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Zallar L, Rivera-Irizarry J, Hamor P, Pigulevskiy I, Liu D, Welday J, Rico Rozo A, Bender R, Asfouri J, Levine O, Skelly M, Hadley C, Fecteau K, Mehanna H, Nelson S, Miller J, Ghazal P, Bellotti P, Singh A, Hollmer L, Erikson D, Geri J, Pleil K. Rapid nongenomic estrogen signaling controls alcohol drinking behavior. bioRxiv 2024:2023.11.02.565358. [PMID: 37961707 PMCID: PMC10635092 DOI: 10.1101/2023.11.02.565358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The sex steroid hormone estrogen is a key modulator of numerous physiological processes and adaptive behaviors, but it may also be co-opted to drive maladaptive behaviors. While many behavioral roles for estrogen signaling have been shown to occur through canonical genomic signaling mechanisms via nuclear receptors, estrogen can also act in a neurotransmitter-like fashion at membrane-associated estrogen receptors to rapidly regulate neuronal function. Early alcohol drinking confers greater risk for alcohol use disorder in women than men, and binge alcohol drinking is correlated with high circulating estrogen but a causal role for estrogen in alcohol drinking has not been established. Here, we demonstrate that gonadally intact female mice consume more alcohol and display an anxiolytic phenotype when they have elevated levels of ovarian-derived estrogen across the estrous cycle. We found that rapid, nongenomic estrogen signaling at membrane-associated estrogen receptor alpha in the bed nucleus of the stria terminalis (BNST) is necessary and sufficient for the pro-alcohol drinking effects of ovarian estrogen signaling, regardless of the transcriptional program of a high ovarian estrogen state. We further show that a population of corticotropin-releasing factor (CRF) BNST neurons (BNSTCRF) is a critical mediator of these effects, as high estrogen rapidly enhances synaptic excitation of BNSTCRF neurons and promotes their role in driving binge alcohol drinking. These findings show a causal role for endogenous, ovarian-derived estrogen in hormonal modulation of risky alcohol consumption and provide the first demonstration of a purely rapid, nongenomic signaling mechanism of ovarian estrogen in the brain controlling behavior in gonadally intact females.
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Affiliation(s)
- L.J. Zallar
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - J.K. Rivera-Irizarry
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - P.U. Hamor
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - I. Pigulevskiy
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - D. Liu
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - J.P. Welday
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - A.S. Rico Rozo
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - R. Bender
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - J. Asfouri
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - O.B. Levine
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - M.J. Skelly
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - C.K. Hadley
- Weill Cornell/Rockefeller/Sloan Kettering Tri-institutional MD-PhD Program, New York, NY 10065, USA
| | - K.M. Fecteau
- Endocrine Technologies Core, Oregon National Primate Research Center, Beaverton, OR, USA
| | - H. Mehanna
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - S. Nelson
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - J. Miller
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - P. Ghazal
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - P. Bellotti
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - A. Singh
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - L.V. Hollmer
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - D.W. Erikson
- Endocrine Technologies Core, Oregon National Primate Research Center, Beaverton, OR, USA
| | - J. Geri
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - K.E. Pleil
- Pharmacology Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Neuroscience Graduate Program, Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
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Bastawros D, Kaczmarski K, Zhao J, Bender R, Myers E, Tarr M. Nitrofurantoin Prophylaxis Following Short-Term Transurethral Catheterization: A Randomized Controlled Trial. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hellinger L, Keppler AM, Schoeppenthau H, Perras J, Bender R. Hyperbaric oxygen therapy for iatrogenic arterial gas embolism after CT-guided lung biopsy : A case report. Anaesthesist 2019; 68:456-460. [PMID: 31264050 DOI: 10.1007/s00101-019-0618-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/01/2019] [Accepted: 06/03/2019] [Indexed: 01/05/2023]
Abstract
Iatrogenic arterial gas embolism (AGE) can be life-threatening. The only causal treatment is immediate hyperbaric oxygen therapy (HBOT). This article reports on a case of a 74-year-old male patient who underwent computed tomography (CT)-guided lung biopsy of suspect nodules after squamous cell carcinoma of the tonsils. During puncture, sudden cardiovascular arrest occurred. The CT scan documented severe arterial gas embolism in the aorta, spinal canal, left heart ventricle, and brain. The patient was then transferred to our hospital for HBOT. After the first HBOT, an additional CT scan showed regression of all gas inclusions. In the treatment of gas embolism, HBOT is considered the gold standard and is indispensable. It is primarily used to reduce acute bubble effects and to avoid secondary bubble effects. Unfortunately, the long persisting gas occlusions and perfusion deficits led to severe hypoxic brain damage and a poor prognosis for the patient. In this case report we present the management of (iatrogenic) arterial gas embolism and point out the necessity of immediate HBOT. Furthermore, we discuss the pathophysiology leading to arterial gas embolism on the basis of the gas laws.
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Affiliation(s)
- L Hellinger
- Department of Trauma Surgery and Intensive Care Medicine, BG Trauma Center Murnau, 82418, Murnau am Staffelsee, Germany.
| | - A M Keppler
- Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - H Schoeppenthau
- Department of Anaesthesiology, Intensive Care Medicine and Hyperbaric Center, BG Trauma Center Murnau, 82418, Murnau am Staffelsee, Germany
| | - J Perras
- Department of Anaesthesiology, Intensive Care Medicine and Hyperbaric Center, BG Trauma Center Murnau, 82418, Murnau am Staffelsee, Germany
| | - R Bender
- Department of Anaesthesiology, Intensive Care Medicine and Hyperbaric Center, BG Trauma Center Murnau, 82418, Murnau am Staffelsee, Germany
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Abstract
Abstract:The Gaussian properties of human EEGs, which were measured over various stages of general anesthesia, were tested. The basis of the method was to describe the EEG signals by autoregressive models and to test the normality of the regression residuals with the Shapiro-Wilk statistic. The results show that in general the human EEG during anesthesia can be considered as a realization of a Gaussian stochastic process.
