1
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Agostinetto E, Buisseret L, Salgado R, Kok M, Ignatiadis M. Residual disease post neoadjuvant chemo-immunotherapy in early triple-negative breast cancer: does it help tailor adjuvant treatment? Ann Oncol 2024; 35:409-411. [PMID: 38484973 DOI: 10.1016/j.annonc.2024.03.003] [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] [Received: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 04/15/2024] Open
Affiliation(s)
- E Agostinetto
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium
| | - L Buisseret
- Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium
| | - R Salgado
- Department of Pathology, ZAS Hospitals, Antwerp, Belgium; Division of Research, Peter Mac Callum cancer Centre, Melbourne, Belgium
| | - M Kok
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Ignatiadis
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium.
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2
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Liefaard MC, van der Voort A, van Seijen M, Thijssen B, Sanders J, Vonk S, Mittempergher L, Bhaskaran R, de Munck L, van Leeuwen-Stok AE, Salgado R, Horlings HM, Lips EH, Sonke GS. Tumor-infiltrating lymphocytes in HER2-positive breast cancer treated with neoadjuvant chemotherapy and dual HER2-blockade. NPJ Breast Cancer 2024; 10:29. [PMID: 38637568 PMCID: PMC11026378 DOI: 10.1038/s41523-024-00636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 04/05/2024] [Indexed: 04/20/2024] Open
Abstract
Tumor-infiltrating lymphocytes (TILs) have been associated with outcomes in HER2-positive breast cancer patients treated with neoadjuvant chemotherapy and trastuzumab. However, it remains unclear if TILs could be a prognostic and/or predictive biomarker in the context of dual HER2-targeting treatment. In this study, we evaluated the association between TILs and pathological response (pCR) and invasive-disease free survival (IDFS) in 389 patients with stage II-III HER2 positive breast cancer who received neoadjuvant anthracycline-containing or anthracycline-free chemotherapy combined with trastuzumab and pertuzumab in the TRAIN-2 trial. Although no significant association was seen between TILs and pCR, patients with TIL scores ≥60% demonstrated an excellent 3-year IDFS of 100% (95% CI 100-100), regardless of hormone receptor status, nodal stage and attainment of pCR. Additionally, in patients with hormone receptor positive disease, TILs as a continuous variable showed a trend to a positive association with pCR (adjusted Odds Ratio per 10% increase in TILs 1.15, 95% CI 0.99-1.34, p = 0.070) and IDFS (adjusted Hazard Ratio per 10% increase in TILs 0.71, 95% CI 0.50-1.01, p = 0.058). We found no interactions between TILs and anthracycline treatment. Our results suggest that high TIL scores might be able to identify stage II-III HER2-positive breast cancer patients with a favorable prognosis.
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Affiliation(s)
- M C Liefaard
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A van der Voort
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M van Seijen
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - B Thijssen
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
| | - J Sanders
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Vonk
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Core Facility Molecular Pathology & Biobanking, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L Mittempergher
- Department of Research and Development, Agendia NV, Amsterdam, The Netherlands
| | - R Bhaskaran
- Department of Research and Development, Agendia NV, Amsterdam, The Netherlands
| | - L de Munck
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - A E van Leeuwen-Stok
- Dutch Breast Cancer Research Group, BOOG Study Center, Amsterdam, The Netherlands
| | - R Salgado
- Department of Pathology, GZA-ZNA Hospitals, Wilrijk, Antwerp, Belgium
| | - H M Horlings
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E H Lips
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - G S Sonke
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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3
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de Boo LW, Jóźwiak K, Ter Hoeve ND, van Diest PJ, Opdam M, Wang Y, Schmidt MK, de Jong V, Kleiterp S, Cornelissen S, Baars D, Koornstra RHT, Kerver ED, van Dalen T, Bins AD, Beeker A, van den Heiligenberg SM, de Jong PC, Bakker SD, Rietbroek RC, Konings IR, Blankenburgh R, Bijlsma RM, Imholz ALT, Stathonikos N, Vreuls W, Sanders J, Rosenberg EH, Koop EA, Varga Z, van Deurzen CHM, Mooyaart AL, Córdoba A, Groen E, Bart J, Willems SM, Zolota V, Wesseling J, Sapino A, Chmielik E, Ryska A, Broeks A, Voogd AC, van der Wall E, Siesling S, Salgado R, Dackus GMHE, Hauptmann M, Kok M, Linn SC. Prognostic value of histopathologic traits independent of stromal tumor-infiltrating lymphocyte levels in chemotherapy-naïve patients with triple-negative breast cancer. ESMO Open 2024; 9:102923. [PMID: 38452438 PMCID: PMC10937239 DOI: 10.1016/j.esmoop.2024.102923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/09/2024] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In the absence of prognostic biomarkers, most patients with early-stage triple-negative breast cancer (eTNBC) are treated with combination chemotherapy. The identification of biomarkers to select patients for whom treatment de-escalation or escalation could be considered remains an unmet need. We evaluated the prognostic value of histopathologic traits in a unique cohort of young, (neo)adjuvant chemotherapy-naïve patients with early-stage (stage I or II), node-negative TNBC and long-term follow-up, in relation to stromal tumor-infiltrating lymphocytes (sTILs) for which the prognostic value was recently reported. MATERIALS AND METHODS We studied all 485 patients with node-negative eTNBC from the population-based PARADIGM cohort which selected women aged <40 years diagnosed between 1989 and 2000. None of the patients had received (neo)adjuvant chemotherapy according to standard practice at the time. Associations between histopathologic traits and breast cancer-specific survival (BCSS) were analyzed with Cox proportional hazard models. RESULTS With a median follow-up of 20.0 years, an independent prognostic value for BCSS was observed for lymphovascular invasion (LVI) [adjusted (adj.) hazard ratio (HR) 2.35, 95% confidence interval (CI) 1.49-3.69], fibrotic focus (adj. HR 1.61, 95% CI 1.09-2.37) and sTILs (per 10% increment adj. HR 0.75, 95% CI 0.69-0.82). In the sTILs <30% subgroup, the presence of LVI resulted in a higher cumulative incidence of breast cancer death (at 20 years, 58%; 95% CI 41% to 72%) compared with when LVI was absent (at 20 years, 32%; 95% CI 26% to 39%). In the ≥75% sTILs subgroup, the presence of LVI might be associated with poor survival (HR 11.45, 95% CI 0.71-182.36, two deaths). We confirm the lack of prognostic value of androgen receptor expression and human epidermal growth factor receptor 2 -low status. CONCLUSIONS sTILs, LVI and fibrotic focus provide independent prognostic information in young women with node-negative eTNBC. Our results are of importance for the selection of patients for de-escalation and escalation trials.
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Affiliation(s)
- L W de Boo
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K Jóźwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - N D Ter Hoeve
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Opdam
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Y Wang
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M K Schmidt
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - V de Jong
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Kleiterp
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Cornelissen
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Baars
- Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R H T Koornstra
- Department of Medical Oncology, Rijnstate Medical center, Arnhem, The Netherlands
| | - E D Kerver
- Department of Medical Oncology, OLVG, Amsterdam, The Netherlands
| | - T van Dalen
- Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands
| | - A D Bins
- Department of Medical Oncology, Amsterdam UMC, Amsterdam, The Netherlands
| | - A Beeker
- Department of Medical Oncology, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | | | - P C de Jong
- Department of Medical Oncology, Sint Antonius Hospital, Utrecht, The Netherlands
| | - S D Bakker
- Department of Internal Medicine, Zaans Medical Centre, Zaandam, The Netherlands
| | - R C Rietbroek
- Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, The Netherlands
| | - I R Konings
- Department of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - R Blankenburgh
- Department of Medical Oncology, Saxenburgh Medical Center, Hardenberg, The Netherlands
| | - R M Bijlsma
- Department of Medical Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands
| | - A L T Imholz
- Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands
| | - N Stathonikos
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W Vreuls
- Department of Pathology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - J Sanders
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E H Rosenberg
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E A Koop
- Department of Pathology, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
| | - Z Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - C H M van Deurzen
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A L Mooyaart
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Córdoba
- Department of Pathology, Complejo Hospitalaria de Navarra, Pamplona, Spain
| | - E Groen
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J Bart
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - S M Willems
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - V Zolota
- Department of Pathology, Rion University Hospital, Patras, Greece
| | - J Wesseling
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - A Sapino
- Department of Medical Sciences, University of Torino, Torino, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - E Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial National Research Institute of Oncology, Gliwice, Poland
| | - A Ryska
- Charles University Medical Faculty and University Hospital, Hradec Kralove, Czech Republic
| | - A Broeks
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A C Voogd
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - E van der Wall
- Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - R Salgado
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium
| | - G M H E Dackus
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - M Kok
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Tumorbiology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S C Linn
- Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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4
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Vega DM, Yee LM, McShane LM, Williams PM, Chen L, Vilimas T, Fabrizio D, Funari V, Newberg J, Bruce LK, Chen SJ, Baden J, Carl Barrett J, Beer P, Butler M, Cheng JH, Conroy J, Cyanam D, Eyring K, Garcia E, Green G, Gregersen VR, Hellmann MD, Keefer LA, Lasiter L, Lazar AJ, Li MC, MacConaill LE, Meier K, Mellert H, Pabla S, Pallavajjalla A, Pestano G, Salgado R, Samara R, Sokol ES, Stafford P, Budczies J, Stenzinger A, Tom W, Valkenburg KC, Wang XZ, Weigman V, Xie M, Xie Q, Zehir A, Zhao C, Zhao Y, Stewart MD, Allen J. Erratum to "Aligning tumor mutational burden (TMB) quantification across diagnostic platforms: phase II of the Friends of Cancer Research TMB Harmonization Project": [Annals of Oncology 32 (2021) 1626-1636]. Ann Oncol 2024; 35:145. [PMID: 37558578 DOI: 10.1016/j.annonc.2023.07.005] [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: 08/11/2023] Open
Affiliation(s)
- D M Vega
- Friends of Cancer Research, Washington
| | - L M Yee
- National Cancer Institute, Bethesda
| | | | - P M Williams
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | - L Chen
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | - T Vilimas
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick
| | | | - V Funari
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - L K Bruce
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - J Baden
- Bristol Myers Squibb Co., Princeton
| | | | - P Beer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - M Butler
- LGC Clinical Diagnostics, Gaithersburg
| | | | | | - D Cyanam
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor
| | - K Eyring
- Intermountain Precision Genomics, St. George
| | - E Garcia
- Brigham and Women's Hospital, Boston, USA
| | - G Green
- Bristol Myers Squibb Co., Princeton
| | | | - M D Hellmann
- Memorial Sloan Kettering Cancer Center, New York
| | | | - L Lasiter
- Friends of Cancer Research, Washington
| | - A J Lazar
- The University of Texas MD Anderson Cancer Center, Houston
| | - M-C Li
- National Cancer Institute, Bethesda
| | | | - K Meier
- Illumina Inc, Clinical Genomics, San Diego
| | | | | | | | | | - R Salgado
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | | | - P Stafford
- Caris Life Sciences Inc, Phoenix, Arizona, USA
| | - J Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - W Tom
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor
| | | | - X Z Wang
- EMD Serono Research and Development Institute, Inc., Billerica
| | | | - M Xie
- AstraZeneca Pharmaceuticals LP, Waltham, USA
| | - Q Xie
- General Dynamics Information Technology, Inc., Columbia, USA
| | - A Zehir
- Memorial Sloan Kettering Cancer Center, New York
| | - C Zhao
- Illumina Inc, Clinical Genomics, San Diego
| | - Y Zhao
- National Cancer Institute, Bethesda
| | | | - J Allen
- Friends of Cancer Research, Washington
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5
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Tarantino P, Viale G, Press MF, Hu X, Penault-Llorca F, Bardia A, Batistatou A, Burstein HJ, Carey LA, Cortes J, Denkert C, Diéras V, Jacot W, Koutras AK, Lebeau A, Loibl S, Modi S, Mosele MF, Provenzano E, Pruneri G, Reis-Filho JS, Rojo F, Salgado R, Schmid P, Schnitt SJ, Tolaney SM, Trapani D, Vincent-Salomon A, Wolff AC, Pentheroudakis G, André F, Curigliano G. ESMO expert consensus statements (ECS) on the definition, diagnosis, and management of HER2-low breast cancer. Ann Oncol 2023; 34:645-659. [PMID: 37269905 DOI: 10.1016/j.annonc.2023.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/05/2023] Open
Abstract
Human epidermal growth factor receptor 2 (HER2)-low breast cancer has recently emerged as a targetable subset of breast tumors, based on the evidence from clinical trials of novel anti-HER2 antibody-drug conjugates. This evolution has raised several biological and clinical questions, warranting the establishment of consensus to optimally treat patients with HER2-low breast tumors. Between 2022 and 2023, the European Society for Medical Oncology (ESMO) held a virtual consensus-building process focused on HER2-low breast cancer. The consensus included a multidisciplinary panel of 32 leading experts in the management of breast cancer from nine different countries. The aim of the consensus was to develop statements on topics that are not covered in detail in the current ESMO Clinical Practice Guideline. The main topics identified for discussion were (i) biology of HER2-low breast cancer; (ii) pathologic diagnosis of HER2-low breast cancer; (iii) clinical management of HER2-low metastatic breast cancer; and (iv) clinical trial design for HER2-low breast cancer. The expert panel was divided into four working groups to address questions relating to one of the four topics outlined above. A review of the relevant scientific literature was conducted in advance. Consensus statements were developed by the working groups and then presented to the entire panel for further discussion and amendment before voting. This article presents the developed statements, including findings from the expert panel discussions, expert opinion, and a summary of evidence supporting each statement.
