1
|
Abdel-Fatah TMA, Ball GR, Thangavelu PU, Reid LE, McCart Reed AE, Saunus JM, Duijf PHG, Simpson PT, Lakhani SR, Pongor L, Győrffy B, Moseley PM, Green AR, Pockley AG, Caldas C, Ellis IO, Chan SYT. Association of Sperm-Associated Antigen 5 and Treatment Response in Patients With Estrogen Receptor-Positive Breast Cancer. JAMA Netw Open 2020; 3:e209486. [PMID: 32633764 PMCID: PMC7341179 DOI: 10.1001/jamanetworkopen.2020.9486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/25/2020] [Indexed: 01/09/2023] Open
Abstract
Importance There is no proven test that can guide the optimal treatment, either endocrine therapy or chemotherapy, for estrogen receptor-positive breast cancer. Objective To investigate the associations of sperm-associated antigen 5 (SPAG5) transcript and SPAG5 protein expressions with treatment response in systemic therapy for estrogen receptor-positive breast cancer. Design, Settings, and Participants This retrospective cohort study included patients with estrogen receptor-positive breast cancer who received 5 years of adjuvant endocrine therapy with or without neoadjuvant anthracycline-based combination chemotherapy (NACT) derived from 11 cohorts from December 1, 1986, to November 28, 2019. The associations of SPAG5 transcript and SPAG5 protein expression with pathological complete response to NACT were evaluated, as was the association of SPAG5 mRNA expression with response to neoadjuvant endocrine therapy. The associations of distal relapse-free survival with SPAG5 transcript or SPAG5 protein expressions were analyzed. Data were analyzed from September 9, 2015, to November 28, 2019. Main Outcomes and Measures The primary outcomes were breast cancer-specific survival, distal relapse-free survival, pathological complete response, and clinical response. Outcomes were examined using Kaplan-Meier, multivariable logistic, and Cox regression models. Results This study included 12 720 women aged 24 to 78 years (mean [SD] age, 58.46 [12.45] years) with estrogen receptor-positive breast cancer, including 1073 women with SPAG5 transcript expression and 361 women with SPAG5 protein expression of locally advanced disease stage IIA through IIIC. Women with SPAG5 transcript and SPAG5 protein expressions achieved higher pathological complete response compared with those without SPAG5 transcript or SPAG5 protein expressions (transcript: odds ratio, 2.45 [95% CI, 1.71-3.51]; P < .001; protein: odds ratio, 7.32 [95% CI, 3.33-16.22]; P < .001). Adding adjuvant anthracycline chemotherapy to adjuvant endocrine therapy for SPAG5 mRNA expression in estrogen receptor-positive breast cancer was associated with prolonged 5-year distal relapse-free survival in patients without lymph node involvement (hazard ratio, 0.34 [95% CI, 0.14-0.87]; P = .03) and patients with lymph node involvement (hazard ratio, 0.35 [95% CI, 0.18-0.68]; P = .002) compared with receiving 5-year endocrine therapy alone. Mean (SD) SPAG5 transcript was found to be downregulated after 2 weeks of neoadjuvant endocrine therapy compared with pretreatment levels in 68 of 92 patients (74%) (0.23 [0.18] vs 0.34 [0.24]; P < .001). Conclusions and Relevance These findings suggest that SPAG5 transcript and SPAG5 protein expressions could be used to guide the optimal therapies for estrogen receptor-positive breast cancer. Retrospective and prospective clinical trials are warranted.
Collapse
Affiliation(s)
- Tarek M. A. Abdel-Fatah
- Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
- Department of Pathology, National Liver Institute, Menoufyia University, Al Minufya, Egypt
| | - Graham R. Ball
- John van Geest Cancer Research Centre, Nottingham Trent University School of Science and Technology, Nottingham United Kingdom
| | - Pulari U. Thangavelu
- Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, Australia
| | - Lynne E. Reid
- UQ Centre for Clinical Research, Faculty of Research, The University of Queensland, Herston, Australia
| | - Amy E. McCart Reed
- UQ Centre for Clinical Research, Faculty of Research, The University of Queensland, Herston, Australia
| | - Jodi M. Saunus
- UQ Centre for Clinical Research, Faculty of Research, The University of Queensland, Herston, Australia
| | - Pascal H. G. Duijf
- Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, Australia
| | - Peter T. Simpson
- UQ Centre for Clinical Research, Faculty of Research, The University of Queensland, Herston, Australia
| | - Sunil R. Lakhani
- UQ Centre for Clinical Research, Faculty of Research, The University of Queensland, Herston, Australia
- Pathology Queensland, The Royal Brisbane and Women’s Hospital, Herston, Australia
| | - Lorinc Pongor
- Lendület Cancer Biomarker Research Group, Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Balázs Győrffy
- Lendület Cancer Biomarker Research Group, Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Paul M. Moseley
- Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Andrew R. Green
- Nottingham Breast Cancer Research Center, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, United Kingdom
| | - Alan G. Pockley
- John van Geest Cancer Research Centre, Nottingham Trent University School of Science and Technology, Nottingham United Kingdom
| | - Carlos Caldas
- Department of Oncology and Cancer Research, UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom
| | - Ian O. Ellis
- Nottingham Breast Cancer Research Center, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, United Kingdom
| | - Stephen Y. T. Chan
- Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| |
Collapse
|
2
|
Abdel-Fatah TMA, Ali R, Sadiq M, Moseley PM, Mesquita KA, Ball G, Green AR, Rakha EA, Chan SYT, Madhusudan S. ERCC1 Is a Predictor of Anthracycline Resistance and Taxane Sensitivity in Early Stage or Locally Advanced Breast Cancers. Cancers (Basel) 2019; 11:cancers11081149. [PMID: 31405143 PMCID: PMC6721618 DOI: 10.3390/cancers11081149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 01/12/2023] Open
Abstract
Genomic instability could be a beneficial predictor for anthracycline or taxane chemotherapy. We interrogated 188 DNA repair genes in the METABRIC cohort (n = 1980) to identify genes that influence overall survival (OS). We then evaluated the clinicopathological significance of ERCC1 in early stage breast cancer (BC) (mRNA expression (n = 4640) and protein level, n = 1650 (test set), and n = 252 (validation)) and in locally advanced BC (LABC) (mRNA expression, test set (n = 2340) and validation (TOP clinical trial cohort, n = 120); and protein level (n = 120)). In the multivariate model, ERCC1 was independently associated with OS in the METABRIC cohort. In ER+ tumours, low ERCC1 transcript or protein level was associated with increased distant relapse risk (DRR). In ER−tumours, low ERCC1 transcript or protein level was linked to decreased DRR, especially in patients who received anthracycline chemotherapy. In LABC patients who received neoadjuvant anthracycline, low ERCC1 transcript was associated with higher pCR (pathological complete response) and decreased DRR. However, in patients with ER−tumours who received additional neoadjuvant taxane, high ERCC1 transcript was associated with a higher pCR and decreased DRR. High ERCC1 transcript was also linked to decreased DRR in ER+ LABC that received additional neoadjuvant taxane. ERCC1 based stratification is an attractive strategy for breast cancers.
Collapse
Affiliation(s)
| | - Reem Ali
- Translational Oncology, Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Maaz Sadiq
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Katia A Mesquita
- Translational Oncology, Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Graham Ball
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Andrew R Green
- Academic Pathology, Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Emad A Rakha
- Academic Pathology, Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Stephen Y T Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK.
| | - Srinivasan Madhusudan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK.
- Translational Oncology, Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK.
