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Yiangou K, Mavaddat N, Dennis J, Zanti M, Wang Q, Bolla MK, Abubakar M, Ahearn TU, Andrulis IL, Anton-Culver H, Antonenkova NN, Arndt V, Aronson KJ, Augustinsson A, Baten A, Behrens S, Bermisheva M, de Gonzalez AB, Białkowska K, Boddicker N, Bodelon C, Bogdanova NV, Bojesen SE, Brantley KD, Brauch H, Brenner H, Camp NJ, Canzian F, Castelao JE, Cessna MH, Chang-Claude J, Chenevix-Trench G, Chung WK, Colonna SV, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Devilee P, Dörk T, Dunning AM, Eccles DM, Eliassen AH, Engel C, Eriksson M, Evans DG, Fasching PA, Fletcher O, Flyger H, Fritschi L, Gago-Dominguez M, Gentry-Maharaj A, González-Neira A, Guénel P, Hahnen E, Haiman CA, Hamann U, Hartikainen JM, Ho V, Hodge J, Hollestelle A, Honisch E, Hooning MJ, Hoppe R, Hopper JL, Howell S, Howell A, Jakovchevska S, Jakubowska A, Jernström H, Johnson N, Kaaks R, Khusnutdinova EK, Kitahara CM, Koutros S, Kristensen VN, Lacey JV, Lambrechts D, Lejbkowicz F, Lindblom A, Lush M, Mannermaa A, Mavroudis D, Menon U, Murphy RA, Nevanlinna H, Obi N, Offit K, Park-Simon TW, Patel AV, Peng C, Peterlongo P, Pita G, Plaseska-Karanfilska D, Pylkäs K, Radice P, Rashid MU, Rennert G, Roberts E, Rodriguez J, Romero A, Rosenberg EH, Saloustros E, Sandler DP, Sawyer EJ, Schmutzler RK, Scott CG, Shu XO, Southey MC, Stone J, Taylor JA, Teras LR, van de Beek I, Willett W, Winqvist R, Zheng W, Vachon CM, Schmidt MK, Hall P, MacInnis RJ, Milne RL, Pharoah PD, Simard J, Antoniou AC, Easton DF, Michailidou K. Differences in polygenic score distributions in European ancestry populations: implications for breast cancer risk prediction. medRxiv 2024:2024.02.12.24302043. [PMID: 38410445 PMCID: PMC10896416 DOI: 10.1101/2024.02.12.24302043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
The 313-variant polygenic risk score (PRS313) provides a promising tool for breast cancer risk prediction. However, evaluation of the PRS313 across different European populations which could influence risk estimation has not been performed. Here, we explored the distribution of PRS313 across European populations using genotype data from 94,072 females without breast cancer, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 225,105 female participants from the UK Biobank. The mean PRS313 differed markedly across European countries, being highest in south-eastern Europe and lowest in north-western Europe. Using the overall European PRS313 distribution to categorise individuals leads to overestimation and underestimation of risk in some individuals from south-eastern and north-western countries, respectively. Adjustment for principal components explained most of the observed heterogeneity in mean PRS. Country-specific PRS distributions may be used to calibrate risk categories in individuals from different countries.
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Affiliation(s)
- Kristia Yiangou
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus, 2371
| | - Nasim Mavaddat
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Maria Zanti
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus, 2371
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Manjeet K. Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Mustapha Abubakar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA, 20850
| | - Thomas U. Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA, 20850
| | - Irene L. Andrulis
- Fred A, Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada, M5G 1X5
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada, M5S 1A8
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA, 92617
| | - Natalia N. Antonenkova
- NN Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus, 223040
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
| | - Kristan J. Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen’s University, Kingston, ON, Canada, K7L 3N6
| | | | - Adinda Baten
- Leuven Multidisciplinary Breast Center, Department of Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium, 3000
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia, 450054
- St Petersburg State University, St, Petersburg, Russia, 199034
| | | | - Katarzyna Białkowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland, 71-252
| | - Nicholas Boddicker
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA, 55905
| | - Clara Bodelon
- Department of Population Science, American Cancer Society, Atlanta, GA, USA, 30303
| | - Natalia V. Bogdanova
- NN Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus, 223040
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany, 30625
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany, 30625
| | - Stig E. Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark, 2730
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark, 2730
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Kristen D. Brantley
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA, 02115
| | - Hiltrud Brauch
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany, 70376
- iFIT-Cluster of Excellence, University of Tübingen, Tübingen, Germany, 72074
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany, 72074
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany, 69120
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
| | - Nicola J. Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA, 84112
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
| | - Jose E. Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS) Foundation, Complejo Hospitalario Universitario de Santiago, SERGAS, Vigo, Spain, 36312
| | - Melissa H. Cessna
- Department of Pathology, Intermountain Healthcare, Salt Lake City, UT, USA, 84143
- Intermountain Biorepository, Intermountain Healthcare, Salt Lake City, UT, USA, 84143
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 20246
| | - Georgia Chenevix-Trench
- Cancer Research Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia, 4006
| | - Wendy K. Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA, 10032
| | - NBCS Collaborators
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital-Radiumhospitalet, Oslo, Norway, 0379
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway, 0450
- Department of Research, Vestre Viken Hospital, Drammen, Norway, 3019
- Section for Breast- and Endocrine Surgery, Department of Cancer, Division of Surgery, Cancer and Transplantation Medicine, Oslo University Hospital-Ullevål, Oslo, Norway, 0450
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway, 0379
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway, 1478
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway, 0379
- Department of Oncology, Division of Surgery, Cancer and Transplantation Medicine, Oslo University Hospital-Radiumhospitalet, Oslo, Norway, 0379
- National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway, 0379
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway, 1478
- Oslo Breast Cancer Research Consortium, Oslo University Hospital, Oslo, Norway, 0379
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway, 0379
| | - Sarah V. Colonna
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA, 84112
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA, 55905
| | - Angela Cox
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK, S10 2TN
| | - Simon S. Cross
- Division of Neuroscience, School of Medicine and Population Health, University of Sheffield, Sheffield, UK, S10 2TN
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 171 65
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA, 19111