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Affiliation(s)
- P Tarantino
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston, USA; Department of Oncology and Hemato-Oncology, University of Milan, Milan
| | - G Viale
- Department of Pathology and Laboratory Medicine, European Institute of Oncology IRCCS, Milan, Italy
| | - M F Press
- Department of Pathology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - X Hu
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - F Penault-Llorca
- Centre de Lutte Contre le Cancer Centre Jean PERRIN, Clermont-Ferrand, France
| | - A Bardia
- Harvard Medical School, Boston, USA; Department of Medical Oncology, Massachusetts General Hospital, Boston, USA
| | - A Batistatou
- Department of Pathology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - H J Burstein
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston, USA
| | - L A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - J Cortes
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Barcelona; Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - C Denkert
- Philipps-University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - V Diéras
- Department of Medical Oncology, Centre Eugène Marquis, Rennes
| | - W Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier University, INSERM U1194, Montpellier, France
| | - A K Koutras
- Division of Oncology, Department of Medicine, University Hospital of Patras, Greece
| | - A Lebeau
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - S Loibl
- German Breast Group/GBG Forschungs GmbH, Neu-Isenburg; Goethe University Frankfurt, Frankfurt, Germany
| | - S Modi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M F Mosele
- Department of Medical Oncology, Institute Gustave Roussy, Villejuif, France
| | - E Provenzano
- Department of Histopathology, Cambridge University NHS Foundation Trust and NIH Cambridge Biomedical Research Centre, Cambridge, UK
| | - G Pruneri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - J S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - F Rojo
- Department of Pathology, IIS-Fundacion Jimenez Diaz University Hospital-CIBERONC, Madrid, Spain
| | - R Salgado
- Department of Pathology, ZAS, Antwerp, Belgium; Division of Research, Peter Mac Callum Cancer Centre, Melbourne, Australia
| | - P Schmid
- Barts Cancer Institute, Queen Mary University London, London, UK
| | - S J Schnitt
- Harvard Medical School, Boston, USA; Department of Pathology, Brigham and Women's Hospital and Breast Oncology Program, Dana-Farber Cancer Institute, Boston, USA
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Harvard Medical School, Boston, USA
| | - D Trapani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; European Institute of Oncology, IRCCS, Milan, Italy
| | - A Vincent-Salomon
- Department of Pathology, Diagnostic and Theranostic Medicine Division, Institut Curie, PSL University, Paris, France
| | - A C Wolff
- The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA
| | | | - F André
- INSERM U981 - Molecular Predictors and New Targets in Oncology, PRISM Center for Precision Medicine, Gustave Roussy, Villejuif, France
| | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan; European Institute of Oncology, IRCCS, Milan, Italy.
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6
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Geurts VCM, Voorwerk L, Balduzzi S, Salgado R, Van de Vijver K, van Dongen MGJ, Kemper I, Mandjes IAM, Heuver M, Sparreboom W, Haanen JBAG, Sonke GS, Horlings HM, Kok M. Unleashing NK- and CD8 T cells by combining monalizumab and trastuzumab for metastatic HER2-positive breast cancer: Results of the MIMOSA trial. Breast 2023; 70:76-81. [PMID: 37393645 DOI: 10.1016/j.breast.2023.06.007] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023] Open
Abstract
The large majority of patients with HER2-positive metastatic breast cancer (MBC) will eventually develop resistance to anti-HER2 therapy and die of this disease. Despite, relatively high levels of stromal tumor infiltrating lymphocytes (sTILs), PD1-blockade has only shown modest responses. Monalizumab targets the inhibitory immune checkpoint NKG2A, thereby unleashing NK- and CD8 T cells. We hypothesized that monalizumab synergizes with trastuzumab by promoting antibody-dependent cell-mediated cytotoxicity. In the phase II MIMOSA-trial, HER2-positive MBC patients were treated with trastuzumab and 750 mg monalizumab every two weeks. Following a Simon's two-stage design, 11 patients were included in stage I of the trial. Treatment was well tolerated with no dose-limiting toxicities. No objective responses were observed. Therefore, the MIMOSA-trial did not meet its primary endpoint. In summary, despite the strong preclinical rationale, the novel combination of monalizumab and trastuzumab does not induce objective responses in heavily pre-treated HER2-positive MBC patients.
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Affiliation(s)
- V C M Geurts
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - L Voorwerk
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - S Balduzzi
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - R Salgado
- Department of Pathology, ZAS, Antwerp, Belgium; Division of Research, Peter Mac Callum Cancer Center, Melbourne, Victoria, Australia.
| | - K Van de Vijver
- Department of Pathology, University Hospital Ghent, Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
| | - M G J van Dongen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - I Kemper
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - I A M Mandjes
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - M Heuver
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | | | - J B A G Haanen
- Division of Molecular Oncology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - G S Sonke
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - H M Horlings
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - M Kok
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
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7
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Thouvenin J, Van Marcke C, Decoster L, Raicevic G, Punie K, Vandenbulcke M, Salgado R, Van Valckenborgh E, Maes B, Joris S, Steichel DV, Vranken K, Jacobs S, Dedeurwaerdere F, Martens G, Devos H, Duhoux FP, Rasschaert M, Pauwels P, Geboes K, Collignon J, Tejpar S, Canon JL, Peeters M, Rutten A, Van de Mooter T, Vermeij J, Schrijvers D, Demey W, Lybaert W, Van Huysse J, Mebis J, Awada A, Claes KBM, Hebrant A, Van der Meulen J, Delafontaine B, Bempt IV, Maetens J, de Hemptinne M, Rottey S, Aftimos P, De Grève J. PRECISION: the Belgian molecular profiling program of metastatic cancer for clinical decision and treatment assignment. ESMO Open 2022; 7:100524. [PMID: 35970014 PMCID: PMC9434164 DOI: 10.1016/j.esmoop.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
PRECISION is an initiative from the Belgian Society of Medical Oncology (BSMO) in collaboration with several stakeholders, encompassing four programs that aim to boost genomic and clinical knowledge with the ultimate goal to offer patients with metastatic solid tumors molecularly guided treatments. The PRECISION 1 study has led to the creation of a clinico-genomic database. The Belgian Approach for Local Laboratory Extensive Tumor Testing (BALLETT) and GeNeo studies will increase the number of patients with advanced cancer that have comprehensive genotyping of their cancer. The PRECISION 2 project consists of investigator-initiated phase II studies aiming to provide access to a targeted drug for patients whose tumors harbor actionable mutations in case the matched drug is not available through reimbursement or clinical trials in Belgium.
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Affiliation(s)
- J Thouvenin
- Hospices Civils de Lyon, Medical Oncology, Lyon, France; Institut Jules Bordet, Medical Oncology Clinic, Brussels, Belgium
| | | | - L Decoster
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Punie
- KU Leuven University Hospitals Leuven, General Medical Oncology, Leuven, Belgium
| | | | - R Salgado
- GasthuisZusters Antwerpen, Pathology, Antwerp, Belgium
| | | | - B Maes
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - S Joris
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Vranken
- Pediatric Oncology, WIV-ISP, Leuven, Belgium
| | | | | | - G Martens
- Laboratoriumgeneeskunde, AZ Delta, Roeselare, Belgium
| | - H Devos
- Laboratoriumgeneeskunde, AZ Sint-Jan, Bruges, Belgium
| | - F P Duhoux
- UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - M Rasschaert
- Universitair Ziekenhuis Antwerpen, Medical Oncology, Antwerpen, Belgium; Medical Oncology, AZ Monica, Deurne, Belgium
| | - P Pauwels
- Universitair Ziekenhuis Antwerpen, Pathology, Antwerpen, Belgium
| | - K Geboes
- Division of Digestive Oncology, Department of Gastroenterology, UZ Gent, Gent, Belgium; Department of Internal Medicine and Pediatrics, UZ Gent, Gent, Belgium
| | - J Collignon
- Medical Oncology, CHU de Liege - Hospital Sart Tilman, Liège, Belgium
| | | | - J-L Canon
- Grand Hôpital de Charleroi Site Notre Dame, Service d'Oncologie-Hématologie, Charleroi, Belgium
| | - M Peeters
- Universitair Ziekenhuis Antwerpen, Oncology, Antwerpen, Belgium
| | - A Rutten
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - T Van de Mooter
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Vermeij
- ZNA Middelheim, Medical Oncology, Antwerpen, Belgium
| | | | - W Demey
- AZ Klina, Medical Oncology, Brasschaat, Belgium
| | - W Lybaert
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Van Huysse
- AZ Sint-Jan Brugge-Oostende, Pathology, Brugge, Belgium
| | - J Mebis
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - A Awada
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | | | | | | | | | | | | | | | - S Rottey
- Medical Oncology Department, UZ Gent, Gent, Belgium
| | - P Aftimos
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | - J De Grève
- UZ Brussel, Medical Oncology, Brussels, Belgium.
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8
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Vega DM, Yee LM, McShane LM, Williams PM, Chen L, Vilimas T, Fabrizio D, Funari V, Newberg J, Bruce LK, Chen SJ, Baden J, Carl Barrett J, Beer P, Butler M, Cheng JH, Conroy J, Cyanam D, Eyring K, Garcia E, Green G, Gregersen VR, Hellmann MD, Keefer LA, Lasiter L, Lazar AJ, Li MC, MacConaill LE, Meier K, Mellert H, Pabla S, Pallavajjalla A, Pestano G, Salgado R, Samara R, Sokol ES, Stafford P, Budczies J, Stenzinger A, Tom W, Valkenburg KC, Wang XZ, Weigman V, Xie M, Xie Q, Zehir A, Zhao C, Zhao Y, Stewart MD, Allen J. Aligning tumor mutational burden (TMB) quantification across diagnostic platforms: phase II of the Friends of Cancer Research TMB Harmonization Project. Ann Oncol 2021; 32:1626-1636. [PMID: 34606929 DOI: 10.1016/j.annonc.2021.09.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tumor mutational burden (TMB) measurements aid in identifying patients who are likely to benefit from immunotherapy; however, there is empirical variability across panel assays and factors contributing to this variability have not been comprehensively investigated. Identifying sources of variability can help facilitate comparability across different panel assays, which may aid in broader adoption of panel assays and development of clinical applications. MATERIALS AND METHODS Twenty-nine tumor samples and 10 human-derived cell lines were processed and distributed to 16 laboratories; each used their own bioinformatics pipelines to calculate TMB and compare to whole exome results. Additionally, theoretical positive percent agreement (PPA) and negative percent agreement (NPA) of TMB were estimated. The impact of filtering pathogenic and germline variants on TMB estimates was assessed. Calibration curves specific to each panel assay were developed to facilitate translation of panel TMB values to whole exome sequencing (WES) TMB values. RESULTS Panel sizes >667 Kb are necessary to maintain adequate PPA and NPA for calling TMB high versus TMB low across the range of cut-offs used in practice. Failure to filter out pathogenic variants when estimating panel TMB resulted in overestimating TMB relative to WES for all assays. Filtering out potential germline variants at >0% population minor allele frequency resulted in the strongest correlation to WES TMB. Application of a calibration approach derived from The Cancer Genome Atlas data, tailored to each panel assay, reduced the spread of panel TMB values around the WES TMB as reflected in lower root mean squared error (RMSE) for 26/29 (90%) of the clinical samples. CONCLUSIONS Estimation of TMB varies across different panels, with panel size, gene content, and bioinformatics pipelines contributing to empirical variability. Statistical calibration can achieve more consistent results across panels and allows for comparison of TMB values across various panel assays. To promote reproducibility and comparability across assays, a software tool was developed and made publicly available.
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Affiliation(s)
- D M Vega
- Friends of Cancer Research, Washington, USA
| | - L M Yee
- National Cancer Institute, Bethesda, USA
| | | | - P M Williams
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - L Chen
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - T Vilimas
- Molecular Characterization Laboratory, Frederick National Lab for Cancer Research, Leidos Biomedical Research Inc., Frederick, USA
| | - D Fabrizio
- Foundation Medicine Inc., Cambridge, USA
| | - V Funari
- NeoGenomics Laboratories, Aliso Viejo, USA
| | - J Newberg
- Foundation Medicine Inc., Cambridge, USA
| | - L K Bruce
- NeoGenomics Laboratories, Aliso Viejo, USA
| | | | - J Baden
- Bristol Myers Squibb Co., Princeton, USA
| | | | - P Beer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - M Butler
- LGC Clinical Diagnostics, Gaithersburg, USA
| | | | | | - D Cyanam
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor, USA
| | - K Eyring
- Intermountain Precision Genomics, St. George, USA
| | - E Garcia
- Brigham and Women's Hospital, Boston, USA
| | - G Green
- Bristol Myers Squibb Co., Princeton, USA
| | | | - M D Hellmann
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - L A Keefer
- Personal Genome Diagnostics, Baltimore, USA
| | - L Lasiter
- Friends of Cancer Research, Washington, USA
| | - A J Lazar
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M-C Li
- National Cancer Institute, Bethesda, USA
| | | | - K Meier
- Illumina Inc, Clinical Genomics, San Diego, USA
| | | | | | | | | | - R Salgado
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | - E S Sokol
- Foundation Medicine Inc., Cambridge, USA
| | | | - J Budczies
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - W Tom
- Clinical Sequencing Division, Thermo Fisher Scientific, Ann Arbor, USA
| | | | - X Z Wang
- EMD Serono Research and Development Institute, Inc., Billerica, USA
| | | | - M Xie
- AstraZeneca Pharmaceuticals LP, Waltham, USA
| | - Q Xie
- General Dynamics Information Technology, Inc., Columbia, USA
| | - A Zehir
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Zhao
- Illumina Inc, Clinical Genomics, San Diego, USA
| | - Y Zhao
- National Cancer Institute, Bethesda, USA
| | - M D Stewart
- Friends of Cancer Research, Washington, USA.
| | - J Allen
- Friends of Cancer Research, Washington, USA
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Salgado R, Hawks SA, Frere F, Vázquez A, Huang CYH, Duggal NK. West Nile Virus Vaccination Protects against Usutu Virus Disease in Mice. Viruses 2021; 13:v13122352. [PMID: 34960621 PMCID: PMC8704473 DOI: 10.3390/v13122352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
West Nile virus (WNV) and Usutu virus (USUV) are mosquito-borne flaviviruses that can cause neuroinvasive disease in humans. WNV and USUV circulate in both Africa and Europe and are closely related. Due to antigenic similarity, WNV-specific antibodies and USUV-specific antibodies have the potential to bind heterologous viruses; however, it is unclear whether this interaction may offer protection against infection. To investigate how prior WNV exposure would influence USUV infection, we used an attenuated WNV vaccine that contains the surface proteins of WNV in the backbone of a dengue virus 2 vaccine strain and protects against WNV disease. We hypothesized that vaccination with this attenuated WNV vaccine would protect against USUV infection. Neutralizing responses against WNV and USUV were measured in vitro using sera following vaccination. Sera from vaccinated CD-1 and Ifnar1-/- mice cross-neutralized with WNV and USUV. All mice were then subsequently challenged with an African or European USUV strain. In CD-1 mice, there was no difference in USUV titers between vaccinated and mock-vaccinated mice. However, in the Ifnar1-/- model, vaccinated mice had significantly higher survival rates and significantly lower USUV viremia compared to mock-vaccinated mice. Our results indicate that exposure to an attenuated form of WNV protects against severe USUV disease in mice and elicits a neutralizing response to both WNV and USUV. Future studies will investigate the immune mechanisms responsible for the protection against USUV infection induced by WNV vaccination, providing critical insight that will be essential for USUV and WNV vaccine development.