| |
Collapse
|
3
|
Abdel-Fatah TMA, Webb R, Li R, Chen X, Giannotti E, Auer D, Walker J, Moseley PM, Pockley AG, Ball G, Ellis IO, Rakhah E, Hodi Z, Lee A, Chan A, Chan S. Evidence that neoadjuvant anthracycline based combination chemotherapy (NACT) in breast cancer (BC) induces phenotypical changes which guides the optimal adjuvant therapy. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
590 Background: We hereby evaluated the histopathological and radiological alterations of tumor characteristics after receiving NACT and the clinical significance of the changes of adjuvant therapy based on these findings. Methods: A pathological assessment of tumor features including ER, PR, HER2 and proliferation markers (Ki67 and SPAG5) status in pre and post NACT tumors tissue have been centrally evaluated in two cohorts [Nottingham University Hospital (NUH; n=850) and Australian cohort (n=250 patients)]. Since 2013 any change in the ER and HER2 status from negative (-) [in the pre NACT biopsies] to positive (+) [in the post NACT surgical specimens] received additional adjuvant therapy (Endocrine therapy (ET) for ER+ and Trastuzumab for HER2+ cases) in NUH. MRI volumetric and texture changes have been assessed in 400 cases. The primary end point was disease free survival (DFS; median follow-up = 62 months). Results: 10% of pre NACT HER2- cases had been converted to post NACT HER2+ and those cases who subsequently received adjuvant Trastuzumab had achieved 92% 5-year DFS compared to those who remained HER- in post NACT specimens (58% 5-year DFS); (HR (95% CI)= 0.25 (0.08-0.80); p=0.016). While 13% of pre NACT HER2+ tumors were converted into HER2- in post NACT surgical specimens and had similar 5-year DFS to those who remained post NACT HER2+ (5-year DFS= 94% vs., 87%; p=0.613). Loss of PR in the residual disease of pre NACT ER+ BC was associated with shorter 5-year DFS after ET compared to those who remained post NACT PR+ (HR (95% CI)=2.1 (1.25-3.46); p=0.005). After NACT, 40% of pre NACT SPAG5+ cases were converted into post NACT SPAG5- and these patients had prolonged DFS compared to those who remained SPAG5+ in post NACT specimens (27%) [5-year DFS=84% vs 49%; (HR (95% CI)= 3.8 (2.1-6.9); p<0.0001). A prognostic model has been generated including factors in table (AUC = 0.854 (95% CI) = 0.777-.0.931; p= 0.00000001]. Conclusions: We hereby showed evidences a change of treatment strategy based on the changes in the tumor post NACT phenotype gives the optimal choice of treatment eg., the introduction of HER2 targeting therapy for the conversion of HER2– to HER2+ phenotype after NACT improved DFS. Multivariate Cox regression model for 5-year DFS. [Table: see text]
Collapse
Affiliation(s)
| | - Rebekah Webb
- Nottingham City Hospital NHS Trust, Nottingham, United Kingdom
| | - Ruizhe Li
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Xin Chen
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | | | - Dorothee Auer
- Radiology Department, University of Nottingham, Nottingham, United Kingdom
| | - Jennifer Walker
- Nottingham City Hospital NHS Trust, Nottingham, United Kingdom
| | - Paul M Moseley
- Nottingham University City Hospital NHS Trust, Nottingham, United Kingdom
| | - A. Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Graham Ball
- Nottingham Trent University, Nottingham, United Kingdom
| | - Ian O. Ellis
- University of Nottingham, Nottingham, United Kingdom
| | - Emad Rakhah
- University of Nottingham, Nottingham, United Kingdom
| | - Zsolt Hodi
- Nottingham City Hospital NHS Trust, Nottingham, United Kingdom
| | - Andrew Lee
- Histopathology Department, Nottingham City Hospital, Nottingham, United Kingdom
| | - Arlene Chan
- Breast Cancer Research Centre-WA & Curtin University, Perth, Australia
| | - Stephen Chan
- Nottingham City Hospital, Nottingham, United Kingdom
| |
Collapse
|
4
|
Abdel-Fatah TMA, Broom RJ, Lu J, Moseley PM, Huang B, Li L, Liu S, Chen L, Ma RZ, Cao W, Wang X, Li Y, Perry JK, Aleskandarany M, Nolan CC, Rakha EA, Lobie PE, Chan SYT, Ellis IO, Hwang LA, Lane DP, Green AR, Liu DX. SHON expression predicts response and relapse risk of breast cancer patients after anthracycline-based combination chemotherapy or tamoxifen treatment. Br J Cancer 2019; 120:728-745. [PMID: 30816325 PMCID: PMC6461947 DOI: 10.1038/s41416-019-0405-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/27/2019] [Accepted: 01/29/2019] [Indexed: 12/31/2022] Open
Abstract
Background SHON nuclear expression (SHON-Nuc+) was previously reported to predict clinical outcomes to tamoxifen therapy in ERα+ breast cancer (BC). Herein we determined if SHON expression detected by specific monoclonal antibodies could provide a more accurate prediction and serve as a biomarker for anthracycline-based combination chemotherapy (ACT). Methods SHON expression was determined by immunohistochemistry in the Nottingham early-stage-BC cohort (n = 1,650) who, if eligible, received adjuvant tamoxifen; the Nottingham ERα− early-stage-BC (n = 697) patients who received adjuvant ACT; and the Nottingham locally advanced-BC cohort who received pre-operative ACT with/without taxanes (Neo-ACT, n = 120) and if eligible, 5-year adjuvant tamoxifen treatment. Prognostic significance of SHON and its relationship with the clinical outcome of treatments were analysed. Results As previously reported, SHON-Nuc+ in high risk/ERα+ patients was significantly associated with a 48% death risk reduction after exclusive adjuvant tamoxifen treatment compared with SHON-Nuc− [HR (95% CI) = 0.52 (0.34–0.78), p = 0.002]. Meanwhile, in ERα− patients treated with adjuvant ACT, SHON cytoplasmic expression (SHON-Cyto+) was significantly associated with a 50% death risk reduction compared with SHON-Cyto− [HR (95% CI) = 0.50 (0.34–0.73), p = 0.0003]. Moreover, in patients received Neo-ACT, SHON-Nuc− or SHON-Cyto+ was associated with an increased pathological complete response (pCR) compared with SHON-Nuc+ [21 vs 4%; OR (95% CI) = 5.88 (1.28–27.03), p = 0.012], or SHON-Cyto− [20.5 vs. 4.5%; OR (95% CI) = 5.43 (1.18–25.03), p = 0.017], respectively. After receiving Neo-ACT, patients with SHON-Nuc+ had a significantly lower distant relapse risk compared to those with SHON-Nuc− [HR (95% CI) = 0.41 (0.19–0.87), p = 0.038], whereas SHON-Cyto+ patients had a significantly higher distant relapse risk compared to SHON-Cyto− patients [HR (95% CI) = 4.63 (1.05–20.39), p = 0.043]. Furthermore, multivariate Cox regression analyses revealed that SHON-Cyto+ was independently associated with a higher risk of distant relapse after Neo-ACT and 5-year tamoxifen treatment [HR (95% CI) = 5.08 (1.13–44.52), p = 0.037]. The interaction term between ERα status and SHON-Nuc+ (p = 0.005), and between SHON-Nuc+ and tamoxifen therapy (p = 0.007), were both statistically significant. Conclusion SHON-Nuce+ in tumours predicts response to tamoxifen in ERα+ BC while SHON-Cyto+ predicts response to ACT.
Collapse
Affiliation(s)
- Tarek M A Abdel-Fatah
- Department of Clinical Oncology, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.,National Liver Institute, Menoufyia University, Menoufyia, Egypt
| | | | - Jun Lu
- The Institute of Genetics and Cytology, Northeast Normal University, Changchun, China
| | - Paul M Moseley
- Department of Clinical Oncology, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Baiqu Huang
- The Key Laboratory of Molecular Epigenetics of Ministry of Education (MOE), Northeast Normal University, Changchun, China
| | - Lili Li
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Suling Liu
- Fudan University Shanghai Cancer Center & Institutes of Biomedical Sciences, Shanghai Medical College, Key Laboratory of Breast Cancer in Shanghai, Cancer Institutes, Fudan University, Shanghai, China
| | - Longxin Chen
- Laboratory of Molecular Biology, Zhengzhou Normal University, Zhengzhou, China
| | - Runlin Z Ma
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Wenming Cao
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Xiaojia Wang
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Yan Li
- The Centre for Biomedical and Chemical Sciences, School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Jo K Perry
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Mohammed Aleskandarany
- Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Christopher C Nolan
- Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Emad A Rakha
- Department of Histopathology, School of Medicine, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, UK
| | - Peter E Lobie
- Tsinghua Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, Guangdong, China
| | - Stephen Y T Chan
- Department of Clinical Oncology, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Ian O Ellis
- Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | - Le-Ann Hwang
- p53 Laboratory, Biomedical Sciences Institutes, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - David P Lane
- p53 Laboratory, Biomedical Sciences Institutes, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Andrew R Green
- Nottingham Breast Cancer Research Centre, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK.
| | - Dong-Xu Liu
- The Institute of Genetics and Cytology, Northeast Normal University, Changchun, China. .,The Centre for Biomedical and Chemical Sciences, School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
| |
Collapse
|
5
|
Copson E, Shaaban AM, Maishman T, Moseley PM, McKenzie H, Bradbury J, Borley A, Brzezinska M, Chan SYT, Ching J, Cutress RI, Danial I, Dall B, Kerin M, Lowery AJ, Macpherson IR, Romics L, Sawyer E, Sharmat N, Sircar T, Vidya R, Pan Y, Rea D, Jones L, Eccles DM, Berditchevski F. The presentation, management and outcome of inflammatory breast cancer cases in the UK: Data from a multi-centre retrospective review. Breast 2018; 42:133-141. [PMID: 30278369 DOI: 10.1016/j.breast.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Inflammatory Breast cancer (IBC) is a rare but aggressive form of breast cancer. Its incidence and behaviour in the UK is poorly characterised. We collected retrospective data from hospitals in the UK and Ireland to describe the presentation, pathology, treatment and clinical course of IBC in the UK. MATERIALS AND METHODS Patients with IBC diagnosed between 1997-2014 at fourteen UK and Irish hospitals were identified from local breast unit databases. Patient characteristics, tumour pathology and stage, and details of surgical, systemic and radiotherapy treatment and follow-up data were collected from electronic patient records and medical notes. RESULT This retrospective review identified 445 patients with IBC accounting for 0.4-1.8% of invasive breast cancer cases. Median follow-up was 4.2 years. 53.2% of tumours were grade 3, 56.2% were oestrogen receptor positive, 31.3% were HER2 positive and 25.1% were triple negative. 20.7% of patients had distant metastases at presentation. Despite trimodality treatment in 86.4%, 40.1% of stage III patients developed distant metastases. Five-year overall survival (OS) was 61.0% for stage III and 21.4% for stage IV patients. CONCLUSIONS This is the largest series of UK IBC patients reported to date. It indicates a lower incidence than in American series, but confirms that IBC has a high risk of recurrence with poor survival despite contemporary multi-modality therapy. A national strategy is required to facilitate translational research into this aggressive disease.