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands, 2333 ZA
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands, 2333 ZA
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany, 30625
| | - Alison M. Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Diana M. Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK, SO17 1BJ
| | - A. Heather Eliassen
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA, 02115
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA, 02115
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA, 02115
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany, 04107
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany, 04103
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 171 65
| | - D. Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK, M13 9WL
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK, M13 9WL
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany, 91054
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK, SW7 3RP
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark, 2730
| | - Lin Fritschi
- School of Population Health, Curtin University, Perth, Western Australia, Australia, 6102
| | - Manuela Gago-Dominguez
- Cancer Genetics and Epidemiology Group, Genomic Medicine Group, Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain, 15706
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK, WC1V 6LJ
- Department of Women’s Cancer, Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
| | - Anna González-Neira
- Human Genotyping Unit-CeGen, Spanish National Cancer Research Centre (CNIO), Madrid, Spain, 28029
- Spanish Network on Rare Diseases (CIBERER)
| | - Pascal Guénel
- Team ‘Exposome and Heredity’, CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France, 94805
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany, 50937
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany, 50937
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA, 90033
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
| | - Jaana M. Hartikainen
- Cancer RC, University of Eastern Finland, Kuopio, Finland, 70210
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland, 70210
| | - Vikki Ho
- Health Innovation and Evaluation Hub, Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada
| | - James Hodge
- Department of Population Science, American Cancer Society, Atlanta, GA, USA, 30303
| | - Antoinette Hollestelle
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands, 3015 GD
| | - Ellen Honisch
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany, 40225
| | - Maartje J. Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands, 3015 GD
| | - Reiner Hoppe
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany, 70376
- University of Tübingen, Tübingen, Germany, 72074
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia, 3010
| | - Sacha Howell
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Nightingale/Prevent Breast Cancer Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Manchester Breast Centre, Manchester Cancer Research Centre, The Christie Hospital, Manchester, UK
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, UK, M13 9PL
| | - ABCTB Investigators
- Australian Breast Cancer Tissue Bank, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia, 2145
| | - kConFab Investigators
- Research Department, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia, 3000
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia, 3000
| | - Simona Jakovchevska
- Research Centre for Genetic Engineering and Biotechnology ‘Georgi D, Efremov’, MASA, Skopje, Republic of North Macedonia, 1000
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland, 71-252
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland, 171-252
| | - Helena Jernström
- Oncology, Clinical Sciences in Lund, Lund University, Lund, Sweden, 221 85
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK, SW7 3RP
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
| | - Elza K. Khusnutdinova
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia, 450054
- Department of Genetics and Fundamental Medicine, Ufa University of Science and Technology, Ufa, Russia, 450076
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA, 20892
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA, 20850
| | - Vessela N. Kristensen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway, 0450
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway, 0379
| | - James V. Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA, 91010
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA, 91010
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium, 3000
- VIB Center for Cancer Biology, VIB, Leuven, Belgium, 3001
| | | | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, 171 76
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden, 171 76
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Arto Mannermaa
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland, 70210
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland, 70210
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece, 711 10
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK, WC1V 6LJ
| | - Rachel A. Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, V6T 1Z4
- Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada, V5Z 1L3
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland, 00290
| | - Nadia Obi
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 20246
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 20246
| | - Kenneth Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, USA, 10065
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA, 10065
| | | | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA, 30303
| | - Cheng Peng
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA, 02115
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM ETS - the AIRC Institute of Molecular Oncology, Milan, Italy, 20139
| | - Guillermo Pita
- Human Genotyping Unit-CeGen, Spanish National Cancer Research Centre (CNIO), Madrid, Spain, 28029
| | - Dijana Plaseska-Karanfilska
- Research Centre for Genetic Engineering and Biotechnology ‘Georgi D, Efremov’, MASA, Skopje, Republic of North Macedonia, 1000
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland, 90220
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland, 90220
| | - Paolo Radice
- Unit of Predictice Medicine, Molecular Bases of Genetic Risk, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy, 20133
| | - Muhammad U. Rashid
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany, 69120
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan, 54000
| | - Gad Rennert
- Technion, Faculty of Medicine and Association for Promotion of Research in Precision Medicine, Haifa, Israel
| | - Eleanor Roberts
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Juan Rodriguez
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 171 65
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain, 28222
| | - Efraim H. Rosenberg
- Department of Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, the Netherlands, 1066 CX
| | | | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA, 27709
| | - Elinor J. Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy’s Campus, King’s College London, London, UK
| | - Rita K. Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany, 50937
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany, 50937
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany, 50931
| | - Christopher G. Scott
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA, 55905