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Abstract
Abstract:An important means in the analysis of survival time data is the estimation and graphical representation of survival probabilities. In this paper unifactorial parametric and non-parametric survival curve estimators and two types of adjusted survival curves based on a parametric multifactorial approach are applied to renal transplant data. It is shown that the resulting survival curves can differ substantially. The unifactorial survival curves yield biased results in case of serious disequilibrium in the data. This drawback of the unifactorial methods has been overcome by the use of adjusted survival curves which take possible distortions in the data set into account. The benefits of adjusted survival curves in assessing potentially prognostic factors are elucidated by the application to data from renal transplantation.
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Bender R, Skipka G. Intervention Effects in the Case of Heterogeneity between Three Subgroups. Methods Inf Med 2018; 49:613-7. [DOI: 10.3414/me09-02-0054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 04/13/2010] [Indexed: 11/09/2022]
Abstract
Summary
Background: Usually, statistical tests for interactions are applied to investigate potential effect modifiers. If an effect modifier, consisting of three categories, is found to be statistically significant, the application of pairwise interaction tests is indicated. In this case, the problem of non-transitive relations may occur if the significance level is fixed at 0.05 for all tests.
Objective: To develop an algorithm for which non-transitive relations do not occur.
Methods: A hierarchical testing procedure is applied, based on the heterogeneity statistic Q. In a first step the interaction will be tested for the three trial subgroups altogether, applying the significance level α = 0.05 (global test). If a significant interaction is proven in the first step, pairwise tests for interaction will be applied in a second step. Theoretical data scenarios will be considered and p-values will be calculated for the pairwise tests. Based on these results the significance level for pairwise testing will be determined.
Results: Fixing the significance level at 0.05 for all tests, the problem of non-transitive relations is mostly relevant, if the difference in the effects between the three trial subgroups is approximately 3.5 standard errors and the effect of the ‘middle’ trial subgroup is not close to one of the other two effects. This problem vanishes when the significance level is set to α = 0.22. We propose to select α = 0.20 to get a more ’even’ and simple value.
Conclusions: By increasing the significance level for the pairwise tests to 0.20, non-transitive relations are virtually avoidable. The proposed hierarchical testing procedure represents a clear practical guidance to perform subgroup analyses in the framework of systematic reviews.
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Busch KH, Bender R, Aust MC. Response to Letter to the Editor: 'Repigmentation or stimulated skin physiology? Medical needling in combination with non-cultured skin cell transplantation-The way of the melanocyte'. Burns 2017; 42:1881-1882. [PMID: 28341093 DOI: 10.1016/j.burns.2016.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 08/20/2016] [Indexed: 11/25/2022]
Affiliation(s)
- K-H Busch
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - R Bender
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - M C Aust
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany.
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Busch KH, Bender R, Walezko N, Aziz H, Altintas MA, Aust MC. [Autologous Skin Cell Transplantation and Medical Needling for Repigmentation of Depigmented Burn Scars on UV-protected and UV-exposed Skin]. HANDCHIR MIKROCHIR P 2016; 48:346-353. [PMID: 27835917 DOI: 10.1055/s-0042-117009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Background: Burn scars remain a serious physical and psychological problem for the affected people. Both clinical studies and basic scientific research have shown that medical needling can significantly increase the quality of burn scars with comparatively low risk and stress for the patient related to skin elasticity, moisture, erythema and transepidermal water loss. However, medical needling does not influence repigmentation of large hypopigmented scars. Objective: The goal is to evaluate whether both established methods - needling (improvement of scar quality) and non-cultured autologous skin cell suspension (NCASCS) "ReNovaCell" (repigmentation) - can be combined. So far, 20 patients with mean age of 33 years (6-60 years) with deep second and third degree burn scars have been treated. The average treated tissue surface was 94 cm² (15-250 cm²) and was focused on areas like face, neck, chest and arm. Methods: Medical needling is performed using a roller covered with 3 mm long needles. The roller is vertically, horizontally and diagonally rolled over the scar, inducing microtrauma. Then, NCASCS is applied, according to the known protocol. The patients have been followed up for 15 months postoperatively. The scars were subdivided into "UV-exposed" and "UV-protected" to discover whether the improved repigmentation is due to transfer of melanocytes or to reactivation of existing melanocytes after exposure to UV or the sun. Results: The objective measures show improved pigmentation in both UV-exposed and UV-protected groups. Melanin increases 1 year after NCASCS treatment in the UV-protected group are statistically significant. Conclusion: Medical needling in combination with NCASCS shows promise for repigmentation of burn scars, even in sun protected scars.