Collapse
Affiliation(s)
- E Copson
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK.
| | - A M Shaaban
- Department of Histopathology and University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW, UK
| | - T Maishman
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - P M Moseley
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - H McKenzie
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - J Bradbury
- Department of Oncology, Salisbury NHS Foundation Trust, Salisbury District Hospital, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK
| | - A Borley
- Velindre Cancer Centre, Whitchurch, Cardiff, CF14 2TL, UK
| | - M Brzezinska
- Edinburgh Breast Unit, Western General Hospital, Edinburgh, Crewe Road South Edinburgh, EH4 2XU, UK
| | - S Y T Chan
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - J Ching
- Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, BH15 2JB, UK
| | - R I Cutress
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - I Danial
- Department of Histopathology and University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW, UK
| | - B Dall
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Leeds Teaching Hospitals NHS Trust, Becket Street, Leeds, LS9 7TF, UK
| | - M Kerin
- The Lambe Institute for Translational Research, National University of Ireland & University Hospital Galway, Galway, Ireland
| | - A J Lowery
- The Lambe Institute for Translational Research, National University of Ireland & University Hospital Galway, Galway, Ireland
| | - I R Macpherson
- Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, G61 1QH, UK
| | - L Romics
- Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, G61 1QH, UK
| | - E Sawyer
- Research Oncology, Division of Cancer Studies, Guy's Hospital, King's College London, London, SE1 9RT, UK
| | - N Sharmat
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Leeds Teaching Hospitals NHS Trust, Becket Street, Leeds, LS9 7TF, UK
| | - T Sircar
- Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton Road, Wolverhampton, WV10 0QP, UK
| | - R Vidya
- Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton Road, Wolverhampton, WV10 0QP, UK
| | - Y Pan
- Centre for Computational Biology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - D Rea
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - L Jones
- Barts NHS Trust and Barts Cancer Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - D M Eccles
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - F Berditchevski
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| |
Collapse
|
6
|
Foulds GA, Vadakekolathu J, Abdel-Fatah TMA, Nagarajan D, Reeder S, Johnson C, Hood S, Moseley PM, Chan SYT, Pockley AG, Rutella S, McArdle SEB. Immune-Phenotyping and Transcriptomic Profiling of Peripheral Blood Mononuclear Cells From Patients With Breast Cancer: Identification of a 3 Gene Signature Which Predicts Relapse of Triple Negative Breast Cancer. Front Immunol 2018; 9:2028. [PMID: 30254632 PMCID: PMC6141692 DOI: 10.3389/fimmu.2018.02028] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/17/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Interactions between the immune system and tumors are highly reciprocal in nature, leading to speculation that tumor recurrence or therapeutic resistance could be influenced or predicted by immune events that manifest locally, but can be detected systemically. Methods: Multi-parameter flow cytometry was used to examine the percentage and phenotype of natural killer (NK) cells, myeloid-derived suppressor cells (MDSCs), monocyte subsets and regulatory T (Treg) cells in the peripheral blood of of 85 patients with breast cancer (50 of whom were assessed before and after one cycle of anthracycline-based chemotherapy), and 23 controls. Transcriptomic profiles of peripheral blood mononuclear cells (PBMCs) in 23 patients were generated using a NanoString gene profiling platform. Results: An increased percentage of immunosuppressive cells such as granulocytic MDSCs, intermediate CD14++CD16+ monocytes and CD127negCD25highFoxP3+ Treg cells was observed in patients with breast cancer, especially patients with stage 3 and 4 disease, regardless of ER status. Following neoadjuvant chemotherapy, B cell numbers decreased significantly, whereas monocyte numbers increased. Although chemotherapy had no effect on the percentage of Treg, MDSC and NK cells, the expression of inhibitory receptors CD85j, LIAR and NKG2A and activating receptors NKp30 and NKp44 on NK cells increased, concomitant with a decreased expression of NKp46 and DNAM-1 activating receptors. Transcriptomic profiling revealed a distinct group of 3 patients in the triple negative breast cancer (TNBC) cohort who expressed high levels of mRNA encoding genes predominantly involved in inflammation. The analysis of a large transcriptomic dataset derived from the tumors of patients with TNBC revealed that the expression of CD163, CXCR4, THBS1 predicted relapse-free survival. Conclusions: The peripheral blood immunome of patients with breast cancer is influenced by the presence and stage of cancer, but not by molecular subtypes. Furthermore, immune profiling coupled with transcriptomic analyses of peripheral blood cells may identify patients with TNBC that are at risk of relapse after chemotherapy.
Collapse
Affiliation(s)
- Gemma A Foulds
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Jayakumar Vadakekolathu
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Tarek M A Abdel-Fatah
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Divya Nagarajan
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Stephen Reeder
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Catherine Johnson
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Simon Hood
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Paul M Moseley
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Stephen Y T Chan
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham, United Kingdom
| | - A Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Sergio Rutella
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Stephanie E B McArdle
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| |
Collapse
|
7
|
Abdel-Fatah TMA, Ball G, Reid AM, Simpson P, Lakhani SR, Pongor L, Gyorffy B, Moseley PM, Green AR, Pockley AG, Caldas C, Ellis IO, Chan S. Sperm associated antigen 5 (SPAG5) as a predictor and monitor for response and distant relapse risk (DRR) to endocrine (ET) and chemo-therapies (CT) in oestrogen receptor positive (ER+) breast cancer (BC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Graham Ball
- Van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Amy McCart Reid
- University of Queensland, Centre for Clinical Research (UQCCR), Queensland, Australia
| | - Peter Simpson
- University of Queensland, Centre for Clinical Research (UQCCR), Queensland, Australia
| | | | | | | | - Paul M Moseley
- Nottingham University City Hospital NHS Trust, Nottingham, United Kingdom
| | | | - A. Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Carlos Caldas
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom
| | - Ian O. Ellis
- University of Nottingham, Nottingham, United Kingdom
| | - Stephen Chan
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| |
Collapse
|
8
|
Al-Subhi N, Ali R, Abdel-Fatah T, Moseley PM, Chan SYT, Green AR, Ellis IO, Rakha EA, Madhusudan S. Targeting ataxia telangiectasia-mutated- and Rad3-related kinase (ATR) in PTEN-deficient breast cancers for personalized therapy. Breast Cancer Res Treat 2018; 169:277-286. [PMID: 29396668 PMCID: PMC5945733 DOI: 10.1007/s10549-018-4683-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 01/18/2018] [Indexed: 11/05/2022]
Abstract
Purpose Phosphate and tensin homolog (PTEN), a negative regulator of PI3K signaling, is involved in DNA repair. ATR is a key sensor of DNA damage and replication stress. We evaluated whether ATR signaling has clinical significance and could be targeted by synthetic lethality in PTEN-deficient triple-negative breast cancer (TNBC). Methods PTEN, ATR and pCHK1Ser345 protein level was evaluated in 1650 human breast cancers. ATR blockade by VE-821 was investigated in PTEN-proficient- (MDA-MB-231) and PTEN-deficient (BT-549, MDA-MB-468) TNBC cell lines. Functional studies included DNA repair expression profiling, MTS cell-proliferation assay, FACS (cell cycle progression & γH2AX accumulation) and FITC-annexin V flow cytometry analysis. Results Low nuclear PTEN was associated with higher grade, pleomorphism, de-differentiation, higher mitotic index, larger tumour size, ER negativity, and shorter survival (p values < 0.05). In tumours with low nuclear PTEN, high ATR and/or high pCHK1ser345 level was also linked to higher grade, larger tumour size and poor survival (all p values < 0.05). VE-821 was selectively toxic in PTEN-deficient TNBC cells and resulted in accumulation of double-strand DNA breaks, cell cycle arrest, and increased apoptosis. Conclusion ATR signalling adversely impact survival in PTEN-deficient breast cancers. ATR inhibition is synthetically lethal in PTEN-deficient TNBC cells. Electronic supplementary material The online version of this article (10.1007/s10549-018-4683-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nouf Al-Subhi
- Translational Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Reem Ali
- Translational Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Tarek Abdel-Fatah
- Department of Oncology, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Stephen Y T Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Andrew R Green
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Ian O Ellis
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - Emad A Rakha
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, NG5 1PB, UK.
| | - Srinivasan Madhusudan
- Translational Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, NG5 1PB, UK. .,Department of Oncology, Nottingham University Hospitals, Nottingham, NG5 1PB, UK.
| |
Collapse
|
9
|
Naidoo K, Wai PT, Maguire SL, Daley F, Haider S, Kriplani D, Campbell J, Mirza H, Grigoriadis A, Tutt A, Moseley PM, Abdel-Fatah TMA, Chan SYT, Madhusudan S, Rhaka EA, Ellis IO, Lord CJ, Yuan Y, Green AR, Natrajan R. Evaluation of CDK12 Protein Expression as a Potential Novel Biomarker for DNA Damage Response-Targeted Therapies in Breast Cancer. Mol Cancer Ther 2018; 17:306-315. [PMID: 29133620 PMCID: PMC6284786 DOI: 10.1158/1535-7163.mct-17-0760] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/19/2017] [Accepted: 10/19/2017] [Indexed: 12/20/2022]
Abstract
Disruption of Cyclin-Dependent Kinase 12 (CDK12) is known to lead to defects in DNA repair and sensitivity to platinum salts and PARP1/2 inhibitors. However, CDK12 has also been proposed as an oncogene in breast cancer. We therefore aimed to assess the frequency and distribution of CDK12 protein expression by IHC in independent cohorts of breast cancer and correlate this with outcome and genomic status. We found that 21% of primary unselected breast cancers were CDK12 high, and 10.5% were absent, by IHC. CDK12 positivity correlated with HER2 positivity but was not an independent predictor of breast cancer-specific survival taking HER2 status into account; however, absent CDK12 protein expression significantly correlated with a triple-negative phenotype. Interestingly, CDK12 protein absence was associated with reduced expression of a number of DDR proteins including ATR, Ku70/Ku80, PARP1, DNA-PK, and γH2AX, suggesting a novel mechanism of CDK12-associated DDR dysregulation in breast cancer. Our data suggest that diagnostic IHC quantification of CDK12 in breast cancer is feasible, with CDK12 absence possibly signifying defective DDR function. This may have important therapeutic implications, particularly for triple-negative breast cancers. Mol Cancer Ther; 17(1); 306-15. ©2017 AACR.