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Affiliation(s)
- Rebecca Salgado
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
| | - Seth A. Hawks
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
| | - Francesca Frere
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
| | - Ana Vázquez
- National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), CIBERESP, CIBER Epidemiology and Public Health, 28220 Madrid, Spain;
| | - Claire Y.-H. Huang
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, CO 80521, USA;
| | - Nisha K. Duggal
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (R.S.); (S.A.H.); (F.F.)
- Correspondence: ; Tel.: +1-540-231-6705
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10
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Foldyna B, Uhlig J, Mayrhofer T, Natale L, Vliegenthart R, Lotz J, Salgado R, Francone M, Nikolaou K, Bamberg F, Maintz D, Maurovich-Horvat P, Thiele H, Hoffmann U, Gutberlet M. Rising utilization of coronary CT angiography across Europe over the last decade: insights from a large prospective European registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0203] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
The recently updated 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes endorse the use of coronary computed tomography angiography (CCTA) for exclusion of obstructive coronary artery disease in patients with a low clinical likelihood (Class I, LOE B). Higher demand for CCTA requires broad availability, inevitably involving smaller healthcare providers, such as non-academic hospitals and private practices. Nevertheless, most published data on CCTA image quality and safety rely on exams performed in high-volume academic centers, and little is known about CCTA in non-academic settings.
Purpose
To investigate the utilization of CCTA across Europe over the last decade, focusing on differences between academic and non-academic centers.
Methods
We included patients with stable chest pain and suspected coronary artery disease (CAD) who received CCTA and were included in the European Society of Cardiovascular Radiology MR/CT registry 01/2010–01/2020. We compared CT equipment, image quality, radiation dose, the incidence of periprocedural adverse events, patient characteristics, and CCTA findings between academic (high volume university hospitals) and non-academic centers (non-academic hospitals and private practices).
Results
Overall, 64,317 patients (41.2% women; age 60±13 years) from 212 sites across 19 European countries were included. Academic centers submitted most cases in 2010—2014 (51.6%), whereas non-academic centers accounted for 71.3% of records in 2015–2020. While non-academic centers used less advanced technology, radiation dose remained low (4.54 [interquartile range (IQR) 2.28–6.76] mSv) with a 30% decline of high-dose scans (>7 mSv) over time. Diagnostic image quality was reported in 97.7% of cases, and the rate of acute scan-related events was low (0.4%) (Figure 1). From 2010–2014 to 2015–2020, CCTA nearly doubled in patients with low to intermediate pretest-probability, women >50, and 40–60 years old men (Figure 2). CAD presence and extent decreased slightly over time (prevalence: 2010–2014: 41.5% vs. 2015–2020: 40.6%), (multi-vessel disease in those with CAD: 2010–2014: 61.9% vs. 2015–2020: 55.9%; all p<0.01).
Conclusion
CCTA expands rapidly to non-academic centers across Europe, increasing availability while maintaining relatively low radiation dose, high diagnostic image quality, and safety. Broad availability of high-quality CCTA is essential for a successfully implementation of the recently updated guidelines for the diagnosis and management of chronic coronary syndromes.
Funding Acknowledgement
Type of funding sources: None. Changes in CCTA utilizationChanges in patient characteristics
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Affiliation(s)
- B Foldyna
- Massachusetts General Hospital - Harvard Medical School, Department of Radiology, Boston, United States of America
| | - J Uhlig
- University Medical Center Goettingen, Department of Diagnostic and Interventional Radiology, Goettingen, Germany
| | - T Mayrhofer
- Stralsund University of Applied Sciences, School of Business Studies, Stralsund, Germany
| | - L Natale
- Catholic University of the Sacred Heart, Radiology, Rome, Italy
| | - R Vliegenthart
- University Medical Center Groningen, Department of Radiology, Groningen, Netherlands (The)
| | - J Lotz
- University Medical Center Goettingen, Department of Diagnostic and Interventional Radiology, Goettingen, Germany
| | - R Salgado
- Antwerp University Hospital, Department of Radiology, Antwerp, Belgium
| | - M Francone
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - K Nikolaou
- University Hospital Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen, Germany
| | - F Bamberg
- University of Freiburg, Department of Diagnostic and Interventional Radiology, Freiburg, Germany
| | - D Maintz
- University of Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Budapest, Hungary
| | - H Thiele
- Heart Center at University of Leipzig, Department of Cardiology, Leipzig, Germany
| | - U Hoffmann
- Massachusetts General Hospital - Harvard Medical School, Department of Radiology, Boston, United States of America
| | - M Gutberlet
- Heart Center at University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig, Germany
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11
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Salgado R, Peg V, Rüschoff J, Vincent-Salomon A, Castellano I, Perner S, Van de Vijver K, Quinn CM, Varga Z. Gene expression signatures for tailoring adjuvant chemotherapy of luminal breast cancer: the pathologists' perspective. Ann Oncol 2021; 32:1316-1321. [PMID: 34461263 DOI: 10.1016/j.annonc.2021.08.1993] [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: 05/03/2021] [Revised: 07/04/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- R Salgado
- Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium; Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - V Peg
- Universidad Autónoma de Barcelona, Barcelona, Spain; Department of Pathology, Vall D'Hebron University Hospital, Barcelona, Spain; Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Madrid, Spain
| | - J Rüschoff
- Targos Molecular Pathology GmbH and Institute of Pathology Nordhessen, Kassel, Germany
| | - A Vincent-Salomon
- Department of Pathology and Department of Diagnostic and Theranostic Medicine, Institut Curie, PSL Research University, Paris, France
| | - I Castellano
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - S Perner
- Institute of Pathology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; Pathology, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - K Van de Vijver
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - C M Quinn
- Department of Pathology, St. Vincent's University Hospital, Dublin and University College Dublin, Dublin, Ireland
| | - Z Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
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12
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Loi S, Michiels S, Adams S, Loibl S, Budczies J, Denkert C, Salgado R. The journey of tumor-infiltrating lymphocytes as a biomarker in breast cancer: clinical utility in an era of checkpoint inhibition. Ann Oncol 2021; 32:1236-1244. [PMID: 34311075 DOI: 10.1016/j.annonc.2021.07.007] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/15/2021] [Accepted: 07/19/2021] [Indexed: 12/12/2022] Open
Abstract
In 2014, we described a method to quantify percentage of tumor-infiltrating lymphocytes (TILs) on hematoxylin and eosin-stained slides of breast cancer samples using light microscopy that could be performed easily by pathologists with no extra stains. The aim of detailing the method was to facilitate independent research groups replicating our prognostic findings using TIL quantity in early-stage breast cancers. A global working group of breast pathologists was convened to standardize, test reproducibility, and refine the method. A website was also established which allowed free training (www.tilsinbreastcancer.org). As a result of this work, TIL data have been collected in over 20 000 primary breast cancer samples worldwide and the robust associations with better prognoses in triple-negative breast cancer (TNBC) and HER2+ BC have been confirmed. This has resulted in the inclusion of the TIL biomarker in several international breast cancer guidelines as well as in national criteria for routine pathology reporting. TIL therefore represents the first biological prognostic biomarker for early-stage TNBCs, and here its prognostic effect is linear, with values of 30%-50% being suggested as suitable for use in potential chemotherapy de-escalation studies. The efficacy of immune checkpoint-targeted agents in breast cancer now provides direct evidence that host immune responses can modify tumor growth in some patients. With the recent granting of accelerated approvals for the first PD-1/PD-L1 targeting agents in early and advanced TNBC, our focus has now moved to investigating the clinical utility of TIL in the setting of immune checkpoint agents, with or without PD-L1 protein assessment. Emerging data suggest that TIL quantity can help clinicians identify patients with breast cancer who benefit most from PD-1/PD-L1 inhibition. In patients with advanced TNBC and HER2+ disease a TIL cut-off of 5% or 10%, with PD-L1 expression can define 'immune-enriched' tumors and currently seems to have the most clinical relevance in this context.
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Affiliation(s)
- S Loi
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
| | - S Michiels
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, University Paris-Saclay, Villejuif, France; Oncostat INSERM U1018, labeled Ligue Contre le Cancer, University Paris-Saclay, Villejuif, France
| | - S Adams
- Perlmutter Cancer Center, New York University School of Medicine, New York, USA
| | - S Loibl
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; German Breast Group, c/o GBG Forschungs GmbH, Frankfurt; Goethe University, Frankfurt
| | - J Budczies
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UK-GM), Marburg, Germany
| | - R Salgado
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium
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13
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Ramos Jimenez J, Marco Del Castillo A, Lozano Granero VC, Lazaro Rivera C, Salgado R, Rodriguez Manero M, Ramos Fernandez P, Dallaglio P, Gunturiz Beltran C, Alonso Fernandez P, Ayala HD, Jimenez Sanchez D, Lopez Gil M, Arribas Ynsaurriaga F, Rodriguez Munoz DA. Clinical recurrence of palpitations following slow pathway ablation in patients with suspected paroxysmal supraventricular tachycardias but non-documented, non-inducible tachycardias. Europace 2021. [DOI: 10.1093/europace/euab116.078] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Catheter ablation is recommended as first-line treatment in patients with atrioventricular nodal reentry tachycardias (AVNRT). However, the best therapeutic modality in patients with dual AV nodal physiology but non-inducible tachycardias in electrophysiological study (EPS) remains controversial, especially when no tachycardias have been documented.
Our objective was to evaluate the results of empirical slow pathway ablation in patients showing dual AV nodal physiology but non-inducible AVNRT.
Methods
Multicenter, retrospective, observational registry of consecutive patients undergoing EPS due to clinical suspicion of paroxysmal supraventricular tachycardias (PSVT), but with no prior ECG documentation. Clinical, EPS and ablation (when performed) data were collected and andalyzed.
Results
427 patients of 12 centers were included. Mean age was 46.3 ±16.1 and 297 (69.6%) were females. AVNRT was induced in 188 patients (typical in 181 cases, atypical in 7). Dual AV nodal physiology with or without single nodal echo beats, but with no sustained tachycardia and without evidence of accessory pathway was present in 68 patients. Ablation of the slow pathway was performed in 187/188 patients with AVNRT and in 30/68 patients with dual physiology. Among subjects with non-inducible tachycardia, ablation reduced significantly recurrences (39.5% in non-ablated vs. 16.7%; p = 0.04), with a level equivalent to those with ablated AVNRT(14.4% vs. 16.7%; p = 0.75). Procedure-related complications were similar in both groups: empirical ablation n = 1; 3.3% vs. induced tachycardia n = 6; 3.2% (p = 0.98).
Conclusions
In patients with high clinical suspicion of PSVT but non-documented and non-inducible arrhythmias, the presence of dual AV nodal physiology makes AVNRT a likely mechanism of the clinical tachycardia. Catheter ablation of slow pathway reduces the risk of recurrence to a level equivalent to those with inducible and ablated AVNRT. AVNRT (n = 188) Dual nodal physiology (n = 68) p value Age (years) 48.6 ± 16.3 41.9 ± 14.0 <0.01 Female 71.8% 67.7% 0.52 Years symptomatic 9.3 ± 11.3 3.6 ± 8.1 <0.01 Sudden onset 83.9% 88.0% 0.54 Abrupt end 73.4% 74.6% 0.96 Previous rate-slowing drugs 30.9% 25.0% 0.36 Previous antiarrhythmic drugs 5.9% 2.9% 0.35 Isoproterenol in EPS 70.0% 89.7% <0.01
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Affiliation(s)
| | | | | | | | - R Salgado
- Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - P Dallaglio
- University Hospital Bellvitge, Barcelona, Spain
| | | | | | - HD Ayala
- University Hospital La Fe, Valencia, Spain
| | | | - M Lopez Gil
- University Hospital 12 de Octubre, Madrid, Spain
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14
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Marco Del Castillo A, Ramos Jimenez J, Lozano Granero VC, Rodriguez Manero M, Ramos Fernandez P, Lazaro Rivera C, Jimenez Sanchez D, Ayala HD, Dallaglio P, Alonso Fernandez P, Salgado R, Gunturiz Beltran C, Fontenla Cerezuela AR, Arribas Ynsaurriaga F, Rodriguez Munoz DA. Recurrence of palpitations following electrophysiological study and ablation in suspected but undocumented paroxysmal supraventricular tachycardias: follow-up results of the BELIEVE-SVT registry. Europace 2021. [DOI: 10.1093/europace/euab116.045] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
ECG documentation of paroxysmal supraventricular tachycardias (PSVT) may be challenging due to their short duration and usually abrupt end. As ablation represents first-line treatment of this pathologies, it is not uncommon that physicians refer patients to electrophysiological study (EPS) when symptoms are suggestive of PSVT even though no ECG documentation has been obtained. Our objective was to evaluate the results of ablation performed in patients with induced arrhythmias in EPS but no previous ECG documentation.
Methods
Retrospective and observational multicenter registry of consecutive patients undergoing EPS, followed or not by ablation, referred because of undocumented clinical suspicion of PSVT. We collected clinical, EPS and clinical follow-up data, along with data regarding ablation, when performed. Descriptive statistical analysis was carried out using Stata.
Results
427 patients of 12 centers were included. Mean age was 46.3 ± 16.1 and 297 (69.6%) were females. Sustained arrhythmias were induced in most patients (n = 255; 59.7%) and ablation was performed in 274 (64.2%). 10 complications (2.3% of procedures) were reported: 3 transient AV block, 2 PR interval prolongation, 2 puncture-related hematoma, 2 painful sites of puncture and 1 catheter entrapment in mitral chordae.
During a mean follow-up of 3.1 ± 2.0 years, 111 patients experienced recurrence of palpitations, mostly (n = 77; 69.4%) without ECG documentation. Clinical recurrence was more frequent in subjects who had not been ablated (41.8% vs 17.2% in ablated patients; risk ratio 2.44 (CI 95% 1.77-3.36); p < 0.001). Table 1 shows types of clinical recurrences.
