with various human traits including colorectal cancer, the two SNPs showing the best associations with PDAC risk merit further investigation through fine mapping and ad hoc functional studies.
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Affiliation(s)
- M Giaccherini
- Department of Biology, University of Pisa, Pisa, Italy
| | - M Rende
- Department of Biology, University of Pisa, Pisa, Italy
| | - M Gentiluomo
- Department of Biology, University of Pisa, Pisa, Italy
| | - C Corradi
- Department of Biology, University of Pisa, Pisa, Italy
| | - L Archibugi
- Digestive and Liver Disease Unit, Sant'Andrea Hospital, Rome, Italy
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRSSC San Raffaele Scientific Institute, Milan, Italy
| | - S Ermini
- Blood Transfusion Service, Azienda Ospedaliero Universitaria Meyer, Florence, Italy
| | - E Maiello
- Department of Oncology, Fondazione IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy
| | - L Morelli
- General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C H J van Eijck
- Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - G M Cavestro
- Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele, Milan, Italy
| | - M Schneider
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - A Mickevicius
- Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - K Adamonis
- Gastroenterology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Basso
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padua, Italy
| | - V Hlavac
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - D Gioffreda
- Division of Gastroenterology and Research Laboratory, Fondazione IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy
| | - R Talar-Wojnarowska
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - B Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - M Lovecek
- Department of Surgery I, University Hospital Olomouc, Olomouc, Czech Republic
| | - G Vanella
- Digestive and Liver Disease Unit, Sant'Andrea Hospital, Rome, Italy
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRSSC San Raffaele Scientific Institute, Milan, Italy
| | - M Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M Uno
- Center for Translational Research in Oncology (LIM24), Instituto Do Câncer Do Estado de São Paulo, (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - E Malecka-Wojciesko
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - P Vodicka
- Institute of Experimental Medicine, Czech Academy of Science, Prague, Czech Republic
- Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University in Prague, Prague, Czech Republic
| | - M Goetz
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M F Bijlsma
- Laboratory for Experimental Oncology and Radiobiology, Center for Experimental and Molecular Medicine, Amsterdam UMC and Cancer Center Amsterdam, Amsterdam, The Netherlands
- Oncode Institute, Amsterdam, The Netherlands
| | - M C Petrone
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRSSC San Raffaele Scientific Institute, Milan, Italy
| | - F Bazzocchi
- Department of Surgery, Fondazione IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy
| | - M Kiudelis
- Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary
| | - S Carrara
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - G Nappo
- Pancreatic Unit, Humanitas Clinical and Research Center IRCCS, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - H Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A C Milanetto
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padua, Italy
| | - P Soucek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - V Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - G Peduzzi
- Department of Biology, University of Pisa, Pisa, Italy
| | - C Rizzato
- Department of Biology, University of Pisa, Pisa, Italy
| | - C Pasquali
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padua, Italy
| | - X Chen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - G Capurso
- Digestive and Liver Disease Unit, Sant'Andrea Hospital, Rome, Italy
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRSSC San Raffaele Scientific Institute, Milan, Italy
| | - T Hackert
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - B Bueno-de-Mesquita
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - F G G Uzunoglu
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - W Greenhalf
- Institute for Health Research Liverpool Pancreas Biomedical Research Unit, University of Liverpool, Liverpool, United Kingdom
| | - G E E Theodoropoulos
- First Department of Propaedeutic Surgery, Hippocration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - C Sperti
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padua, Italy
| | - F Perri
- Division of Gastroenterology and Research Laboratory, Fondazione IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy
| | - M Oliverius
- Surgery Clinic Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - A Mambrini
- Oncological Department Massa Carrara, Azienda USL Toscana Nord Ovest, Carrara, Italy
| | - F Tavano
- Division of Gastroenterology and Research Laboratory, Fondazione IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy
| | - R Farinella
- Department of Biology, University of Pisa, Pisa, Italy
| | - P G Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRSSC San Raffaele Scientific Institute, Milan, Italy
| | - M Lucchesi
- Oncological Department Massa Carrara, Azienda USL Toscana Nord Ovest, Carrara, Italy
| | - S Bunduc
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Fundeni Clinical Institute, Bucharest, Romania
| | - J Kupcinskas
- Gastroenterology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - G Di Franco
- General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - S Stocker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - J P Neoptolemos
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - F Bambi
- Blood Transfusion Service, Azienda Ospedaliero Universitaria Meyer, Florence, Italy
| | - K Jamroziak
- Department of Hematology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - S G G Testoni
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRSSC San Raffaele Scientific Institute, Milan, Italy
| | - M N Aoki
- Laboratory for Applied Science and Technology in Health, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz), Curitiba, Brazil
| | | | - J R Izbicki
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Pezzilli
- County Medical Association of Potenza, Potenza, Italy
| | - R T Lawlor
- ARC-NET: Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy
| | - E F Kauffmann
- Division of General and Transplant Surgery, Pisa University Hospital, Pisa, Italy
| | - E López de Maturana
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - N Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - F Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Campa
- Department of Biology, University of Pisa, Pisa, Italy
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Affiliation(s)
- Margarethe Goetz
- Margarethe Goetz practices in neurology at Duke Raleigh Hospital in Raleigh, N.C. The author has disclosed no potential conflicts of interest, financial or otherwise
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Zurloh M, Goetz M, Herold T, Treckmann J, Markus P, Schumacher B, Albers D, Rink A, Rosery V, Zaun G, Kostbade K, Pogorzelski M, Ting S, Schmidt H, Stiens R, Wiesweg M, Schuler M, Kasper S, Virchow I. Impact of encorafenib on survival of patients with BRAF V600E-mutant metastatic colorectal cancer in a real-world setting. J Cancer Res Clin Oncol 2023; 149:12903-12912. [PMID: 37466791 PMCID: PMC10587317 DOI: 10.1007/s00432-023-05141-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Patients with BRAFV600E-mutant metastatic colorectal cancer (mCRC) have a dismal prognosis. The best strategies in these patients remain elusive. Against this background, we report the clinical course of patients with BRAFV600E-mutant mCRC to retrieve the best treatment strategy. PATIENTS AND METHODS Clinico-pathological data were extracted from the electronic health records. Kaplan-Meier method was used to estimate overall (OS) and progression-free survival (PFS). Objective response rate (ORR) was assessed according to RECIST 1.1. RESULTS In total, 51 patients were enrolled. FOLFOXIRI was administered to 12 patients; 29 patients received FOLFOX or FOLFIRI as first-line treatment. Median OS was 17.6 months. Median PFS with FOLFOXIRI (13.0 months) was significantly prolonged (HR 0.325) as compared to FOLFOX/FOLFIRI (4.3 months). However, this failed to translate into an OS benefit (p = 0.433). Interestingly, addition of a monoclonal antibody to chemotherapy associated with superior OS (HR 0.523). A total of 64.7% patients received further-line therapy, which included a BRAF inhibitor in 17 patients. Targeted therapy associated with very favourable OS (25.1 months). CONCLUSION Patients with BRAFV600E-mutated mCRC benefit from the addition of an antibody to first-line chemotherapy. Further-line treatment including a BRAF inhibitor has a dramatic impact on survival.
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Affiliation(s)
- M Zurloh
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Goetz
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
| | - T Herold
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - J Treckmann
- West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - P Markus
- Department of General Surgery and Traumatology, Elisabeth Hospital, Essen, Germany
| | - B Schumacher
- Department of Gastroenterology, Elisabeth Hospital, Essen, Germany
| | - D Albers
- Department of Gastroenterology, Elisabeth Hospital, Essen, Germany
| | - A Rink
- West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - V Rosery
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - G Zaun
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - K Kostbade
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - S Ting
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
- Institute of Pathology Nordhessen, Kassel, Germany
| | - H Schmidt
- Department of Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - R Stiens
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
- Medical Faculty, University Duisburg-Essen, Essen, Germany.
| | - I Virchow
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
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Lusk JB, Choi S, Clark AG, Johnson K, Ford CB, Greiner MA, Goetz M, Kaufman BG, O'Brien R, O'Brien EC. Dementia and Parkinson's disease diagnoses in electronic health records vs. Medicare claims data: a study of 101,980 linked patients. BMC Neurol 2023; 23:325. [PMID: 37700254 PMCID: PMC10496225 DOI: 10.1186/s12883-023-03361-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Medicare claims and electronic health record data are both commonly used for research and clinical practice improvement; however, it is not known how concordant diagnoses of neurodegenerative diseases (NDD, comprising dementia and Parkinson's disease) are in these data types. Therefore, our objective was to determine the sensitivity and specificity of neurodegenerative disease (NDD) diagnoses contained in structured electronic health record (EHR) data compared to Medicare claims data. METHODS This was a retrospective cohort study of 101,980 unique patients seen at a large North Carolina health system between 2013-2017, which were linked to 100% North and South Carolina Medicare claims data, to evaluate the accuracy of diagnoses of neurodegenerative diseases in EHRs compared to Medicare claims data. Patients age > 50 who were enrolled in fee-for-service Medicare were included in the study. Patients were classified as having or not having NDD based on the presence of validated ICD-CM-9 or ICD-CM-10 codes associated with NDD or claims for prescription drugs used to treat NDD. EHR diagnoses were compared to Medicare claims diagnoses. RESULTS The specificity of any EHR diagnosis of NDD was 99.0%; sensitivity was 61.3%. Positive predictive value and negative predictive value were 90.8% and 94.1% respectively. Specificity of an EHR diagnosis of dementia was 99.0%, and sensitivity was 56.1%. Specificity of an EHR diagnosis of PD was 99.7%, while sensitivity was 76.1%. CONCLUSIONS More research is needed to investigate under-documentation of NDD in electronic health records relative to Medicare claims data, which has major implications for clinical practice (particularly patient safety) and research using real-world data.
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Affiliation(s)
- Jay B Lusk
- Duke University School of Medicine, DUMC 3710, Durham, NC, 27710, USA.
- Duke University Fuqua School of Business, Durham, NC, USA.
- Department of Population Health Sciences, Duke University, Durham, NC, USA.
- Department of Neurology, Duke University, Durham, NC, USA.
| | - Sujung Choi
- Janssen Scientific Affairs, Inc, Titusville, NJ, USA
| | - Amy G Clark
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Kim Johnson
- Department of Neurology, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Cassie B Ford
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Melissa A Greiner
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | | | - Brystana G Kaufman
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | | | - Emily C O'Brien
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Department of Neurology, Duke University, Durham, NC, USA
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Rodler S, Goetz M, Graser A, Pal S, Vaishampayan U, Battle D, Staehler M. Patients experience with recurrence of renal cell carcinoma. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00523-7] [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: 02/12/2023]
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Patterson SL, Marcus M, Goetz M, Vaccarino V, Gooding HC. Depression and Anxiety Are Associated With Cardiovascular Health in Young Adults. J Am Heart Assoc 2022; 11:e027610. [PMID: 36533593 PMCID: PMC9798786 DOI: 10.1161/jaha.122.027610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Cardiovascular health (CVH) declines in young adulthood, and mood disorders commonly emerge during this life stage. This study examined the association between depression, anxiety, and CVH metrics among young adults. Methods and Results We conducted a cross-sectional analysis of participants aged 18 to 34 years who completed the Emory Healthy Aging Study Health History Questionnaire (n=875). We classified participants as having poor, intermediate, or ideal levels of the 8 CVH metrics using definitions set forth by the American Heart Association with adaptions when necessary. We defined depression and anxiety as absent, mild, or moderate to severe using standard cutoffs for Patient Health Questionnaire and General Anxiety Disorder scales. We used multivariable regression to examine the association between depression and anxiety and CVH, adjusting for age, sex, race and ethnicity, income, and education. The mean participant age was 28.3 years, and the majority identified as women (724; 82.7%); 129 (14.7%) participants had moderate to severe anxiety, and 128 (14.6%) participants had moderate to severe depression. Compared with those without anxiety, participants with moderate to severe anxiety were less likely to meet ideal levels of physical activity (adjusted prevalence ratio [aPR], 0.60 [95% CI, 0.44-0.82]), smoking (aPR, 0.90 [95% CI, 0.82-0.99]), and body mass index (aPR, 0.79 [95% CI, 0.66-0.95]). Participants with moderate to severe depression were less likely than those without depression to meet ideal levels of physical activity (aPR, 0.48 [95% CI, 0.34-0.69]), body mass index (aPR, 0.75 [95% CI, 0.61-0.91]), sleep (aPR, 0.79 [95% CI, 0.66-0.94]), and blood pressure (aPR, 0.92 [95% CI, 0.86-0.99]). Conclusions Anxiety and depression are associated with less ideal CVH in young adults. Interventions targeting CVH behaviors such as physical activity, diet, and sleep may improve both mood and CVH.