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Affiliation(s)
- K H Busch
- Plastic and Reconstructive Surgery, Johanniter-Krankenhaus Bonn GmbH, Bonn
| | - R Bender
- Plastic and Reconstructive Surgery, Johanniter-Krankenhaus Bonn GmbH, Bonn
| | - N Walezko
- Plastic and Reconstructive Surgery, Johanniter-Krankenhaus Bonn GmbH, Bonn
| | - H Aziz
- Plastic and Reconstructive Surgery, Johanniter-Krankenhaus Bonn GmbH, Bonn
| | - M A Altintas
- Klinik für Plastische und Ästhetische Chirurgie/Handchirurgie, Bergmannsheil Buer Krankenhaus, Gelsenkirchen
| | - M C Aust
- Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Zentrum für Schwerbrandverletzte, Medizinische Hochschule Hannover, Hannover
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Gatalica Z, Ghazalpour A, Swensen J, Bender R, Vranic S, Feldman R, Reddy S. Molecular profiling of locally advanced/metastatic olfactory neuroblastomas. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Busch K, Bender R, Walezko N, Aziz H, Altintas M, Aust M. Combination of medical needling and non-cultured autologous skin cell transplantation (renovacell) for repigmentation of hypopigmented burn scars in children and young people. Ann Burns Fire Disasters 2016; 29:116-122. [PMID: 28149233 PMCID: PMC5241190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/18/2016] [Indexed: 06/06/2023]
Abstract
Burn scars remain a serious physical and psychological problem for the affected. Clinical studies as well as basic scientific research have shown that Medical Needling can significantly increase the quality of burn scars with comparatively low risk and stress for the patient with regards to skin elasticity, moisture, erythema and transepidermal water loss. However, Medical Needling has no influence on repigmentation of large hypopigmented scars. The goal is to evaluate whether both established methods - Needling (improvement of scar quality) and ReNovaCell (repigmentation) - can be combined. So far, eight patients with mean age of 20 years (6-28 years) with deep second and third degree burn scars have been treated. The average treated tissue surface was 76cm² (15-250cm²) and was focused on areas like face, neck, chest and arm. Medical Needling is performed using a roller covered with 3mm long needles. The roller is vertically, horizontally and diagonally rolled over the scar, inducing microtrauma. Then, non-cultured autologous skin cell suspension (ReNovaCell) is applied, according to the known protocol. The patients were followed 12 months postoperatively. Pigmentation changes were measured objectively, and with patient and observer ratings. Patient satisfaction/preference was also obtained. We present the final study results. Taken together, pigmentation ratings and objective measures indicate improvement in six of the study participants. Melanin increase seen 12 months after ReNovaCell treatment in the study group as a whole is notable. Medical Needling in combination with ReNovaCell shows promise for repigmentation of burn scars.
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Affiliation(s)
- K.H. Busch
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - R. Bender
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - N. Walezko
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - H. Aziz
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - M.A. Altintas
- Department for Plastic and Reconstructive Surgery, Bergmannsheil und Kinderklinik Buer, Gelsenkirchen, Germany
| | - M.C. Aust
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
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Busch KH, Bender R, Walezko N, Aziz H, Altintas MA, Aust MC. Combination of medical needling and non-cultured autologous skin cell transplantation (ReNovaCell) for repigmentation of hypopigmented burn scars. Burns 2016; 42:1556-1566. [PMID: 27156803 DOI: 10.1016/j.burns.2016.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 12/22/2015] [Revised: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 12/24/2022]
Abstract
Burn scars remain a serious physical and psychological problem for the affected people. Clinical studies as well as basic scientific research have shown that medical needling can significantly increase the quality of burn scars with comparatively low risk and stress for the patient with regards to skin elasticity, moisture, erythema and transepidermal water loss. However, medical needling has no influence on repigmentation of large hypopigmented scars. The goal of this study is to evaluate whether two established methods - needling (for improvement of scar quality) and non-cultured autologous skin cell suspension (for repigmentation) - can be successfully combined. Twenty subjects with mean age of 33 years (6-60 years) with scars from deep second and third degree burns have been treated. The average treated surface area was 94cm2 (15-250cm2) and was focused on prominent areas such as the face, neck, chest and arm. Percutaneous collagen induction or "medical needling" was performed using a roller covered with 3mm long needles. The roller is vertically, horizontally and diagonally rolled over the scar, inducing microtrauma. Then, non-cultured autologous skin cell suspension (NCASCS) was produced and applied using the ReNovaCell Autologous Cell Harvesting Device (Avita Medical), according to the manufacturer's instructions. The patients were followed 12 months postoperatively. Pigmentation changes were measured objectively, as well as with patient and observer ratings. Patient satisfaction/preference was also obtained. Taken together, the pigmentation ratings and objective measures indicate individual improvement in 17 of the study participants. The melanin increases seen 12 months after NCASCS treatment are statistically significant. Medical needling in combination with NCASCS shows promise for repigmentation of burn cars.
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Affiliation(s)
- K H Busch
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - R Bender
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - N Walezko
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - H Aziz
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany
| | - M A Altintas
- Department for Plastic and Reconstructive Surgery, Bergmannsheil und Kinderklinik Buer, Gelsenkirchen, Germany
| | - M C Aust
- Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany.
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Gatalica Z, Vranic S, Ghazalpour A, Xiu J, Ocal I, McGill J, Bender R, Discianno E, Sanati S, Reddy S, Pockaj B. Abstract P4-09-19: Comprehensive multiplatform molecular profiling identifies potentially targetable biomarkers in malignant phyllodes tumors of the breast. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-09-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Malignant phyllodes tumors are rare breast malignancies (0.1% of all breast tumors) with limited effective treatment options for recurrent and metastatic disease. Recent trials indicated a potential for anti-angiogenic therapy in soft tissue sarcomas, which led us to investigate these pathways.
Materials and Methods: Thirty-five malignant phyllodes tumors (including two cases with matched primary and metastatic tumors) were profiled using gene sequencing (Next-generation and Sanger), gene copy number analysis (in-situ hybridization), whole genome RNA expression, and protein expression (immunohistochemical assay).
Results: RNA microarray assay showed consistent over-expression of genes involved in angiogenesis including VEGFA, Angiopoietin2, VCAM1, PDGFRA, PTTG1, and CYP3A5 in all cases analyzed (n=5). No mutations in KDR (VEGFR2) were detected (0/26). EGFR protein overexpression was observed in 25/26 (96%) of cases with amplification of the EGFR gene in 8 cases (33%). EGFR gene mutations were identified in 2 cases (8%) including one case with presumed pathogenic V774M mutation and one case with EGFRvIII mutation. The most common mutations included those of TP53 (50%) and PIK3CA (15%) while other mutations (BRCA1, BRCA2, RET, CDH1, MLH1, ATM) were rare affecting single phyllodes cases. Two cases with matched primary and metastatic cancers harbored the same mutations in both sites (PIK3CA/KRAS and RB1 gene mutations, respectively).