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA, 37232
| | - Melissa C. Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia, 3168
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia, 3010
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia, 3004
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia, 3010
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia, 6000
| | - Jack A. Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA, 27709
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA, 27709
| | - Lauren R. Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA, 30303
| | - Irma van de Beek
- Department of Clinical Genetics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, the Netherlands, 1066 CX
| | - Walter Willett
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA, 02115
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA, 02115
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA, 02115
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland, 90220
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland, 90220
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA, 37232
| | - Celine M. Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA, 55905
| | - Marjanka K. Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands, 1066 CX
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, the Netherlands, 1066 CX
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands, 2333 ZA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 171 65
- Department of Oncology, Södersjukhuset, Stockholm, Sweden, 118 83
| | - Robert J. MacInnis
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia, 3010
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia, 3004
| | - Roger L. Milne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia, 3010
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia, 3168
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia, 3004
| | - Paul D.P. Pharoah
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, USA, 90069
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec – Université Laval Research Center, Québec City, Québec, Canada, G1V 4G2
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK, CB1 8RN
| | - Kyriaki Michailidou
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus, 2371
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, CB1 8RN
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Levi H, Carmi S, Rosset S, Yerushalmi R, Zick A, Yablonski-Peretz T, Wang Q, Bolla MK, Dennis J, Michailidou K, Lush M, Ahearn T, Andrulis IL, Anton-Culver H, Antoniou AC, Arndt V, Augustinsson A, Auvinen P, Beane Freeman L, Beckmann M, Behrens S, Bermisheva M, Bodelon C, Bogdanova NV, Bojesen SE, Brenner H, Byers H, Camp N, Castelao J, Chang-Claude J, Chirlaque MD, Chung W, Clarke C, Collee MJ, Colonna S, Couch F, Cox A, Cross SS, Czene K, Daly M, Devilee P, Dork T, Dossus L, Eccles DM, Eliassen AH, Eriksson M, Evans G, Fasching P, Fletcher O, Flyger H, Fritschi L, Gabrielson M, Gago-Dominguez M, García-Closas M, Garcia-Saenz JA, Genkinger J, Giles GG, Goldberg M, Guénel P, Hall P, Hamann U, He W, Hillemanns P, Hollestelle A, Hoppe R, Hopper J, Jakovchevska S, Jakubowska A, Jernström H, John E, Johnson N, Jones M, Vijai J, Kaaks R, Khusnutdinova E, Kitahara C, Koutros S, Kristensen V, Kurian AW, Lacey J, Lambrechts D, Le Marchand L, Lejbkowicz F, Lindblom A, Loibl S, Lori A, Lubinski J, Mannermaa A, Manoochehri M, Mavroudis D, Menon U, Mulligan A, Murphy R, Nevelsteen I, Newman WG, Obi N, O'Brien K, Offit K, Olshan A, Plaseska-Karanfilska D, Olson J, Panico S, Park-Simon TW, Patel A, Peterlongo P, Rack B, Radice P, Rennert G, Rhenius V, Romero A, Saloustros E, Sandler D, Schmidt MK, Schwentner L, Shah M, Sharma P, Simard J, Southey M, Stone J, Tapper WJ, Taylor J, Teras L, Toland AE, Troester M, Truong T, van der Kolk LE, Weinberg C, Wendt C, Yang XR, Zheng W, Ziogas A, Dunning AM, Pharoah P, Easton DF, Ben-Sachar S, Elefant N, Shamir R, Elkon R. Evaluation of European-based polygenic risk score for breast cancer in Ashkenazi Jewish women in Israel. J Med Genet 2023; 60:1186-1197. [PMID: 37451831 PMCID: PMC10715538 DOI: 10.1136/jmg-2023-109185] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/28/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Polygenic risk score (PRS), calculated based on genome-wide association studies (GWASs), can improve breast cancer (BC) risk assessment. To date, most BC GWASs have been performed in individuals of European (EUR) ancestry, and the generalisation of EUR-based PRS to other populations is a major challenge. In this study, we examined the performance of EUR-based BC PRS models in Ashkenazi Jewish (AJ) women. METHODS We generated PRSs based on data on EUR women from the Breast Cancer Association Consortium (BCAC). We tested the performance of the PRSs in a cohort of 2161 AJ women from Israel (1437 cases and 724 controls) from BCAC (BCAC cohort from Israel (BCAC-IL)). In addition, we tested the performance of these EUR-based BC PRSs, as well as the established 313-SNP EUR BC PRS, in an independent cohort of 181 AJ women from Hadassah Medical Center (HMC) in Israel. RESULTS In the BCAC-IL cohort, the highest OR per 1 SD was 1.56 (±0.09). The OR for AJ women at the top 10% of the PRS distribution compared with the middle quintile was 2.10 (±0.24). In the HMC cohort, the OR per 1 SD of the EUR-based PRS that performed best in the BCAC-IL cohort was 1.58±0.27. The OR per 1 SD of the commonly used 313-SNP BC PRS was 1.64 (±0.28). CONCLUSIONS Extant EUR GWAS data can be used for generating PRSs that identify AJ women with markedly elevated risk of BC and therefore hold promise for improving BC risk assessment in AJ women.
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Grants
- R01 CA176785 NCI NIH HHS
- NU58DP006344 NCCDPHP CDC HHS
- R37 CA070867 NCI NIH HHS
- HHSN261201800015I NCI NIH HHS
- R01 CA064277 NCI NIH HHS
- P50 CA116201 NCI NIH HHS
- G1000143 Medical Research Council
- P30 CA062203 NCI NIH HHS
- HHSN261201800015C NCI NIH HHS
- R01 CA047305 NCI NIH HHS
- HHSN261201800009I NCI NIH HHS
- R01 CA163353 NCI NIH HHS
- UM1 CA164917 NCI NIH HHS
- U01 CA199277 NCI NIH HHS
- U01 CA179715 NCI NIH HHS
- HHSN261201800032C NCI NIH HHS
- U54 CA156733 NCI NIH HHS
- HHSN261201800009C NCI NIH HHS
- Z01 CP010119 Intramural NIH HHS
- UM1 CA164973 NCI NIH HHS
- P01 CA087969 NCI NIH HHS
- UM1 CA164920 NCI NIH HHS
- NU58DP006320 CDC HHS
- UM1 CA176726 NCI NIH HHS
- R01 CA092447 NCI NIH HHS
- Z01 ES049030 Intramural NIH HHS
- R01 CA058860 NCI NIH HHS
- K07 CA092044 NCI NIH HHS
- HHSN261201800016C NCI NIH HHS
- P50 CA058223 NCI NIH HHS
- R01 CA100374 NCI NIH HHS
- P30 CA008748 NCI NIH HHS
- R01 CA128978 NCI NIH HHS
- R01 CA047147 NCI NIH HHS
- U19 CA148537 NCI NIH HHS
- R01 CA116167 NCI NIH HHS
- R01 CA148667 NCI NIH HHS
- R01 CA063464 NCI NIH HHS
- HHSN261201800016I NCI NIH HHS
- UM1 CA186107 NCI NIH HHS
- P30 CA023100 NCI NIH HHS
- U01 CA063464 NCI NIH HHS
- R01 CA077398 NCI NIH HHS
- R01 CA054281 NCI NIH HHS
- R01 CA132839 NCI NIH HHS
- P30 CA068485 NCI NIH HHS
- U01 CA058860 NCI NIH HHS
- U01 CA164920 NCI NIH HHS
- R35 CA253187 NCI NIH HHS
- 14136 Cancer Research UK
- U19 CA148112 NCI NIH HHS
- HHSN261201800032I NCI NIH HHS
- U01 CA098758 NCI NIH HHS
- Z01 ES044005 Intramural NIH HHS
- U19 CA148065 NCI NIH HHS
- P30 CA033572 NCI NIH HHS
- R01 CA069664 NCI NIH HHS
- Wellcome Trust
- 001 World Health Organization
- Z01 ES049033 Intramural NIH HHS
- R01 CA192393 NCI NIH HHS
- U01 CA164973 NCI NIH HHS
- R37 CA054281 NCI NIH HHS