Conclusions
EPS in patients with high clinical suspicion of PSVT, followed by ablation when tachycardia is induced is effective in preventing future recurrences of palpitations. Early referral for EPS can, therefore, reduce visits to the emergency room, admissions and healthcare burden due to other low-yield, unnecessary tests. Type of recurrence ECG documentation 34(8.0%) ·Sinus rhythm 12(2.8%) ·Atrial tachycardia 6(1.4%) ·Typical atrioventricular nodal reentrant tachycardia 5(1.2%) ·Atrial fibrillation 5(1.2%) ·Premature ventricular beats 3(0.7%) ·Orthodromic atriventricular tachycardia 2(0.5%) Non documented recurrence 77(18.0%)
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Affiliation(s)
| | | | | | | | | | | | | | - HD Ayala
- University Hospital La Fe, Valencia, Spain
| | - P Dallaglio
- University Hospital Bellvitge, Barcelona, Spain
| | | | - R Salgado
- Hospital Clinico San Carlos, Madrid, Spain
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15
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Voorwerk L, Horlings H, Van Dongen M, Sikorska K, Kemper I, Mandjes I, Van Geel J, Boers J, De Boer M, Salgado R, Sonke G, De Visser K, Schumacher T, Blank C, Jager A, Schroder C, Tjan-Heijnen V, Linn S, Kok M. LBA3 Atezolizumab with carboplatin as immune induction in metastatic lobular breast cancer: First results of the GELATO-trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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16
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Affiliation(s)
- R. Van Hee
- Departments of Surgery, Academic Surgical Centre Stuivenberg, Antwerpen, Belgium
| | - I. De Laet
- Departments of Surgery, Academic Surgical Centre Stuivenberg and University Hospital, University of Antwerp — UIA, Antwerpen, Belgium
| | - R. Salgado
- Departments of Surgery, Academic Surgical Centre Stuivenberg and University Hospital, University of Antwerp — UIA, Antwerpen, Belgium
| | - D. Ysebaert
- Departments of Surgery, Academic Surgical Centre Stuivenberg and University Hospital, Antwerpen, Belgium
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17
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Inácio W, Leite S, Stangarlini Rivas C, Salgado R, Vieira Couto B, Sadatsune JUN E, Pereira R. Unfreeze the Frozen Pelvis: The Safe Technique. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.281] [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: 11/26/2022]
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18
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Fonseca de Oliveira J, Pereira M, Salgado R, Mandarino T, De Paula F, Lima R, Pereira R. Total Laparoscopic Rectosigmoidectomy without Bowel Exteriorization: A New Surgical Technique for Endometriosis. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Salgado R, Moita B, Lopes S. Frequency and patient attributes associated with ED visits within 30 days after discharge. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.931] [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: 11/13/2022] Open
Abstract
Abstract
Background
About 20%-25% of patients return to the emergency department (ED) within 30 days after inpatient discharge. This outcome is relevant since it may signal failures in inpatient care and care transitions. However, literature on the topic is still scarce. Our study aims to describe frequency and patient attributes associated with ED visits within 30 days (30d) of inpatient discharge in one public Portuguese hospital.
Methods
The study included adult patients discharged in 2016. Admissions of deceased or transferred patients were excluded. The rate of 30d ED visits after discharge was computed for selected patient (gender and age) and admission attributes [urgent, Major Diagnostic Category (MDC)]. Number of days from discharge to ED visit was determined. Logistic regression was used to compute crude and age-gender adjusted odds-ratios (cOR, aOR) for each selected admission attribute.
Results
From the 21744 admissions included (median age: 58y; 40% male), for 5058 there was at least one ED visit within 30d after discharge (23%). The majority of ED visits were triaged urgent (n = 2286; 45%) or very urgent (n = 1499; 30%). Time to first ED visit was, on average, 11 days. The risk of ED visit was increased among men (cOR = 1.180; 95% confidence interval - 95%CI: 1.103-1.262) and patients aged 75 or older (cOR = 1.704; 95%CI: 1.557-1.866). After controlling for gender and age differences, admissions with mental diseases (aOR = 1.807; 95%CI: 1.452-2.247), respiratory diseases (aOR = 1.786; 95%CI: 1.535-2.078), endocrine diseases (aOR = 1.758; 95%CI: 1.374-2.250) showed increased risk of visiting ED after discharge.
Conclusions
ED visits after inpatient discharge are frequent and mostly due to urgent and very urgent needs. Older age, mental, respiratory and endocrine conditions are relevant patient risk factors for returning hospital for ED care shortly after discharge.
Key messages
Improved quality of inpatient care and care transitions that reduce ED visits after discharge may benefit a significant part of patients. Future initiatives to reduce adverse events after discharge may target patients with older age or with mental conditions.
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Affiliation(s)
- R Salgado
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - B Moita
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Algarve University Hospital Centre, Faro, Portugal
| | - S Lopes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
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20
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Tolaney S, Jerusalem G, Salgado R, Liu X, Chen T, Zhang H, Roberts M, Zardavas D, Prat A. 133TiP A phase II trial of nivolumab + palbociclib + anastrozole in postmenopausal women with ER+/HER2– primary breast cancer: CheckMate 7A8. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.235] [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: 10/24/2022] Open
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21
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Park JH, Jonas SF, Bataillon G, Criscitiello C, Salgado R, Loi S, Viale G, Lee HJ, Dieci MV, Kim SB, Vincent-Salomon A, Curigliano G, André F, Michiels S. Prognostic value of tumor-infiltrating lymphocytes in patients with early-stage triple-negative breast cancers (TNBC) who did not receive adjuvant chemotherapy. Ann Oncol 2019; 30:1941-1949. [PMID: 31566659 DOI: 10.1093/annonc/mdz395] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although stromal tumor-infiltrating lymphocytes (sTILs) have been considered an important prognostic factor in early-stage triple-negative breast cancer (TNBC), there have been limited data on their prognostic value in the absence of adjuvant chemotherapy. PATIENTS AND METHODS A pooled analysis was carried out using four cohorts of TNBC patients not treated with chemotherapy. sTILs were evaluated in the most representative tumoral block of surgical specimens. Cox proportional hazards regression models were used for invasive disease-free survival (iDFS), distant disease-free survival (D-DFS), and overall survival (OS), fitting sTILs as a continuous variable adjusted for clinicopathologic factors. RESULTS We analyzed individual data of 476 patients from 4 centers diagnosed between 1989 and 2015. Their median age was 64 years. The median tumor size was 1.6 cm and 83% were node-negative. The median level of sTILs was 10% (Q1-Q3, 4%-30%). Higher grade was associated with higher sTILs (P < 10-3). During follow-up, 107 deaths, and 173 and 118 events for iDFS and D-DFS were observed, respectively. In the multivariable analysis, sTILs obtained an independent prognostic value for all end points (likelihood ratio χ2 = 7.14 for iDFS; P < 10-2; χ2 = 9.63 for D-DFS, P < 10-2; χ2 = 5.96 for OS, P = 0.015). Each 10% increment in sTILs corresponded to a hazard ratio of 0.90 [95% confidence interval (CI) 0.82 - 0.97] for iDFS, 0.86 (95% CI 0.77 - 0.95) for D-DFS, and 0.88 (95% CI 0.79 - 0.98) for OS, respectively. In patients with pathological stage I tumors with sTILs ≥30% (n = 74), 5-year iDFS was 91% (95% CI 84% to 96%), D-DFS was 97% (95% CI 93% to 100%), and OS was 98% (95% CI 95% to 100%). CONCLUSION sTILs add important prognostic information in systemically untreated early-stage TNBC patients. Notably, sTILs can identify a subset of stage I TNBC patients with an excellent prognosis without adjuvant chemotherapy.
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Affiliation(s)
- J H Park
- Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Hemato-Oncology, Konkuk Medical Center, University of Konkuk College of Medicine, Seoul, Korea
| | - S F Jonas
- Department of Biostatistics and Epidemiology, Gustave Roussy; INSERM, Unit 1018, University Paris-Sud, University Paris-Saclay, Villejuif
| | - G Bataillon
- Department of Pathology, Institut Curie, Université Paris Sciences Lettres, Paris, France
| | - C Criscitiello
- IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - R Salgado
- GZA, Antwerp, Belgium; Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - S Loi
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - G Viale
- Department of Pathology, European Institute of Oncology, IRCCS, Milano, Italy
| | - H J Lee
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Veneto Institute of Oncology IOV - IRCCS, Padova, Italy
| | - S-B Kim
- Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - A Vincent-Salomon
- Department of Pathology, Institut Curie, Université Paris Sciences Lettres, Paris, France; Inserm Unit 934, Paris, France
| | - G Curigliano
- IEO, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy
| | - F André
- Department of Oncology, Gustave Roussy; INSERM, Unit 981, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - S Michiels
- Department of Biostatistics and Epidemiology, Gustave Roussy; INSERM, Unit 1018, University Paris-Sud, University Paris-Saclay, Villejuif.
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22
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Cruz-Campos A, Wang A, Link T, Bryant S, Grande J, Flynn C, Le P, Braddock B, Yith S, Kieu E, Abeje A, Anbarani B, Sun J, Vega A, Salgado R, Rodems K, Whitters E. P051 PERFORMANCE EVALUATION OF THE NOVEOS SPECIFIC IGE D001 AND D002* (HOUSE DUST MITE) ASSAYS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.238] [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: 10/25/2022]
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23
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Branche E, Simon AY, Sheets N, Kim K, Barker D, Nguyen AVT, Sahota H, Young MP, Salgado R, Mamidi A, Viramontes KM, Carnelley T, Qiu H, Elong Ngono A, Regla-Nava JA, Susantono MX, Valls Cuevas JM, Kennedy K, Kodihalli S, Shresta S. Human Polyclonal Antibodies Prevent Lethal Zika Virus Infection in Mice. Sci Rep 2019; 9:9857. [PMID: 31285451 PMCID: PMC6614477 DOI: 10.1038/s41598-019-46291-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/23/2018] [Accepted: 06/17/2019] [Indexed: 02/06/2023] Open
Abstract
Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that represents a major threat to global health. ZIKV infections in adults are generally asymptomatic or present with mild symptoms. However, recent outbreaks of ZIKV have revealed that it can cause Congenital Zika Syndrome in neonates and Guillain-Barré syndrome in adults. Currently, no ZIKV-specific vaccines or antiviral treatments are available. In this study, we tested the efficacy of convalescent plasma IgG hyperimmune product (ZIKV-IG) isolated from individuals with high neutralizing anti-ZIKV titers as a therapeutic candidate against ZIKV infection using a model of ZIKV infection in Ifnar1-/- mice. ZIKV-IG successfully protected mice from lethal ZIKV challenge. In particular, ZIKV-IG treatment at 24 hours after lethal ZIKV infection improved survival by reducing weight loss and tissue viral burden and improving clinical score. Additionally, ZIKV-IG eliminated ZIKV-induced tissue damage and inflammation in the brain and liver. These results indicate that ZIKV-IG is efficacious against ZIKV, suggesting this human polyclonal antibody is a viable candidate for further development as a treatment against human ZIKV infection.
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Affiliation(s)
- Emilie Branche
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Ayo Yila Simon
- Research and Development, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada
| | - Nicholas Sheets
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Kenneth Kim
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Douglas Barker
- Research and Development, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada
| | - Anh-Viet T Nguyen
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Harpreet Sahota
- Medical Affairs, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada
| | - Matthew Perry Young
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Rebecca Salgado
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Anila Mamidi
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Karla M Viramontes
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Trevor Carnelley
- Research and Development, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada
| | - Hongyu Qiu
- Research and Development, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada
| | - Annie Elong Ngono
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | | | | | - Joan M Valls Cuevas
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA
| | - Kieron Kennedy
- Research and Development, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada
| | - Shantha Kodihalli
- Research and Development, Emergent BioSolutions Canada Inc, 155 Innovation Drive, Winnipeg, MB, R3T 5Y3, Canada.
| | - Sujan Shresta
- La Jolla Institute for Immunology 9420 Athena Circle, La Jolla, CA, 92037, USA.
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24
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Loi S, Schmid P, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (pembro)+chemotherapy (CT) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): Phase Ib KEYNOTE-173 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Nederlof I, de Bortoli D, Bareche Y, Hooijer G, Sotiriou C, van de Vijver M, Horlings H, Salgado R, Biganzoli E, Desmedt C. Comprehensive evaluation of methodology to assess abundance of immune infiltrates in breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.002] [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: 11/14/2022] Open
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26
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Szekely B, Bareche Y, Van den Eynden G, Salgado R, Buisseret L, Garaud S, Willard-Gallo K, Hatzis C, Szasz M, Kulka J, Larsimont D, Sotiriou C, Pusztai L, Desmedt C. Abstract PD5-10: Immune characterization of matched primary and multiple metastatic samples issued from an institutional autopsy cohort. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-10] [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
While immune infiltrates have already been extensively characterized in primary tumors (P), data on breast cancer metastases (M) remains limited. To this end we quantified and qualified the immune cells in a unique cohort of multiple matched P and M samples selected from an institutional breast cancer autopsy cohort.
Patients and methods
Twenty-three patients were selected from an institutional autopsy program (Semmelweis University, Budapest, Hungary) based on matched P and M sample availability (124 samples). All samples were centrally characterized for estrogen (ER), progesterone (PR) and HER2 receptors. The primary molecular subtypes were as follows: 9 ER+/PR+/HER2-, 8 triple negative and 6 HER2+. Ten patients relapsed ≤1 year after diagnosis and were further referred to as “early relapsers”, as opposed to the remaining qualified as “late relapsers”. Immunohistochemistry (IHC) was carried out against CD3/CD20 and CD4/CD8 in 21 patients (119 samples). Tumor infiltrating lymphocytes (TILs) were assessed on hematoxylin and eosin (H&E) and CD3-stained slides. Gene expression data were generated using the NanoString nCounter assay (PanCancer Immune Profiling Panel) for 11 patients (35 samples) and analyzedusing the R package NanoStringQCPro. The scores from published immune gene signatures were calculated as a weighted sum of the expressions of their genes. All samples were analyzed for 22 immune cell subtypes relative abundance using CIBERSORT.