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Affiliation(s)
- Sierra L. Patterson
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNC
| | - Michele Marcus
- Department of EpidemiologyRollins School of Public HealthAtlantaGA,Department of Environmental HealthRollins School of Public HealthAtlantaGA
| | | | - Viola Vaccarino
- Department of EpidemiologyRollins School of Public HealthAtlantaGA
| | - Holly C. Gooding
- Department of PediatricsEmory University School of MedicineAtlantaGAUnited States,Children’s Healthcare of AtlantaAtlantaGA
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Lusk JB, Ford C, Clark AG, Greiner MA, Johnson K, Goetz M, Kaufman BG, Mantri S, Xian Y, O'Brien R, O'Brien EC. Racial/ethnic disparities in dementia incidence, outcomes, and health‐care utilization. Alzheimers Dement 2022. [DOI: 10.1002/alz.12891] [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] [Received: 02/25/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Jay B. Lusk
- Duke University School of Medicine Durham North Carolina USA
- Duke University Fuqua School of Business Durham North Carolina USA
| | - Cassie Ford
- Department of Population Health Sciences Duke University Durham North Carolina USA
| | - Amy G. Clark
- Department of Population Health Sciences Duke University Durham North Carolina USA
| | - Melissa A. Greiner
- Department of Population Health Sciences Duke University Durham North Carolina USA
| | - Kim Johnson
- Department of Neurology Duke University Durham North Carolina USA
- Department of Psychiatry and Behavioral Sciences Duke University Duke University Medical Center Durham North Carolina USA
| | - Margarethe Goetz
- Department of Neurology Duke University Durham North Carolina USA
| | - Brystana G. Kaufman
- Department of Population Health Sciences Duke University Durham North Carolina USA
| | - Sneha Mantri
- Department of Neurology Duke University Durham North Carolina USA
| | - Ying Xian
- Department of Neurology University of Texas‐Southwestern Dallas Texas USA
- Department of Population and Data Sciences University of Texas‐Southwestern Dallas Texas USA
| | - Richard O'Brien
- Department of Neurology Duke University Durham North Carolina USA
| | - Emily C. O'Brien
- Department of Population Health Sciences Duke University Durham North Carolina USA
- Department of Neurology Duke University Durham North Carolina USA
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Rodler S, Kopliku R, Tamalunas A, Goetz M, Berg E, Staehler M, Causcuelli J. Outcomes of patients with discontinuation of immunotherapy due to immune related adverse events (irAE). EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02549-6] [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: 11/11/2022] Open
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9
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Goetz M, Schröter J, Dattner T, Brennenstuhl H, Lenz D, Opladen T, Hörster F, Okun JG, Hoffmann GF, Kölker S, Staufner C. Genotypic and phenotypic spectrum of cytosolic phosphoenolpyruvate carboxykinase deficiency. Mol Genet Metab 2022; 137:18-25. [PMID: 35868242 DOI: 10.1016/j.ymgme.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Pathogenic biallelic variants in PCK1 coding for the cytosolic phosphoenolpyruvate carboxykinase (PEPCK-C) cause PEPCK-C deficiency, a rare disorder of gluconeogenesis presenting with hypoglycemia, lactic acidosis, and hepatopathy. To date, there has been no systematic analysis of its phenotypic, biochemical, and genetic spectrum. METHODS All currently published individuals and a novel patient with genetically confirmed PEPCK-C deficiency were included. Clinical, biochemical, and genetic findings were analyzed. Protein and in-silico prediction score modeling was applied to analyze potential variant effects. RESULTS Thirty-two individuals from 25 families were found, including one previously unreported patient. The typical biochemical pattern was hypoglycemia triggered by catabolic situations, elevated urinary concentrations of tricarboxylic acid cycle metabolites, mildly elevated alanine and aspartate aminotransferase and elevated lactate concentrations in serum. Plasma glutamine concentrations were elevated in some patients and may be a suitable marker for newborn screening. With adequate treatment, biochemical abnormalities usually normalized following a hypoglycemic episode. Symptom onset usually occurred in infancy with a broad range from neonatal age to adulthood. Regardless of the genotype, different phenotypes with a broad clinical spectrum were found. To date, eight genotypes with nine different PCK1 variants were identified, of which alleles with the recurrent variant c.925G > A; p.(Gly309Arg) are predominant and appear to be endemic in the Finnish population. Protein modeling suggests altered manganese- and substrate-binding as superordinate pathomechanisms. CONCLUSIONS Environmental factors appear to be the main determinant for the phenotype in patients with biallelic variants in PCK1. Based on the biochemical pattern, PEPCK-C deficiency is a recognizable cause of childhood hypoglycemia. It is a treatable disease and early diagnosis is important to prevent metabolic derailment and morbidity. Newborn screening can identify at least a sub-cohort of affected individuals through elevated glutamine concentrations in dry blood.
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Affiliation(s)
- M Goetz
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - J Schröter
- Division of Pediatric Epileptology, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - T Dattner
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - H Brennenstuhl
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - D Lenz
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - T Opladen
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - F Hörster
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - J G Okun
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - G F Hoffmann
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - S Kölker
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - C Staufner
- Division of Child Neurology and Metabolic Disorders, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany..
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10
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Ingenwerth M, Brandenburg T, Führer-Sakel D, Goetz M, Weber F, Dralle H, Schildhaus HU, Schmid KW, Theurer S. DLL3 (delta-like protein 3) expression correlates with stromal desmoplasia and lymph node metastases in medullary thyroid carcinomas. Endocr Connect 2021; 10:283-289. [PMID: 33617464 PMCID: PMC8052580 DOI: 10.1530/ec-20-0611] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 12/12/2022]
Abstract
Medullary thyroid carcinomas (MTC) are rare and aggressive neuroendocrine tumors of the thyroid. About 70% of MTC are sporadic; approximately 50% of those harbor somatic RET mutation. DLL3 is widely expressed in many neuroendocrine tumors and has been evaluated as a potential therapeutic target. Since stromal desmoplasia in sporadic MTC has been identified as a reliable predictor of aggressive behavior and development of lymph node metastases, a possible correlation of DLL3 expression with the presence of stromal desmoplasia was of particular interest. 59 paraffin-embedded samples of sporadic MTC with (44 cases) and without (15 cases) stromal desmoplasia and known lymph node status were included. DLL3 expression was determined by immunohistochemistry; no expression (0%), low expression (1-49%) and high expression (≥50%) were correlated with clinicopathological data. The proportion of DLL3 positivity was significantly correlated with both stromal desmoplasia (P < 0.0001) and lymph node metastases (P < 0.0001). MTC without stromal desmoplasia consistently lack DLL3 expression. This is the first study to focus on MTC regarding DLL3 expression and the relationship to various factors. Our results demonstrate that expression of DLL3 in MTC represents a reliable surrogate marker for stromal desmoplasia and lymph node metastases and might be an indicator for aggressive clinical behavior. DLL3 expression in ≥50% of tumor cells virtually excludes MTC without stromal desmoplasia. DLL3 was discussed as a potential therapeutic target in malignant tumors of other locations with positive immunohistochemical reaction and might therefore be a new therapeutic option in MTC, as well.
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Affiliation(s)
- M Ingenwerth
- Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany
| | - T Brandenburg
- Division of Laboratory Research, Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry, University Hospital Essen, University of Duisburg-Essen, Germany
| | - D Führer-Sakel
- Division of Laboratory Research, Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry, University Hospital Essen, University of Duisburg-Essen, Germany
| | - M Goetz
- Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany
| | - F Weber
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - H Dralle
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - H-U Schildhaus
- Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany
| | - K W Schmid
- Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany
| | - S Theurer
- Institute of Pathology, University Hospital of Essen, University of Duisburg–Essen, Essen, Germany
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11
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Nohuz E, Akoum V, Lamblin G, Goetz M, Lebail-Carval K, Chêne G. [How I do…the diagnosis of a cervical pregnancy]. Gynecol Obstet Fertil Senol 2021; 49:137-142. [PMID: 32659453 DOI: 10.1016/j.gofs.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Indexed: 06/11/2023]
Affiliation(s)
- E Nohuz
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France.
| | - V Akoum
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - G Lamblin
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - M Goetz
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - K Lebail-Carval
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - G Chêne
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France
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12
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Kulshreshtha A, Goetz M, Alonso A, Shah AJ, Bremner JD, Goldberg J, Vaccarino V. Association Between Cardiovascular Health and Cognitive Performance: A Twins Study. J Alzheimers Dis 2020; 71:957-968. [PMID: 31476151 PMCID: PMC6918828 DOI: 10.3233/jad-190217] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVE The 2020 Strategic Impact Goal introduced by the American Heart Association (AHA) aims at improving cardiovascular health (CVH) of all Americans by 20%. AHA defined ideal CVH across seven established modifiable risk factors for cardiovascular diseases. Prior studies have indicated that ideal CVH also benefits brain health and cognitive aging, but it is possible that this association is explained by familial factors. METHODS We examined 272 male monozygotic and dizygotic twin pairs (total 544 subjects) free of overt cardiovascular disease and dementia from the Vietnam Era Twin Registry. Memory and learning were measured by Trail Making tests and Wechsler Memory Scale (Immediate and Delayed Memory tests and Visual Reproductive Test). Each of the seven CVH components (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was scored per established criterion. RESULTS The mean age of the twins was 55 years, 96% were whites, and 61% monozygotic. When considering twins as individuals, for every unit increase in CVH score (indicating better cardiovascular health), twins demonstrated faster cognitive processing speed (Trail B: - 5.6 s, 95% CI - 10.3, - 0.9; p = 0.03) and better story recall, both immediate (0.35, 95% CI 0.06, 0.62; p = 0.02) and delayed (0.39, 95% CI 0.08, 0.70; p = 0.01). CONCLUSIONS Better CVH is associated with better cognitive health in several domains. As suggested by within-pair analysis, this association is largely explained by familial factors, implying that early life exposures are shared determinants of both brain health and cardiovascular health.
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Affiliation(s)
- Ambar Kulshreshtha
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Margarethe Goetz
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences and the Department of Radiology, Emory University School of Medicine, and the Atlanta VA Medical Center, Decatur, GA, USA
| | - Jack Goldberg
- Vietnam Era Twin Registry, Seattle, WA, USA.,University of Washington School of Public Health, Seattle, WA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
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13
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Schwen L, Nitsch J, Bauer S, Bertram S, Goetz M, Hamacher R, Hardes J, Homeyer A, Schacherer D, Streitbürger A, Höfener H, Schildhaus HU. 1659P AI-based grading approach identifies FNCLCC grade 3 soft tissue sarcomas. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1885] [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: 10/23/2022] Open
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14
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Moazzami K, Wittbrodt MT, Lima BB, Nye JA, Mehta PK, Pearce BD, Almuwaqqat Z, Hammadah M, Levantsevych O, Sun YV, Raggi P, Garcia EV, Goetz M, Quyyumi AA, Bremner JD, Vaccarino V, Shah AJ. Higher Activation of the Rostromedial Prefrontal Cortex During Mental Stress Predicts Major Cardiovascular Disease Events in Individuals With Coronary Artery Disease. Circulation 2020; 142:455-465. [PMID: 32522022 PMCID: PMC7677173 DOI: 10.1161/circulationaha.119.044442] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Psychological stress is a risk factor for major adverse cardiovascular events (MACE) in individuals with coronary artery disease. Certain brain regions that control both emotional states and cardiac physiology may be involved in this relationship. The rostromedial prefrontal cortex (rmPFC) is an important brain region that processes stress and regulates immune and autonomic functions. Changes in rmPFC activity with emotional stress (reactivity) may be informative of future risk for MACE. METHODS Participants with stable coronary artery disease underwent acute mental stress testing using a series of standardized speech/arithmetic stressors and simultaneous brain imaging with high-resolution positron emission tomography brain imaging. We defined high rmPFC activation as a difference between stress and control scans greater than the median value for the entire cohort. Interleukin-6 levels 90 minutes after stress, and high-frequency heart rate variability during stress were also assessed. We defined MACE as a composite of cardiovascular death, myocardial infarction, unstable angina with revascularization, and heart failure hospitalization. RESULTS We studied 148 subjects (69% male) with mean±SD age of 62±8 years. After adjustment for baseline demographics, risk factors, and baseline levels of interleukin-6 and high-frequency heart rate variability, higher rmPFC stress reactivity was independently associated with higher interleukin-6 and lower high-frequency heart rate variability with stress. During a median follow-up of 3 years, 34 subjects (21.3%) experienced a MACE. Each increase of 1 SD in rmPFC activation with mental stress was associated with a 21% increase risk of MACE (hazard ratio, 1.21 [95% CI, 1.08-1.37]). Stress-induced interleukin-6 and high-frequency heart rate variability explained 15.5% and 32.5% of the relationship between rmPFC reactivity and MACE, respectively. Addition of rmPFC reactivity to conventional risk factors improved risk reclassification for MACE prediction, and C-statistic improved from 0.71 to 0.76 (P=0.03). CONCLUSIONS Greater rmPFC stress reactivity is associated with incident MACE. Immune and autonomic responses to mental stress may play a contributory role.