Collapse
Affiliation(s)
- Kalnisha Naidoo
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Patty T Wai
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Division of Molecular Pathology, Centre for Evolution and Cancer and Centre for Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Sarah L Maguire
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Frances Daley
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Syed Haider
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Divya Kriplani
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - James Campbell
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Hasan Mirza
- Cancer Bioinformatics, Cancer Division, King's College London, London, United Kingdom
| | - Anita Grigoriadis
- Cancer Bioinformatics, Cancer Division, King's College London, London, United Kingdom
| | - Andrew Tutt
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Cancer Now Research Unit, King's College London, London, United Kingdom
| | - Paul M Moseley
- Clinical Oncology, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Tarek M A Abdel-Fatah
- Clinical Oncology, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Stephen Y T Chan
- Clinical Oncology, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Srinivasan Madhusudan
- Department of Histopathology and Division of Cancer & Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Emad A Rhaka
- Department of Histopathology and Division of Cancer & Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Ian O Ellis
- Department of Histopathology and Division of Cancer & Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Christopher J Lord
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Yinyin Yuan
- Division of Molecular Pathology, Centre for Evolution and Cancer and Centre for Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Andrew R Green
- Department of Histopathology and Division of Cancer & Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, United Kingdom
| | - Rachael Natrajan
- The Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom.
- Division of Molecular Pathology, Centre for Evolution and Cancer and Centre for Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| |
Collapse
|
10
|
Machado LR, Moseley PM, Moss R, Deen S, Nolan C, Spendlove I, Ramage JM, Chan SY, Durrant LG. High mobility group protein B1 is a predictor of poor survival in ovarian cancer. Oncotarget 2017; 8:101215-101223. [PMID: 29254158 PMCID: PMC5731868 DOI: 10.18632/oncotarget.20538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 08/07/2017] [Indexed: 01/16/2023] Open
Abstract
High-mobility group protein B1 (HMGB1) has been implicated in numerous tumour types where expression regulates tumour cell growth and survival. We hypothesised that high HMGB1 expression in ovarian tumours would predict poor patient survival. Using tissue microarrays of primary ovarian cancers combined with a comprehensive database of clinicopathological variables, the expression of HMGB1 was assessed by immunohistochemistry in two independent cohorts (n=194 and n=360) using a monoclonal antibody specific for HMGB1. Kaplan-Meier analysis showed an association of HMGB1 expression with progression free survival in the primary cohort (p=0.023). In the validation cohort, expression was associated with overall survival (p=0.002). Low expression of HMGB1 was protective and in a multivariate model HMGB1 expression was shown to be an independent predictor of poor survival in ovarian cancer (p=0.006). The role of HMGB1 in cancer is complex. As high levels of HMGB1 expression are likely to render ovarian cancer cells resistant to chemotherapy, therapies targeting the HMGB1 axis may be appropriate in the treatment of ovarian cancer patients.
Collapse
Affiliation(s)
- Lee R Machado
- Faculty of Health and Society, University of Northampton, Boughton Green Road, Northampton, NN2 7AL, United Kingdom.,Department of Genetics, University of Leicester, Leicester, LE1 7RH, UK.,Faculty of Science, Technology, Engineering & Mathematics, The Open University, Milton Keynes, MK7 6AA, UK
| | - Paul M Moseley
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Robert Moss
- Academic Department of Clinical Oncology, Division of Cancer and Stem cells, City Hospital Campus, University of Nottingham, Nottingham NG5 1PB, UK
| | - Suha Deen
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus Division of Clinical Pathology Division of Clinical Oncology, School of Molecular Medical Sciences, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UK
| | - Christopher Nolan
- Academic Department of Clinical Oncology, Division of Cancer and Stem cells, City Hospital Campus, University of Nottingham, Nottingham NG5 1PB, UK
| | - Ian Spendlove
- Academic Department of Clinical Oncology, Division of Cancer and Stem cells, City Hospital Campus, University of Nottingham, Nottingham NG5 1PB, UK
| | - Judith M Ramage
- Academic Department of Clinical Oncology, Division of Cancer and Stem cells, City Hospital Campus, University of Nottingham, Nottingham NG5 1PB, UK
| | - Stephen Yt Chan
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Lindy G Durrant
- Academic Department of Clinical Oncology, Division of Cancer and Stem cells, City Hospital Campus, University of Nottingham, Nottingham NG5 1PB, UK
| |
Collapse
|
11
|
Abdel-Fatah TMA, Agarwal D, Zafeiris D, Pongor L, Györffy B, Rueda OM, Moseley PM, Green AR, Liu DX, Pockley AG, Rees RC, Caldas C, Ellis IO, Ball GR, Chan SYT. Abstract P6-09-16: Identification of proliferation related derivers and their roles in precision medicine for breast cancers: A retrospective multidimensional comparative, integrated genomic, transcriptomic, and protein analysis. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-16] [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
Backgound and Aim: The best test to guide the choice of systemic therapy for breast cancer (BC) has not yet been identified. We did this study to identify factors that drive proliferation features in BC and assess their association with clinical outcomes after systemic therapy.
Methods: We applied an artificial neural network-based integrative data mining approach to three cohorts of patients with untreated lymph node (LN)-negative BC (Wang et al; n=286, Desmedt et al; n=198 and Schmidt et al; n=200). The results were validated in four cohorts of BC patients (the Nottingham discovery cohort (n=171), Uppsala cohort (n=249), The Cancer Genome Atlas-Breast Cancer project [TCGA-BRCA; n= 970] and Molecular Taxonomy of Breast Cancer International Consortium [METABRIC cohort; n=1980]. Genes that featured prominently in our interactome map of proliferation have been chosen to take them forward to investigate their clinicopathological relevance of their gene copy number aberrations (CNAs), mRNA transcript expression, and protein expression and their associations with breast cancer-specific survival (BCSS), distant relapse-free survival (DRFS) and pathological complete response (pCR) in ten international cohorts of BC (n>12000 patients).
Findings: ESR1, SPAG5, EGFR, BCL2, and FOXA1 were among the 39 common gene probes that were predictive across most proliferation features and datasets. In TCGA-BRCA cohort, SPAG5 gene mutation, gain/amplification and loss at the Ch17q11.2 locus were detected in 43 (4.4%), 177 (18.2%) and 180 (18.8%) of 970 patients, respectively and 65 (31%) of 479 ER-positive /HER-positive patients showed gain/amplification of SPAG5 gene. In multivariable analysis, high SPAG5 transcript and SPAG5 protein expression were associated with reduced BCSS compared with lower expression (METABRIC: HR 1·27, 95% CI 1·02–1·58, p=0·034; untreated LN-negative cohort: 2·34, 1·24–4·42, p=0·0090; and Nottingham-cohort: 1·73, 1·23–2·46, p=0·0020). In patients with ER-negative/HER2-negative or ER-positive/HER2-negative BC, high SPAG5 transcript expression was associated with an increased pCR compared with low SPAG5 transcript expression after receiving anthracycline neoadjuvant chemotherapy (AC-NeoACT) [(Multicentre phase 2 clinical trial cohort; n=136; OR 2·47, 95% CI 1·17–5·21, p=0.016) and (MD Anderson- taxane+AC-NeoACT cohort; n=287; OR 3·16, 95% CI 1·46–6·84, p=0.003); respectively]. In patients with ER-positive/HER2-negative BC who received taxane+AC-NeoACT followed by adjuvant tamoxifen (Adj-Tam) for 5 years (MD Anderson- taxane+AC-NeoACT cohort; n=287), high and low SPAG5 transcript expression had similar DRFS (HR 1·40, 95% CI 0.76–2·58, p=0.282). Whereas in ER-positive/HER2-negative BC patients who received only adj-Tam (n=298), high SPAG5 transcript expression was associated with reduced DRF at 5 years compared with lower expression (HR 1.98, 95% CI 1.19–3.27, p=0.008).
Interpretation: The transcript and protein products of SPAG5 are independent prognostic and predictive biomarkers that might have clinical utility as biomarkers for combination cytotoxic chemotherapy sensitivity in ER-positive/HER-negative BC.
Citation Format: Abdel-Fatah TMA, Agarwal D, Zafeiris D, Pongor L, Györffy B, Rueda OM, Moseley PM, Green AR, Liu D-X, Pockley AG, Rees RC, Caldas C, Ellis IO, Ball GR, Chan SYT. Identification of proliferation related derivers and their roles in precision medicine for breast cancers: A retrospective multidimensional comparative, integrated genomic, transcriptomic, and protein analysis [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 P6-09-16.