Results
TILs assessed on H&E and CD3-stained slides were weakly correlated (Rho= 0.38, p<.001). TIL levels as well as the number of tertiary lymphoid structures (TLS) were significantly lower in Ms as compared to Ps (p<.001). Among the different metastatic sites, the lung was more infiltrated when considering CD3+ and CD4+ cells (p=.01 and .02, respectively). We further observed significantly higher levels of TILs, CD3+, CD4+ and CD8+ cells in the Ms but not in the Ps from late relapsers as opposed to those from early relapsers. Gene expression analyses further confirmed these observations as several immune gene signatures displayed significantly higher scores in the Ms from late compared to early relapsers. An unsupervised analysis identified 13 genes significantly differentially expressed between Ps and Ms: CSF1R, CXCL14, CYBB, IL21R, IL2RB, TNF and TNFSF15 were upregulated in Ps while BCL2L1, C7, HSD11B1, and PSMB7 were upregulated in Ms. The matched P/M CIBERSORT analyses revealed a distinct composition of immune cell types between P and M of a same patient. Apart from a potential increase in M0 macrophages, no common trait was observed in immune cell composition between the Ms from the different patients.
Conclusion
This is to the best of our knowledge the first study characterizing the immune infiltration in patients with multiple matched P and M samples. The results suggest that Ms have not only a globally lower immune infiltration as compared to Ps, but also a different immune composition. Additionally, Ms from late relapsers are more infiltrated as compared to early relapsers. The present data also uncovers not only important inter-patient but also intra-patient immune heterogeneity, which should be taken into consideration for optimal treatment decision.
Citation Format: Szekely B, Bareche Y, Van den Eynden G, Salgado R, Buisseret L, Garaud S, Willard-Gallo K, Hatzis C, Szasz M, Kulka J, Larsimont D, Sotiriou C, Pusztai L, Desmedt C. Immune characterization of matched primary and multiple metastatic samples issued from an institutional autopsy cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-10.
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Affiliation(s)
- B Szekely
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - Y Bareche
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - G Van den Eynden
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - R Salgado
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - L Buisseret
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - S Garaud
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - K Willard-Gallo
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - C Hatzis
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - M Szasz
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - J Kulka
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - D Larsimont
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - C Sotiriou
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - L Pusztai
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
| | - C Desmedt
- Semmelweis University, Budapest, Hungary; Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; Sint Augustinus, Wilrijk, Belgium; Yale, New Haven
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27
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Nguyen B, Marion M, Salgado R, Venet D, Vuylsteke P, Polastro L, Wieldiers H, Simon P, Lindeman G, Larsimont D, Van den Eynden G, Velghe C, Rothe F, Garaud S, Michiels S, Willard-Gallo K, Azim Jr HA, Loi S, Piccart M, Sotiriou C. Abstract PD5-06: The immunomodulatory potential of denosumab in breast cancer: results from D-BEYOND, a window of opportunity trial evaluating a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Breast cancer (BC) in young women has unique biology and poor prognosis. Previous reports suggest that they often express RANKL, which was also shown to play a role in mammary tumorigenesis and various immune processes. Here, we present the primary results of D-BEYOND, a window study investigating the biological activity of the RANKL inhibitor; denosumab in pre-menopausal BC patients.
Methods
D-BEYOND is a prospective, phase Iia, single-arm, multicenter study assessing the effect of denosumab on BC biology in premenopausal women with early BC (NCT01864798). Patients received two subcutaneous injections of denosumab (120mg), one week apart, followed by breast surgery. The primary endpoint was geometric mean change in tumor Ki67 assessed by immunohistochemistry (IHC). Blood, tumor and normal adjacent breast tissue were collected pre- and post-treatment. Serum levels of RANKL, OPG and CTX were assessed by ELISA. RNA was extracted from fresh-frozen tissue and RNAseq was performed. DESeq2 was used for differential expression analysis, GAGE was used for pathway analysis and CIBERSORT was used to infer immune cell subsets between pre- and post-treatment. Ki67, CD4/Foxp3 and CD4/CD8 IHC were performed on FFPE tissue to further assess the immune microenvironment. The percentage of TILs was independently evaluated by two pathologists on H&E slides. Pre- and post-treatment values were compared using a paired t-test.
Results
A total of 27 patients were enrolled in the study between October 2013 and July 2016. The median age was 45 years (range 35-51 years). Tumors of 21 patients were hormone receptor positive (77.8%), 4 were HER2 positive (14.8%) and 2 were triple negative (7.4%). No serious adverse events were reported, the most frequent non-serious adverse event being arthralgia (14.8%). After treatment, serum levels of CTX and RANKL decreased in all patients (P < 0.001) whereas OPG increased in 76.9% of patients (P = 0.009, 95% CI 0.56-0.91). There was no significant reduction of Ki67 values from baseline (geometric mean [GM] change after treatment; 0.98, 95% CI 0.76-1.26; P = 0.90). Twenty-four pre- and post-treatment tumor pairs were available for RNAseq, IHC and TILs evaluation. There was a significant increase in the percentage of stromal TILs after treatment (GM change of 1.75, 95% CI 1.28–2.39; P = 0.001). 1084 differentially expressed genes were identified and pathway analysis revealed enrichment of several immune processes. CIBERSORT revealed an enrichment of CD8+ T cells (GM change 1.72, 95% CI 1.19–2.48; P = 0.006) and a decrease of Treg cells (0.71, 95% CI 0.52–0.98, P = 0.040). These results were confirmed by IHC of CD8+ and CD4+/Foxp3+ cells (GM change 1.59, 95% CI 1.14–2.21; P = 0.008 and 0.63, 95% CI 0.49–0.83, P = 0.001, respectively).
Conclusion
Short course of denosumab did not reduce tumor proliferation rate. However, it induced a significant increase in TILs and CD8 cytotoxic T cells, while Treg infiltration decreased. These findings suggest an immunomodulatory role for denosumab in young breast cancer and that its use in combination could boost immunotherapy efficacy.
Citation Format: Nguyen B, Marion M, Salgado R, Venet D, Vuylsteke P, Polastro L, Wieldiers H, Simon P, Lindeman G, Larsimont D, Van den Eynden G, Velghe C, Rothe F, Garaud S, Michiels S, Willard-Gallo K, Azim Jr HA, Loi S, Piccart M, Sotiriou C. The immunomodulatory potential of denosumab in breast cancer: results from D-BEYOND, a window of opportunity trial evaluating a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-06.
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Affiliation(s)
- B Nguyen
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - M Marion
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - R Salgado
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - D Venet
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - P Vuylsteke
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - L Polastro
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - H Wieldiers
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - P Simon
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - G Lindeman
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - D Larsimont
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - G Van den Eynden
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - C Velghe
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - F Rothe
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - S Garaud
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - S Michiels
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - K Willard-Gallo
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - HA Azim Jr
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - S Loi
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - M Piccart
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
| | - C Sotiriou
- Institut Jules Bordet, ULB, Brussels, Belgium; CMSE, CHU UCL Namur, Namur, Belgium; UZ Leuven, KUL, Leven, Belgium; CHU Erasme, ULB, Brussels, Belgium; Peter MacCallum Cancer Centre, Melbourne, Australia; Institut Gustave Roussy, Paris, France; American University of Beirut (AUB), Beirut, Lebanon
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Savas P, Virassamy B, Ye C, Salim A, Mintoff CP, Caramia F, Salgado R, Teo ZL, Dushyanthen S, Byrne A, Luen SJ, Fox SB, Speed TP, Mackay LK, Neeson PJ, Loi S. Abstract PD5-03: Characterization of high TIL breast cancers reveals a prognostic and functionally distinct tissue-resident memory subpopulation. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Tumor infiltrating lymphocytes (TILs) assessed via light microscopy are prognostic and predictive in the early stage and advanced triple negative and HER2-amplified breast cancer (BC). Higher TILs can also identify patients more likely to benefit from anti-PD-1 therapy. In this study we interrogated T cell subsets that comprise high TILs to determine if distinct subpopulations are key mediators of anti-tumor immunity.
Methods: We characterised TILs with a focus on CD3+ T cells in 129 primary and metastatic BC samples using flow cytometry, bulk RNASeq on flow sorted T cell populations, multiplex immunohistochemistry and microdroplet based single cell 3' mRNA sequencing on the 10X Genomics Chromium platform. Cell type specific gene expression signatures were determined from differential expression between putative T cell subpopulations. These signatures were investigated in clinical cohorts, including trial cohorts treated with pembrolizumab.
Results: High TIL Infiltrates consisted primarily of CD3+ T cells, with both CD8 and CD4 populations. Unsupervised clustering of single cell sequencing identified 9 CD8 and CD4 subpopulations with distinct gene expression profiles. In addition to Tregs and CD8 effector memory (TEM) T cells, we found a CD8+ tissue resident memory (TRM) population expressing greater levels of T-cell checkpoints and cytotoxic markers compared to effector memory cells. In 2 primary tumours and 1 liver metastasis, bulk RNASeq of flow sorted TEM and TRM corroborated the single cell mRNASeq results. T cell receptor profiling (TCR) in the 3 samples found non-overlapping repertoires in the 2 primary tumours, but overlap in one metastatic lesion, suggesting divergent developmental origins in the breast, but the potential for nascent TRM differentiation in a metastatic niche. Clustering of these TCRs suggested differing antigen specificities between TRM and non-TRM CD8 T cells. Using Metabric data, the CD8 TRM gene expression signature was prognostic for disease free survival (DFS) in primary TNBCs (n=329, log-rank p=0.003), and was able to further stratify cases with high and low CD8A expression for DFS (log-rank p = 0.03). The CD8 TRM signature was enriched in baseline tumour samples of responders (n = 9) compared with non-responders (n=36) in 45 patients with metastatic melanoma treated with T cell checkpoint blockade (p < 0.0001). Additional single cell sequencing data with TCR sequencing will be combined with these initial results, and an independent data set of single cell mRNASeq and TCR Seq on CD3+ BC TILs will be used to confirm our findings. Cell type specific signatures will be explored in additional clinical cohorts including KEYNOTE-086, and presented at the meeting.
Conclusion: Using single cell profiling of the immune microenvironment in BC we demonstrate that high TIL BCs contain multiple T cell subpopulations with different functional and prognostic significance. Our approach identified a CD8 TRM population with a distinct gene expression profile and strong expression of key immune checkpoints likely representing the presence of true tumor specific immunity. This population may be a key target of immune checkpoint blockade.
Citation Format: Savas P, Virassamy B, Ye C, Salim A, Mintoff CP, Caramia F, Salgado R, Teo ZL, Dushyanthen S, Byrne A, Luen SJ, Fox SB, Speed TP, Mackay LK, Neeson PJ, Loi S. Characterization of high TIL breast cancers reveals a prognostic and functionally distinct tissue-resident memory subpopulation [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-03.
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Affiliation(s)
- P Savas
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - B Virassamy
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - C Ye
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - A Salim
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - CP Mintoff
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - F Caramia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - R Salgado
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - ZL Teo
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - S Dushyanthen
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - A Byrne
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - SJ Luen
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - SB Fox
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - TP Speed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - LK Mackay
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - PJ Neeson
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
| | - S Loi
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Tsinghua University, Beijing, Haidian Qu, China; La Trobe University, Melbourne, Victoria, Australia; Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; GZA Ziekenhuizen, Antwerp, Belgium
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Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim SB, Sohn J, Im SA, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Abstract P3-10-09: Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract
Background:Increasing quantities of stromal TILs (sTILs) are associated with higher pathologic complete response (pCR) rates with conventional chemo in early-stage TNBC. We evaluated the association between sTILs and PD-L1 expression with response to pembro+chemo as NAT for TNBC in the KEYNOTE-173 trial (NCT02622074).
Methods: sTILs were quantified using light microscopy of H&E-stained slides from pretreatment and on-treatment (during first 3 weeks of pembro monotherapy) tumor biopsies by a pathologist blind to response data. Pretreatment PD-L1 expression was assessed using the PD-L1 IHC 22C3 pharmDx assay and reported as combined positive score (CPS). Endpoints were pCR rate by ypT0 ypN0 and ypT0/Tis ypN0 and objective response rate (ORR; RECIST v1.1) after the first 4 cycles of NAT (taxane±carboplatin+pembro) by MRI. sTILs and PD-L1 CPS were evaluated as continuous variables. Association between sTILs and PD-L1 CPS with response was assessed using logistic regression and area under the reciever operating curve (AUROC) analyses, with a 1-sided alpha level of 0.10. Correlation between PD-L1 and sTILs was assessed by Spearman's rank correlation coefficient. Multivariate analysis included sTILs (pretreatment and on-treatment) and PD-L1 CPS. Likelihood ratio tests were used to evaluate the added value of factors in predicting pCR rate.
Results: Of 60 total pts, 34 had tumors evaluated for pretreatment sTILs, 52 for PD-L1 CPS, and 33 for both sTILs and CPS. On-treatment sTILs were evaluated in 31 pts. Overall pCR rates were 56.7% and 60% by ypT0 ypN0 and ypT0/Tis ypN0, respectively; ORR was 78.3%. In pts evaluated for sTILs and CPS (individually), pCR rates and ORR were comparable with overall pCR rates and ORR. There was a significant correlation between pretreatment sTILs and PD-L1 CPS (ρ=0.65, P<0.001).Higher pretreatment sTILs were significantly associated with response: ypT0 ypN0 P= 0.011; ypT0/Tis ypN0 P=0.006; ORR P=0.061. On-treatment sTILs were also significantly associated with response: ypT0 ypN0 P=0.061; ypT0/Tis ypN0 P=0.041; ORR P=0.031. Pretreatment PD-L1 CPS was significantly associated with response: ypT0 ypN0 P=0.073; ypT0/is ypN0 P=0.030; and ORR P=0.021. AUROC of pretreatment sTIL association with pCR was numerically higher than with on-treatment sTILs and PD-L1 CPS (0.69 vs 0.61 vs 0.56 for ypT0ypN0 and 0.72 vs 0.67 vs 0.62 for ypT0/Tis ypN0). Responders had higher median pretreatment sTIL levels vs nonresponders: 45% [10, 75] vs 10% [5, 20] for pCR rate by ypT0 ypN0 and 52.5% [10, 73.8] vs 10% [5, 20] for pCR rate by ypT0/Tis ypN0; 25% [5, 70] vs 10% [6.3, 27.5] for ORR. In multivariate analysis, only pretreatment sTILs were significant for both pCR endpoints (ypT0 ypN0 P=0.031; ypT0/Tis ypN0 P=0.034). Likelihood ratio tests demonstrated that for both pCR endpoints, PD-L1 CPS (P=0.683/P=0.422) and on-treatment sTILs (P=0.984/P=0.568) did not add significantly more value to pretreatment sTILs when predicting pCR.