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Affiliation(s)
- Kasra Moazzami
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Matthew T. Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Bruno B. Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Jonathon A. Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Puja K. Mehta
- Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Zakaria Almuwaqqat
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Muhammad Hammadah
- Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Oleksiy Levantsevych
- Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Yan V. Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute and the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Ernest V Garcia
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Margarethe Goetz
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Arshed A. Quyyumi
- Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - J. Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA,Atlanta VA Medical Center, Decatur, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA,Atlanta VA Medical Center, Decatur, GA
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15
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Pounder KC, Mukhida F, Brown RP, Carter D, Daltry JC, Fleming T, Goetz M, Halsey LG, Hughes G, Questel K, Saccheri IJ, Williams R, Soanes LM. Testing for hybridisation of the Critically Endangered Iguana delicatissima on Anguilla to inform conservation efforts. CONSERV GENET 2020. [DOI: 10.1007/s10592-020-01258-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractThe Caribbean Island of Anguilla in the north-eastern Lesser Antilles is home to one of the last populations of the Critically Endangered Lesser Antillean iguana Iguana delicatissima. This population is highly threatened primarily because of hybridisation with non-native Iguana iguana. This study assesses the degree of hybridisation between Anguilla’s Iguana species firstly using morphological characteristics and then genetic analysis to validate the genetic integrity of morphologically identified I. delicatissima. We also examined the genetic diversity of Anguilla’s I. delicatissima population, and that of a population on the nearby island of Îlet Fourchue, St Barthélemy. Forty-five iguanas were captured in Anguilla and 10 in St Barthélemy, and sequences from 3 nuclear and 1 mtDNA genes were obtained for each. Of the 45 iguanas captured in Anguilla, 22 were morphologically identified as I. delicatissima, 12 as I. iguana and the remainder were identified as hybrids. Morphological assignments were all confirmed by genetic analyses except for one I. iguana and one hybrid individual. These two individuals appeared likely to have originated following ancestral hybridisation events several generations ago. A significant paucity of genetic diversity was found within Anguillan and St Barthélemy I. delicatissima populations, with a single haplotype being identified for each of the three nuclear genes and the mtDNA sequence. This study highlights the urgency for immediate action to conserve Anguilla’s remnant I. delicatissima population. Protection from hybridisation will require translocation to I. iguana-free offshore cays, with supplementary individuals being sourced from neighbouring islands to enhance the genetic diversity of the population.
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16
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Wiesweg M, Mairinger F, Reis H, Goetz M, Walter RFH, Hager T, Metzenmacher M, Eberhardt WEE, McCutcheon A, Köster J, Stuschke M, Aigner C, Darwiche K, Schmid KW, Rahmann S, Schuler M. Machine learning-based predictors for immune checkpoint inhibitor therapy of non-small-cell lung cancer. Ann Oncol 2019; 30:655-657. [PMID: 30753264 DOI: 10.1093/annonc/mdz049] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- M Wiesweg
- Department of Medical Oncology, West German Cancer Center; Division of Thoracic Oncology, Ruhrlandklinik; Genome Informatics, Institute of Human Genetics
| | - F Mairinger
- Institute of Pathology, West German Cancer Center
| | - H Reis
- Institute of Pathology, West German Cancer Center
| | - M Goetz
- Institute of Pathology, West German Cancer Center
| | - R F H Walter
- Institute of Pathology, West German Cancer Center
| | - T Hager
- Institute of Pathology, West German Cancer Center
| | - M Metzenmacher
- Department of Medical Oncology, West German Cancer Center
| | - W E E Eberhardt
- Department of Medical Oncology, West German Cancer Center; Division of Thoracic Oncology, Ruhrlandklinik
| | - A McCutcheon
- Department of Medical Oncology, West German Cancer Center
| | - J Köster
- Genome Informatics, Institute of Human Genetics
| | - M Stuschke
- Department of Radiotherapy, West German Cancer Center
| | - C Aigner
- Department of Thoracic Surgery and Endoscopy, Ruhrlandklinik
| | - K Darwiche
- Department of Pulmonary Medicine, Section of Interventional Pneumology, Ruhrlandklinik - University Hospital Essen, University Duisburg-Essen, Essen
| | - K W Schmid
- Institute of Pathology, West German Cancer Center; German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany
| | - S Rahmann
- Genome Informatics, Institute of Human Genetics
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center; Division of Thoracic Oncology, Ruhrlandklinik; German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany.
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17
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Aspros K, Nelson A, Ye Z, Sun Z, Chernukhin I, Carroll J, Ingle J, Goetz M, Hawse J. Abstract P5-05-03: Estrogen receptor beta elicits anti-cancer effects in triple negative breast cancer through suppression of NFκB signaling. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-05-03] [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
Background: Triple Negative Breast Cancer (TNBC) affects approximately 15-20% of BC patients, yet accounts for a disproportionately higher rate of BC morbidity and mortality, in part due to lack of targeted therapies. Using well-validated antibodies, Estrogen Receptor Beta (ERβ) protein has been shown to be expressed in approximately 25% of TNBCs and is associated with improved patient outcomes. Using multiple ERβ +/- TNBC cell lines and PDX models, we have demonstrated that ligand-mediated activation of ERβ by estradiol (E2) decreases cell proliferation, invasion, and migration in vitro, as well as primary tumor growth and metastatic spread in vivo.
Methods: To determine the mechanisms by which ERβ elicits these anti-cancer effects, we elucidated the ERβ transcriptome and cistrome via Microarray and ChIPseq, respectively, in TNBC cells stably expressing ERβ in a doxycycline-inducible manner. We also performed gene expression and luciferase assays to assess the impact of ERβ on NFκB signaling, followed by ChIP-PCR and ChIPseq to assess how ERβ modifies chromatin architecture near NFκB target genes.
Results: Pathway analysis of ERβ-regulated genes identified NFκB signaling as one of the most suppressed pathways in response to E2 treatment. Indeed, numerous NFκB target genes were among the most down-regulated genes following E2 treatment but only in the presence of ERβ expression. Chromatin Immunoprecipitation followed by sequencing (ChIPseq) revealed that ERβ primarily associated with estrogen response elements (EREs), but was also enriched around NFκB binding sites following E2 treatment. In fact, 12% of all ERβ binding sites were enriched for NFκB response elements and ERβ was shown to physically associate with NFκB protein. Using an NFκB reporter construct and qPCR, ERβ was shown to block TNFα-mediated induction of NFκB signaling and NFκB target gene expression. Globally, RNAseq identified 200 genes to be significantly regulated by TNFα in TNBC cells, of which 81 were significantly altered in the presence of E2+TNFα. ChIPseq demonstrated that ligand-mediated activation of ERβ significantly diminished an activating histone mark (H3K27Ac) at many of these NFκB target genes while enhancing a repressive mark (H3K27Me3). These modifications are also associated with recruitment of the histone methyltransferase, EZH2, to enhancer elements of these NFκB target genes. Drug-mediated blockade of HDAC and EZH2 activity reversed suppression of NFκB target gene expression by ERβ.
Conclusions: Our data suggest that ERβ may elicit its anti-cancer effects in part via formation of a novel co-repressor complex consisting of ERβ, NFκB, and EZH2. These data are in keeping with prior observations of the importance of NFκB signaling as it relates to TNBC cell proliferation and invasion, and that decreased expression of NFκB target genes is associated with improved outcomes in TNBC patients. Currently, a Mayo Breast SPORE prospective study is underway to investigate the role of estradiol in ERβ expressing TNBC and to further evaluate the cross-talk between ERβ and NFκB signaling in TNBC.
Citation Format: Aspros K, Nelson A, Ye Z, Sun Z, Chernukhin I, Carroll J, Ingle J, Goetz M, Hawse J. Estrogen receptor beta elicits anti-cancer effects in triple negative breast cancer through suppression of NFκB signaling [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-05-03.
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Affiliation(s)
- K Aspros
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - A Nelson
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - Z Ye
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - Z Sun
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - I Chernukhin
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - J Carroll
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - J Ingle
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - M Goetz
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
| | - J Hawse
- Mayo Clinic, Rochester, MN; Cambridge Research Institute, Cambridge, United Kingdom
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18
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Metzger-Filho O, Mandrekar S, Loibl S, Ciruelos E, Gianni L, Lim E, Miller K, Huang C, Koehler M, Francis P, Valagussa P, Goel S, Prat A, Goetz M, Loi S, Krop I, Carey L, Lanzillotti J, Winer E, Tripathy D, DeMichele A. Abstract OT3-05-07: PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2 positive metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-05-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Pre-clinical data and initial results from clinical studies point to the added benefit of CDK4/6 inhibition when combined with anti-HER2 tx. The current study is designed to evaluate the added benefit of palbociclib when given in combination with anti-HER2 and endocrine tx maintenance in the 1st†line setting of metastatic HER2+HR+ breast cancer.
Trial design
PATINA is an international, open-label, pivotal Phase III study. Primary objective is to demonstrate that the combination of palbociclib with anti-HER2 plus endocrine tx is superior to anti-HER2 plus endocrine tx in prolonging PFS. Sample size is 496 pts. The study starts after completion of 6-8 cycles of chemotherapy-containing anti-HER2 tx for metastatic breast cancer in the 1st line setting. Pts are eligible provided they are without evidence of disease progression by local assessment (i.e. CR, PR or SD). To account for the need for less intense tx regimens for a subset of pts diagnosed with HER2+ER+ disease, clinicians may recommend the combination of trastuzumab with either a taxane or vinorelbine prior to study initiation. Clinicians might also choose a non-pertuzumab option for pts previously treated with pertuzumab in the neo(adjuvant) setting. Secondary objectives include measures of tumor control (OR, CBR, DOR), OS, safety and QOL. The translational science main objective is to compare PFS estimates according to PIK3CA mutation status assessed by cfDNA analysis. Endocrine tx options are AI or fulvestrant. Premenopausal pts must receive ovarian suppression. The study has a 90% power to detect a hazard ratio of 0.667 in favor of the palbociclib arm. Pts approached to participate in AFT-38 will be asked to indicate on the informed consent forms whether remaining biospecimens and clinical data from the control arm of the study can be shared with the Mastering Breast Cancer (MBC) Initiative. The overarching purpose of the MBC is to create a mechanism for understanding the natural history of metastatic breast cancer by cataloguing longitudinally studied tumor-specific markers and treatment effects.
ClinicalTrials.gov Identifier: NCT02947685
Citation Format: Metzger-Filho O, Mandrekar S, Loibl S, Ciruelos E, Gianni L, Lim E, Miller K, Huang C, Koehler M, Francis P, Valagussa P, Goel S, Prat A, Goetz M, Loi S, Krop I, Carey L, Lanzillotti J, Winer E, Tripathy D, DeMichele A. PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2 positive metastatic breast cancer [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 OT3-05-07.