Collapse
Affiliation(s)
- TMA Abdel-Fatah
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - D Agarwal
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - D Zafeiris
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - L Pongor
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - B Györffy
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - OM Rueda
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - PM Moseley
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - AR Green
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - D-X Liu
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - AG Pockley
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - RC Rees
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - C Caldas
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - IO Ellis
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - GR Ball
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| | - SYT Chan
- University of Nottingham Hospital NHS Trust, Nottingham, United Kingdom; John van Geest Cancer Research Centre, School of Science and Technology , Nottingham Trent University, Nottingham, United Kingdom; MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary; Cancer Research UK, Cambridge Research Institute, LiKa Shing Centre, Cambridge, United Kingdom; School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Liggins Institute, University of Auck, Auckland, New Zealand
| |
Collapse
|
12
|
Abdel-Fatah TMA, Arora A, Moseley PM, Perry C, Rakha EA, Green AR, Chan SYT, Ellis IO, Madhusudan S. DNA repair prognostic index modelling reveals an essential role for base excision repair in influencing clinical outcomes in ER negative and triple negative breast cancers. Oncotarget 2016; 6:21964-78. [PMID: 26267318 PMCID: PMC4673139 DOI: 10.18632/oncotarget.4157] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/20/2015] [Indexed: 01/23/2023] Open
Abstract
Stratification of oestrogen receptor (ER) negative and triple negative breast cancers (TNBCs) is urgently needed. In the current study, a cohort of 880 ER- (including 635 TNBCs) was immuno-profiled for a panel of DNA repair proteins including: Pol β, FEN1, APE1, XRCC1, SMUG1, PARP1, BRCA1, ATR, ATM, DNA-PKcs, Chk1, Chk2, p53, and TOPO2. Multivariate Cox proportional hazards models (with backward stepwise exclusion of these factors, using a criterion of p < 0.05 for retention of factors in the model) were used to identify factors that were independently associated with clinical outcomes. XRCC1 (p = 0.002), pol β (p = 0.032) FEN1 (p = 0.001) and BRCA1 (p = 0.040) levels were independently associated with poor BCSS. Subsequently, DNA repair index prognostic (DRPI) scores for breast cancer specific survival (BCSS) were calculated and two prognostic groups (DRPI-PGs) were identified. Patients in prognostic group 2 (DRPI-PG2) have higher risk of death (p < 0.001). Furthermore, in DRPI-PG2 patients, exposure to anthracycline reduced the risk of death [(HR (95% CI) = 0.79 (0.64–0.98), p = 0.032) by 21–26%. In addition, DRPI-PG2 patients have adverse clinicopathological features including higher grade, lympho-vascular invasion, Her-2 positive phenotype, compared to those in DRPI-PG1 (p < 0.01). Receiver operating characteristic (ROC) curves indicated that the DRPI outperformed the currently used prognostic factors and adding DRPI to lymph node stage significantly improved their performance as a predictor for BCSS [p < 0.00001, area under curve (AUC) = 0.70]. BER strongly influences pathogenesis of ER- and TNBCs. The DRPI accurately predicts BCSS and can also serve as a valuable prognostic and predictive tool for TNBCs.
Collapse
Affiliation(s)
| | - Arvind Arora
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51 PB, UK
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Christina Perry
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51 PB, UK
| | - Emad A Rakha
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Andrew R Green
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Stephen Y T Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Ian O Ellis
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Srinivasan Madhusudan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK.,Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51 PB, UK
| |
Collapse
|
13
|
Abdel-Fatah TMA, Agarwal D, Liu DX, Russell R, Rueda OM, Liu K, Xu B, Moseley PM, Green AR, Pockley AG, Rees RC, Caldas C, Ellis IO, Ball GR, Chan SYT. SPAG5 as a prognostic biomarker and chemotherapy sensitivity predictor in breast cancer: a retrospective, integrated genomic, transcriptomic, and protein analysis. Lancet Oncol 2016; 17:1004-1018. [PMID: 27312051 DOI: 10.1016/s1470-2045(16)00174-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/08/2016] [Accepted: 03/11/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Proliferation markers and profiles have been recommended for guiding the choice of systemic treatments for breast cancer. However, the best molecular marker or test to use has not yet been identified. We did this study to identify factors that drive proliferation and its associated features in breast cancer and assess their association with clinical outcomes and response to chemotherapy. METHODS We applied an artificial neural network-based integrative data mining approach to data from three cohorts of patients with breast cancer (the Nottingham discovery cohort (n=171), Uppsala cohort (n=249), and Molecular Taxonomy of Breast Cancer International Consortium [METABRIC] cohort; n=1980). We then identified the genes with the most effect on other genes in the resulting interactome map. Sperm-associated antigen 5 (SPAG5) featured prominently in our interactome map of proliferation and we chose to take it forward in our analysis on the basis of its fundamental role in the function and dynamic regulation of mitotic spindles, mitotic progression, and chromosome segregation fidelity. We investigated the clinicopathological relevance of SPAG5 gene copy number aberrations, mRNA transcript expression, and protein expression and analysed the associations of SPAG5 copy number aberrations, transcript expression, and protein expression with breast cancer-specific survival, disease-free survival, distant relapse-free survival, pathological complete response, and residual cancer burden in the Nottingham discovery cohort, Uppsala cohort, METABRIC cohort, a pooled untreated lymph node-negative cohort (n=684), a multicentre combined cohort (n=5439), the Nottingham historical early stage breast cancer cohort (Nottingham-HES; n=1650), Nottingham early stage oestrogen receptor-negative breast cancer adjuvant chemotherapy cohort (Nottingham-oestrogen receptor-negative-ACT; n=697), the Nottingham anthracycline neoadjuvant chemotherapy cohort (Nottingham-NeoACT; n=200), the MD Anderson taxane plus anthracycline-based neoadjuvant chemotherapy cohort (MD Anderson-NeoACT; n=508), and the multicentre phase 2 neoadjuvant clinical trial cohort (phase 2 NeoACT; NCT00455533; n=253). FINDINGS In the METABRIC cohort, we detected SPAG5 gene gain or amplification at the Ch17q11.2 locus in 206 (10%) of 1980 patients overall, 46 (19%) of 237 patients with a PAM50-HER2 phenotype, and 87 (18%) of 488 patients with PAM50-LumB phenotype. Copy number aberration leading to SPAG5 gain or amplification and high SPAG5 transcript and SPAG5 protein concentrations were associated with shorter overall breast cancer-specific survival (METABRIC cohort [copy number aberration]: hazard ratio [HR] 1·50, 95% CI 1·18-1·92, p=0·00010; METABRIC cohort [transcript]: 1·68, 1·40-2·01, p<0·0001; and Nottingham-HES-breast cancer cohort [protein]: 1·68, 1·32-2·12, p<0·0001). In multivariable analysis, high SPAG5 transcript and SPAG5 protein expression were associated with reduced breast cancer-specific survival at 10 years compared with lower concentrations (Uppsala: HR 1·62, 95% CI 1·03-2·53, p=0·036; METABRIC: 1·27, 1·02-1·58, p=0·034; untreated lymph node-negative cohort: 2·34, 1·24-4·42, p=0·0090; and Nottingham-HES: 1·73, 1·23-2·46, p=0·0020). In patients with oestrogen receptor-negative breast cancer with high SPAG5 protein expression, anthracycline-based adjuvant chemotherapy increased breast cancer-specific survival overall compared with that for patients who did not receive chemotherapy (Nottingham-oestrogen receptor-negative-ACT cohort: HR 0·37, 95% CI 0·20-0·60, p=0·0010). Multivariable analysis showed high SPAG5 transcript concentrations to be independently associated with longer distant relapse-free survival after receiving taxane plus anthracycline neoadjuvant chemotherapy (MD Anderson-NeoACT: HR 0·68, 95% CI 0·48-0·97, p=0·031). In multivariable analysis, both high SPAG5 transcript and high SPAG5 protein concentrations were independent predictors for a higher proportion of patients achieving a pathological complete response after combination cytotoxic chemotherapy (MD Anderson-NeoACT: OR 1·71, 95% CI, 1·07-2·74, p=0·024; Nottingham-ACT: 8·75, 2·42-31·62, p=0·0010). INTERPRETATION SPAG5 is a novel amplified gene on Ch17q11.2 in breast cancer. The transcript and protein products of SPAG5 are independent prognostic and predictive biomarkers that might have clinical utility as biomarkers for combination cytotoxic chemotherapy sensitivity, especially in oestrogen receptor-negative breast cancer. FUNDING Nottingham Hospitals Charity and the John and Lucille van Geest Foundation.
Collapse
Affiliation(s)
- Tarek M A Abdel-Fatah
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Devika Agarwal
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, UK
| | - Dong-Xu Liu
- Liggins Institute, University of Auckland, Auckland, New Zealand; The Institute of Genetics and Cytology, Northeast Normal University, Changchun, China
| | - Roslin Russell
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Oscar M Rueda
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Karen Liu
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Bing Xu
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul M Moseley
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew R Green
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Alan G Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, UK
| | - Robert C Rees
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, UK
| | - Carlos Caldas
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Ian O Ellis
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Graham R Ball
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, UK
| | - Stephen Y T Chan
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| |
Collapse
|
14
|
Abdel-Fatah TMA, Agarwal D, Liu DX, Russell R, Rueda OM, Pongor L, Gyorffy B, Moseley PM, Green A, Pockley AG, Rees R, Caldas C, Ellis IO, Ball G, Chan S. A retrospective study of SPAG5 expression and its clinical implications in >8,000 patients of ER positive (ER+) breast cancer (BC): Genomic, transcriptomic and protein analysis. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Devika Agarwal
- Nottingham Trent University - The John van Geest Cancer Research Centre, Nottingham, United Kingdom
| | - Dong-Xu Liu
- The University of Auckland - Liggins Institute, Auckland, New Zealand
| | - Roslin Russell
- Cancer Research UK, Cambridge Research Institute, Cambridge, United Kingdom
| | - Oscar M Rueda
- Cancer Research UK, Cambridge Research Institute, Cambridge, United Kingdom
| | | | | | - Paul M Moseley
- Nottingham University City Hospital NHS Trust, Nottingham, United Kingdom
| | - Andrew Green
- University of Nottingham, Nottingham, United Kingdom
| | - A Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Robert Rees
- Van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Carlos Caldas
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Ian O. Ellis
- Division of Pathology, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Graham Ball
- Van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Stephen Chan
- Nottingham University Hospital City Campus, Nottingham, United Kingdom
| |
Collapse
|
15
|
Pu X, Storr SJ, Ahmad NS, Chan SY, Moseley PM, Televantou D, Cresti N, Boddy A, Ellis IO, Martin SG. Calpain-1 is associated with adverse relapse free survival in breast cancer: a confirmatory study. Histopathology 2016; 68:1021-9. [PMID: 26496999 DOI: 10.1111/his.12896] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 10/20/2015] [Indexed: 02/02/2023]
Abstract
AIMS Calpain-1 is a ubiquitously expressed calcium-activated intracellular cysteine protease. Altered expression of calpain system proteins has been implicated in cancer progression and response to chemotherapy. METHODS AND RESULTS The aim of the current study was to confirm previous data that suggested that calpain-1 expression is associated with relapse-free survival in trastuzumab-treated breast cancer patients (n = 93). An expanded patient cohort from Nottingham (n = 194; including 72 of the previous cohort) and an independent patient cohort from Newcastle (n = 87) were used. All patients received trastuzumab following adjuvant therapy according to local guidelines with expression of calpain-1 investigated using standard immunohistochemistry. Results show that calpain-1 expression is associated with relapse-free survival in both the Nottingham (P = 0.01) and Newcastle (P = 0.019) cohorts, with high expression associated with adverse relapse-free survival. Expression was also associated with poor relapse-free survival when patient cohorts were combined (n = 281, P = 0.01). Calpain-1 remained, from multivariate analysis, an independent marker for relapse-free survival in the Newcastle cohort [hazard ratio (HR) = 5.169; 95% confidence interval (CI) 1.468-18.200; P = 0.011]. CONCLUSIONS Calpain-1 expression is associated with poor relapse-free survival in breast cancer patients treated with trastuzumab. Further work is warranted to standardize and develop methodology with a view to potentially introducing assessment of this important biomarker into clinical practice.