Conclusions: Comprehensive multiplatform profiling approach to phyllodes tumors identifies various molecular alterations of which some are potentially actionable. Our data suggests that anti-angiogenic therapy may also be effective in patients with malignant phyllodes tumor. Evaluation of EGFR pathway discovered consistent protein over-expression but rare activating mutations, which necessitates refinement in patient selection targeting these pathways.
Citation Format: Gatalica Z, Vranic S, Ghazalpour A, Xiu J, Ocal I, McGill J, Bender R, Discianno E, Sanati S, Reddy S, Pockaj B. Comprehensive multiplatform molecular profiling identifies potentially targetable biomarkers in malignant phyllodes tumors of the breast. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-09-19.
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Affiliation(s)
- Z Gatalica
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - S Vranic
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - A Ghazalpour
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - J Xiu
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - I Ocal
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - J McGill
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - R Bender
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - E Discianno
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - S Sanati
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - S Reddy
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
| | - B Pockaj
- Caris Life Sciences, Phoenix, AZ; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegowina; Mayo Clinic Arizona, Phoenix, AZ; Miraca Life Sciences, Phoenix, AZ; Washington University School of Medicine, Saint Louis, MO
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Wisnioski E, Förster Schreiber NM, Wuyts S, Wuyts E, Bandara K, Wilman D, Genzel R, Bender R, Davies R, Fossati M, Lang P, Mendel JT, Beifiori A, Brammer G, Chan J, Fabricius M, Fudamoto Y, Kulkarni S, Kurk J, Lutz D, Nelson EJ, Momcheva I, Rosario D, Saglia R, Seitz S, Tacconi LJ, van Dokkum PG. THE KMOS3DSURVEY: DESIGN, FIRST RESULTS, AND THE EVOLUTION OF GALAXY KINEMATICS FROM 0.7 ⩽z⩽ 2.7. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/799/2/209] [Citation(s) in RCA: 338] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Genzel R, Förster Schreiber NM, Rosario D, Lang P, Lutz D, Wisnioski E, Wuyts E, Wuyts S, Bandara K, Bender R, Berta S, Kurk J, Mendel JT, Tacconi LJ, Wilman D, Beifiori A, Brammer G, Burkert A, Buschkamp P, Chan J, Carollo CM, Davies R, Eisenhauer F, Fabricius M, Fossati M, Kriek M, Kulkarni S, Lilly SJ, Mancini C, Momcheva I, Naab T, Nelson EJ, Renzini A, Saglia R, Sharples RM, Sternberg A, Tacchella S, van Dokkum P. EVIDENCE FOR WIDE-SPREAD ACTIVE GALACTIC NUCLEUS-DRIVEN OUTFLOWS IN THE MOST MASSIVEz∼ 1-2 STAR-FORMING GALAXIES. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/0004-637x/796/1/7] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Gatalica Z, Basu G, Ghazalpour A, Bender R, Vranic S, Millis S, McGill J, Voss A. Biomarkers of Targeted Therapies in Malignant Phyllodes Tumors of the Breast. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu328.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ghazalpour A, Basu G, Bender R, Gatalica Z. 475 Differences in Gene Expression Between Androgen Receptor Positive and Negative Triple Negative (ER/PR/Her2) Breast Carcinomas. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Bell D, Hooper A, Bender R, McMahon J, Edwards G, van Bockxmeer F, Watts G, Burnett J. Opportunistic Screening for Familial Hypercholesterolaemia Via a Community Laboratory. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Basu G, Van Vickle G, Ghazalpour A, Ashfaq R, Gatalica Z, Blevins R, Arguello D, Brisbin L, Roberts C, Loesch D, Bender R. Frequency distribution of SPARC in triple-negative breast cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.37] [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
37 Background: SPARC (secreted protein acid rich in cysteine) belongs to a group of extracellular matrix proteins and promotes adhesion of cells from the matrix. It plays an important role in tumor development in breast cancer and has a significant bearing on patient prognosis and long term survival. It is also known to predict response to nab-paclitaxel in certain tumor types including breast cancer. In 2005, FDA approved a solvent free formulation of paclitaxel for the treatment of metastatic breast cancer that utilizes albumin bound (nab) technology (nab-paclitaxel). Clinical studies have shown that nab-paclitaxel is significantly more effective than paclitaxel. Our study evaluated the frequency distribution of SPARC among triple negative breast cancer patients in which identification of a novel therapeutic target is warranted. Methods: In a total of 951 breast cancer patients, we analyzed tumor SPARC expression by immunohistochemistry (IHC) using a monoclonal (R&D Systems) and a polyclonal antibody (Exalpha Biologicals). Immunoreactivity was assessed by scoring the percentage of cells stained in each field and by the intensity of staining. A cutoff point of 2+ and >30% stained tumor cells were considered as positive. Results: From our analysis of 951 breast cancer patients profiled, a total of 165 patients (17%) were triple negative for ER, PR and HER2. Within this pathologic subtype, 29% patients stained positive with SPARC monoclonal antibody and 21% stained positive with SPARC polyclonal antibody. The correlation of SPARC tumor staining with hormone receptor status will be presented in detail. Conclusions: We conclude that SPARC over-expression is a functionally important feature of a subset of triple negative breast cancer patients. The triple negative subset of tumors generally has a more aggressive clinical course and does not benefit from conventional targeted therapies. Our study suggests that nab-paclitaxel may serve as a therapeutic agent for the subset of triple negative patients that over-express SPARC. To the best of our knowledge, this is the first study involving a large patient pool in which SPARC has been investigated in a single clinical laboratory using standardized IHC with two different SPARC antibodies.