- Consellería de Industria Programa Sectorial de Investigación Aplicada
- Statistics Netherlands
- South Eastern Norway Health Authority
- Lower Saxonian Cancer Society
- Lise Boserup Fund
- Heidelberger Zentrum für Personalisierte Onkologie Deutsches Krebsforschungszentrum In Der Helmholtz-Gemeinschaft
- Lon V. Smith Foundation
- Scottish Funding Council
- Komen Foundation
- Claudia von Schilling Foundation for Breast Cancer Research
- Russian Foundation for Basic Research
- Ligue Contre le Cancer
- Sigrid Juselius Foundation
- Kuopion Yliopistollinen Sairaala
- Sheffield Experimental Cancer Medicine Centre
- Stockholm läns landsting
- Department of Health and Human Services (USA)
- Department of Defence (USA)
- Stichting Tegen Kanker
- David F. and Margaret T. Grohne Family Foundation
- Sundhed og Sygdom, Det Frie Forskningsråd
- Stavros Niarchos Foundation
- Post-Cancer GWAS initiative
- Institute of the Ruhr University Bochum
- Instituto de Salud Carlos III
- Institute of Cancer Research
- Public Health Institute
- Fondation du cancer du sein du Québec
- Institut National de la Santé et de la Recherche Médicale
- Pink Ribbon
- Institute for Prevention and Occupational Medicine
- K.G. Jebsen Centre for Breast Cancer Research
- Research Centre for Genetic Engineering and Biotechnology
- Center of Excellence (Finland)
- Robert and Kate Niehaus Clinical Cancer Genetics Initiative
- Rudolf Bartling Foundation
- Center for Disease Control and Prevention (USA)
- Karolinska Institutet
- Norges Forskningsråd
- Robert Bosch Stiftung
- Intramural Research Funds of the National Cancer Institute (USA)
- Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC
- Intramural Research Program of the Division of Cancer Epidemiology and Genetics
- Centre International de Recherche sur le Cancer
- Queensland Cancer Fund
- Red Temática de Investigación Cooperativa en Cáncer
- Intramural Research Program of the National Institutes of Health
- National Health Service (UK)
- Ministerie van Volksgezondheid, Welzijn en Sport
- National cancer institute (USA)
- KWF Kankerbestrijding
- Märit and Hans Rausings Initiative Against Breast Cancer
- Associazione Italiana per la Ricerca sul Cancro
- Fundación Científica Asociación Española Contra el Cáncer
- ERC advanced grant
- Australian National Health and Medical Research Council
- Agence Nationale de la Recherche
- Dutch Prevention Funds,
- Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail
- American Cancer Society
- Dutch Zorg Onderzoek
- Alexander von Humboldt-Stiftung
- Ministerio de Economia y Competitividad (Spain)
- Ministère du Développement Économique, de l’Innovation et de l’Exportation
- Susan G. Komen for the Cure
- Minister of Science and Higher Education
- Medical Research Council UK
- Ministry of Science and Higher Education of the Russian Federation
- Ministry of Science and Higher Education (Sweden)
- Against Breast Cancer
- Mutuelle Générale de l’Education Nationale
- Academy of Finland
- Deutsche Krebshilfe e.V.
- Dietmar-Hopp Foundation,
- Division of Cancer Prevention, National Cancer Institute
- Deutsche Krebshilfe
- World Cancer Research Fund
- Genome Québec
- National Cancer Institute’s Surveillance, Epidemiology and End Results Program
- Breast Cancer Campaign
- National Cancer Research Network
- Berta Kamprad Foundation FBKS
- Bert von Kantzows foundation
- Biomedical Research Centre at Guy’s and St Thomas
- Genome Canada
- Freistaat Sachsen
- Biobanking and Biomolecular Resources Research Infrastructure
- Friends of Hannover Medical School
- Breast Cancer Research Foundation
- California Department of Public Health
- Government of Russian Federation
- Deutsche Forschungsgemeinschaft
- National Institute for Health and Care Research
- National Health and Medical Research Council (Australia)
- German Federal Ministry of Research and Education
- National Institute of Environmental Health Sciences
- Breast Cancer Now
- Seventh Framework Programme
- Transcan
- Centrum för idrottsforskning
- UK National Institute for Health Research Biomedical Research Centre
- University of Crete
- National Breast Cancer Foundation (Finland)
- European Regional Development Fund
- National Breast Cancer Foundation (Australia)
- United States Army Medical Research and Materiel Command
- EU Horizon 2020 Research and Innovation Programme
- Directorate-General XII, Science, Research, and Development
- Baden Württemberg Ministry of Science, Research and Arts
- VicHealth
- Fondo de Investigación Sanitario
- Victorian Breast Cancer Research Consortium.
- Finnish Cancer Foundation
- University of Southern California San Francisco
- Fomento de la Investigación Clínica Independiente
- the Cancer Biology Research Center (CBRC), Djerassi Oncology Center
- Bundesministerium für Bildung und Forschung
- Cancerfonden
- Tel Aviv University Center for AI and Data Science
- University of Oulu
- National Breast Cancer Foundation (JS)
- Safra Center for Bioinformatics
- Fondation de France, Institut National du Cancer
- Israeli Science Foundation
- University of Utah
- National Cancer Center Research and Development Fund (Japan)
- Chief Scientist Office, Scottish Government Health and Social Care Directorate
- Oak Foundation
- Health Research Fund (FIS)
- Ontario Familial Breast Cancer Registry
- New South Wales Cancer Council
- North Carolina University Cancer Research Fund
- Kreftforeningen
- Northern California Breast Cancer Family Registry
- Institut Gustave Roussy
- Huntsman Cancer Institute, University of Utah
- Ovarian Cancer Research Fund
- NIHR Oxford Biomedical Research Centre
- Hellenic Health Foundation
- Oulun Yliopistollinen Sairaala
- Helmholtz Society
- Herlev and Gentofte Hospital
- PSRSIIRI-701
- Helsinki University Hospital Research Fund
- Cancer Council Victoria
- National Research Council (Italy)
- Cancer Council Tasmania
- Cancer Council Western Australia
- Hamburger Krebsgesellschaft
- Gustav V Jubilee foundation
- National Program of Cancer Registries
- Canadian Cancer Society
- Cancer Council South Australia
- Canadian Institutes of Health Research
- Cancer Council NSW
- Guy's & St. Thomas' NHS Foundation Trust
- Netherlands Organisation of Scientific Research
- Cancer Institute NSW
- National Institutes of Health (USA)
- National Research Foundation of Korea
- Syöpäsäätiö
- Cancer Foundation of Western Australia
- Netherlands Cancer Registry (NKR),
- Cancer Fund of North Savo
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Affiliation(s)
- Hagai Levi
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- Department of Human Molecular Genetics and Biochemistry, Tel Aviv University, Tel Aviv, Israel
| | - Shai Carmi
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Saharon Rosset
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Rinat Yerushalmi
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviad Zick
- Department of oncology, Hadassah Medical Center, Jerusalem, Israel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tamar Yablonski-Peretz
- Department of oncology, Hadassah Medical Center, Jerusalem, Israel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annelie Augustinsson
- Oncology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Päivi Auvinen
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland
| | - Laura Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Matthias Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - Clara Bodelon
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, Hamburg, Germany
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Helen Byers