Conclusions:Higher quantities of pretreatment sTILs and PD-L1 CPS and on-treatment sTILs were significantly associated with higher pCR rates and ORR in primary TNBC treated with pembro and NAT.
Citation Format: Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim S-B, Sohn J, Im S-A, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-09.
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Affiliation(s)
- S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - P Schmid
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - T Foukakis
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S Kuemmel
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - A Wang
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - V Karantza
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Salgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
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Luen SJ, Salgado R, Dieci MV, Vingiani A, Curigliano G, Gould RE, Castaneda C, D'Alfonso T, Sanchez J, Cheng E, Andreopoulou E, Castillo M, Adams S, Demaria S, Symmans WF, Michiels S, Loi S. Prognostic implications of residual disease tumor-infiltrating lymphocytes and residual cancer burden in triple-negative breast cancer patients after neoadjuvant chemotherapy. Ann Oncol 2019; 30:236-242. [PMID: 30590484 DOI: 10.1093/annonc/mdy547] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND For primary triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy (NAC), higher pretreatment tumor-infiltrating lymphocytes (TILs) correlates with increased pathologic complete response (pCR) rates, and improved survival. We evaluated the added prognostic value of residual disease (RD) TILs to residual cancer burden (RCB) in predicting survival post-NAC. PATIENTS AND METHODS We combined four TNBC NAC patient cohorts who did not achieve pCR. RD TILs were investigated for associations with recurrence-free survival (RFS), and overall survival (OS) using Cox models with stromal TILs as a continuous variable (per 10% increment). The likelihood ratio test was used to evaluate added prognostic value of RD TILs. RESULTS A total of 375 RD TNBC samples were evaluable for TILs and RCB. The median age was 50 years, with 62% receiving anthracycline/taxane chemotherapy. The RCB class after NAC was 11%, 50%, and 39% for I, II, and III, respectively. The median RD TIL level was 20% (IQR 10-40). There was a positive correlation between RD TIL levels and CD8+ T-cell density (ρ = 0.41). TIL levels were significantly lower with increasing post-NAC tumor (P = 0.005), nodal stage (P = 0.032), but did not differ by RCB class (P = 0.84). Higher RD TILs were significantly associated with improved RFS (HR: 0.86; 95% CI 0.79-0.92; P < 0.001), and improved OS (HR: 0.87; 95% CI 0.80-0.94; P < 0.001), and remained significant predictors in multivariate analysis (RFS P = 0.032; OS P = 0.038 for OS). RD TILs added significant prognostic value to multivariate models including RCB class (P < 0.001 for RFS; P = 0.021 for OS). The positive prognostic effect of RD TILs significantly differed by RCB class for RFS (PInt=0.003) and OS (PInt=0.008) with a greater magnitude of positive effect observed for RCB class II than class III. CONCLUSIONS TIL levels in TNBC RD are significantly associated with improved RFS and OS and add further prognostic information to RCB class, particularly in RCB class II.
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Affiliation(s)
- S J Luen
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - R Salgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia; Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium
| | - M V Dieci
- University of Padova, Padova, Italy; Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - A Vingiani
- European Institute of Oncology IRCCS, Milan, Italy
| | - G Curigliano
- European Institute of Oncology IRCCS, Milan, Italy; University of Milano, Milan, Italy
| | - R E Gould
- MD Anderson Cancer Centre, Houston, USA
| | - C Castaneda
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - T D'Alfonso
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - J Sanchez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - E Cheng
- Department of Radiation Oncology and Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, USA
| | - E Andreopoulou
- Department of Radiation Oncology and Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, USA
| | - M Castillo
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - S Adams
- New York University School of Medicine, New York, USA
| | - S Demaria
- Department of Radiation Oncology and Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, USA
| | | | - S Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia.
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Brom-de-Luna J, Salgado R, Canesin H, Diaw M, Hinrichs K. 72 Effect of incubation temperature and of CO2 concentration during early cleavage on equine in vitro embryo production. Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Intracytoplasmic sperm injection (ICSI) is currently being used for equine in vitro embryo production for both research and clinical purposes. However, some basic parameters for in vitro embryo production, such as the optimum incubator temperature and the optimum CO2 concentration/pH of medium for early embryo development, have not yet been established in the horse. The incubation temperature used by many laboratories for equine in vitro embryo production is 38.2°C, whereas the range of normal rectal temperature in the horse is 37.2 to 38.3°C. In Exp. 1, we evaluated maturation, cleavage, and blastocyst rates under 3 different culture temperatures. Cumulus-oocyte complexes were recovered from slaughterhouse-derived ovaries and shipped overnight at room temperature. Oocyte maturation was performed concurrently in separate incubators set to 37.2, 37.7, or 38.2°C. Mature oocytes were subjected to ICSI, then cultured in mixed gas (6% CO2, 5% O2, and remainder N2) at the same temperature at which they were matured. Embryo culture media used were a commercial human medium (global) for Days 0 to 5, then DMEM/F-12 from Day 5 to 10, both with 10% fetal bovine serum (FBS). In Exp. 2, we evaluated 3 different CO2 concentrations (6, 6.5, or 7% CO2) in mixed gas for the Day 0 to 5 culture in global+FBS, at 38.2°C. Cumulus-oocyte complexes were recovered from live mares by transvaginal aspiration and held overnight at room temperature; all other parameters remained the same as for Exp. 1. Data were analysed by Fisher’s exact test. In Exp. 1, a total of 280 oocytes were utilised; the outcomes for the 37.2, 37.7, and 38.2°C treatments were, respectively: maturation rates of 33, 38, and 42%; cleavage rates of 84, 86, and 88%; and blastocyst rates per injected oocyte of 35, 44, and 44%. There were no significant differences among the 3 temperature treatments for any parameter (P>0.2). In Exp. 2, the pH of the global+FBS medium was 7.38, 7.35, and 7.3 for 6, 6.5, and 7% CO2, respectively. A total of 106 mature oocytes underwent ICSI; the outcomes for the 3 CO2 atmospheres, respectively, were cleavage rates of 68, 80, and 70% and blastocyst rates per injected oocyte of 42, 54, and 27%. The blastocyst rate for the 7% CO2 treatment was significantly lower than that for the 6.5% CO2 treatment (P<0.05). These results indicate that equine in vitro embryo production is equally effective throughout the range of normal equine body temperature, and that equine blastocyst production is sensitive to small changes in CO2 atmosphere/pH of medium during early cleavage-stage development.
Research was supported by the Clinical Equine ICSI Program, Texas A&M University, the Link Equine Research Endowment, Texas A&M University, and Fonds en Santé Équine (FSÉ), Faculté de Médecine Vétérinaire, and Université de Montréal.
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Klauschen F, Müller KR, Binder A, Bockmayr M, Hägele M, Seegerer P, Wienert S, Pruneri G, de Maria S, Badve S, Michiels S, Nielsen T, Adams S, Savas P, Symmans F, Willis S, Gruosso T, Park M, Haibe-Kains B, Gallas B, Thompson A, Cree I, Sotiriou C, Solinas C, Preusser M, Hewitt S, Rimm D, Viale G, Loi S, Loibl S, Salgado R, Denkert C. Scoring of tumor-infiltrating lymphocytes: From visual estimation to machine learning. Semin Cancer Biol 2018; 52:151-157. [DOI: 10.1016/j.semcancer.2018.07.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 12/12/2022]
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Geth SN, Salgado R, Moerenhout C, Heuten H, Gorissen P, Heidbuchel H, Shivalkar B. P6497Combined multimodality anatomic and functional imaging have improved diagnostic and prognostic value for coronary lesions with mixed plaque and intermediate degree of stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6497] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S N Geth
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - R Salgado
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - C Moerenhout
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - H Heuten
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - P Gorissen
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - H Heidbuchel
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - B Shivalkar
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
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Vermeulen S, Faure M, Luyckx E, Salgado R, Parizel P. Incidental CT finding of myocardial calcifications following severe septic shock. J Cardiovasc Comput Tomogr 2018; 12:e7-e8. [DOI: 10.1016/j.jcct.2017.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 09/08/2017] [Accepted: 09/20/2017] [Indexed: 10/18/2022]
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Ortiz M, Masjuan J, Egocheaga MI, Martín A, Suarez C, Roldán I, Salgado R, Mira JJ, Llamas P. [Design of a thromboprophylaxis care process in patients with atrial fibrillation]. J Healthc Qual Res 2018; 33:144-156. [PMID: 30337019 DOI: 10.1016/j.jhqr.2018.02.004] [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: 12/02/2017] [Revised: 02/15/2018] [Accepted: 02/22/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To describe the milestones in the anticoagulant care process of atrial fibrillation patients (AF), as well as quality and safety indicators, in order to establish an integrated care process of these patients in the Community of Madrid. METHODS A consensus conference technique was applied, with the participation of 21 professionals (seven in the Steering Group and 14 known experts), from the specialties of Emergency, Internal Medicine, Cardiology, Neurology, Haematology, Family Medicine, Nursing, and Quality. Hospitals and Primary Care were represented. Milestones, elements and barriers/limitations were agreed upon in the care process of anticoagulated AF patients. A minimum set of indicators were also defined to assess the quality of care. RESULTS Four milestones (stratification of thromboembolism and bleeding risk, evaluation for anticoagulant treatment, follow-up of direct-acting oral anticoagulants, and follow-up of treatment with vitamin K antagonists) were identified. A total of 14 barriers/limitations were also prioritised. In total, six indicators were defined (two structural-related, two processes-related, and two outcomes-related). CONCLUSIONS Milestones and critical activities, together with a set of indicators, have been agreed for the development of guidelines with which to achieve a better therapeutic approach for anticoagulated AF patients.
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Affiliation(s)
- M Ortiz
- Unidad de Calidad, Hospital Universitario de Fuenlabrada, Madrid, España.
| | - J Masjuan
- Neurología, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, Madrid, España; Red INVICTUS PLUS, España
| | - M I Egocheaga
- Medicina de Familia y Comunitaria, Centro de Salud Isla de Oza, Madrid, España
| | - A Martín
- Urgencias, Hospital Universitario Severo Ochoa, Madrid, España
| | - C Suarez
- Medicina Interna, Hospital Universitario La Princesa, Madrid, España; FIB La Princesa, Madrid, España
| | - I Roldán
- Cardiología, Hospital La Paz, Madrid, España; CIBER-CV, Idipaz, Madrid, España
| | - R Salgado
- Enfermería, Centro de Salud Isla de Oza, Madrid, España
| | - J J Mira
- Grupo de Investigación Calitè, Universidad Miguel Hernández, Elche, España; REDISSEC, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, España
| | - P Llamas
- Hematología, Quirón Salud Hospitales Públicos, Madrid, España; IIS Fundación Jiménez Díaz, Madrid, España
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Pinto M, Salgado R, Laia C, Cooper WJ, Sontag G, Burrows HD, Branco L, Vale C, Noronha J. The effect of chloride ions and organic matter on the photodegradation of acetamiprid in saline waters. J Photochem Photobiol A Chem 2018. [DOI: 10.1016/j.jphotochem.2018.04.020] [Citation(s) in RCA: 6] [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: 01/14/2023]
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Arceluz MR, Castellanos E, Barrio T, Salgado R, Martin J, Lazaro C, Ortiz MR, Garcia J, Peinado R, Almendral J. 591New entrainment criteria for macroreentrant atrial tachycardias. Europace 2018. [DOI: 10.1093/europace/euy015.318] [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: 11/14/2022] Open
Affiliation(s)
- M R Arceluz
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
| | - E Castellanos
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
| | - T Barrio
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
| | - R Salgado
- Complejo Asistencial Universitario , Burgos, Spain
| | - J Martin
- Complejo Asistencial Universitario , Burgos, Spain
| | - C Lazaro
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
| | - M R Ortiz
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
| | - J Garcia
- Complejo Asistencial Universitario , Burgos, Spain
| | - R Peinado
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
| | - J Almendral
- Montepríncipe University Hospital, Electrophysiology unit , Madrid, Spain
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Gruosso T, Gigoux M, Bertos N, Manem VS, Zuo D, Saleg SM, Souleimanova M, Zhao H, Johnson RM, Monette A, Muñoz Ramos V, Hallett MT, Stagg J, Lapointe R, Omeroglu A, Meterissian S, Buisseret L, Van den Eyden G, Salgado R, Guiot MC, Haibe-Kains B, Park M. Abstract PD6-05: Distinct tumor microenvironments stratify triple negative breast cancer into immune subtypes. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Triple negative breast cancer (TNBC) are especially difficult to treat effectively. While only 20-30% of TNBC patients respond to chemotherapy in the neoadjuvant setting, overall outcome remains poor for non-responding patients. Engaging the immune system promises optimal personalized cancer therapy as mounting evidence suggests that immune-checkpoint inhibitor immunotherapies may become a therapeutic option for TNBC patients. The presence of CD8+ T cells, a crucial component of the cytotoxic arm of the adaptive immune response, is associated with good clinical outcome in TNBC patients. Specifically, it is the efficient CD8+ T cell invasion and infiltration in the tumor that is associated with good outcome. On the other hand, some tumors accumulate CD8+ T cells in the tumor-associated stroma with poor infiltration in the tumor epithelium. These patients show poor outcome. As CD8+ T cell infiltration in the tumor is a crucial step to mount an efficient anti-tumor response, we thus wondered how the tumor microenvironment affects CD8+ T cell invasion into the tumor epithelial compartment of the TNBC tumors.
Methods:
To identify potential stroma-dependent mechanisms that potentiate or inhibit CD8+ T cells invasion into the tumor epithelium, we coupled analysis of spatial patterns of CD8+ T cell localization by Immunohistochemistry (IHC) andperformed gene expression profiling of laser-capture microdissected tumor-associated stroma (as well as matched epithelium and bulk tumor) from 38 TNBC chemotherapy-naive primary cases. GSEA-based Metasignatures were derived from bulk tumor gene expression data from our cohort. To investigate the compartment of origin of the pathways identified via the Metasignatures, the (LCM)-derived tumor stromal and epithelial gene expression were analyzed.