Collapse
Affiliation(s)
- Xuan Pu
- Department of Clinical Oncology, School of Medicine, Division of Cancer and Stem Cells, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Sarah J Storr
- Department of Clinical Oncology, School of Medicine, Division of Cancer and Stem Cells, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Narmeen S Ahmad
- Department of Clinical Oncology, School of Medicine, Division of Cancer and Stem Cells, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Stephen Y Chan
- Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Paul M Moseley
- Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Despina Televantou
- Department of Cancer Pharmacology, Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Nicola Cresti
- Department of Cancer Pharmacology, Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Alan Boddy
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - Ian O Ellis
- Department of Histopathology, School of Medicine, Division of Cancer and Stem Cells, University of Nottingham, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Stewart G Martin
- Department of Clinical Oncology, School of Medicine, Division of Cancer and Stem Cells, Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|
16
|
Arora A, Abdel-Fatah TMA, Agarwal D, Doherty R, Croteau DL, Moseley PM, Hameed K, Green A, Aleskandarany MA, Rakha EA, Patterson K, Ball G, Chan SYT, Ellis IO, Bohr VA, Bryant HE, Madhusudan S. Clinicopathological and prognostic significance of RECQL5 helicase expression in breast cancers. Carcinogenesis 2015; 37:63-71. [PMID: 26586793 DOI: 10.1093/carcin/bgv163] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/30/2015] [Indexed: 01/16/2023] Open
Abstract
RECQL5 is a member of the RecQ family of DNA helicases and has key roles in homologous recombination, base excision repair, replication and transcription. The clinicopathological significance of RECQL5 expression in breast cancer is unknown. In this study, we have evaluated RECQL5 mRNA expression in 1977 breast cancers, and RECQL5 protein level in 1902 breast cancers [Nottingham Tenovus series (n = 1650) and ER- cohort (n = 252)]. Expression levels were correlated to aggressive phenotypes and survival outcomes. High RECQL5 mRNA expression was significantly associated with high histological grade (P = 0.007), HER2 overexpression (P = 0.032), ER+/HER2-/high proliferation genefu subtype (P < 0.0001), integrative molecular clusters (intClust 1and 9) (P < 0.0001) and poor survival (P < 0.0001). In subgroup analysis, high RECQL5 mRNA level remains significantly associated with poor BCSS in ER+ cohort (P < 0.0001) but not in ER- cohort (P = 0.116). At the protein level, in tumours with low RAD51, high RECQL5 level was significantly associated with high histological grade (P < 0.0001), higher mitotic index (P = 0.008), dedifferentiation (P = 0.025), pleomorphism (P = 0.027) and poor survival (P = 0.003). In subgroup analysis, high RECQL5/low RAD51 remains significantly associated with poor BCSS in ER+ cohort (P = 0.010), but not in ER- cohort (P = 0.628). In multivariate analysis, high RECQL5 mRNA and high RECQL5/low RAD51 nuclear protein coexpression independently influenced survival (P = 0.022) in whole cohort and in the ER+ subgroup. Preclinically, we show that exogenous expression of RECQL5 in MCF10A cells can drive proliferation supporting an oncogenic function for RECQL5 in breast cancer. We conclude that RECQL5 is a promising biomarker in breast cancer.
Collapse
Affiliation(s)
- Arvind Arora
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK, Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK
| | | | - Devika Agarwal
- School of Science and Technology, Nottingham Trent University, Clifton campus, Nottingham NG11 8NS, UK
| | - Rachel Doherty
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Deborah L Croteau
- Laboratory of Molecular Gerontology, Biomedical Research Center, National Institute on Aging, National Institutes of Health, Baltimore, MA 21224-6825, USA
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK
| | - Khalid Hameed
- Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK
| | - Andrew Green
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham NG51PB, UK and
| | - Mohammed A Aleskandarany
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham NG51PB, UK and
| | - Emad A Rakha
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham NG51PB, UK and
| | - Karl Patterson
- Academic Unit of Molecular Oncology, Department of Oncology, Medical School Sheffield Cancer Research Centre, University of Sheffield, Sheffield S10 2RX, UK
| | - Graham Ball
- School of Science and Technology, Nottingham Trent University, Clifton campus, Nottingham NG11 8NS, UK
| | - Stephen Y T Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK
| | - Ian O Ellis
- Laboratory of Molecular Gerontology, Biomedical Research Center, National Institute on Aging, National Institutes of Health, Baltimore, MA 21224-6825, USA
| | - Vilhelm A Bohr
- Laboratory of Molecular Gerontology, Biomedical Research Center, National Institute on Aging, National Institutes of Health, Baltimore, MA 21224-6825, USA
| | - Helen E Bryant
- Academic Unit of Molecular Oncology, Department of Oncology, Medical School Sheffield Cancer Research Centre, University of Sheffield, Sheffield S10 2RX, UK
| | - Srinivasan Madhusudan
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK, Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK,
| |
Collapse
|
17
|
Alsubhi N, Middleton F, Abdel-Fatah TMA, Stephens P, Doherty R, Arora A, Moseley PM, Chan SYT, Aleskandarany MA, Green AR, Rakha EA, Ellis IO, Martin SG, Curtin NJ, Madhusudan S. Chk1 phosphorylated at serine345 is a predictor of early local recurrence and radio-resistance in breast cancer. Mol Oncol 2015; 10:213-23. [PMID: 26459098 DOI: 10.1016/j.molonc.2015.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/15/2015] [Accepted: 09/19/2015] [Indexed: 12/28/2022] Open
Abstract
Radiation-induced DNA damage activates the DNA damage response (DDR). DDR up-regulation may predict radio-resistance and increase the risk of early local recurrence despite radiotherapy in early stage breast cancers. In 1755 early stage breast cancers, DDR signalling [ATM, ATR, total Ckh1, Chk1 phosphorylated at serine(345) (pChk1), Chk2, p53], base excision repair [PARP1, POLβ, XRCC1, FEN1, SMUG1], non-homologous end joining (Ku70/Ku80, DNA-PKcs) and homologous recombination [RAD51, BRCA1, γH2AX, BLM, WRN, RECQL5, PTEN] protein expression was correlated to time to early local recurrence. Pre-clinically, radio-sensitization by inhibition of Chk1 activation by ATR inhibitor (VE-821) and inhibition of Chk1 (V158411) were investigated in MDA-MB-231 (p53 mutant) and MCF-7 (p53 wild-type) breast cancer cells. In the whole cohort, 208/1755 patients (11.9%) developed local recurrence of which 126 (61%) developed local recurrence within 5 years of initiation of primary therapy. Of the 20 markers tested, only pChk1 and p53 significantly associated with early local recurrence (p value = 0.015 and 0.010, respectively). When analysed together, high cytoplasmic pChk1-nuclear pChk1 (p = 0.039), high cytoplasmic pChk1-p53 (p = 0.004) and high nuclear pChk1-p53 (p = 0.029) co-expression remain significantly linked to early local recurrence. In multivariate analysis, cytoplasmic pChk1 level independently predicted early local recurrence (p = 0.025). In patients who received adjuvant local radiotherapy (n = 949), p53 (p = 0.014) and high cytoplasmic pChk1-p53 (p = 0.017) remain associated with early local recurrence. Pre-clinically, radio-sensitisation by VE-821 or V158411 was observed in both MCF-7 and MDA-MB-231 cells and was more pronounced in MCF-7 cells. We conclude that pChk1 is a predictive biomarker of radiotherapy resistance and early local recurrence.