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Nicola Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt lake city, UT, USA
| | - Jose Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Wendy Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Christine Clarke
- Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Margriet J Collee
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, Netherlands
| | - Sarah Colonna
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt lake city, UT, USA
| | - Fergus Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Angela Cox
- Department of Oncology and Metabolism, Sheffield Institute for Nucleic Acids (SInFoNiA), University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
- Department of Human Genetics, Leiden University Medical, Leiden, Netherlands
| | - Thilo Dork
- Gynaecology Research Unit, Hannover Medical School, Hamburg, Germany
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Diana M Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gareth Evans
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Peter Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Lin Fritschi
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Jeanine Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, New York, USA
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Mark Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, QU, Canada
| | - Pascal Guénel
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Hillemanns
- Gynaecology Research Unit, Hannover Medical School, Hamburg, Germany
| | | | - Reiner Hoppe
- Dr Margarete Fischer Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tubingen, Germany
| | - John Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simona Jakovchevska
- Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje, North Macedonia
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Helena Jernström
- Oncology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Esther John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Michael Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Joseph Vijai
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Cari Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Vessela Kristensen
- Institute of Clinical Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Allison W Kurian
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - James Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Flavio Lejbkowicz
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Annika Lindblom
- Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | | | - Adriana Lori
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College, London, UK
| | - AnnaMarie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Rachel Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Ines Nevelsteen
- Leuven Multidisciplinary Breast Center, Department of Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - William G Newman
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katie O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Ken Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Janet Olson
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Salvatore Panico
- Dipertimento Di Medicina Clinca e Chirurgia, Federico II University, Naples, Italy
| | | | - Alpa Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM ETS - the AIRC Institute of Molecular Oncology, Milan, Italy
| | - Brigitte Rack
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Valerie Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Atocha Romero
- Laboratorio de Oncología Molecular, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Dale Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Priyanka Sharma
- Department of Internal Medicine, Division of Medical Oncology, University of Kansas Medical Center, Westwood, KS, USA
| | - Jacques Simard
- Genomics Center, Molecular Medicine, Université Laval, Quebec, Quebec, Canada
| | - Melissa Southey
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - William J Tapper
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jack Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Lauren Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA
| | - Melissa Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thérèse Truong
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | | | - Clarice Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Camilla Wendt
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Xiaohong Rose Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Shay Ben-Sachar
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Clalit Research Institute, Clalit Health Services, Ramat Gan, Israel
| | - Naama Elefant
- Clalit Research Institute, Clalit Health Services, Ramat Gan, Israel
- Department of Genetics, Hadassah Medical Center, Jerusalem, Israel
| | - Ron Shamir
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Ran Elkon
- Department of Human Molecular Genetics and Biochemistry, Tel Aviv University, Tel Aviv, Israel
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3
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Wichert K, Hoppe R, Ickstadt K, Behrens T, Winter S, Herold R, Terschüren C, Lo WY, Guénel P, Truong T, Bolla MK, Wang Q, Dennis J, Michailidou K, Lush M, Andrulis IL, Brenner H, Chang-Claude J, Cox A, Cross SS, Czene K, Eriksson M, Figueroa JD, García-Closas M, Goldberg MS, Hamann U, He W, Holleczek B, Hopper JL, Jakubowska A, Ko YD, Lubiński J, Mulligan AM, Obi N, Rhenius V, Shah M, Shu XO, Simard J, Southey MC, Zheng W, Dunning AM, Pharoah PDP, Hall P, Easton DF, Brüning T, Brauch H, Harth V, Rabstein S. Polymorphisms in genes of melatonin biosynthesis and signaling support the light-at-night hypothesis for breast cancer. Eur J Epidemiol 2023; 38:1053-1068. [PMID: 37789226 PMCID: PMC10570222 DOI: 10.1007/s10654-023-01048-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023]
Abstract
Light-at-night triggers the decline of pineal gland melatonin biosynthesis and secretion and is an IARC-classified probable breast-cancer risk factor. We applied a large-scale molecular epidemiology approach to shed light on the putative role of melatonin in breast cancer. We investigated associations between breast-cancer risk and polymorphisms at genes of melatonin biosynthesis/signaling using a study population of 44,405 women from the Breast Cancer Association Consortium (22,992 cases, 21,413 population-based controls). Genotype data of 97 candidate single nucleotide polymorphisms (SNPs) at 18 defined gene regions were investigated for breast-cancer risk effects. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (CI) by logistic regression for the main-effect analysis as well as stratified analyses by estrogen- and progesterone-receptor (ER, PR) status. SNP-SNP interactions were analyzed via a two-step procedure based on logic regression. The Bayesian false-discovery probability (BFDP) was used for all analyses to account for multiple testing. Noteworthy associations (BFDP < 0.8) included 10 linked SNPs in tryptophan hydroxylase 2 (TPH2) (e.g. rs1386492: OR = 1.07, 95% CI 1.02-1.12), and a SNP in the mitogen-activated protein kinase 8 (MAPK8) (rs10857561: OR = 1.11, 95% CI 1.04-1.18). The SNP-SNP interaction analysis revealed noteworthy interaction terms with TPH2- and MAPK-related SNPs (e.g. rs1386483R ∧ rs1473473D ∧ rs3729931D: OR = 1.20, 95% CI 1.09-1.32). In line with the light-at-night hypothesis that links shift work with elevated breast-cancer risks our results point to SNPs in TPH2 and MAPK-genes that may impact the intricate network of circadian regulation.