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Affiliation(s)
- O Metzger-Filho
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Mandrekar
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Loibl
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Ciruelos
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - L Gianni
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Lim
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - K Miller
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - C Huang
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - M Koehler
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - P Francis
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - P Valagussa
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Goel
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - A Prat
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - M Goetz
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Loi
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - I Krop
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - L Carey
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - J Lanzillotti
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Winer
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - D Tripathy
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - A DeMichele
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
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Jackson G, Goetz M, Goldstein F, Loring D, John S. A-06Mental Health and Demographic Characteristics, But Not Parental History, Influence Subjective Ratings of Cognitive Functioning. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Goetz M, Schach C, Maier L, Endemann D, Wagner S. P1092ROS-dependent store-operated Ca entry does not increase diastolic Ca in isolated ventricular myocytes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1092] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Goetz M, Heller A, Zausig Y, Schach C, Maier L, Wagner S. P3493Dexamethasone improves cardiac contractile force via SOCE activation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3493] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Markwardt N, Berg A, Dominik N, Goetz M, Haj-Hosseini N, Polzer C, Sroka R, Stepp H, Zelenkov P, Rühm A. Optical spectroscopy for stereotactic biopsy of brain tumors. Photodiagnosis Photodyn Ther 2017. [DOI: 10.1016/j.pdpdt.2017.01.165] [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: 11/29/2022]
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Cairns J, Ingle J, Dudenkov T, Kalari K, Buzdar A, Kubo M, Robson M, Ellis M, Goss P, Shepherd L, Goetz M, Weinshilboum R, Wang L. Abstract PD1-04: CSMD1 SNPs selectively affect anastrozole response in postmenopausal breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-pd1-04] [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: Based on prospective clinical trials, there is no evidence for differences in efficacy between the 3 aromatase inhibitors (AIs) anastrozole, exemestane, and letrozole. The purpose of this study was to identify germline genetic variants associated with response to AIs and to help identify novel mechanisms associated with drug disease efficacy.
METHODS: A genome-wide association study (GWAS) was performed for 624 patients (Steroids 2015;99:32-38) to identify SNPs associated with estrogen level change in women with estrogen receptor (ER) positive breast cancer treated with anastrozole. Replication of associated SNPs was performed in a GWAS from the MA.27 trial that compared adjuvant anastrozole and exemestane treatment of post-menopausal women with ER+ breast cancer. Functional studies were subsequently performed to determine SNP effects and underlying mechanisms.
RESULTS: Our initial GWAS identified SNPs within CSMD1 that were associated with changes in estrogen levels during anastrozole therapy. An additional SNP in CSMD1 was also associated with breast cancer events in CCTG MA.27. Functionally, we showed that CSMD1 regulates CYP19 expression in a SNP-, and in an anastrozole- dependent fashion. These phenomena were not observed for either letrozole or exemestane. In MA.27, an anastrozole- specific effect was also seen with the minor allele having a protective effect on time to distant metastasis (HR=0.49, p=0.00259), but this was not the case for exemestane (HR=0.71, p=0.111). Our in vitro functional studies indicated that overexpression of CSMD1 sensitized anastrozole or letrozole resistant cells to anastrozole but not to the other two AIs. The SNP in CSMD1 that was associated with increased CSMD1 and CYP19 expression levels increased anastrozole sensitivity, but not letrozole or exemestane in lymphoblastoid cell lines (LCLs) homozygous for either WT or variant CSMD1 SNP genotypes. Based on these observations, we explored whether anastrozole has additional mechanisms beyond its function as a CYP19 inhibitor. Utilizing an estrogen response element (ERE) luciferase reporter assay in a CYP19 CRISPR knockout breast cancer T47D cell line and a surface plasmon resonance (SPR) assay, we found that anastrozole can also function as an ERα agonist, and can bind to, and result in, proteasome dependent ERα degradation, especially in the presence of E2. Treatment of these CYP19 CRISPR knockout cells with anastrozole in the presence of increasing concentrations of E2 results in greater sensitivity compared with anastrozole alone, while the addition of E2, as expected, does not improve letrozole or exemestane sensitivity. These same observations were also seen in letrozole and anastrazole resistant cells.
CONCLUSIONS: Our findings suggest that anastrozole might be more effective than letrozole or exemestane in patients with the CSMD1 SNP. Furthermore, anastrozole can function as an ERα agonist, binding to ERα and resulting in its degradation, especially in the presence of E2. These findings should help to make it possible to develop precision endocrine therapies for women who are candidates for AIs.
Citation Format: Cairns J, Ingle J, Dudenkov T, Kalari K, Buzdar A, Kubo M, Robson M, Ellis M, Goss P, Shepherd L, Goetz M, Weinshilboum R, Wang L. CSMD1 SNPs selectively affect anastrozole response in postmenopausal breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD1-04.
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Affiliation(s)
- J Cairns
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - J Ingle
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - T Dudenkov
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - K Kalari
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - A Buzdar
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - M Kubo
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - M Robson
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - M Ellis
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - P Goss
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - L Shepherd
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - M Goetz
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - R Weinshilboum
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
| | - L Wang
- Mayo Clinic, Rochester, MN; The University of Texas MD Anderson Cancer Center, Houston, TX; Riken Center for Integrative Medical Science, Yokohama, Japan; Memorial Sloan Kettering Cancer Center, New York, NY; Baylor Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Kingston, ON, Canada
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Eichler R, Asai M, Brand H, Chiera N, Di Nitto A, Dressler R, Düllmann C, Even J, Fangli F, Goetz M, Haba H, Hartmann W, Jäger E, Kaji D, Kanaya J, Kaneya Y, Khuyagbaatar J, Kindler B, Komori Y, Kraus B, Kratz J, Krier J, Kudou Y, Kurz N, Miyashita S, Morimoto K, Morita K, Murakami M, Nagame Y, Ooe K, Piguet D, Sato N, Sato T, Steiner J, Steinegger P, Sumita T, Takeyama M, Tanaka K, Tomitsuka T, Toyoshima A, Tsukada K, Türler A, Usoltsev I, Wakabayashi Y, Wang Y, Wiehl N, Wittwer Y, Yakushev A, Yamaki S, Yano S, Yamaki S, Qin Z. Complex chemistry with complex compounds. EPJ Web Conf 2016. [DOI: 10.1051/epjconf/201613107005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Weissenberger S, Klicperova-Baker M, Zimbardo P, Schonova K, Akotia D, Kostal J, Goetz M, Raboch J, Ptacek R. ADHD and Present Hedonism: time perspective as a potential diagnostic and therapeutic tool. Neuropsychiatr Dis Treat 2016; 12:2963-2971. [PMID: 27895485 PMCID: PMC5118029 DOI: 10.2147/ndt.s116721] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The article draws primarily from the behavioral findings (mainly psychiatric and psychological observations) and points out the important relationships between attention-deficit/hyperactivity disorder (ADHD) symptoms and time orientation. Specifically, the authors argue that there is a significant overlap between the symptoms of ADHD and Present Hedonism. Present Hedonism is defined by Zimbardo's time perspective theory and assessed by Zimbardo Time Perspective Inventory. Developmental data on Present Hedonism of males and females in the Czech population sample (N=2201) are also presented. The hypothesis of relationship between ADHD and Present Hedonism is mainly derived from the prevalence of addictive behavior (mainly excessive Internet use, alcohol abuse, craving for sweets, fatty foods, and fast foods), deficits in social learning, and increased aggressiveness both in ADHD and in the population scoring high on Present Hedonism in the Zimbardo Time Perspective Inventory. We conclude that Zimbardo's time perspective offers both: 1) a potential diagnostic tool - the Zimbardo Time Perspective Inventory, particularly its Present Hedonism scale, and 2) a promising preventive and/or therapeutic approach by the Time Perspective Therapy. Time Perspective Therapy has so far been used mainly to treat past negative trauma (most notably, posttraumatic stress disorder); however, it also has value as a potential therapeutic tool for possible behavioral compensation of ADHD.
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Affiliation(s)
| | - M Klicperova-Baker
- Institute of Psychology, Academy of Sciences of the Czech Republic, Praha, Czech Republic
| | - P Zimbardo
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - K Schonova
- First Medical Faculty, Charles University
| | - D Akotia
- First Medical Faculty, Charles University
| | - J Kostal
- Institute of Psychology, Academy of Sciences of the Czech Republic, Praha, Czech Republic
| | - M Goetz
- Second Faculty of Medicine, Department of Child Psychiatry, Charles University, Motol University Hospital, Praha, Czech Republic
| | - J Raboch
- First Medical Faculty, Charles University
| | - R Ptacek
- First Medical Faculty, Charles University
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Ma CX, Gao F, Northfelt D, Goetz M, Forero A, Naughton M, Ademuyiwa F, Suresh R, Anderson KS, Margenthaler J, Aft R, Hobday T, Moynihan T, Gillanders W, Cyr A, Eberlein TJ, Hieken T, Krontiras H, Hoog J, Han J, Guo Z, Vij K, Mardis E, Al-Kateb H, Sanati S, Ellis MJ. Abstract S6-05: A phase II trial of neoadjuvant palbociclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor, in combination with anastrozole for clinical stage 2 or 3 estrogen receptor positive HER2 negative (ER+HER2-) breast cancer (BC). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-s6-05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
ER+ BC is associated with activated CDK4/6. The CDK4/6 inhibitor palbociclib (P) markedly improves time to progression in advanced ER+HER2- BC. We conducted a neoadjuvant phase II trial to determine the activity of P in primary breast cancer as a prelude to adjuvant studies.
Methods
To assess molecular changes induced by anastrozole (A) or P+A, patients (pts) were treated initially with A alone (1mg PO daily) for 28 days in cycle 0 (C0) before the addition of P (125mg PO daily on D1-21 each cycle) on C1D1. P+A was administered for 4 28-day cycles followed by C5 with A alone for 2-4 weeks (wks) before surgery. P was added in C5 for 10-12 days immediately prior to surgery in the last 20 pts enrolled to assess molecular changes induced by A, either alone or in combination with P immediately prior to surgery, in resected tumor. Goserelin was added in premenopausal pts.
Research tumor biopsies were obtained at baseline, C1D1, and C1D15. Central Ki67 analysis was performed at all timepoints, those with Ki67 >10% at C1D15 went off study treatment.
The primary endpoint was complete cell cycle arrest (CCA), defined as Ki67 <2.7%, at C1D15. Patient stratification was based on PIK3CA mutation status with an initial focus on PIK3CA wild type (WT) disease. Pts with PIK3CA mutant (Mut) tumors enrolled to a separate cohort. A sample size of 33 pts in the PIK3CA WT cohort was chosen based on the Fleming's single-stage phase II design to test the hypothesis that P+A leads to > 50% improvement over A in CCA rate on C1D15 biopsy (44% with A alone based on historical data, vs 66% with P+A, power = 0.8, alpha=0.05). The primary endpoint is met if >20 pts achieved CCA in this cohort.
Correlative endpoints included assessment of markers of proliferation, apoptosis, senescence, Rb, gene expression microarray, intrinsic subtype, and next generation sequencing of 83-gene panels, which will be reported at the meeting.
Results
Between 4/23/2013 and 4/24/2015, 50 pts (33 PIK3CA WT, 11 PIK3CA Mut, 2 pending, 4 tissue quantity or quality not sufficient for sequencing (QNS)) were enrolled to the study. Median age was 57.5 (range: 34.1–79.6) years. Four pts, all with WT PIK3CA, went off study due to Ki67 >10% on C1D15 biopsy, 26 pts completed treatment and surgery, 1 refused surgery, 3 withdrew study treatment in C1, and 16 continued to receive study drug (2 in C0, 3 in C1, 4 in C2, 5 in C3, 1 in C4, and 1 in C5). Among the 40 pts currently evaluable for the primary endpoint (C1D15 Ki67), CCA occurred in 34 (85%) pts, including 9 of 9 (100%) PIK3CA Mut, 22 of 28 (78.5%) WT, and 3 of 3 QNS pts. Preliminary analysis of available data indicated a significantly lower Ki67 value after 2 wks of P+A (C1D15) compared to that on A alone (C1D1) (p=0.034, n=18).