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Affiliation(s)
- G. Basu
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - G. Van Vickle
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - A. Ghazalpour
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - R. Ashfaq
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - Z. Gatalica
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - R. Blevins
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - D. Arguello
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - L. Brisbin
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - C. Roberts
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - D. Loesch
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
| | - R. Bender
- Caris Life Sciences, Phoenix, AZ; Caris Life Sciences, Irving, TX
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20
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Kormendy J, Bender R, Cornell ME. Supermassive black holes do not correlate with galaxy disks or pseudobulges. Nature 2011; 469:374-6. [PMID: 21248845 DOI: 10.1038/nature09694] [Citation(s) in RCA: 197] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 11/19/2010] [Indexed: 11/09/2022]
Abstract
The masses of supermassive black holes are known to correlate with the properties of the bulge components of their host galaxies. In contrast, they seem not to correlate with galaxy disks. Disk-grown 'pseudobulges' are intermediate in properties between bulges and disks; it has been unclear whether they do or do not correlate with black holes in the same way that bulges do. At stake in this issue are conclusions about which parts of galaxies coevolve with black holes, possibly by being regulated by energy feedback from black holes. Here we report pseudobulge classifications for galaxies with dynamically detected black holes and combine them with recent measurements of velocity dispersions in the biggest bulgeless galaxies. These data confirm that black holes do not correlate with disks and show that they correlate little or not at all with pseudobulges. We suggest that there are two different modes of black-hole feeding. Black holes in bulges grow rapidly to high masses when mergers drive gas infall that feeds quasar-like events. In contrast, small black holes in bulgeless galaxies and in galaxies with pseudobulges grow as low-level Seyfert galaxies. Growth of the former is driven by global processes, so the biggest black holes coevolve with bulges, but growth of the latter is driven locally and stochastically, and they do not coevolve with disks and pseudobulges.
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Affiliation(s)
- John Kormendy
- Department of Astronomy, University of Texas at Austin, 1 University Station, Austin, Texas 78712-0259, USA.
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21
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Bender R, Bier K, Manrer G. Messung der spezifischen Wärme und des Joule-Thomson-Koeffizienten von Kohlendioxid bei Temperaturen von - 40°C bis 200°C und Drücken bis 15 bar. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bbpc.19810850809] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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22
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Laubender RP, Bender R. Estimating adjusted risk difference (RD) and number needed to treat (NNT) measures in the Cox regression model. Stat Med 2010; 29:851-9. [PMID: 20213710 DOI: 10.1002/sim.3793] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In medical research, risk difference (RD) and number needed to treat (NNT) measures for survival times have been mainly proposed without consideration of covariates. In this paper, we develop adjusted RD and NNT measures for use in observational studies with survival time outcomes within the framework of the Cox proportional hazards regression model taking the distribution of confounders into account. We consider the typical situation of a cohort study in which the effect of an exposure on a survival time outcome is investigated and important covariates have to be taken into account. The exposure effect described by means of the RD and NNT measures in dependence on whether the effect of allocating an exposure to unexposed persons (number needed to be exposed) or that of removing an exposure from exposed persons (exposure impact number) is considered. Estimation of these adjusted RD and NNT measures is performed by using the average RD approach recently developed for logistic regression. To determine standard errors and confidence intervals for these estimators we use two approaches, the delta method with respect to the regression coefficients of the Cox model and bootstrapping and compare each other. The performance of these estimators is assessed by performing Monte Carlo simulations demonstrating clear advantages of the bootstrap method. The proposed method for point and interval estimation of adjusted RD and NNT measures in the Cox model is illustrated by means of data of the Düsseldorf Obesity Mortality Study (DOMS).
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Affiliation(s)
- R P Laubender
- Institute of Medical Informatics, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich, Germany.
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23
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Hemkens LG, Grouven U, Bender R, Sawicki PT. Insufficient evaluation of adverse events is not a proof of safety. Diabetologia 2010; 53:790-2; author reply 793-4. [PMID: 20099058 DOI: 10.1007/s00125-009-1654-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Accepted: 12/18/2009] [Indexed: 12/29/2022]
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24
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Soesan M, de Snoo F, Westerga J, Floore A, Bender R. Microarray analysis as a helpful tool in identifying the primary tumour in cancer with an unknown primary site. Neth J Med 2010; 68:50-51. [PMID: 20103826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/genetics
- Adenocarcinoma/secondary
- Aged
- Breast Neoplasms/diagnosis
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary/secondary
- Female
- Gene Expression Profiling
- Humans
- Lung Neoplasms/secondary
- Neoplasms, Unknown Primary/diagnosis
- Neoplasms, Unknown Primary/genetics
- Neoplasms, Unknown Primary/radiotherapy
- Neoplasms, Unknown Primary/surgery
- Oligonucleotide Array Sequence Analysis
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25
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Grouven U, Hemkens LG, Bender R, Sawicki PT. Risk of malignancies in patients with diabetes treated with human insulin or insulin analogues. Reply to Nagel JM, Mansmann U, Wegscheider K et al. [letter] and Simon D [letter]. Diabetologia 2010; 53:209-11. [PMID: 19855952 DOI: 10.1007/s00125-009-1582-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Accepted: 09/09/2009] [Indexed: 12/29/2022]
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26
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de Snoo F, Krijgsman O, Roepman P, Bender R, Glas A. Molecular Subtype Profile Reveals Therapy Predictive Power. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6131] [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
BackgroundClassification of breast cancers into molecular subtypes may be important for accurate selection of therapy for patients. Here we report the respective chemotherapy responsiveness of the molecular subtypes profile defined Luminal, ERBB2 and Basal type.MethodsAn 80-gene subtype profile was developed based on a series of 200 samples with concordant ER, PR and Her2 receptor IHC and single gene readout status. Previously we reported the excellent validation of the profile classification using 784 samples. Here we report a second in silico validation consisting of 133 samples (Hess et al, JCO, 2006) which tested the profile as a predictor of pathological Complete Response (pCR) in these patients treated with T/FAC neoadjuvant chemotherapy.ResultsIn the 133 publicly available samples the profile classified 62% (82) as Luminal-type, 18% (24) as ERBB2-type and 20% (27) as Basal-type. These results were consistent with percentages found in the training and validation cohorts (n=1079; 295 training and 784 validation samples); 66% (712) Luminal-type, 18% (194) as ERBB2-type and 16% (173) Basal-type. Chemotherapy response was measured by pathological Complete Response (pCR) at the time of surgery In the Luminal-type subgroup 9% (7) of patients showed pCR, in the ERBB2-type subgroup 50% (12) of patients had a pCR and in the Basal-type subgroup 56% (15) of patients had a pCR.ConclusionsThe developed multi-gene profile can classify breast cancer tumors into Luminal-, ERBB2- and Basal-type subgroups. Within the subgroups, a significant difference in chemotherapy response, as measured by pCR, is observed. Implementation of this knowledge may improve the clinical management of breast cancer patients, by enabling the physician to decide who is most likely to benefit from chemotherapy or endocrine therapy prior to surgery.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6131.