Collapse
Affiliation(s)
- Nouf Alsubhi
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Fiona Middleton
- Northern Institute for Cancer Research, School of Clinical & Laboratory Sciences, Newcastle University, Medical School, Newcastle upon Tyne NE2 4HH, UK
| | | | - Peter Stephens
- Northern Institute for Cancer Research, School of Clinical & Laboratory Sciences, Newcastle University, Medical School, Newcastle upon Tyne NE2 4HH, UK
| | - Rachel Doherty
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Arvind Arora
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK
| | - Stephen Y T Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK
| | | | - Andrew R Green
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Emad A Rakha
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Ian O Ellis
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Stewart G Martin
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK
| | - Nicola J Curtin
- Northern Institute for Cancer Research, School of Clinical & Laboratory Sciences, Newcastle University, Medical School, Newcastle upon Tyne NE2 4HH, UK.
| | - Srinivasan Madhusudan
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham NG51PB, UK; Department of Oncology, Nottingham University Hospitals, Nottingham NG51PB, UK.
| |
Collapse
|
18
|
Abdel-Fatah TMA, McArdle SEB, Agarwal D, Moseley PM, Green AR, Ball GR, Pockley AG, Ellis IO, Rees RC, Chan SYT. HAGE in Triple-Negative Breast Cancer Is a Novel Prognostic, Predictive, and Actionable Biomarker: A Transcriptomic and Protein Expression Analysis. Clin Cancer Res 2015; 22:905-14. [PMID: 26240276 DOI: 10.1158/1078-0432.ccr-15-0610] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 07/07/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE The expression of HAGE as a novel prognostic and predictive tool was assessed in 1,079 triple-negative breast cancers (TNBC). EXPERIMENTAL DESIGN HAGE protein expression was investigated in an early primary TNBC (EP-TNBC; n = 520) cohort who received adjuvant chemotherapy (ACT) and in a locally advanced primary TNBC cohort who received anthracycline combination Neo-ACT (n = 110; AC-Neo-ACT). HAGE-mRNA expression was evaluated in the METABRIC-TNBC cohort (n = 311) who received ACT and in a cohort of patients with TNBC who received doxorubicin/cyclophosphamide Neo-ACT, followed by 1:1 randomization to ixabepilone (n = 68) or paclitaxel (n = 64) as part of a phase II clinical trial. Furthermore, a cohort of 128 tumors with integrated HAGE gene copy number changes, mRNA, and protein levels were analyzed. RESULTS In patients with EP-TNBC, who were chemotherapy-naïve, high HAGE protein expression (HAGE(+)) was associated with a higher risk of death [HR, 1.3; 95% confidence interval (CI), 1.2-1.5; P = 0.000005] when compared with HAGE(-) cases. Patients who received ACT and expressed mRNA-HAGE(+) were at a lower risk of death than those who were mRNA-HAGE(-) (P = 0.004). The expression of HAGE was linked to the presence of tumor-infiltrating lymphocytes (TIL), and both features were found to be independent predictors for pathologic complete response (pCR, P < 0.001) and associated with prolonged survival (P < 0.01), following AC-Neo-ACT. In patients with residual disease, HAGE(+) had a 2-fold death risk increase (P = 0.018) compared with HAGE(-). CONCLUSIONS HAGE expression is a potential prognostic marker and a predictor of response to anthracycline treatment in TNBC. A prospective clinical trial to examine the therapeutic value of HAGE for TNBC cases is warranted.
Collapse
Affiliation(s)
- Tarek M A Abdel-Fatah
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Stephanie E B McArdle
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Devika Agarwal
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Paul M Moseley
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Andrew R Green
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Graham R Ball
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - A Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Ian O Ellis
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Robert C Rees
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Stephen Y T Chan
- Clinical Oncology Department, Nottingham University Hospitals, Nottingham, United Kingdom.
| |
Collapse
|
19
|
Abdel-Fatah TMA, McArdle S, Agarwal D, Moseley PM, Green AR, Ball G, Pockley AG, Ellis IO, Rees R, Chan SY. Transcriptomic and protein expression analysis of helicase antigen (HAGE) in triple negative breast cancer (TNBC) as a novel prognostic and predictive biomarker. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Devika Agarwal
- Nottingham Trent University - The John van Geest Cancer Research Centre, Nottingham, United Kingdom
| | - Paul M Moseley
- Nottingham University City Hospital NHS Trust, Nottingham, United Kingdom
| | - Andrew R. Green
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Graham Ball
- Van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - A Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Ian O. Ellis
- Division of Pathology, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Robert Rees
- Van Geest Cancer research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Steve Y.T. Chan
- Nottingham University Hospitals Trust, Nottingham, United Kingdom
| |
Collapse
|
20
|
Abdel-Fatah TMA, Liu DX, Agarwal D, Russell R, Rueda OM, Moseley PM, Green AR, Mukherjee A, Reis-Filho J, Caldas C, Ellis IO, Ball G, Chan SY. Mechanistic and clinical analysis of Sperm associated antigen 5 (SPAG5) as a novel prognostic, predictive, actionable gene in Breast Cancer (BC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Dong-Xu Liu
- The University of Auckland - Liggins Institute, Auckland, New Zealand
| | - Devika Agarwal
- Nottingham Trent University - The John van Geest Cancer Research Centre, Nottingham, United Kingdom
| | - Roslin Russell
- Cancer Research UK, Cambridge Research Institute, Cambridge, United Kingdom
| | - Oscar M Rueda
- Cancer Research UK, Cambridge Research Institute, Cambridge, United Kingdom
| | - Paul M Moseley
- Nottingham University City Hospital NHS Trust, Nottingham, United Kingdom
| | - Andrew R. Green
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abhik Mukherjee
- University of Nottingham, Division of Pathology, School of Molecular Medical Sciences, Nottingham, United Kingdom
| | | | - Carlos Caldas
- Cambridge Cancer Centre, Cambridge Research Institute, Cambridge, United Kingdom
| | - Ian O. Ellis
- Division of Pathology, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Graham Ball
- Van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Steve Y.T. Chan
- Nottingham University Hospitals Trust, Nottingham, United Kingdom
| |
Collapse
|
21
|
Arora A, Abdel-Fatah TMA, Agarwal D, Doherty R, Moseley PM, Aleskandarany MA, Green AR, Ball G, Alshareeda AT, Rakha EA, Chan SYT, Ellis IO, Madhusudan S. Transcriptomic and Protein Expression Analysis Reveals Clinicopathological Significance of Bloom Syndrome Helicase (BLM) in Breast Cancer. Mol Cancer Ther 2015; 14:1057-65. [PMID: 25673821 DOI: 10.1158/1535-7163.mct-14-0939] [Citation(s) in RCA: 39] [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] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/04/2015] [Indexed: 11/16/2022]
Abstract
Bloom syndrome helicase (BLM) has key roles in homologous recombination repair, telomere maintenance, and DNA replication. Germ-line mutations in the BLM gene causes Bloom syndrome, a rare disorder characterized by premature aging and predisposition to multiple cancers, including breast cancer. The clinicopathologic significance of BLM in sporadic breast cancers is unknown. We investigated BLM mRNA expression in the Molecular Taxonomy of Breast Cancer International Consortium cohort (n = 1,950) and validated in an external dataset of 2,413 tumors. BLM protein level was evaluated in the Nottingham Tenovus series comprising 1,650 breast tumors. BLM mRNA overexpression was significantly associated with high histologic grade, larger tumor size, estrogen receptor-negative (ER(-)), progesterone receptor-negative (PR(-)), and triple-negative phenotypes (ps < 0.0001). BLM mRNA overexpression was also linked to aggressive molecular phenotypes, including PAM50.Her2 (P < 0.0001), PAM50.Basal (P < 0.0001), and PAM50.LumB (P < 0.0001) and Genufu subtype (ER(+)/Her2(-)/high proliferation; P < 0.0001). PAM50.LumA tumors and Genufu subtype (ER(+)/Her2(-)/low proliferation) were more likely to express low levels of BLM mRNA (ps < 0.0001). Integrative molecular clusters (intClust) intClust.1 (P < 0.0001), intClust.5 (P < 0.0001), intClust.9 (P < 0.0001), and intClust.10 (P < 0.0001) were also more likely in tumors with high BLM mRNA expression. BLM mRNA overexpression was associated with poor breast cancer-specific survival (BCSS; ps < 0.000001). At the protein level, altered subcellular localization with high cytoplasmic BLM and low nuclear BLM was linked to aggressive phenotypes. In multivariate analysis, BLM mRNA and BLM protein levels independently influenced BCSS. This is the first and the largest study to provide evidence that BLM is a promising biomarker in breast cancer.