Conclusion
This study met the primary endpoint demonstrating that P+A is a highly effective anti-proliferative combination. The sequential biopsy design clearly demonstrated that P+A increased cell cycle control over A alone. P+A was effective regardless of PIK3CA mutation status and these results support the evaluation of this combination in the adjuvant setting for ER+HER2- BC.
Citation Format: Ma CX, Gao F, Northfelt D, Goetz M, Forero A, Naughton M, Ademuyiwa F, Suresh R, Anderson KS, Margenthaler J, Aft R, Hobday T, Moynihan T, Gillanders W, Cyr A, Eberlein TJ, Hieken T, Krontiras H, Hoog J, Han J, Guo Z, Vij K, Mardis E, Al-Kateb H, Sanati S, Ellis MJ. A phase II trial of neoadjuvant palbociclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor, in combination with anastrozole for clinical stage 2 or 3 estrogen receptor positive HER2 negative (ER+HER2-) breast cancer (BC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr S6-05.
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Affiliation(s)
- CX Ma
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - F Gao
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - D Northfelt
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - M Goetz
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - A Forero
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - M Naughton
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - F Ademuyiwa
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - R Suresh
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - KS Anderson
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - J Margenthaler
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - R Aft
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - T Hobday
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - T Moynihan
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - W Gillanders
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - A Cyr
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - TJ Eberlein
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - T Hieken
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - H Krontiras
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - J Hoog
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - J Han
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - Z Guo
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - K Vij
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - E Mardis
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - H Al-Kateb
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - S Sanati
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
| | - MJ Ellis
- Washington University, Saint Louis, MO; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Rochester, MN; University of Alabama at Birmingham, Birmingham, AL; Baylor College of Medicine, Houston, TX
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Reese J, Bruinsma E, Subramaniam M, Suman V, Pitel K, Kalari K, Yu J, Wang L, Goetz M, Ingle J, Hawse J. Abstract P5-04-01: ERβ elicits tumor suppressive effects in triple negative breast cancer through the induction of cystatins and suppression of TGFβ signaling. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-04-01] [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: Triple negative breast cancer (TNBC) accounts for approximately 20% of all breast cancer diagnoses. Clinical management of TNBC is limited to surgery, chemotherapy and radiation due to lack of estrogen receptor alpha and HER2 expression. Recently, we have shown that approximately 40% of TNBCs express estrogen receptor beta (ERβ) and have begun to explore the possibility that this receptor could be utilized as a novel therapeutic target for this disease.
Methods: To examine the biological functions of ERβ in TNBC, novel ERβ expressing TN cell lines (MDA-MB-231 and Hs578T) were developed. In vitro experiments were employed to determine alterations in the global gene expression profiles, biological pathways, proliferation rates, and cell cycle progression following estrogen or ERβ-specific agonist treatment. Cell line xenografts were also established in athymic ovariectomized nude mice to examine tumoral responses to ERβ targeting agents and to investigate gene and protein expression patterns as well as potential serum biomarkers indicative of therapeutic response. Additionally, using the resources of the Mayo Clinic Breast Cancer Genome Guided Therapy Study (BEAUTY), we have identified, and begun to analyze, ERβ+ and ERβ- patient derived xenografts (PDX) established from women with TNBC.
Results: Our studies have revealed that both estrogen and multiple ERβ-specific agonists elicit significant anti-proliferative effects in ERβ+ TNBC cells primarily through a G1/S phase cell cycle arrest. These anti-proliferative effects appear to be mediated by cystatins, a family of small secreted cysteine protease inhibitors which are highly induced following estrogen and ERβ-specific agonist treatment. Conditioned media isolated from estrogen or ERβ-specific agonist treated cells decreased the proliferation rates of multiple non-ERβ expressing cell lines; effects that were completely reversed when cystatins were depleted from the media. In addition, we have shown that activation of ERβ, and the subsequent induction of cystatin gene expression, leads to suppression of canonical TGFβ signaling through multiple mechanisms including suppression of TGFβR2 expression, induction of Smad7 expression and blockade of TGFβ ligand-mediated activation of this pathway both in vitro and in vivo. Finally, ERβ+ TNBC PDXs exhibit significantly decreased tumor growth rates in estrogen-treated mice compared to ERβ- TN breast tumors.
Conclusions: Our in vitro and in vivo data show that estrogen and ERβ-specific agonists elicit anti-cancer effects in ERβ+ TNBC. These effects appear to be mediated, in part, by cystatins through their inhibitory effects on canonical TGFB signaling, a pathway known to drive TNBC progression. Importantly, these data lay the foundation for studies aimed at examining the ability to therapeutically target ERβ in TNBC patients.
Citation Format: Reese J, Bruinsma E, Subramaniam M, Suman V, Pitel K, Kalari K, Yu J, Wang L, Goetz M, Ingle J, Hawse J. ERβ elicits tumor suppressive effects in triple negative breast cancer through the induction of cystatins and suppression of TGFβ signaling. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-04-01.
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Affiliation(s)
| | | | | | | | | | | | - J Yu
- Mayo Clinic, Rochester, MN
| | - L Wang
- Mayo Clinic, Rochester, MN
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Ma CX, Suman VJ, Goetz M, Northfelt D, Burkard M, Ademuyiwa F, Naughton M, Margenthaler J, Aft R, Gray R, Tavaarwerk A, Wilke L, Haddad T, Moynihan T, Loprinzi C, Hieken T, Hoog J, Guo Z, Han J, Vij K, Mardis E, Sanati S, Al-Kateb H, Doyle L, Erlichman C, Ellis MJ. Abstract P5-13-04: A phase II neoadjuvant trial of MK-2206, an AKT inhibitor, in combination with anastrozole for clinical stage 2 or 3 PIK3CA mutant estrogen receptor positive HER2 negative (ER+HER2-) breast cancer (BC). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-13-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Activating mutations in PIK3CA occur in approximately 40% ER+BC. MK-2206 (M), a pan-AKT inhibitor, induced apoptosis of ER+ BC under estrogen deprivation in preclinical studies. We conducted this neoadjuvant trial to determine the pathologic complete response (pCR) rate of M plus anastrozole (A) for PIK3CA mutant (Mut) ER+ BC.
Methods
This single arm open label study of M+A used a 2-stage Simon phase II design (stage 1, n=16; stage 2, n=13, alpha=0.10, power=0.90) to test whether pCR rate <1% (based on historical data with A alone), against the alternative that pCR rate ≥15% in PIK3CA Mut ER+ BC. At least 1 pCR in stage 1 was required to proceed to stage 2.
Eligible patients (pts) with clinical stage II or III ER+HER2- BC were pre-registered and proceeded to a research tumor biopsy for PIK3CA sequencing, followed by treatment with daily A monotherapy for 28 days (cycle 0). Pts with PIK3CA Mut BC were subsequently registered, underwent a second biopsy, and started M (150mg PO weekly) with daily A on cycle 1 day 1 (C1D1) for a maximum of four 28-day cycles followed by surgery. Goserelin was added for premenopausal pts. A tumor biopsy on C1D17, 17 days post the start of M, was performed. Those with C1D17 Ki67 >10% discontinued study treatment. pCR was defined as no invasive cancer in the breast and the lymph nodes. Tumor specimens collected at all timepoints are being analyzed for markers of proliferation, apoptosis, and PI3K pathway activity, gene expression microarray, intrinsic subtypes, and next generation sequencing of 83 genes.
Results
Of the 51 pts pre-registered, 35 pts did not register due to no PIK3CA mutation (n=22), inadequate specimen for testing (n=6), physician/pt decision (n=7). The remaining 16 pts (median age: 58, range: 40-77 years) received combination therapy. Three pts did not complete 4 cycles due to C1D17 Ki67 >10% (n=2) and intolerability (grade (Gr) 4 transaminase elevation in C1, n=1). Other severe toxicities possibly related to M included Gr 3 rash (25%) and pruritus (12.5%). Of the 13 pts completed study therapy and underwent surgery, all had residual disease in the breast and 7 also had positive nodes. Table 1 summarized changes in Ki67 during treatment.
ComparisonsnAbsolute changes in Ki67 median (range)Wilcoxon signed rank p-valueC1D1 relative to pre-registration11-17.0% (-49.8 to 4.1%)0.0020C1D17 relative to pre-registration14-16.4% (-51.4 to 4.1%)0.0004C1D17 relative to C1D112-1.5% (-18.6 to 15.8%)0.9697C1D1, biopsy post 28 days of A alone; C1D17 biopsy post 17 days on combination therapy
Although Ki67 levels post A monotherapy (C1D1) or M+A (C1D17) were significantly lower than that of pre-registration samples, Ki67 did not differ between C1D17 and C1D1 samples. Other correlative studies are ongoing and results will be presented.
Conclusion
Despite the small sample size, biomarker analysis on serial biopsy specimens demonstrated that M+A is unlikely to be more effective than A alone in PIK3CA Mut ER+ BC. This trial demonstrated the feasibility of genomic sequencing for pt selection and the value of a small, well-designed proof-of-principle neoadjuvant trial for the evaluation of targeted agents.
Citation Format: Ma CX, Suman VJ, Goetz M, Northfelt D, Burkard M, Ademuyiwa F, Naughton M, Margenthaler J, Aft R, Gray R, Tavaarwerk A, Wilke L, Haddad T, Moynihan T, Loprinzi C, Hieken T, Hoog J, Guo Z, Han J, Vij K, Mardis E, Sanati S, Al-Kateb H, Doyle L, Erlichman C, Ellis MJ. A phase II neoadjuvant trial of MK-2206, an AKT inhibitor, in combination with anastrozole for clinical stage 2 or 3 PIK3CA mutant estrogen receptor positive HER2 negative (ER+HER2-) breast cancer (BC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-13-04.
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Affiliation(s)
- CX Ma
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - VJ Suman
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - M Goetz
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - D Northfelt
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - M Burkard
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - F Ademuyiwa
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - M Naughton
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - J Margenthaler
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - R Aft
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - R Gray
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - A Tavaarwerk
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - L Wilke
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - T Haddad
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - T Moynihan
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - C Loprinzi
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - T Hieken
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - J Hoog
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - Z Guo
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - J Han
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - K Vij
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - E Mardis
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - S Sanati
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - H Al-Kateb
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - L Doyle
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - C Erlichman
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
| | - MJ Ellis
- Washington University, Saint Louis, MO; Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AZ; Universtiy of Wisconsin, Madison, WI; National Cancer Institute, Bethesda, MD; Baylor College of Medicine, Houston, TX
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Goetz M, Judd S, Safford M, Hartman T, McClellan WM, Vaccarino V. Dietary Flavonoid Intake and Incident Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS). Ann Epidemiol 2015. [DOI: 10.1016/j.annepidem.2015.06.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wagner V, Plentz RR, Schraml C, Malek NP, Goetz M. Recurrent pyogenic cholangitis as a differential diagnosis in biliary tract diseases. Z Gastroenterol 2015; 53:1087-1090. [PMID: 26367025 DOI: 10.1055/s-0035-1553341] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recurrent Pyogenic Cholangitis (RPC) or Primary Hepatolithiasis is a common disease of the biliary tract in Asia, whereas it is usually not seen in Europeans. With increasing global mobility, the disease will be encountered in Europe more frequently, too. It should therefore be considered as a differential diagnosis in patients from endemic countries with recurrent symptoms of cholestasis/cholangitis and bile duct dilations, strictures and hepatolithiasis. In this case report, we present the history of a 37-year old patient from Sri Lanka and describe typical aspects of RPC. The patient presented at our hospital with scleral jaundice and pruritus. In the past she had been treated for septic cholangitis. Diagnosis in our patient was made after laboratory tests, MRT/MRCP and ERC. She was treated interventionally by ERC and is now monitored on a regular basis.