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Affiliation(s)
| | | | | | | | - A. Glas
- 2Agendia BV, The Netherlands
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27
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Somlo G, Lau S, Frankel P, Garberoglio C, Kruper L, Yen Y, Luu T, Hurria A, Chung C, Mortimer J, Yim J, Paz I, Krijgsman O, Delahaye L, Stork-Sloots L, Bender R. Basal-, Luminal-, and HER2- Molecular Subtype, and the MammaPrint 70-Gene Signature as Predictors of Response to Neoadjuvant Chemotherapy (NCT) with Docetaxel, Doxorubicin, Cyclophosphamide (TAC), or AC and Nab-Paclitaxel and Carboplatin +/- Trastuzumab in Patients (Pts) with Stage II-III and Inflammatory Breast Cancer (BC). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-2026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Pathologic complete response (pCR) and minimal residual cancer burden (RCB scores of 0 [pCR]-1[near CR]) after NCT may predict for improved survival (Symmans et al. J Clin Oncol 25:4414-22, 2007). Hence, improved NCT regimens in conjunction with molecular markers that predict for both response and/or resistance are needed. Materials and Methods: 115 pts with stages II-III BC were to be prospectively randomized to receive 6 cycles of docetaxel 75 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2 with filgrastim support (TAC, arm A) versus a novel regimen of A 60 mg/m2 and C 600 mg/m2 given every 2 weeks x 4, followed by 3 weekly doses of carboplatin (AUC 2) and nab-paclitaxel 100 mg/m2 repeated as 28 day cycles x 3 (arm B). Pts with HER2 + BC received NCT similar to arm B, but with the addition of 12 weekly doses of trastuzumab given together with carboplatin and nab-paclitaxel (arm C). Core biopsies were performed prior to NCT and were preserved fresh frozen. 70-gene (MammaPrint™) profiling and 80-gene profiling (van de Vijver et al. NEJM 347:1999-2009, 2002) to categorize all tumors for basal-, HER2-, and luminal subtypes were carried out. We set out to assess the predictive value of Mammaprint scores (poor vs. good), as well as basal, vs. luminal, vs. HER2 molecular subtype profiling, for response to treatment on arms A vs. B vs. C. Responses were dichotomized as complete or near complete response (Symmans RCB scores of 0-1) vs. suboptimal response (RCB score > 1). Results: Sufficient amount of BC tissue and good quality RNA for gene array assessment were procured in 64% of the first 90 patients who have undergone pre-treatment core biopsies, and then proceeded to NCT, followed by definitive surgery. Here we report on the first 50 pts with complete set of data analyzed. The median age was 50 years (range:31-69). Pts were treated for stage II (49%) and III locally advanced (41%), and inflammatory BC (10%). By gene profiling, 28% of the tumors were HER2-type (vs. 38% by IHC 3+, or FISH, representing all pts treated on arm C), 26% basal-type, 42% luminal-type, and 4% borderline luminal-type. Poor-prognosis signature by the 70-gene (MammaPrint) assay was observed in 74% of pts: 92% of HER2-type, 100% of basal-type, and 52% of luminal-type tumors were characterized as poor-risk by the 70-gene assay. Following NCT, Symmans RCB scores of 0-1 were observed in 71% of pts with HER2-type, in 38% with basal-type, and 28% of pts with luminal-type molecular subtype characteristics. Conclusion: BC with HER2- and basal-molecular subtypes are more likely to respond to NCT and is frequently associated with poor-risk characteristics as determined by the 70-gene assay. The complete analysis of correlations among response to specific sets of NCT, molecular subtype, and 70-gene assay results in the entire pt population will be presented.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2026.