Results:
CD8+ T cell quantification in different compartments of the tumor identify 3 main subgroups of TNBC based on CD8+ T cell localization. Importantly we developed a 2-step classification scheme based on CD8+ T cell localization. We developed metasignatures following our 2 steps classification and identified key bulk tumor metasignatures that showed prognostic value in an independent cohort. In addition the matched LCM gene expression from the tumor epithelium and stromal compartments allowed us to identify the compartment of origin.
Importantly, while 1 group of TNBC tumor was showing a significant anti-tumor response, the 2 other groups showed absence of such environment. The 2 non inflamed immune subtypes showed distinct phenotypes and biologies associated with poor anti-tumor response that we validated by immunohistochemistry and fluorescence. These results highlight different potential mecanisms that lead to immune evasion and allow us to stratify TNBC into immune subgroups.
Citation Format: Gruosso T, Gigoux M, Bertos N, Manem VS, Zuo D, Saleg SM, Souleimanova M, Zhao H, Johnson RM, Monette A, Muñoz Ramos V, Hallett MT, Stagg J, Lapointe R, Omeroglu A, Meterissian S, Buisseret L, Van den Eyden G, Salgado R, Guiot M-C, Haibe-Kains B, Park M. Distinct tumor microenvironments stratify triple negative breast cancer into immune subtypes [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD6-05.
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Affiliation(s)
- T Gruosso
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Gigoux
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - N Bertos
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - VS Manem
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - D Zuo
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - SM Saleg
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Souleimanova
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - H Zhao
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - RM Johnson
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Monette
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - V Muñoz Ramos
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - MT Hallett
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J Stagg
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - R Lapointe
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Omeroglu
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Meterissian
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - L Buisseret
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - G Van den Eyden
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - R Salgado
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M-C Guiot
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - B Haibe-Kains
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Park
- Goodman Cancer Research Center, McGill University, Montreal, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada; 7Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Montreal, Canada; McGill University Health Centre and McGill University, Montreal, Canada; Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Balko JM, Johnson DB, Ericsson-Gonzalez P, Nixon MJ, Salgado R, Sanchez V, Shreeder DM, Rimm DL, Loi S, Kim JY, Bordeaux J, Sanders ME, Davis RS. Abstract P1-08-02: Breast tumor-specific MHC-II expression drives a unique pattern of adaptive resistance to antitumor immunity through MHC-II receptor checkpoint engagement. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-08-02] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We have previously shown that some breast cancers express major histocompatibility complex II (MHC-II), correlating with enhanced immune infiltration. In other tumor types, we have shown that MHC-II expression on tumor cells predicts clinical response to checkpoint inhibition. We sought to determine the direct effects of MHC-II on anti-tumor immunity and characterize mechanisms of immune escape in this breast cancer subset.
Methods: To determine the functional effects of MHC-II on tumor cells, we generated isogenic mouse breast tumor cells with enforced MHC-II expression and determined their ability to generate tumors in syngeneic mice, the impact on immunity, and their response to checkpoint inhibition. In a series of molecularly-characterized HER2+ (n=8) and triple-negative breast cancers (TNBC; n=103), we performed immunohistochemistry (IHC) and quantitative immunofluorescence (QIF) for Lag-3, PD-L1, CD4, CD8, FCRL6, and granzyme B.
Results: Following injection in syngeneic immunocompetent mice, MHC-II+ mouse breast tumors were more frequently rejected (p=0.04) and recruited greater numbers of CD4+ TILs. When MHC-II+ tumors escaped rejection, they expressed higher degrees of PD-1 and Lag-3 in the tumor and in the draining lymph node. Since Lag-3 is a checkpoint that specifically targets MHC-II, we hypothesized that MHC-II+ breast cancers escape anti-tumor immunity through suppressing MHC-II-mediated antigen presentation. Combinations of anti-Lag-3 and anti-Pd-1 antibodies inhibited growth of MHC-II+ tumors. These findings led us to also explore Fc receptor-like 6 (FCRL6), a previously reported MHC-II receptor expressed on NK and cytotoxic T cells. Residual MHC-II+ TNBC post-neoadjuvant chemotherapy (NAC) recruited greater numbers of CD4+ and CD8+ TILs (p=0.0001 and p=0.0002), suggesting enhanced immune recognition. However, MHC-II+ TNBCs also demonstrated a greater frequency of Lag-3+ and FCRL6+ TILs (p<0.001 and p=0.01, respectively) which frequently co-occurred (p=0.003). Thus, our data suggest that MHC-II expression in breast tumors supports recruitment of MHC-II-specific checkpoint-positive TILs. In line with this concept, QIF analysis demonstrated that the presence of Lag3+ and/or FCRL6+ TILs was strongly associated with suppression of T cell cytotoxicity as assessed by granzyme-B+ CD8+ T cells (p=0.0001 and p=0.002, respectively). Functional analyses of FCRL6 on human NK cell lines and peripheral blood mononuclear cells (PBMCs) demonstrated that like Lag3, FCRL6 is a checkpoint which engages MHC-II and suppresses cytotoxic NK and T cell activity.
Conclusions: These data suggest that MHC-II+ breast tumors are immunologically active and circumvent anti-tumor immunity by targeting MHC-II antigen presentation through recruitment of Lag-3+ and FCRL6+ TILs. We describe herein FCRL6 as a novel bona fide immune checkpoint which targets MHC-II, which may impact a variety of cancers. MHC-II expression status may be a useful biomarker for patient stratification on anti-PD-1/anti-Lag-3 combination, and eventually, anti-PD-1/anti-FCRL6 combinations in patients with breast cancer.
Citation Format: Balko JM, Johnson DB, Ericsson-Gonzalez P, Nixon MJ, Salgado R, Sanchez V, Shreeder DM, Rimm DL, Loi S, Kim JY, Bordeaux J, Sanders ME, Davis RS. Breast tumor-specific MHC-II expression drives a unique pattern of adaptive resistance to antitumor immunity through MHC-II receptor checkpoint engagement [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-08-02.
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Affiliation(s)
- JM Balko
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - DB Johnson
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - P Ericsson-Gonzalez
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - MJ Nixon
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - R Salgado
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - V Sanchez
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - DM Shreeder
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - DL Rimm
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - S Loi
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - JY Kim
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - J Bordeaux
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - ME Sanders
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
| | - RS Davis
- Vanderbilt University Medical Center; GZA and Jules Bordet Institute; University of Pennsylvania; Yale University; Peter MacCallum Cancer Center; Navigate BioPharma Services, Inc., a Novartis Company; University of Alabama
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Nielsen TO, Leung SCY, Zabaglo LA, Arun I, Badve SS, Bane AL, Bartlet JMS, Borgquist S, Chang MC, Dodson A, Ehinger A, Fineberg S, Focke CM, Gao D, Gown AM, Gutierrez C, Hugh JC, Kos Z, Lænkholm AV, Mastropasqua MG, Moriya T, Nofech-Mozes S, Osborne CK, Penault-Llorca FM, Piper T, Sakatani T, Salgado R, Starczynski J, Sugie T, van der Vegt B, Viale G, Hayes DF, McShane LM, Dowsett M. Abstract P2-03-01: Analytical validation of a standardized scoring protocol for Ki67 assessed on breast excision whole sections: An international multicenter collaboration. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-03-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aims: (i) Determine whether between-observer reproducibility for Ki67 when assessed on whole sections according to a standardized scoring protocol is adequate for clinical application. (ii) Compare between-observer reproducibility of Ki67 scores assessed on hot-spots to scores using a global method that averages across a tissue section.
Background: The nuclear proliferation biomarker Ki67 has multiple potential roles in breast cancer, including aiding decisions based on prognosis, but unacceptable levels of between-laboratory variability have been observed. The International Ki67 in Breast Cancer Working Group has undertaken a systematic program to determine whether Ki67 measurement can be analytically validated and standardized across labs. In phase 1, variability in visual interpretation was identified as an important source of variability. Phases 2 and 3a showed that adherence to defined scoring methods substantially improved reproducibility in scoring tissue microarrays and core-cut biopsies. We now assess whether acceptable reproducibility can be achieved on whole sections.
Methods: Adjacent sections from 30 primary ER+ breast cancers were centrally stained for Ki67 to assemble 4 sets of 30 stained tumor sections, circulated around 23 labs in 12 countries. Ki67 was scored by 2 methods by all labs: (a) global: 4 fields of 100 tumor cells each were selected to reflect observed heterogeneity in nuclear staining (b) hot-spot: the field with highest Ki67 percentage of tumor cells with nuclear staining was selected and up to 500 cells scored. Ki67 scores were log2-transformed for statistical analyses and back-transformed for presentation. The primary objective was to assess whether either method could achieve an intraclass correlation coefficient (ICC) significantly greater than 0.8, considered substantial to almost-perfect reproducibility. Secondary objectives were to assess which method had highest observed ICC and to assess whether observers identified the same “hot-spots”.
Results: ICC for the global method was 0.87 (95%CI: 0.799-0.93), marginally meeting the prespecified success criterion. The ICC for the hot-spot method was 0.83 (95%CI: 0.74-0.90) and had a CI extending below the success criterion. Across the 23 labs, geometric mean value of the 30 scores ranged from 8.5 to 19.6 for the global method and from 12.8 to 30.3 for the hot-spot method. The overall mean (95% CI) of these values was 12.9 (11.9-14.0) and 20.9 (19.1-22.8), respectively. Visually, between-laboratory agreement in location of selected hot-spot varies between cases. The median times for scoring were 9 and 6 minutes for global and hot-spot methods respectively.
Conclusions: The global method marginally met the prespecified criterion of success; it should now be evaluated for clinical validity in appropriate cohorts of cases. The hot-spot method was observed to have slightly less reproducibility between labs. The time taken for scoring by either method is practical using counting software we are making publicly available. Establishment of external quality assessment schemes is likely to improve the reproducibility between labs further.
(Supported by a grant from the Breast Cancer Research Foundation)
Citation Format: Nielsen TO, Leung SCY, Zabaglo LA, Arun I, Badve SS, Bane AL, Bartlet JMS, Borgquist S, Chang MC, Dodson A, Ehinger A, Fineberg S, Focke CM, Gao D, Gown AM, Gutierrez C, Hugh JC, Kos Z, Lænkholm A-V, Mastropasqua MG, Moriya T, Nofech-Mozes S, Osborne CK, Penault-Llorca FM, Piper T, Sakatani T, Salgado R, Starczynski J, Sugie T, van der Vegt B, Viale G, Hayes DF, McShane LM, Dowsett M. Analytical validation of a standardized scoring protocol for Ki67 assessed on breast excision whole sections: An international multicenter collaboration [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-03-01.
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Affiliation(s)
- TO Nielsen
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - SCY Leung
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - LA Zabaglo
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - I Arun
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - SS Badve
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - AL Bane
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - JMS Bartlet
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - S Borgquist
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - MC Chang
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - A Dodson
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - A Ehinger
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - S Fineberg
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - CM Focke
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - D Gao
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - AM Gown
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - C Gutierrez
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - JC Hugh
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - Z Kos
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - A-V Lænkholm
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - MG Mastropasqua
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - T Moriya
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - S Nofech-Mozes
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - CK Osborne
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - FM Penault-Llorca
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - T Piper
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - T Sakatani
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - R Salgado
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - J Starczynski
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - T Sugie
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - B van der Vegt
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - G Viale
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - DF Hayes
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - LM McShane
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
| | - M Dowsett
- University of British Columbia, Vancouver, BC, Canada; The Institute of Cancer Research, London, United Kingdom; Tata Medical Center, Kolkata, West Bengal, India; Indiana University Simon Cancer Center, Indianapolis, IN; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada; Lund University, Lund, Sweden; Sinai Health System and University of Toronto, Toronto, ON, Canada; Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany; PhenoPath Laboratories, Seattle, WA; Lester and Sue Smith Breast Center and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX; University of Alberta, Edmonton, AB, Canada; University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada; Zealand University Hosp
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Venet D, Rothé F, Dupont F, Maetens M, Fumagalli D, Salgado R, Bradbury I, Pusztai L, Harbeck N, Izquierdo M, de la Pena L, Ignatiadis M, de Azambuja E, Huober J, Nuciforo P, Baselga J, Piccart M, Loi S, Sotiriou C. Abstract P2-05-04: Deregulation of A-to-I RNA editing is associated with poor prognosis in HER2+ breast cancers in the neoALTTO trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
A-to-I RNA editing, a post-transcriptional modification of the RNA catalyzed by the ADAR family of enzymes, is emerging as a widespread phenomenon in breast cancer (BC). A-to-I RNA editing is more frequent in the highly repetitive Alu regions but can affect both coding and non-coding regions. It has been shown to greatly impact cell functionality. In a recent report, we have shown that A-to-I RNA editing is regulated both by ADAR copy number and type I interferon response (Fumagalli et al. Cell Rep 2015). The main aim of the current study was to investigate the extent and profile of A-to-I RNA editing in HER2+ BC patients (pts) treated in the NeoALTTO trial, and to explore its impact on pathologic complete response (pCR) and survival.
Methods
Aligned RNAseq reads of sufficient quality and quantity were obtained for 252 of the 455 pts enrolled in the study, as described previously (Fumagalli et al. JAMA Oncol 2016). Editing sites from the rediPortal database were assessed. The editing level at a given site was computed by counting the number of Gs and As. Sites with coverage more than 10 were considered for further analyses. Editing in normal tissues was obtained from the GTEx project of the rediPortal database. Tumor infiltrating lymphocytes (TILs) and copy number aberrations were previously reported. Correlations between different parameters were assessed using Spearman correlations (ρ). The Mann-Whitney test was used to relate binary and numerical features. Event-free survival (EFS) analysis was performed using the Cox proportional hazard model.