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Affiliation(s)
- V Wagner
- Innere Medizin I, Universitätsklinikum Tübingen, Germany
| | - R R Plentz
- Innere Medizin I, Universitätsklinikum Tübingen, Germany
| | - C Schraml
- Radiologie, Universitätsklinikum Tübingen, Germany
| | - N P Malek
- Innere Medizin I, Universitätsklinikum Tübingen, Germany
| | - M Goetz
- Innere Medizin I, Universitätsklinikum Tübingen, Germany
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Schempf U, Kratt T, Hoetker M, Stüker D, Plentz RR, Malek NP, Goetz M. [OTSC-assisted resection of a duodenal neuroendocrine tumor: a case report]. Z Gastroenterol 2015; 53:205-7. [PMID: 25775170 DOI: 10.1055/s-0034-1398898] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The over the scope clip (OTSC) is mainly used for closure of gastrointestinal endoluminal defects and treatment of gastrointestinal bleeding. Its use for resection of subepithelial tumors or full-thickness resection is still under investigation. Duodenal neuroendocrine tumors (NET) are rare neoplasms. Endoscopic resection is appropriate up to a size of 20 mm, however positive deep margins are a frequent challenge in these subepithelial tumors. We report on a 60-year-old male patient who had undergone endoscopic mucosal resection with R1 deep margins of a NET (G1) in the duodenal bulb. To avoid local surgical resection in this multimorbid patient, we performed OTSC-assisted deep resection. Complete resection (R0) was achieved, and no complications occurred. Our report suggests that OTSC-assisted resection of subepithelial tumors is a possible and safe option, especially for patient's and in locations with a high perioperative risk.
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Affiliation(s)
- U Schempf
- Innere Medizin 1, Universitätsklinikum Tübingen
| | - T Kratt
- Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen
| | - M Hoetker
- Innere Medizin 1, Universitätsklinikum Tübingen
| | - D Stüker
- Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen
| | - R R Plentz
- Innere Medizin 1, Universitätsklinikum Tübingen
| | - N P Malek
- Innere Medizin 1, Universitätsklinikum Tübingen
| | - M Goetz
- Innere Medizin 1, Universitätsklinikum Tübingen
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Rey JW, Deris N, Marquardt JU, Thomaidis T, Moehler M, Kittner JM, Nguyen-Tat M, Dümcke S, Tresch A, Biesterfeld S, Goetz M, Mudter J, Neurath MF, Galle PR, Kiesslich R, Hoffman A. High-definition endoscopy with iScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group. Dis Esophagus 2014; 29:185-91. [PMID: 25515856 DOI: 10.1111/dote.12308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nonerosive reflux disease (NERD) is commonly diagnosed in patients with symptoms of reflux. The aim of the present study was to determine whether high-definition endoscopy (HD) plus equipped with the iScan function or chromoendoscopy with Lugol's solution might permit the differentiation of NERD patients from those without reflux symptoms, proven by targeted biopsies of endoscopic lesions. A total of 100 patients without regular intake of proton pump inhibitors and with a normal conventional upper endoscopy were prospectively divided into NERD patients and controls. A second upper endoscopy was performed using HD+ with additional iScan function and then Lugol's solution was applied. Biopsy specimens were taken from the gastroesophageal junction in all patients. A total of 65 patients with reflux symptoms and 27 controls were included. HD(+) endoscopy with iScan revealed subtle mucosal breaks in 52 patients; the subsequent biopsies confirmed esophagitis in all cases. After Lugol's solution, 58 patients showed mucosal breaks. Sensitivity for the iScan procedure was 82.5%, whereas that for Lugol's solution was 92.06%. Excellent positive predictive values of 100% and 98.3%, respectively, were noted. The present study suggests that the majority of patients with NERD and typical symptoms of reflux disease can be identified by iScan or Lugol's chromoendoscopy as minimal erosive reflux disease (ERD) patients.
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Affiliation(s)
- J W Rey
- First Department of Internal Medicine, University Medical Center, Mainz, Germany.,Department of Internal Medicine II, HSK Hospital, Wiesbaden, Germany
| | - N Deris
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - J U Marquardt
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - T Thomaidis
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - M Moehler
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - J M Kittner
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - M Nguyen-Tat
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - S Dümcke
- Max Planck Institute for Plant Breeding Research Cologne, Cologne, Germany.,Institute for Genetics, University of Cologne, Cologne, Germany
| | - A Tresch
- Max Planck Institute for Plant Breeding Research Cologne, Cologne, Germany.,Institute for Genetics, University of Cologne, Cologne, Germany
| | - S Biesterfeld
- Institute for Pathology, University Hospital, Düsseldorf, Germany
| | - M Goetz
- First Department of Internal Medicine, University Medical Center, Mainz, Germany.,First Department of Internal Medicine, University Hospital, Tübingen, Germany
| | - J Mudter
- First Department of Internal Medicine, University Hospital, Erlangen, Germany
| | - M F Neurath
- First Department of Internal Medicine, University Hospital, Erlangen, Germany
| | - P R Galle
- First Department of Internal Medicine, University Medical Center, Mainz, Germany
| | - R Kiesslich
- First Department of Internal Medicine, University Medical Center, Mainz, Germany.,Department of Internal Medicine II, HSK Hospital, Wiesbaden, Germany
| | - A Hoffman
- First Department of Internal Medicine, University Medical Center, Mainz, Germany.,Department of Internal Medicine II, HSK Hospital, Wiesbaden, Germany
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Goetz M, Shah A, Goldberg J, Cheema F, Shallenberger L, Murrah NV, Bremner JD, Vaccarino V. Posttraumatic stress disorder, combat exposure, and carotid intima-media thickness in male twins. Am J Epidemiol 2014; 180:989-96. [PMID: 25301813 PMCID: PMC4224362 DOI: 10.1093/aje/kwu225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is associated with an increased risk of ischemic heart disease, though the pathophysiologic mechanisms remain unclear. Carotid artery intima-media thickness (CIMT) is a measure of subclinical atherosclerosis. We examined whether PTSD and combat exposure were associated with CIMT in Vietnam War-era twins after controlling for shared genetic and childhood factors. Between 2002 and 2010, we studied 465 middle-aged twins from the Vietnam Era Twin Registry who were free from cardiovascular disease. PTSD was diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and CIMT was measured by ultrasound. Mixed-effects regression models were used to examine individual, between-pair, and within-pair associations. Approximately 13% of participants met the criteria for PTSD, and 45% served in the Vietnam Theater. PTSD was associated with 32.7 μm higher CIMT (95% confidence interval (CI): 0.9, 64.5) after adjustment for confounders. The average CIMT for the pair increased by 59.7 μm for each additional twin with PTSD (95% CI: 15.9, 104.2). We found no significant within-pair differences in CIMT when comparing PTSD-discordant co-twins. Results for combat exposure were similar, but its association with CIMT weakened after adjustment for PTSD (95% CI: 7.0, 45.3). Among Vietnam War-era veterans, combat exposure and PTSD are associated with CIMT, though the associations are largely mediated by shared childhood factors.
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Affiliation(s)
| | | | | | | | | | | | | | - Viola Vaccarino
- Correspondence to Dr. Viola Vaccarino, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Room 3011, Atlanta, GA 30322 (e-mail: )
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Goetz M, Walther U, Malek N, Fuchs J, Königsrainer A, Kratt T. Transpapillary retrieval of a proximally migrated stent using a three-prong polyp retrieval device in a 2-years-old girl. Z Gastroenterol 2014; 52:351-3. [PMID: 24718940 DOI: 10.1055/s-0034-1366050] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Endoscopic retrieval of proximally migrated biliary stents is sometimes challenging. We report on the successful use of a three-prong colon polyp retrieval device in a two year old child.
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Affiliation(s)
- M Goetz
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Tübingen, Tübingen, Germany
| | - U Walther
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Tübingen, Tübingen, Germany
| | - N Malek
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Tübingen, Tübingen, Germany
| | - J Fuchs
- Department of Paediatric Surgery, University Hospital Tübingen, Tübingen, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - T Kratt
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
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Werner CR, Graepler F, Glatzle J, Stüker D, Kratt T, Schmehl J, Bitzer M, Königsrainer A, Malek NP, Goetz M. Proximal duodenal obstruction--Bouveret's syndrome revisited. Endoscopy 2014; 45 Suppl 2 UCTN:E231-2. [PMID: 23945924 DOI: 10.1055/s-0033-1344324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- C R Werner
- Department of Gastroenterology, University Hospital Tübingen, Medical Clinic, Tübingen, Germany.
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Eisner T, Hill D, Goetz M, Jain S, Alsop D, Camazine S, Meinwald J. Antifeedant action ofZ-dihydromatricaria acid from soldier beetles (Chauliognathus spp.). J Chem Ecol 2014; 7:1149-58. [PMID: 24420837 DOI: 10.1007/bf00987634] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/1981] [Revised: 03/02/1981] [Indexed: 10/25/2022]
Abstract
The acetylenic acid,Z-dihydromatricaria acid (DHMA), previously isolated from the defensive secretion ofChauliognathus lecontei, and now shown to occur also inC. pennsylvanicus, is a potent feeding deterrent to jumping spiders (Phidippus spp.). A simple bioassay withPhidippus is described, which is generally applicable to studies dealing with the isolation and evaluation of feeding deterrency of natural products from insects. By use of this assay,Phidippus were shown to be sensitive to as little as 1 μg DHMA, an amount equivalent to less than 2% of the DHMA content ofC. pennsylvanicus.
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Affiliation(s)
- T Eisner
- Section of Neurobiology and Behavior Division of Biological Sciences, Cornell University, 14853, Ithaca, New York
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Plantinga LC, Kim M, Goetz M, Kleinbaum DG, McClellan W, Patzer RE. Pre-end-stage renal disease care not associated with dialysis facility neighborhood poverty in the United States. Am J Nephrol 2014; 39:50-8. [PMID: 24434854 DOI: 10.1159/000358067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/12/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Receipt of nephrology care prior to end-stage renal disease (ESRD) is a strong predictor of decreased mortality and morbidity, and neighborhood poverty may influence access to care. Our objective was to examine whether neighborhood poverty is associated with lack of pre-ESRD care at dialysis facilities. METHODS In a multi-level ecological study using geospatially linked 2007-2010 Dialysis Facility Report and 2006-2010 American Community Survey data, we examined whether high neighborhood poverty (≥20% of households in census tract living below poverty) was associated with dialysis facility-level lack of pre-ESRD care (percentage of patients with no nephrology care prior to dialysis start) in mixed-effects models, adjusting for facility and neighborhood confounders and allowing for neighborhood and regional random effects. RESULTS Among the 5,184 facilities examined, 1,778 (34.3%) were located in a high-poverty area. Lack of pre-ESRD care was similar in poverty areas (30.8%) and other neighborhoods (29.6%). With adjustment, the absolute increase in percentage of patients at a facility with no pre-ESRD care associated with facility location in a poverty area versus other neighborhood was only 0.08% (95% CI -1.32, 1.47; p = 0.9). Potential effect modification by race and income inequality was detected. CONCLUSION Despite previously reported detrimental effects of neighborhood poverty on health, facility neighborhood poverty was not associated with receipt of pre-ESRD care, suggesting no need to target interventions to increase access to pre-ESRD care at facilities in poorer geographic areas.
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Affiliation(s)
- Laura C Plantinga
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Ga., USA
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Contreras A, Herrera S, Wang T, Mayer I, Forero A, Nanda R, Goetz M, Chang JC, Pavlick AC, Fuqua SAW, Gutierrez C, Hilsenbeck SG, Li MM, Osborne CK, Schiff R, Rimawi MF. Abstract PD1-2: PIK3CA mutations and/or low PTEN predict resistance to combined anti-HER2 therapy with lapatinib and trastuzumab and without chemotherapy in TBCRC006, a neoadjuvant trial of HER2-positive breast cancer patients. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-pd1-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
We have recently reported that in patients with HER2-positive breast cancer, neoadjuvant targeted therapy with lapatinib and trastuzumab to more completely block the HER receptor layer, combined with endocrine therapy (in ER-positive tumors) and without chemotherapy led to a substantial 27% pathologic complete response (pCR) rate in the breast. Activation of downstream signaling pathways may lead to resistance to therapies targeting the HER pathway receptors. Aberrant activation of the PI3K pathway via decreased levels of PTEN and/or the presence of activating PIK3CA mutations has been implicated in resistance to targeted anti-HER2 therapy, but results of clinical trials are all confounded by the co-administration of chemotherapy and are inconsistent. We sought to clarify the role of these variables in predicting pCR, a surrogate for long-term outcome, in patients treated with potent targeted therapy alone in a prospective Phase II neoadjuvant trial in patients with HER2-positive breast cancer.