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Grants
- C12292/A11174 Cancer Research UK
- C5047/A15007 Cancer Research UK
- UM1 CA164920 NCI NIH HHS
- R01CA100374 NIH HHS
- C1281/A12014 Cancer Research UK
- C5047/A10692 Cancer Research UK
- R01 CA100374 NCI NIH HHS
- C490/A16561 Cancer Research UK
- C8197/A16565 Cancer Research UK
- C490/A10124 Cancer Research UK
- R01 CA128978 NCI NIH HHS
- C1287/A10118 Cancer Research UK
- P30 CA068485 NCI NIH HHS
- U01 CA164920 NCI NIH HHS
- CA128978 NIH HHS
- U19 CA148112 NCI NIH HHS
- C1287/A10710 Cancer Research UK
- C5047/A8384 Cancer Research UK
- European Union's Horizon 2020 Research and Innovation Programme
- Genome Canada
- Canadian Institutes of Health Research
- Ministère de l’Économie et de l'Innovation du Québec
- Government of Canada
- Génome Québec
- Fondation du cancer du sein du Québec
- Confluence project by National Cancer Institute Intramural Research Program, National Institutes of Health
- European Community's Seventh Framework Programme
- Cancer Research UK
- National Institutes of Health
- Post-Cancer GWAS initiative
- Department of Defence
- Canadian Institutes of Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer
- Susan G. Komen for the Cure
- Breast Cancer Research Foundation
- Ovarian Cancer Research Fund
- National Cancer Institute (USA)
- National Health and Medical Research Council of Australia
- Cancer Council NSW
- Victorian Health Promotion Foundation (Australia)
- Victorian Breast Cancer Research Consortium
- National Health and Medical Research Council
- Fondation de France
- Institut National du Cancer (INCa)
- Ligue Nationale contre le Cancer
- Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail
- Agence Nationale de la Recherche
- Ministerium für Wissenschaft, Forschung und Kunst Baden-Württemberg
- Deutsche Krebshilfe
- Bundesministerium für Bildung und Forschung
- Robert Bosch Stiftung
- Deutsches Krebsforschungszentrum
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA)
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, Bonn, Germany
- Märit and Hans Rausings Initiative Against Breast Cancer
- Hamburger Krebsgesellschaft
- Canadian Institutes of Health Research for the “CIHR Team in Familial Risks of Breast Cancer” program
- Ministry of Economic Development, Innovation and Export Trade
- NIH
- Survey and Biospecimen Shared Resource
- USA National Cancer Institute of the National Institutes of Health
- Intramural Research Funds of the National Cancer Institute, Department of Health and Human Services, USA
- Agency for Science, Technology and Research of Singapore
- US National Institute of Health
- Susan G. Komen
- Sheffield Experimental Cancer Medicine Centre
- Breast Cancer Now Tissue Bank
- UK National Institute for Health Research Biomedical Research Centre at the University of Cambridge
- NHS in the East of England through the Clinical Academic Reserve
- Minister of Science and Higher Education, Regional Initiative of Excellence, project number 002/RID/2018/19
- Ruhr-Universität Bochum (1007)
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Affiliation(s)
- Katharina Wichert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Katja Ickstadt
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Stefan Winter
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Robert Herold
- Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Wing-Yee Lo
- Department of Clinical Pathology, University of Melbourne Centre for Cancer Research Victorian Comprehensive Cancer Centre Melbourne, Melbourne, VIC, Australia
| | - Pascal Guénel
- Team "Exposome and Heredity", CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Thérèse Truong
- Team "Exposome and Heredity", CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonine D Figueroa
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montréal, QC, Canada
- Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montréal, QC, Canada
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Yon-Dschun Ko
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, Bonn, Germany
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Valerie Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
- iFIT-Cluster of Excellence, University of Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine Hamburg (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sylvia Rabstein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
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4
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Middha P, Wang X, Behrens S, Bolla MK, Wang Q, Dennis J, Michailidou K, Ahearn TU, Andrulis IL, Anton-Culver H, Arndt V, Aronson KJ, Auer PL, Augustinsson A, Baert T, Freeman LEB, Becher H, Beckmann MW, Benitez J, Bojesen SE, Brauch H, Brenner H, Brooks-Wilson A, Campa D, Canzian F, Carracedo A, Castelao JE, Chanock SJ, Chenevix-Trench G, Cordina-Duverger E, Couch FJ, Cox A, Cross SS, Czene K, Dossus L, Dugué PA, Eliassen AH, Eriksson M, Evans DG, Fasching PA, Figueroa JD, Fletcher O, Flyger H, Gabrielson M, Gago-Dominguez M, Giles GG, González-Neira A, Grassmann F, Grundy A, Guénel P, Haiman CA, Håkansson N, Hall P, Hamann U, Hankinson SE, Harkness EF, Holleczek B, Hoppe R, Hopper JL, Houlston RS, Howell A, Hunter DJ, Ingvar C, Isaksson K, Jernström H, John EM, Jones ME, Kaaks R, Keeman R, Kitahara CM, Ko YD, Koutros S, Kurian AW, Lacey JV, Lambrechts D, Larson NL, Larsson S, Le Marchand L, Lejbkowicz F, Li S, Linet M, Lissowska J, Martinez ME, Maurer T, Mulligan AM, Mulot C, Murphy RA, Newman WG, Nielsen SF, Nordestgaard BG, Norman A, O'Brien KM, Olson JE, Patel AV, Prentice R, Rees-Punia E, Rennert G, Rhenius V, Ruddy KJ, Sandler DP, Scott CG, Shah M, Shu XO, Smeets A, Southey MC, Stone J, Tamimi RM, Taylor JA, Teras LR, Tomczyk K, Troester MA, Truong T, Vachon CM, Wang SS, Weinberg CR, Wildiers H, Willett W, Winham SJ, Wolk A, Yang XR, Zamora MP, Zheng W, Ziogas A, Dunning AM, Pharoah PDP, García-Closas M, Schmidt MK, Kraft P, Milne RL, Lindström S, Easton DF, Chang-Claude J. A genome-wide gene-environment interaction study of breast cancer risk for women of European ancestry. Breast Cancer Res 2023; 25:93. [PMID: 37559094 PMCID: PMC10411002 DOI: 10.1186/s13058-023-01691-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Genome-wide studies of gene-environment interactions (G×E) may identify variants associated with disease risk in conjunction with lifestyle/environmental exposures. We conducted a genome-wide G×E analysis of ~ 7.6 million common variants and seven lifestyle/environmental risk factors for breast cancer risk overall and for estrogen receptor positive (ER +) breast cancer. METHODS Analyses were conducted using 72,285 breast cancer cases and 80,354 controls of European ancestry from the Breast Cancer Association Consortium. Gene-environment interactions were evaluated using standard unconditional logistic regression models and likelihood ratio tests for breast cancer risk overall and for ER + breast cancer. Bayesian False Discovery Probability was employed to assess the noteworthiness of each SNP-risk factor pairs. RESULTS Assuming a 1 × 10-5 prior probability of a true association for each SNP-risk factor pairs and a Bayesian False Discovery Probability < 15%, we identified two independent SNP-risk factor pairs: rs80018847(9p13)-LINGO2 and adult height in association with overall breast cancer risk (ORint = 0.94, 95% CI 0.92-0.96), and rs4770552(13q12)-SPATA13 and age at menarche for ER + breast cancer risk (ORint = 0.91, 95% CI 0.88-0.94). CONCLUSIONS Overall, the contribution of G×E interactions to the heritability of breast cancer is very small. At the population level, multiplicative G×E interactions do not make an important contribution to risk prediction in breast cancer.