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Affiliation(s)
- G. Somlo
- 1City of Hope Comprehensive Cancer Center, CA,
| | - S. Lau
- 1City of Hope Comprehensive Cancer Center, CA,
| | - P. Frankel
- 1City of Hope Comprehensive Cancer Center, CA,
| | | | - L. Kruper
- 1City of Hope Comprehensive Cancer Center, CA,
| | - Y. Yen
- 1City of Hope Comprehensive Cancer Center, CA,
| | - T. Luu
- 1City of Hope Comprehensive Cancer Center, CA,
| | - A. Hurria
- 1City of Hope Comprehensive Cancer Center, CA,
| | - C. Chung
- 1City of Hope Comprehensive Cancer Center, CA,
| | - J. Mortimer
- 1City of Hope Comprehensive Cancer Center, CA,
| | - J. Yim
- 1City of Hope Comprehensive Cancer Center, CA,
| | - I. Paz
- 1City of Hope Comprehensive Cancer Center, CA,
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Hemkens LG, Grouven U, Bender R, Günster C, Gutschmidt S, Selke GW, Sawicki PT. Risk of malignancies in patients with diabetes treated with human insulin or insulin analogues: a cohort study. Diabetologia 2009; 52:1732-44. [PMID: 19565214 PMCID: PMC2723679 DOI: 10.1007/s00125-009-1418-4] [Citation(s) in RCA: 408] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Accepted: 05/26/2009] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The aim of this cohort study was to investigate the risk of malignant neoplasms and mortality in patients with diabetes treated either with human insulin or with one of three insulin analogues. METHODS Data were provided by the largest German statutory health insurance fund (time-frame: January 1998 to June 2005 inclusive), on patients without known malignant disease who had received first-time therapy for diabetes mellitus exclusively with human insulin, aspart, lispro or glargine. The primary outcome was the diagnosis of a malignant neoplasm. Data were analysed by multiple Cox regression models adjusting for potential confounders. RESULTS A total of 127,031 patients were included, with a mean follow-up time of 1.63 (median 1.41, maximum 4.41) years. A positive association between cancer incidence and insulin dose was found for all insulin types. Because patients receiving combined therapy with insulin analogues and human insulin were excluded, the mean daily dose was much lower for glargine than for human insulin, and a slightly lower cancer incidence in the glargine group was found. After adjusting for dose, a dose-dependent increase in cancer risk was found for treatment with glargine compared with human insulin (p < 0.0001): the adjusted HR was 1.09 (95% CI 1.00 to 1.19) for a daily dose of 10 IU, 1.19 (95% CI 1.10 to 1.30) for a daily dose of 30 IU, and 1.31 (95% CI 1.20 to 1.42) for a daily dose of 50 IU. No increased risk was found for aspart (p = 0.30) or lispro (p = 0.96) compared with human insulin. CONCLUSIONS/INTERPRETATION Considering the overall relationship between insulin dose and cancer, and the lower dose with glargine, the cancer incidence with glargine was higher than expected compared with human insulin. Our results based on observational data support safety concerns surrounding the mitogenic properties of glargine in diabetic patients. Prospective long-term studies are needed to further evaluate the safety of insulin analogues, especially glargine.
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Affiliation(s)
- L G Hemkens
- Institute for Quality and Efficiency in Health Care (IQWiG), Dillenburger Strasse 27, D-51105, Cologne, Germany.
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30
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Tong KB, Chen E, Brink G, Bender R, de Snoo F, Malin J. Cost-effectiveness of targeting chemotherapy with the 70-gene prognostic signature in early-stage breast cancer (ESBC) patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6570 Background: The 70-gene microarray test (MammaPrint) has been shown to provide additional prognostic information to clinicopathologic risk assessment for women ESBC; however, the cost-effectiveness of this strategy is not well understood. Methods: The objective of this analysis was to estimate the incremental benefits, costs, and cost-effectiveness of the treatments guided by the 70-gene signature versus Adjuvant! Software (AS) to decide on the use of adjuvant chemotherapy for women ≤61 years with lymph node negative, HER-2 negative ESBC with estrogen receptor (ER) positive or negative disease. A Markov model with a lifetime horizon and three health states (alive without recurrence, death from cancer and death from other causes) was constructed using TreeAge Pro software. Risk classification and patient outcomes data were based on a multi-center 70-gene signature validation study. Efficacy of chemotherapy derived from published meta-analysis of clinical trials. Costs and health utilities were obtained from the literature. Costs and benefits were discounted 3%/year. Results: Compared to AS, the 70-gene signature strategy resulted in 35% of patients being reassigned to a different risk classification and avoided chemotherapy in 9% of patients. In the base case, the 70-gene signature strategy was cost neutral (lifetime costs per patient: $178,811 versus $178,893 for the 70-gene signature and AS strategy). Moreover the 70-gene signature strategy was associated with an increase of 0.13 life years (LYs) and 0.16 quality adjusted life years (QALYs). The model results were sensitive to the cost of 70-gene signature test, cost of adjuvant chemotherapy, and relative risk reduction associated with chemotherapy; however, the 70-gene strategy remained cost-effective across a wide range of assumptions. Conclusions: In this analysis, the 70-gene signature was associated with a reduction in chemotherapy use and an increase in life expectancy. The 70-gene signature appears to be a cost-effective strategy for obtaining additional information to guide the decision to use adjuvant chemotherapy in patients with lymph node negative ESBC. [Table: see text]
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Affiliation(s)
- K. B. Tong
- Quorum Consulting Inc., San Francisco, CA; Agendia, Inc., Huntington Beach, CA; David Geffen School of Medicine at UCLA, Los Angles, CA
| | - E. Chen
- Quorum Consulting Inc., San Francisco, CA; Agendia, Inc., Huntington Beach, CA; David Geffen School of Medicine at UCLA, Los Angles, CA
| | - G. Brink
- Quorum Consulting Inc., San Francisco, CA; Agendia, Inc., Huntington Beach, CA; David Geffen School of Medicine at UCLA, Los Angles, CA
| | - R. Bender
- Quorum Consulting Inc., San Francisco, CA; Agendia, Inc., Huntington Beach, CA; David Geffen School of Medicine at UCLA, Los Angles, CA
| | - F. de Snoo
- Quorum Consulting Inc., San Francisco, CA; Agendia, Inc., Huntington Beach, CA; David Geffen School of Medicine at UCLA, Los Angles, CA
| | - J. Malin
- Quorum Consulting Inc., San Francisco, CA; Agendia, Inc., Huntington Beach, CA; David Geffen School of Medicine at UCLA, Los Angles, CA
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31
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Knauer M, Straver M, Rutgers E, Bender R, Cardoso F, Mook S, van de Vijver M, Saghatchian M, Koornstra R, Bueno-de-Mesquita J, Rodenhuis S, Linn S, van 't Veer L. 0073 The 70-gene MammaPrint signature is predictive for chemotherapy benefit in early breast cancer. Breast 2009. [DOI: 10.1016/s0960-9776(09)70118-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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de Snoo F, Glas A, Floore A, Mayordomo J, Modollel A, Rolfo C, van 't Veer L, Rutgers E, Rodenhuis S, Bender R. 0074 Early prognosis prediction: MammaPrint on core-needle biopsies. Breast 2009. [DOI: 10.1016/s0960-9776(09)70119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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33
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Roepman P, Horlings H, Krijgsman O, Bueno-de-Mesquita J, Bender R, Linn S, Glas A, van de Vijver M. Microarray-based determination of ER, PR and HER2 receptor status: validation and comparison with IHC assessments. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #3007
Background
 In breast cancer patients the level of expression of estrogen receptor (ER), progesterone receptor (PR) and HER2 is predictive for prognosis and/or treatment response. However, differences in assessment methods and interpretation can substantially affect the accuracy and reproducibility of the results. Previously, we have determined the association between immunohistochemistry (IHC) and mRNA levels for ER, PR and HER2, and have confirmed the accuracy of microarray readout on >400 samples. In the current study we describe the use of this microarray based readout on prospectively collected samples. We compared these readouts with multiple IHC and fluorescent in situ hybridization (FISH) assessments generated in various hospitals and a CLIA-certified reference laboratory and developed a microarray based test called TargetPrint™.