Patients with large tumors (median 6 cm) were given 12 weeks of lapatinib plus trastuzumab followed by surgery (Rimawi et al. JCO, 2013). Serial tissue biopsies were obtained from study participants. For this study, we focused on baseline pre-treatment characteristics. PTEN protein levels were measured by IHC and scored using the H-score. PIK3CA mutations were identified on extracted DNA using multiplex PCR with targeted next generation sequencing (the Ion Torrent 50-gene cancer mutation panel).
Of 64 evaluable patients, tissue was available on 59 for PTEN IHC, and sufficient DNA was available on 33 for the mutation panel. PTEN median H-score was 100 (range 0-300). PTEN status when dichotomized by the median was correlated with pCR (32% in high PTEN vs. 9% in low PTEN, p = 0.04). Activating PIK3CA mutations were identified in 12 out of 33 tumors (36%; 3 mutations in the helical and 9 in the catalytic domain) and were independent of ER status. None of the patients whose tumors harbored a PIK3CA mutation achieved pCR (p = 0.06). There was no association between PTEN status and PIK3CA mutation suggesting they are independent variables (p = 0.44). When PIK3CA mutations were considered together with PTEN status, there were 31 cases with data on both. The overall pCR rate in this cohort was 16% (lower than pCR rate observed in the overall trial). However, 0/17 cases (0%) with a mutation and/or PTEN low expression (<100 H score) had a pCR compared to 5/14 cases (36%) with PI3KCA wild type and high PTEN levels (p = 0.01).
We conclude that PI3K pathway activation downstream of HER2 as a result of either low PTEN or activating PIK3CA mutation results in resistance to the combination of lapatinib and trastuzumab. This is the first report on patient tissue samples from a neoadjuvant trial using the combination of lapatinib and trastuzumab without chemotherapy. If validated in a larger cohort, our findings suggest that patients with HER2 positive tumors and who also harbor aberrant downstream PI3K pathway activation may benefit from the addition of PI3K/Akt/mTOR inhibitors to potent HER2 blockade.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD1-2.
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Affiliation(s)
- A Contreras
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - S Herrera
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - T Wang
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - I Mayer
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - A Forero
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - R Nanda
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - M Goetz
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - JC Chang
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - AC Pavlick
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - SAW Fuqua
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - C Gutierrez
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - SG Hilsenbeck
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - MM Li
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - CK Osborne
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - R Schiff
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
| | - MF Rimawi
- Baylor College of Medicine, Houston, TX; Vanderbilt University, Nashville, TN; University of Alabama in Birmingham, Birmingham, AL; University of Chicago, Chicago, IL; Mayo Clinic, Rochester, MN; The Methodist Hospital, Houston, TX
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Somlo G, Frankel P, Luu T, Ma C, Arun B, Garcia A, Cigler T, Fleming G, Harvey H, Sparano J, Nanda R, Chew H, Moynihan T, Vahdat L, Goetz M, Hurria A, Mortimer J, Gandara D, Chen A, Weitzel J. Abstract P2-16-05: Efficacy of ABT-888 (veliparib) in patients with BRCA-associated breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-16-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The potential for exploiting BRCA deficiencies with DNA repair inhibitors has both pre-clinical and clinical support. ABT-888 (veliparib), a DNA repair inhibitor initially thought to target Poly(ADP-Ribose) Polymerases (PARP), has demonstrated in vitro inhibition of BRCA1 and BRCA2 deficient mouse embryonic stell cells, with a larger effect on BRCA1 cells. We report on the pre-planned interim analysis of the efficacy of single agent veliparib in patients with either BRCA1 or BRCA2-associated stage IV breast cancer. Methods: BRCA 1 or 2 carrier patients with stage IV breast cancer, with measurable disease, without prior exposure to a PARP inhibitor or a platinum compound in the metastatic setting, were eligible. Velapirib was administered orally, at doses of 400 mg twice daily. Dose adjustments based on toxicity were permitted. Patients progressing on velapirib alone received carboplatin at an AUC of 5, IV, given Q 21 days, and velapirib 150 mg twice daily (the maximum tolerated dose [MTD] of the combination from our completed Phase I study: J Clin Oncol 30, 2012 [suppl; abstr 1024]). Patients were to be accrued from 7 NCI NO1- supported consortia. Initially 10 patients were to be accrued to each stratum (BRCA1 and BRCA2) to provide evidence of single agent activity. If there was sufficient activity to warrant consideration of velapirib as single agent therapy (defined as 2 or more confirmed partial [PR] or better responses out of 10 per stratum), an additional 12 patients would be accrued per stratum. Results: 20 evaluable patients (11 BRCA1 and 9 BRCA2 [1 in screening]) have been accrued, the majority with lung or liver as visceral metastatic sites of disease. Median age (range) is 46 (29-68) years. Tumors from 9 patients were hormone receptor positive. BRCA1 cohort: 4 of 11 patients are off treatment at a median of 2 months (1-4); 1 patient stopped velapirib due to toxicity (grade 2 rash/pruritus, grade 2 vomiting), 3 stopped for progressive disease (one with an unconfirmed PR). Seven patients are still on single agent veliparib with 1 unconfirmed PR, and 1 patient with two evaluations showing stable disease. BRCA2 cohort: 2 patients are off treatment at 2 months for progressive disease, 7 are still on treatment with 1 confirmed PR, and 3 unconfirmed PRs. Data on patients receiving combination of velapirib and carboplatin after progression is too early. Treatment-related toxicity is being updated and has so far been reported from 14 patients: 1 patient had grade 3 fatigue, 1 patient with liver metastasis had both grade 3 alanine aminotransferase elevation and grade 3 abdominal pain. Grade 2 toxicities occurring in more than 1 patient included nausea/vomiting (6 patients), chills (2 patients), and fatigue (2 patients). Conclusion: Velapirib has single agent activity in both BRCA1 and BRCA2-associated stage IV breast cancer patients, and is well-tolerated. Mature response, treatment, and toxicity data will be presented.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-16-05.
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Affiliation(s)
- G Somlo
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - P Frankel
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - T Luu
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - C Ma
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - B Arun
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - A Garcia
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - T Cigler
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - G Fleming
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - H Harvey
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - J Sparano
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - R Nanda
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - H Chew
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - T Moynihan
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - L Vahdat
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - M Goetz
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - A Hurria
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - J Mortimer
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - D Gandara
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - A Chen
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
| | - J Weitzel
- City of Hope Cancer Center, Duarte, CA; Washington University School of Medicine, St. Louis, MO; The University of Texas MD Anderson Cancer Center, Houston, TX; USC Norris Comprehensive Cancer Center, Los Angeles, CA; Weill Cornell Medical College, New York, NY; Alliance for Clinical Trials in Oncology, Chicago, IL; Milton S. Hershey Medical Center, Hershey, PA; Montefiore Medical Center, Bronx, NY; University of Chicago, Chicago, IL; University of California, Davis Cancer Center, Sacramento, CA; Mayo Clinic, Rochester, MN; National Cancer Institute, Bethesda, MD
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Goetz M, Hainz M, Schadmand-Fischer S, Kittner JM, Heinrich S. Echinococcosis mimicking autoimmune or malignant bile duct disease. Z Gastroenterol 2013; 51:1089-91. [PMID: 24022203 DOI: 10.1055/s-0033-1335751] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Indeterminate strictures of the bile ducts are common diagnostic dilemmas in gastroenterology, and differential diagnosis includes inflammatory and neoplastic diseases. Alveolar echinococcosis (AE) is rarely considered as a differential diagnosis, although it is endemic in the Northern hemisphere. In this case report on a 50-year-old male patient, the lack of cystic lesions or calcifications on CT, and suggestive ERCP findings made a hilar cholangiocellular carcinoma the most probable differential diagnosis, and only explorative laparotomy provided the definite diagnosis of AE. AE should therefore be included in the differential diagnosis of indeterminate biliary strictures even in the absence of typical stigmata in imaging studies.
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Affiliation(s)
- M Goetz
- Innere Medizin I, Universitätsklinikum Tübingen, Tübingen, Germany
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Goetz M. [Microscopy of the gastrointestinal tract: confocal endomicroscopy - clinical and scientific benefits]. Zentralbl Chir 2013; 139:428-33. [PMID: 23824617 DOI: 10.1055/s-0032-1327970] [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: 10/26/2022]
Abstract
Endomicroscopy is a novel method that allows microscopy of the gastrointestinal mucosa during ongoing endoscopy. This necessitates the application of fluorescent contrast agents. Indications for endomicroscopy include inflammatory and (pre-)neoplastic diseases that are often only incompletely assessed by random biopsies. Multiple trials have established the value of endomicroscopy of the upper and lower gastrointestinal tract. Follow-up studies have evaluated intravital microscopy of the biliary tract, the liver or pancreas. Endomicroscopy for the first time enables microscopic imaging of the intact tissue virtually free of artifacts. This allows an unprecedented approach to the patient in gastrointestinal science and molecular imaging. CLE therefore links clinical patient care with translational science.
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Affiliation(s)
- M Goetz
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz, Deutschland
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Robins S, Stewart I, McNay D, Taylor V, Giachino C, Goetz M, Ninkovic J, Briancon N, Maratos-Flier E, Flier J, Kokoeva M, Placzek M. α-Tanycytes of the adult hypothalamic third ventricle include distinct populations of FGF-responsive neural progenitors. Nat Commun 2013; 4:2049. [DOI: 10.1038/ncomms3049] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 05/23/2013] [Indexed: 01/19/2023] Open
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Goetz M, Hoetker MS, Diken M, Galle PR, Kiesslich R. In vivo molecular imaging with cetuximab, an anti-EGFR antibody, for prediction of response in xenograft models of human colorectal cancer. Endoscopy 2013; 45:469-77. [PMID: 23580409 DOI: 10.1055/s-0032-1326361] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [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: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Molecular imaging has mainly been studied for detection of lesions using diagnostic probes. The aim of the current trial was to evaluate in vivo confocal laser endomicroscopy (CLE) with cetuximab, an antibody targeting the epidermal growth factor receptor (EGFR), for detection and moreover early prediction of response to molecular chemotherapy in models of human colorectal cancer (CRC). METHODS Xenografts with cetuximab-sensitive (HT29) and cetuximab-resistant (SW620) human CRC cell lines were induced in 44 mice. CLE was performed 48 h after injection of a fluorescently labelled cetuximab test dose, and compared with isotype antibody or untreated controls on d0, and d30 (HT29) or d15 (SW620). Initial fluorescence intensity was examined in relation to clinical readouts (tumor growth, thriving, mortality) during cetuximab treatment vs. controls. Results were validated in vivo with wide-field molecular imaging in three HT29 mice and ex vivo using fluorescence-activated cell sorting (FACS) and immunohistochemistry. RESULTS All HT29 xenografts showed specific fluorescence in vivo after cetuximab injection on d0 and d30. Fluorescence at d0 was significantly stronger in cetuximab-treated HT29 tumors than in HT29 controls (P = 0.0017) or cetuximab-treated SW620 tumors (P = 0.0027), and accorded with significantly slower tumor progression (P = 0.0009), better overall survival (P = 0.02), and better physical condition (P < 0.0001). Cetuximab sensitivity could be predicted from fluorescence intensity at d0 with high positive predictive value. CONCLUSIONS Molecular CLE was for the first time linked to early prediction of response to targeted therapy in models of human CRC. Therapeutic antibodies can be used as molecular beacons in CLE and wide-field techniques. These results may indicate a promising principle for early patient stratification.
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Affiliation(s)
- M Goetz
- I. Medizinische Klinik und Poliklinik, Universtitäsmedizin Mainz, Mainz, Germany.