Results
There was a median of 71470 edited sites per sample. As expected, mean editing per sample correlated with ADAR expression (ρ=59%, p<10-16) and ADAR copy number (ρ=54%, p<10-16). It was also correlated with the IFN-gamma driven signature (ρ=22%, p=0.0005), as well as with ESR1 gene expression (ρ=24%, p=0.0002). Neither ADAR expression nor mean editing was correlated with TILs (ρ=-0.5% and ρ=3%). No relationship between mean editing and pCR or EFS was found. The correlations between editing in NeoALTTO tumor samples and GTEx normal tissues were computed, and the median editing per sample was taken. These median correlations, ranging from 32% to 56%, were not associated with ADAR expression (ρ=-25%, p=6x10-5) nor mean editing (ρ=8%, p=0.19). Of interest, patients whose tumors showed low correlation with editing in normal tissues were associated with poor EFS (p=0.028, HR=0.56 to 0.96) suggesting that deregulation of RNA editing may impact disease progression and outcome. Similar results were obtained when the correlations were assessed between tumor samples instead of between tumor and normal samples (ρ between the two median editing: 76%; p-value survival: 0.013). The median correlations were not predictive for pCR (p=0.44). There was no interaction between editing and treatment arm.
Conclusions
Our study shows for the first time that deregulated RNA editing, as compared to editing in normal tissues, is a widespread phenomenon in HER2+ BC patients treated in the NeoALTTO trial and is associated with poor outcome. These results may provide new perspectives for the treatment of HER2+ disease by developing therapies targeting RNA editing.
Citation Format: Venet D, Rothé F, Dupont F, Maetens M, Fumagalli D, Salgado R, Bradbury I, Pusztai L, Harbeck N, Izquierdo M, de la Pena L, Ignatiadis M, de Azambuja E, Huober J, Nuciforo P, Baselga J, Piccart M, Loi S, Sotiriou C. Deregulation of A-to-I RNA editing is associated with poor prognosis in HER2+ breast cancers in the neoALTTO trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-05-04.
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Affiliation(s)
- D Venet
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - F Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - F Dupont
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Maetens
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - D Fumagalli
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - R Salgado
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - I Bradbury
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - L Pusztai
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - N Harbeck
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Izquierdo
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - L de la Pena
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Ignatiadis
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - E de Azambuja
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - J Huober
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - P Nuciforo
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - J Baselga
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Piccart
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - S Loi
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast International Group - BIG aisbl, Belgium; Frontier Science Scotland, United Kingdom; Breast Medical Oncology Section, Yale Cancer Center, Yale School of Medicine, New Haven; University of Munich, Germany; Novartis Pharmaceuticals Corporation; SOLTI-Breast Cancer Research Group, Barcelona, Spain; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Breast European Adjuvant Study Team, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Ulm, Germany; Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York; Peter MacCallum Cancer Center, Melbourne, Australia
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Morfouace M, Hewitt SM, Salgado R, Hartmann K, Litiere S, Tejpar S, Golfinopoulos V, Lively T, Thurin M, Conley B, Lacombe D. A transatlantic perspective on the integration of immuno-oncology prognostic and predictive biomarkers in innovative clinical trial design. Semin Cancer Biol 2018; 52:158-165. [PMID: 29307568 DOI: 10.1016/j.semcancer.2018.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 07/26/2017] [Revised: 12/11/2017] [Accepted: 01/04/2018] [Indexed: 02/07/2023]
Abstract
Immuno-therapeutics aim to activate the body's own immune system against cancer and are one of the most promising cancer treatment strategies, but currently limited by a variable response rate. Biomarkers may help to distinguish those patients most likely to respond to therapy; they may also help guide clinical decision making for combination therapies, dosing schedules, and determining progression versus relapse. However, there is a need to confirm such biomarkers in preferably prospective clinical trials before they can be used in practice. Accordingly, it is essential that clinical trials for immuno-therapeutics incorporate biomarkers. Here, focusing on the specific setting of immune therapies, we discuss both the scientific and logistical hurdles to identifying potential biomarkers and testing them in clinical trials.
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Affiliation(s)
| | - S M Hewitt
- Experimental Pathology Laboratory, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda MD, USA
| | - R Salgado
- EORTC Pathobiology Group, Breast Cancer Translational Research Laboratory, Jules Bordet Institute, Brussels, Belgium; Translational Breast Cancer Genomic and Therapeutics Laboratory, Peter Mac Callum Cancer Center, Victoria, Australia, Australia; Department of Pathology, GZA, Antwerp, Belgium
| | | | - S Litiere
- EORTC Headquarters, Brussels, Belgium
| | - S Tejpar
- Molecular Digestive Oncology Unit, University Hospital Gasthuisberg, Leuven, Belgium
| | | | - T Lively
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, DHHS,9609 Medical Center Drive, Bethesda, MD 20892 USA
| | - M Thurin
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, DHHS,9609 Medical Center Drive, Bethesda, MD 20892 USA
| | - B Conley
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, DHHS,9609 Medical Center Drive, Bethesda, MD 20892 USA
| | - D Lacombe
- EORTC Headquarters, Brussels, Belgium
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Pruneri G, Lazzeroni M, Bagnardi V, Tiburzio GB, Rotmensz N, DeCensi A, Guerrieri-Gonzaga A, Vingiani A, Curigliano G, Zurrida S, Bassi F, Salgado R, Van den Eynden G, Loi S, Denkert C, Bonanni B, Viale G. The prevalence and clinical relevance of tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ of the breast. Ann Oncol 2017; 28:321-328. [PMID: 28426105 DOI: 10.1093/annonc/mdw623] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Tumor-infiltrating lymphocytes (TILs) are a robust prognostic adjunct in invasive breast cancer, but their clinical role in ductal carcinoma in situ (DCIS) has not been ascertained. Patients and methods We evaluated the prevalence and clinical relevance of TILs in a well annotated series of 1488 consecutive DCIS women with a median follow-up of 8.2 years. Detailed criteria for TILs evaluation were pre-defined involving the International Immuno-Oncology Biomarker Working Group. TILs percentage was considered both as a continuous and categorical variable. Levels of TILs were examined for their associations with ipsilateral breast event (IBE), whether in situ or invasive. Results Of the 1488 patients with DCIS under study, 35.1% had <1%, 58.3% 1-49% and 6.5% ≥50% peri-ductal stromal lymphocytes. The interobserver agreement in TILs evaluation, measured by the intraclass correlation coefficient (ICC) was 0.96 (95% CI 0.95-0.97). At univariable analysis, clinical factors significantly associated with TILs (P ≤0.001) were intrinsic subtype, grade, necrosis, type of surgery. Her-2 positive DCIS were more frequently associated with TILs (24% of patients with TILs ≥50%), followed by the triple negative (11%), Luminal B/Her-2 positive (9%) and Luminal A/B subtypes (1%) (P < 0.0001). We did not find any association between TILs as a continuous variable and the risk of IBEs. Likewise, when patients were stratified by TILs percentage (<1%, between 1% and 49.9%, and ≥50%), no statistically significant association was observed (10-year cumulative incidence of IBEs: 19%, 17.3%, and 18.7% respectively, P = 0.767). Conclusion TILs occur more frequently in the Her-2 positive DCIS. Although we did not find a significant association between TILs and the 10-year risk of IBE, our data suggest that immunotherapies might be considered in subsets of DCIS patients.
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Affiliation(s)
- G Pruneri
- Department of Pathology, European Institute of Oncology, Milan.,School of Medicine, University of Milan, Milan
| | - M Lazzeroni
- Cancer Prevention and Genetics, European Institute of Oncology, Milan
| | - V Bagnardi
- Epidemiology and Biostatistics, European Institute of Oncology, Milan.,Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan
| | - G B Tiburzio
- Department of Pathology, European Institute of Oncology, Milan
| | - N Rotmensz
- Epidemiology and Biostatistics, European Institute of Oncology, Milan
| | - A DeCensi
- Cancer Prevention and Genetics, European Institute of Oncology, Milan.,Division of Medical Oncology, E.O. Ospedali Galliera, Genoa
| | | | - A Vingiani
- Department of Pathology, European Institute of Oncology, Milan
| | - G Curigliano
- Experimental Therapeutics European Institute of Oncology, Milan
| | - S Zurrida
- Division of Senology, European Institute of Oncology, Milan, Italy
| | - F Bassi
- Division of Senology, European Institute of Oncology, Milan, Italy
| | - R Salgado
- Department of Pathology, GZA, Breast Cancer Translational Research Group, Jules Bordet Institute, Brussels
| | - G Van den Eynden
- Molecular Immunology Lab, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Loi
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre University of Melbourne, East Melbourne, Victoria, Australia
| | - C Denkert
- Institute of Pathology Charité University Hospital, Berlin, Germany and German Cancer Consortium, Berlin, Germany
| | - B Bonanni
- Cancer Prevention and Genetics, European Institute of Oncology, Milan
| | - G Viale
- Department of Pathology, European Institute of Oncology, Milan.,School of Medicine, University of Milan, Milan
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Fumagalli D, Wilson TR, Salgado R, Lu X, Yu J, O'Brien C, Walter K, Huw LY, Criscitiello C, Laios I, Jose V, Brown DN, Rothé F, Maetens M, Zardavas D, Savas P, Larsimont D, Piccart-Gebhart MJ, Michiels S, Lackner MR, Sotiriou C, Loi S. Somatic mutation, copy number and transcriptomic profiles of primary and matched metastatic estrogen receptor-positive breast cancers. Ann Oncol 2017; 27:1860-6. [PMID: 27672107 DOI: 10.1093/annonc/mdw286] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/14/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Estrogen receptor-positive (ER+) breast cancers (BCs) constitute the most frequent BC subtype. The molecular landscape of ER+ relapsed disease is not well characterized. In this study, we aimed to describe the genomic evolution between primary (P) and matched metastatic (M) ER+ BCs after failure of adjuvant therapy. MATERIALS AND METHODS A total of 182 ER+ metastatic BC patients with long-term follow-up were identified from a single institution. P tumor tissue was available for all patients, with 88 having matched M material. According to the availability of tumor material, samples were characterized using a 120 mutational hotspot qPCR, a 29 gene copy number aberrations (CNA) and a 400 gene expression panels. ESR1 mutations were assayed by droplet digital PCR. Molecular alterations were correlated with overall survival (OS) using the Cox proportional hazards regression models. RESULTS The median follow-up was 6.4 years (range 0.5-26.6 years). Genomic analysis of P tumors revealed somatic mutations in PIK3CA, KRAS, AKT1, FGFR3, HRAS and BRAF at frequencies of 41%, 6%, 5%, 2%, 1% and 2%, respectively, and CN amplification of CCND1, ZNF703, FGFR1, RSF1 and PAK1 at 23%, 19%, 17%, 12% and 11%, respectively. Mutations and CN amplifications were largely concordant between P and matched M (>84%). ESR1 mutations were found in 10.8% of the M but none of the P. Thirteen genes, among which ESR1, FOXA1, and HIF1A, showed significant differential expression between P and M. In P, the differential expression of 18 genes, among which IDO1, was significantly associated with OS (FDR < 0.1). CONCLUSIONS Despite the large concordance between P and matched M for the evaluated molecular alterations, potential actionable targets such as ESR1 mutations were found only in M. This supports the importance of characterizing the M disease. Other targets we identified, such as HIF1A and IDO1, warrant further investigation in this patient population.
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Affiliation(s)
- D Fumagalli
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - T R Wilson
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - R Salgado
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - X Lu
- Department of Biostatistics, Genentech Inc., South San Francisco, CA, USA
| | - J Yu
- Department of Biostatistics, Genentech Inc., South San Francisco, CA, USA
| | - C O'Brien
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - K Walter
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - L Y Huw
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - C Criscitiello
- Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, Milan, Italy
| | - I Laios
- Department of Pathology, Institut Jules Bordet, Brussels, Belgium
| | - V Jose
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - D N Brown
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - F Rothé
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - M Maetens
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium
| | - D Zardavas
- Breast International Group, Brussels, Belgium
| | - P Savas
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - D Larsimont
- Department of Pathology, Institut Jules Bordet, Brussels, Belgium
| | | | - S Michiels
- Division of Biostatistics and Epidemiology, Institut Gustave Roussy, Villejuif, France INSERM U1018, CESP, University of Paris, Villejuif, France
| | - M R Lackner
- Oncology Biomarker Development, Genentech Inc., South San Francisco, CA, USA
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Free University of Bruxelles, Brussels, Belgium Division of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
| | - S Loi
- Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
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Loi S, Adams S, Schmid P, Cortés J, Cescon D, Winer E, Toppmeyer D, Rugo H, De Laurentiis M, Nanda R, Iwata H, Awada A, Tan A, Wang A, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocyte (TIL) levels and response to pembrolizumab (pembro) in metastatic triple-negative breast cancer (mTNBC): Results from KEYNOTE-086. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.005] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [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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Kok M, Horlings H, van de Vijver K, Wiersma T, Russell N, Voorwerk L, Sikorska K, van Werkhoven E, Mandjes I, Kemper I, Foekema J, Wilgenhof S, Chalabi M, Stouthard J, Sonke G, Cullen D, Salgado R, Schumacher T, Blank C, Linn S. Adaptive phase II randomized non-comparative trial of nivolumab after induction treatment in triple negative breast cancer: TONIC-trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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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Shivalkar B, Wollaert K, Ennekens G, Roelant E, Salgado R, Moerenhout C, Heidbuchel H, Vrints C. 2855Anthropometric measures of obesity, prevalent coronary atherosclerosis and long term cardiovascular outcomes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.2855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Solinas C, Ceppi M, Lambertini M, Scartozzi M, Buisseret L, Garaud S, Fumagalli D, de Azambuja E, Salgado R, Sotiriou C, Willard-Gallo K, Ignatiadis M. Tumor-infiltrating lymphocytes in patients with HER2-positive breast cancer treated with neoadjuvant chemotherapy plus trastuzumab, lapatinib or their combination: A meta-analysis of randomized controlled trials. Cancer Treat Rev 2017; 57:8-15. [DOI: 10.1016/j.ctrv.2017.04.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 04/21/2017] [Accepted: 04/23/2017] [Indexed: 01/13/2023]
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Sonnenblick A, Salgado R, Peretz T, Francis P, Crown J, Azambuja E, Lieveke A, Piccart M, Bromberg J, Sotiriou C. pSTAT3 in luminal breast cancer. Integrated RNA-protein pooled analysis and results from the BIG 2-98 phase III trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx138.002] [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: 11/14/2022] Open
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50
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Gruosso T, Gigoux M, Bertos N, Manem V, Guiot MC, Buisseret L, Salgado R, Van den Eyden G, Haibe-Kains B, Park M. Distinct immune microenvironments stratify triple-negative breast cancer and predict outcome. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx140.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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