 Methods
 Gene expression data for ER, PR and HER2 were obtained by analysis of 100 breast carcinomas that have been collected prospectively within the RASTER study. Samples were stratified as receptor positive or negative using thresholds for ER, PR and HER2 mRNA levels. IHC assessment was performed (1) according to local standards of the hospital from where the sample originated, (2) by the central laboratory of the Netherlands Cancer Institute, and (3) at an independent reference laboratory using FDA-approved procedures and ASCO/CAP guidelines. A tumor was classified positive for ER and PR when ≥10% of tumor cells showed positive staining. HER2 IHC status was scored as 0, 1+, 2+ or 3+; a score of 3+ was considered positive. In case of 2+ samples, a FISH was performed to assess final HER2 amplification status. The cohort used in this study was pre-selected to include about two-third ER and PR positive samples and one-third HER2 positive samples.
 Results
 Multiple microarray readouts were highly reproducible (Pearson correlation 0.991) and resulted in 67, 61 and 39 percent positive samples for ER, PR and HER2, respectively. Comparison of microarray results with IHC (including FISH for HER2) performed at the three centers indicated highly similar results for receptor readout with a concordance of 92, 93 and 92% for ER; 84, 81 and 86% for PR; and 93, 95 and 94% for HER2. Overall misclassification rates between microarray and IHC readout were low for ER (0.08) and HER2 (0.06) and quite low for PR (0.14), and were comparable to the misclassification rates between the three IHC methods.
 Conclusion
 A microarray-based assessment of ER, PR and HER2 in relation to mRNA levels gives results comparable to multiple IHC methods and FISH and provides an objective and more quantitative assessment of tumor receptor status than IHC alone. Using TargetPrint™ for microarray readouts for hormone and HER2 receptor in addition to standard IHC will improve molecular characterization of breast cancer tissue.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3007.
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Affiliation(s)
- P Roepman
- 1 Agendia BV, Amsterdam, Netherlands
| | - H Horlings
- 2 Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - R Bender
- 3 Agendia Inc, Huntington Beach, CA
| | - S Linn
- 2 Netherlands Cancer Institute, Amsterdam, Netherlands
| | - A Glas
- 1 Agendia BV, Amsterdam, Netherlands
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Affiliation(s)
- U Grouven
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany
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35
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Affiliation(s)
- U Grouven
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany
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Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- A Ziegler
- Institut für Medizinische Biometrie und Statistik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Germany.
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Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- A Ziegler
- Institut für Medizinische Biometrie und Statistik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Germany.
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Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- S J Klug
- Institut für Medizinische Biometrie, Epidemiologie und Informatik, Klinikum der Johannes Gutenberg-Universität Mainz, Germany.
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Abstract
AIM OF THE STUDY The aim of this study was to calculate, for the first time, minimum provider volumes in total knee replacement using routine German data. MATERIALS AND METHODS In patients with primary total knee replacement (TKR), the relationship between hospital volume per year and risk of "insufficient mobility" (primary quality indicator) and "wound infection" (secondary quality indicator) was calculated by means of logistic regression models. RESULTS For both indicators, a statistically significant relationship between hospital volume and outcome could be demonstrated. Other risk factors such as age and ASA status also had a significant influence, but did not appear as important confounders. The risk for the secondary quality indicator "infection" decreased constantly with increasing hospital volume, thus the curve was very flat. This supports the hypothesis that high volume hospitals have a higher quality level than low volume hospitals. A threshold value could be calculated. However, the explanation value for hospital volume was too low to derive a threshold level that clearly discriminates between good and bad quality of care. The relationship between the primary quality indicator "insufficient mobility" and hospital volume unexpectedly showed a U-shaped distribution. This questions the concept of a minimum provider volume regulation for primary total knee replacement for the quality indicator "insufficient mobility". Therefore, in this case no quantitative threshold values were calculated. CONCLUSION This analysis supports the hypothesis of a volume-outcome relationship in primary total knee replacement. However, a minimum provider volume that clearly discriminates between good and bad quality of care could not be calculated on the basis of these German quality assurance data.
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Affiliation(s)
- P Schräder
- Medizinischer Dienst der Spitzenverbände der Krankenkassen (MDS) e.V., Lützowstr. 53, 45141 Essen.
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Affiliation(s)
- S Lange
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany
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Affiliation(s)
- S Lange
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Bender R, Lange S. Verlaufskurven. Dtsch Med Wochenschr 2007; 132 Suppl 1:e22-3. [PMID: 17530588 DOI: 10.1055/s-2007-959033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- R Bender
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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Affiliation(s)
- A Ziegler
- Institut für Medizinische Biometrie und Statistik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Germany.
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Lange S, Bender R. Was ist ein Signifikanztest? Allgemeine Aspekte. Dtsch Med Wochenschr 2007; 132 Suppl 1:e19-21. [PMID: 17530587 DOI: 10.1055/s-2007-959032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- S Lange
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Köln, Germany.
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