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Kiesslich R, Duckworth CA, Moussata D, Gloeckner A, Lim LG, Goetz M, Pritchard DM, Galle PR, Neurath MF, Watson AJM. Local barrier dysfunction identified by confocal laser endomicroscopy predicts relapse in inflammatory bowel disease. Gut 2012; 61:1146-53. [PMID: 22115910 PMCID: PMC3388727 DOI: 10.1136/gutjnl-2011-300695] [Citation(s) in RCA: 244] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Loss of intestinal barrier function plays an important role in the pathogenesis of inflammatory bowel disease (IBD). Shedding of intestinal epithelial cells is a potential cause of barrier loss during inflammation. The objectives of the study were (1) to determine whether cell shedding and barrier loss in humans can be detected by confocal endomicroscopy and (2) whether these parameters predict relapse of IBD. METHODS Confocal endomicroscopy was performed in IBD and control patients using intravenous fluorescein to determine the relationship between cell shedding and local barrier dysfunction. A grading system based on appearances at confocal endomicroscopy in humans was devised and used to predict relapse in a prospective pilot study of 47 patients with ulcerative colitis and 11 patients with Crohn's disease. RESULTS Confocal endomicroscopy in humans detected shedding epithelial cells and local barrier defects as plumes of fluorescein effluxing through the epithelium. Mouse experiments demonstrated inward flow through some leakage-associated shedding events, which was increased when luminal osmolarity was decreased. In IBD patients in clinical remission, increased cell shedding with fluorescein leakage was associated with subsequent relapse within 12 months after endomicroscopic examination (p<0.001). The sensitivity, specificity and accuracy for the grading system to predict a flare were 62.5% (95% CI 40.8% to 80.4%), 91.2% (95% CI 75.2 to 97.7) and 79% (95% CI 57.7 to 95.5), respectively. CONCLUSIONS Cell shedding and barrier loss detected by confocal endomicroscopy predicts relapse of IBD and has potential as a diagnostic tool for the management of the disease.
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Affiliation(s)
- R Kiesslich
- Medical Department, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - C A Duckworth
- Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, UK
| | - D Moussata
- Department of Gastroenterology, Lyon Sud Hospital, Claude Bernard University, Pierre Benite, France
| | - A Gloeckner
- Medical Department, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - L G Lim
- Department of Gastroenterology and Hepatology, National University Health System, Yong Yoo Lin School of Medicine, National University of Singapore, Singapore
| | - M Goetz
- Medical Department, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - D M Pritchard
- Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, UK
| | - P R Galle
- Medical Department, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M F Neurath
- Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany
| | - A J M Watson
- Faculty of Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich UK
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Kiesslich R, Schuster N, Hoffman A, Goetz M, Galle PR, Santo E, Halpern Z. MedJet--a new CO2-based disposable cleaning device allows safe and effective bowel cleansing during colonoscopy: a pilot study. Endoscopy 2012; 44:767-71. [PMID: 22438188 DOI: 10.1055/s-0031-1291703] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND STUDY AIMS Complete bowel cleansing is mandatory for effective colon cancer screening and surveillance. The aim of the current pilot study, which was conducted in humans, was to test the safety and efficiency of a newly developed disposable cleaning device, the MedJet, for intraprocedural bowel cleansing. PATIENTS AND METHODS Patients with screening or surveillance colonoscopy after previous polypectomy were included. The colonoscope was first inserted to the cecum and the overall cleansing was assessed according to the Ottawa scale. The MedJet device was used if colon cleansing had been incomplete. The MedJet catheter was passed over the working channel of the colonoscope and the colon was cleaned during withdrawal. The MedJet device delivered controlled jets comprising compressed CO2 and minimal amounts of sterile water, which allowed disintegration and removal of residual stool. The efficiency of cleaning was assessed according to the Boston scale. RESULTS A total of 32 patients (16 female; mean age 61 years) were treated with the device. No device-related adverse or serious adverse events were noted. MedJet application during withdrawal provided effective and significant improvement in bowel cleansing (P = 0.005). Furthermore, 18 adenomas and 1 colon cancer, which were hidden behind stool remnants, could be identified in 11 patients following use of the MedJet device. However, the withdrawal times were prolonged (11.4±6.0 minutes) due to the additional cleaning procedure. All patients tolerated the procedure well. CONCLUSIONS The new MedJet device enabled highly effective and safe bowel cleansing during colonoscopy. The catheter-based system was easy to use and CO2 was applied for cleansing. The procedure was well tolerated by patients.
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Affiliation(s)
- R Kiesslich
- I. Med. Klinik, Universitätsmedizin Mainz, Langenbeckstrasse 1, Mainz, Germany.
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Ploch P, Schimanski CC, Goetz M, Orth C, Lang H, Galle PR, Schuchmann M, Kittner JM. [With the scalpel against the immune system: HIV infection complicated by an unclear colitis]. Z Gastroenterol 2012; 50:382-5. [PMID: 22467540 DOI: 10.1055/s-0031-1273454] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A 35-year-old Kenian lady with advanced immunodeficiency due to HIV infection started on an antiretroviral therapy. Five months later, a severe colitis was diagnosed, however, no causal pathogen could be found. In order to avoid imminent perforation, a hemicolectomy became necessary, and immediately the symptoms and inflammation markers normalized rapidly. M. tuberculosis could be proven in culture in a draining abdominal lymph node. We assume that the severe inflammation was caused by an immune restoration inflammatory syndrome (IRIS). Essentials in diagnosis, pathogenesis and therapy of IRIS are discussed.
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Affiliation(s)
- P Ploch
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
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Goetz M, Hou X, Suman V, Reinicke K, Kuffel M, Haluska P, Oberg A, Grill D, Reid J, Brodie A, Ingle J, Ames M. PD01-06: Endoxifen Exhibits Potent Anti-Tumor Activity and Regulates Different Genes Than Tamoxifen in an Aromatase Expressing MCF7 Model Resistant to Letrozole. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-pd01-06] [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: First in human studies of Z-endoxifen hydrochloride (E), the active metabolite of tamoxifen (T), are underway in metastatic breast cancer (BC). Previous data have demonstrated the superiority of aromatase inhibitors (AI's) over T in estrogen receptor (ER) + BC. Using an in vivo aromatase expressing model (MCF7/AC1), we compared the antitumor activity of E with T and Letrozole (L), as well as the antitumor activity and global gene expression changes of E with T in an L-resistant model.
Methods: MCF7/AC1 tumors were stimulated with androstenedione. Once tumor size reached 300 mm3, mice (30/group) were randomly assigned to one of five treatment groups: control (daily, po), T (500 μg/day, sc), endoxifen 25 mg/kg/day p.o.(LDE) endoxifen 75 mg/kg/day p.o. (HDE) or letrozole, 10 μg/day s.c for 4 weeks. Tumors were harvested from control, T, and E groups while the L group continued treatment until the development of resistance defined as an increase in tumor volume of at least 300% from day 1. Mice with L-resistant tumors were randomly assigned to T (n=4) or E (n=5) for 4 weeks and then sacrificed. Gene expression in L-resistant tumors was quantified using Affymetrix U133+2 and changes in gene expression profiles [comparing T and E with L-resistant (n=3)] were analyzed. Genes identified as significantly different were confirmed by real-time RT-PCR assays.
Results: At the 4 week time point, both doses of E and L resulted in greater anti-tumor activity than control (Wilcoxon rank sum test: all p < 0.0001); however, tumor burden did not differ between T and control (p=0.095). HDE resulted in significantly less tumor burden than T (p=0.002) but was similar to L. In mice that continued on L, resistance developed at 24 weeks in 9/25 mice. These mice were randomly assigned to either T (n=4) or E (n=5) for 4 weeks. Tumor volume (expressed as a% of its size prior to randomization) was significantly different comparing E (73.3%; range: 69.3 to 80.75%) versus T (148.39%; range: 114.07 to 165.99%) (Wilcoxon rank sum test p=0.016). Compared to control, microarray studies identified 1518 unique probe sets regulated by E (p<0.001) compared to 441 for T including estrogen-regulated genes such as progesterone receptor (PGR) and amphiregulin (AREG) that were significantly down-regulated in the E group [PGR (−6.2 fold, p=0.000008) and AREG (−3.2 fold, p=.0006) but unchanged or up-regulated in the T group (PGR unchanged and AREG +9.2 fold p=0.00002). These findings were confirmed by RT-PCR.
Conclusions: Using the MCF7/AC1 model previously used to show the superiority of AI's over T, HDE demonstrated similar antitumor activity to L and was superior to T. In cells resistant to L, E was superior to T and gene expression changes demonstrate that E down-regulates while T activates estrogen regulated genes. These findings support the ongoing development of E for the treatment of ER+ BC.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD01-06.
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Affiliation(s)
- M Goetz
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - X Hou
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - V Suman
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - K Reinicke
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - M Kuffel
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - P Haluska
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - A Oberg
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - D Grill
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - J Reid
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - A Brodie
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - J Ingle
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
| | - M Ames
- 1Mayo Clinic, Rochester, MN; University of Maryland, Baltimore, MD
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Karch HW, Gockel I, Goetz M, Kreft A, Lang H. [Granular-cell tumor (Abrikossoff's tumor): precise preoperative diagnosis is crucial when for minimally-invasive resection]. Dtsch Med Wochenschr 2011; 136:1609-12. [PMID: 21809253 DOI: 10.1055/s-0031-1281564] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
HISTORY AND ADMISSION FINDINGS A 38-year-old man was referred to a gastroenterologist because of thoracic pain and dysphagia of uncertain cause. INVESTIGATIONS Endoscopy revealed a centrally depressed, coarse submucosal tumor, 1.0 cm in diameter, in the anterior wall of the esophagus at about 35 cm from the teeth. Button-hole biopsy revealed histologically and immunohistochemically a granular cell tumor (Abrikossoff's tumor), positive for S-100 protein. CT-staging was unremarkable, except for a thickening of the distal esophageal wall. TREATMENT AND COURSE Minimally invasive submucosal resection was undertaken using the videoscopic/endoscopic rendezvous technique. Histological examination confirmed complete resection of the tumor. The clinical course was uneventful and endoscopy 6 and 12 weeks after the operation showed complete resection of the tumor. CONCLUSION An exact preoperative diagnosis beyond a mere description of site and morphology, but also providing the histopathological data creates favorable conditions for planning and performing a minimally invasive resection. Submucosal resection with the videoscopic/endoscopic in rendezvous technique offers the possibility of complete resection, which can often not be achieved in a submucosal tumor by only endoscopic resection.
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Babiak AM, Steinhauser M, Hofmann S, Conzelmann J, Schneider V, Goetz M, Zhang L, Dohner H, Greiner J. Implications of specific T-cell responses by different novel and known immunogenic tumor-associated antigens (TAA) in patients with metastatic lung cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10619] [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: 11/20/2022] Open
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Keppner H, Torres P, Meier J, Platz R, Fischer D, Kroll U, Dubail S, Anna Selvan JA, Pellaton Vaucher N, Ziegler Y, Tscharner R, Hof C, Beck N, Goetz M, Pernet P, Goerlitzer M, Wyrsch N, Veuille J, Cuperus J, Shah A, Pohl J. The “Micromorph” Cell: a New Way to High-Efficiency-Low-Temperature Crystalline Silicon Thin-Film Cell Manufacturing? ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-452-865] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractIn the past, microcrystalline silicon (μc-Si:H) has been successfully used as active semiconductor in entirely μc-Si:H p-i-n solar cells and a new type of tandem solar cell, called the “micromorph” cell, was introduced [1]. Micromorph cells consist of an amorphous silicon top cell and a microcrystalline bottom cell. In the paper a micromorph cell with a stable efficiency of 10.7 % (confirmed by ISE Freiburg) is reported.Among sofar existing crystalline silicon-based solar cell manufacturing techniques, the application of microcrystalline silicon is a new promising way towards implementing thin-film silicon solar cells with a low temperature deposition. Microcrystalline silicon can, indeed, be deposited at temperatures as low as 220°C; hence, the way is here open to use cheap substrates as, e.g. plastic or glass. In the present paper, the development of single and tandem cells containing microcrystalline silicon is reviewed. As stated in previous publications, microcrystalline silicon technique has at present a severe drawback that has yet to be overcome: Its deposition rate for solar-grade material is about 2Å/s; in a more recent case 4.3 Å/s [2] could be obtained. In the present paper, using suitable mixtures of silane, hydrogen and argon, deposition rates of 9.4 Å/s are presented. Thereby the dominating plasma mechanism and the basic properties of resulting layers are described in detail. A first entirely microcrystalline cell deposited at 8.7 Å/s has an efficiency of 3.15%.
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