Collapse
Affiliation(s)
- Arvind Arora
- Department of Oncology, Nottingham University Hospitals, Nottingham, United Kingdom. Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Devika Agarwal
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Rachel Doherty
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Mohammed A Aleskandarany
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Andrew R Green
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Graham Ball
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Alaa T Alshareeda
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Emad A Rakha
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Stephen Y T Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Ian O Ellis
- Department of Pathology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Srinivasan Madhusudan
- Department of Oncology, Nottingham University Hospitals, Nottingham, United Kingdom. Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
| |
Collapse
|
22
|
Abdel-Fatah TM, Ball G, Lee AH, Pinder S, MacMilan RD, Cornford E, Moseley PM, Silverman R, Price J, Latham B, Palmer D, Chan A, Ellis IO, Chan SY. Nottingham Clinico-Pathological Response Index (NPRI) after Neoadjuvant Chemotherapy (Neo-ACT) Accurately Predicts Clinical Outcome in Locally Advanced Breast Cancer. Clin Cancer Res 2014; 21:1052-62. [DOI: 10.1158/1078-0432.ccr-14-0685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
23
|
Abdel-Fatah TMA, Perry C, Arora A, Thompson N, Doherty R, Moseley PM, Green AR, Chan SYT, Ellis IO, Madhusudan S. Is there a role for base excision repair in estrogen/estrogen receptor-driven breast cancers? Antioxid Redox Signal 2014; 21:2262-8. [PMID: 25111287 PMCID: PMC4620128 DOI: 10.1089/ars.2014.6077] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Estrogen and estrogen metabolite-induced reactive oxygen species generation can promote oxidative DNA base damage. If unrepaired, base damaging lesions could accelerate mutagenesis, leading to a "mutator phenotype" characterized by aggressive behavior in estrogen-estrogen receptor (ER)-driven breast cancer. To test this hypothesis, we investigated 1406 ER(+) early-stage breast cancers with 20 years' long-term clinical follow-up data for DNA polymerase β (pol β), flap endonuclease 1 (FEN1), AP endonuclease 1 (APE1), X-ray cross-complementation group 1 protein (XRCC1), single-strand monofunctional uracil glycosylase-1 (SMUG1), poly (ADP-ribose) polymerase 1 (PARP1), ataxia telangiectasia mutated and Rad3 related (ATR), ataxia telangiectasia mutated (ATM), DNA-dependent protein kinase catalytic subunit (DNA-PKcs), Chk1, Chk2, p53, breast cancer susceptibility gene 1 (BRCA1), and topoisomerase 2 (TOPO2) expression. Multivariate Cox proportional hazards model was used to calculate a DNA repair prognostic index and correlated to clinicopathological variables and survival outcomes. Key base excision repair (BER) proteins, including XRCC1, APE1, SMUG1, and FEN1, were independently associated with poor breast cancer-specific survival (BCSS) (ps≤0.01). Multivariate Cox model stratified patients into four distinct prognostic sub-groups with worsening BCSS (ps<0.01). In addition, compared with prognostic sub-group 1, sub-groups 2, 3, and 4 manifest increasing tumor size, grade, mitosis, pleomorphism, differentiation, lymphovascular invasion, high Ki67, loss of Bcl-2, luminal B phenotype (ps≤0.01), and poor survival, including in patients who received tamoxifen adjuvant therapy (p<0.00001). Our observation supports the hypothesis that BER-directed stratification could inform appropriate therapies in estrogen-ER-driven breast cancers. Antioxid.
Collapse
Affiliation(s)
- Tarek M A Abdel-Fatah
- 1 Department of Oncology, Nottingham University Hospitals , Nottingham, United Kingdom
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Abdel-Fatah TMA, Middleton FK, Arora A, Agarwal D, Chen T, Moseley PM, Perry C, Doherty R, Chan S, Green AR, Rakha E, Ball G, Ellis IO, Curtin NJ, Madhusudan S. Untangling the ATR-CHEK1 network for prognostication, prediction and therapeutic target validation in breast cancer. Mol Oncol 2014; 9:569-85. [PMID: 25468710 DOI: 10.1016/j.molonc.2014.10.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/24/2014] [Accepted: 10/28/2014] [Indexed: 12/31/2022] Open
Abstract
ATR-CHEK1 signalling is critical for genomic stability. ATR-CHEK1 signalling may be deregulated in breast cancer and have prognostic, predictive and therapeutic significance. We investigated ATR, CHEK1 and phosphorylated CHEK1 (Ser345) protein (pCHEK1) levels in 1712 breast cancers. ATR and CHEK1 mRNA expression was evaluated in 1950 breast cancers. Pre-clinically, biological consequences of ATR gene knock down or ATR inhibition by the small molecule inhibitor (VE-821) were investigated in MCF7 and MDA-MB-231 breast cancer cell lines and in non-tumorigenic breast epithelial cells (MCF10A). High ATR and high cytoplasmic pCHEK1 levels were significantly associated with higher tumour stage, higher mitotic index, pleomorphism and lymphovascular invasion. In univariate analyses, high ATR and high cytoplasmic pCHEK1 levels were associated with poor breast cancer specific survival (BCSS). In multivariate analysis, high ATR level remains an independent predictor of adverse outcome. At the mRNA level, high CHEK1 remains associated with aggressive phenotypes including lymph node positivity, high grade, Her-2 overexpression, triple negative, aggressive molecular phenotypes and adverse BCSS. Pre-clinically, CHEK1 phosphorylation at serine(345) following replication stress was impaired in ATR knock down and in VE-821 treated breast cancer cells. Doxycycline inducible knockdown of ATR suppressed growth, which was restored when ATR was re-expressed. Similarly, VE-821 treatment resulted in a dose dependent suppression of cancer cell growth and survival (MCF7 and MDA-MB-231) but was less toxic in non-tumorigenic breast epithelial cells (MCF10A). We provide evidence that ATR and CHEK1 are promising biomarkers and rational drug targets for personalized therapy in breast cancer.
Collapse
Affiliation(s)
| | - Fiona K Middleton
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Arvind Arora
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Devika Agarwal
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Tao Chen
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Paul M Moseley
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Christina Perry
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Rachel Doherty
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Stephen Chan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Andrew R Green
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Emad Rakha
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Graham Ball
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Ian O Ellis
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - Nicola J Curtin
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Srinivasan Madhusudan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK; Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1PB, UK.
| |
Collapse
|
25
|
Abdel-Fatah TM, Arora A, Alsubhi N, Agarwal D, Moseley PM, Perry C, Doherty R, Chan SY, Green AR, Rakha E, Ball G, Ellis IO, Madhusudan S. Clinicopathological significance of ATM-Chk2 expression in sporadic breast cancers: a comprehensive analysis in large cohorts. Neoplasia 2014; 16:982-91. [PMID: 25425972 PMCID: PMC4240925 DOI: 10.1016/j.neo.2014.09.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/19/2014] [Accepted: 09/22/2014] [Indexed: 12/28/2022]
Abstract
ATM-Chk2 network is critical for genomic stability, and its deregulation may influence breast cancer pathogenesis. We investigated ATM and Chk2 protein levels in two cohorts [cohort 1 (n = 1650) and cohort 2 (n = 252)]. ATM and Chk2 mRNA expression was evaluated in the Molecular Taxonomy of Breast Cancer International Consortium cohort (n = 1950). Low nuclear ATM protein level was significantly associated with aggressive breast cancer including larger tumors, higher tumor grade, higher mitotic index, pleomorphism, tumor type, lymphovascular invasion, estrogen receptor (ER)-, PR -, AR -, triple-negative, and basal-like phenotypes (Ps < .05). Breast cancer 1, early onset negative, low XRCC1, low SMUG1, high FEN1, high MIB1, p53 mutants, low MDM2, low Bcl-2, low p21, low Bax, high CDK1, and low Chk2 were also more frequent in tumors with low nuclear ATM level (Ps < .05). Low ATM protein level was significantly associated with poor survival including in patients with ER-negative tumors who received adjuvant anthracycline or cyclophosphamide, methotrexate, and 5-fluorouracil-based adjuvant chemotherapy (Ps < .05). Low nuclear Chk2 protein was likely in ER -/PR -/AR -; HER-2 positive; breast cancer 1, early onset negative; low XRCC1; low SMUG1; low APE1; low polβ; low DNA-PKcs; low ATM; low Bcl-2; and low TOPO2A tumors (P < .05). In patients with ER + tumors who received endocrine therapy or ER-negative tumors who received chemotherapy, nuclear Chk2 levels did not significantly influence survival. In p53 mutant tumors, low ATM (P < .000001) or high Chk2 (P < .01) was associated with poor survival. When investigated together, low-ATM/high-Chk2 tumors have the worst survival (P = .0033). Our data suggest that ATM-Chk2 levels in sporadic breast cancer may have prognostic and predictive significance.
Collapse
Affiliation(s)
| | - Arvind Arora
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Nouf Alsubhi
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Devika Agarwal
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Paul M. Moseley
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Christina Perry
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Rachel Doherty
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Stephen Y.T. Chan
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Andrew R. Green
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Emad Rakha
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Graham Ball
- School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Ian O. Ellis
- Department of Pathology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| | - Srinivasan Madhusudan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
- Academic Unit of Oncology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham University Hospitals, Nottingham NG5 1 PB, UK
| |
Collapse
|
26
|
Hall DM, Oberley TD, Moseley PM, Buettner GR, Oberley LW, Weindruch R, Kregel KC. Caloric restriction improves thermotolerance and reduces hyperthermia-induced cellular damage in old rats. FASEB J 2000; 14:78-86. [PMID: 10627282 DOI: 10.1096/fasebj.14.1.78] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [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] [Indexed: 01/22/2023]
Abstract
Adult-onset, long-term caloric restriction (CR) prolongs maximum life span in laboratory rodents. However, the effect of this intervention on an organism's ability to cope with a physical challenge has not been explored. We investigated the influence of CR and aging on stress tolerance in old rats exposed to an environmental heating protocol on two consecutive days. We hypothesized that CR would increase heat tolerance by reducing cellular stress and subsequent accrual of oxidative injury. All calorically restricted rats survived both heat exposures compared with only 50% of their control-fed counterparts. CR also decreased heat-induced radical generation, stress protein accumulation, and cellular injury in the liver. In addition, heat stress stimulated marked induction of the antioxidant enzymes manganese-containing superoxide dismutase and catalase, along with strong nuclear catalase expression in liver samples from rats subjected to CR. In contrast, stress-related induction of antioxidant enzymes was blunted, and nuclear catalase expression was unchanged from euthermic conditions in the control-fed group. These data suggest that CR reduces cellular injury and improves heat tolerance of old animals by lowering radical production and preserving cellular ability to adapt to stress through antioxidant enzyme induction and translocation of these proteins to the nucleus.
Collapse
Affiliation(s)
- D M Hall
- Department of Exercise Science, The Free Radical Research Institute, and. Radiation Research Laboratory, The University of Iowa, Iowa City, Iowa 52242, USA
| | | | | | | | | | | | | |
Collapse
|