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Affiliation(s)
- Pooja Middha
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Xiaoliang Wang
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristan J Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Paul L Auer
- Division of Biostatistics, Institute for Health and Equity, and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Thaïs Baert
- Department of Oncology, Leuven Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Javier Benitez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- iFIT-Cluster of Excellence, University of Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, Tübingen, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Biology, University of Pisa, Pisa, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angel Carracedo
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, Centro de Investigación en Red de Enfermedades Raras (CIBERER) y Centro Nacional de Genotipado (CEGEN-PRB2), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Emilie Cordina-Duverger
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Angela Cox
- Department of Oncology and Metabolism, Sheffield Institute for Nucleic Acids (SInFoNiA), University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Pierre-Antoine Dugué
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, School of Biological Sciences, University of Manchester, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Graham G Giles
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anna González-Neira
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Felix Grassmann
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute for Clinical Research and Systems Medicine, Health and Medical University, Potsdam, Germany
| | - Anne Grundy
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Pascal Guénel
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Susan E Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Amherst, MA, USA
| | - Elaine F Harkness
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Nightingale and Genesis Prevention Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Unit, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Christian Ingvar
- Surgery, Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Karolin Isaksson
- Department of Surgery, Kristianstad Hospital, Kristianstad, Sweden
| | - Helena Jernström
- Oncology, Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Yon-Dschun Ko
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, Bonn, Germany
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Allison W Kurian
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Nicole L Larson
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Susanna Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Flavio Lejbkowicz
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Shuai Li
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Martha Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Oncology Institute, Warsaw, Poland
| | - Maria Elena Martinez
- Moores Cancer Center and Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Tabea Maurer
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Claire Mulot
- INSERM UMR-S1138. CRB EPIGENETEC, Université Paris Cité, Paris, France
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - William G Newman
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, School of Biological Sciences, University of Manchester, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sune F Nielsen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Børge G Nordestgaard
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Aaron Norman
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Janet E Olson
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Ross Prentice
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Valerie Rhenius
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Christopher G Scott
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Mitul Shah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ann Smeets
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Katarzyna Tomczyk
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thérèse Truong
- Team 'Exposome and Heredity', CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Sophia S Wang
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Hans Wildiers
- Department of Oncology, Leuven Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Walter Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stacey J Winham
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - M Pilar Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Roger L Milne
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Sara Lindström
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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5
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Morra A, Schreurs MAC, Andrulis IL, Anton‐Culver H, Augustinsson A, Beckmann MW, Behrens S, Bojesen SE, Bolla MK, Brauch H, Broeks A, Buys SS, Camp NJ, Castelao JE, Cessna MH, Chang‐Claude J, Chung WK, Colonna SV, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Dennis J, Devilee P, Dörk T, Dunning AM, Dwek M, Easton DF, Eccles DM, Eriksson M, Evans DG, Fasching PA, Fehm TN, Figueroa JD, Flyger H, Gabrielson M, Gago‐Dominguez M, García‐Closas M, García‐Sáenz JA, Genkinger J, Grassmann F, Gündert M, Hahnen E, Haiman CA, Hamann U, Harrington PA, Hartikainen JM, Hoppe R, Hopper JL, Houlston RS, Howell A, Jakubowska A, Janni W, Jernström H, John EM, Johnson N, Jones ME, Kristensen VN, Kurian AW, Lambrechts D, Le Marchand L, Lindblom A, Lubiński J, Lux MP, Mannermaa A, Mavroudis D, Mulligan AM, Muranen TA, Nevanlinna H, Nevelsteen I, Neven P, Newman WG, Obi N, Offit K, Olshan AF, Park‐Simon T, Patel AV, Peterlongo P, Phillips K, Plaseska‐Karanfilska D, Polley EC, Presneau N, Pylkäs K, Rack B, Radice P, Rashid MU, Rhenius V, Robson M, Romero A, Saloustros E, Sawyer EJ, Schmutzler RK, Schuetze S, Scott C, Shah M, Smichkoska S, Southey MC, Tapper WJ, Teras LR, Tollenaar RAEM, Tomczyk K, Tomlinson I, Troester MA, Vachon CM, van Veen EM, Wang Q, Wendt C, Wildiers H, Winqvist R, Ziogas A, Hall P, Pharoah PDP, Adank MA, Hollestelle A, Schmidt MK, Hooning MJ. Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival. Cancer Med 2023; 12:16142-16162. [PMID: 37401034 PMCID: PMC10469654 DOI: 10.1002/cam4.6272] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/30/2023] [Accepted: 06/03/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers. AIM To assessed the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS. METHODS Analyses were based on 82,701 women diagnosed with a first primary invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations with treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death. RESULTS There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status. The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR (95% CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR (95% CI): 1.30 (1.09-1.56)]. CONCLUSION Systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk.
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Affiliation(s)
- Anna Morra
- Division of Molecular PathologyThe Netherlands Cancer InstituteAmsterdamthe Netherlands
| | | | - Irene L. Andrulis
- Fred A. Litwin Center for Cancer GeneticsLunenfeld‐Tanenbaum Research Institute of Mount Sinai HospitalTorontoOntarioCanada
- Department of Molecular GeneticsUniversity of TorontoTorontoOntarioCanada
| | - Hoda Anton‐Culver
- Department of Medicine, Genetic Epidemiology Research InstituteUniversity of California IrvineIrvineCaliforniaUSA
| | | | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Sabine Behrens
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Stig E. Bojesen
- Copenhagen General Population Study, Herlev and Gentofte HospitalCopenhagen University HospitalHerlevDenmark
- Department of Clinical Biochemistry, Herlev and Gentofte HospitalCopenhagen University HospitalHerlevDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Manjeet K. Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Hiltrud Brauch
- Dr. Margarete Fischer‐Bosch‐Institute of Clinical PharmacologyStuttgartGermany
- iFIT‐Cluster of ExcellenceUniversity of TübingenTübingenGermany
- German Cancer Consortium (DKTK), Partner Site TübingenGerman Cancer Research Center (DKFZ)TübingenGermany
| | - Annegien Broeks
- Division of Molecular PathologyThe Netherlands Cancer InstituteAmsterdamthe Netherlands
| | - Saundra S. Buys
- Department of Internal Medicine and Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Nicola J. Camp
- Department of Internal Medicine and Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Jose E. Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS)Xerencia de Xestion Integrada de Vigo‐SERGASVigoSpain
| | | | - Jenny Chang‐Claude
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH)University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Wendy K. Chung
- Departments of Pediatrics and MedicineColumbia UniversityNew YorkNew YorkUSA
| | - Sarah V. Colonna
- Department of Internal Medicine and Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Fergus J. Couch
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Angela Cox
- Department of Oncology and Metabolism, Sheffield Institute for Nucleic Acids (SInFoNiA)University of SheffieldSheffieldUK
| | - Simon S. Cross
- Department of Neuroscience, Academic Unit of PathologyUniversity of SheffieldSheffieldUK
| | - Kamila Czene
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Mary B. Daly
- Department of Clinical GeneticsFox Chase Cancer CenterPhiladelphiaPennsylvaniaUSA
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Peter Devilee
- Department of PathologyLeiden University Medical CenterLeidenthe Netherlands
- Department of Human GeneticsLeiden University Medical CenterLeidenthe Netherlands
| | - Thilo Dörk
- Gynaecology Research UnitHannover Medical SchoolHannoverGermany
| | - Alison M. Dunning
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Miriam Dwek
- School of Life SciencesUniversity of WestminsterLondonUK
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | | | - Mikael Eriksson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - D. Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Academic Health Science CentreManchesterUK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Tanja N. Fehm
- Department of Gynecology and Obstetrics, University Hospital DüsseldorfHeinrich‐Heine University DüsseldorfDüsseldorfGermany
| | - Jonine D. Figueroa
- Usher Institute of Population Health Sciences and InformaticsThe University of EdinburghEdinburghUK
- Cancer Research UK Edinburgh CentreThe University of EdinburghEdinburghUK
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte HospitalCopenhagen University HospitalHerlevDenmark
| | - Marike Gabrielson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Manuela Gago‐Dominguez
- Cancer Genetics and Epidemiology Group, SERGAS, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS) FoundationComplejo Hospitalario Universitario de SantiagoSantiago de CompostelaSpain
| | - Montserrat García‐Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - José A. García‐Sáenz
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC)Centro Investigación Biomédica en Red de Cáncer (CIBERONC)MadridSpain
| | - Jeanine Genkinger
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
- Herbert Irving Comprehensive Cancer CenterNew YorkNew YorkUSA
| | - Felix Grassmann
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Health and Medical UniversityPotsdamGermany
| | - Melanie Gündert
- Molecular Epidemiology Group, C080German Cancer Research Center (DKFZ)HeidelbergGermany
- Molecular Biology of Breast Cancer, University Womens Clinic HeidelbergUniversity of HeidelbergHeidelbergGermany
- Institute of Diabetes Research, Helmholtz Zentrum MünchenGerman Research Center for Environmental HealthNeuherbergGermany
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ute Hamann
- Molecular Genetics of Breast CancerGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Patricia A. Harrington
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Jaana M. Hartikainen
- Translational Cancer Research AreaUniversity of Eastern FinlandKuopioFinland
- Institute of Clinical Medicine, Pathology and Forensic MedicineUniversity of Eastern FinlandKuopioFinland
| | - Reiner Hoppe
- Dr. Margarete Fischer‐Bosch‐Institute of Clinical PharmacologyStuttgartGermany
- University of TübingenTübingenGermany
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Richard S. Houlston
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Anthony Howell
- Division of Cancer SciencesUniversity of ManchesterManchesterUK
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
- Independent Laboratory of Molecular Biology and Genetic DiagnosticsPomeranian Medical UniversitySzczecinPoland
| | - Wolfgang Janni
- Department of Gynaecology and ObstetricsUniversity Hospital UlmUlmGermany
| | | | - Esther M. John
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCaliforniaUSA
- Division of Oncology, Department of Medicine, Stanford Cancer InstituteStanford University School of MedicineStanfordCaliforniaUSA
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research CentreThe Institute of Cancer ResearchLondonUK
| | - Michael E. Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Vessela N. Kristensen
- Faculty of Medicine, Institute of Clinical MedicineUniversity of OsloOsloNorway
- Department of Medical GeneticsOslo University Hospital and University of OsloOsloNorway
| | - Allison W. Kurian
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCaliforniaUSA
- Division of Oncology, Department of Medicine, Stanford Cancer InstituteStanford University School of MedicineStanfordCaliforniaUSA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human GeneticsKU LeuvenLeuvenBelgium
- VIB Center for Cancer BiologyVIBLeuvenBelgium
| | - Loic Le Marchand
- Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHawaiiUSA
| | - Annika Lindblom
- Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
- Department of Clinical GeneticsKarolinska University HospitalStockholmSweden
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Michael P. Lux
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Arto Mannermaa
- Translational Cancer Research AreaUniversity of Eastern FinlandKuopioFinland
- Institute of Clinical Medicine, Pathology and Forensic MedicineUniversity of Eastern FinlandKuopioFinland
- Biobank of Eastern FinlandKuopio University HospitalKuopioFinland
| | - Dimitrios Mavroudis
- Department of Medical OncologyUniversity Hospital of HeraklionHeraklionGreece
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoOntarioCanada
- Laboratory Medicine ProgramUniversity Health NetworkTorontoOntarioCanada
| | - Taru A. Muranen
- Department of Obstetrics and Gynecology, Helsinki University HospitalUniversity of HelsinkiHelsinkiFinland
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University HospitalUniversity of HelsinkiHelsinkiFinland
| | - Ines Nevelsteen
- Department of Oncology, Leuven Multidisciplinary Breast Center, University Hospitals LeuvenLeuven Cancer InstituteLeuvenBelgium
| | - Patrick Neven
- Department of Oncology, Leuven Multidisciplinary Breast Center, University Hospitals LeuvenLeuven Cancer InstituteLeuvenBelgium
| | - William G. Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Academic Health Science CentreManchesterUK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - Nadia Obi
- Institute for Medical Biometry and EpidemiologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Kenneth Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and GeneticsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Clinical Genetics Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | - Alpa V. Patel
- Department of Population ScienceAmerican Cancer SocietyAtlantaGeorgiaUSA
| | - Paolo Peterlongo
- IFOM ETS ‐ The AIRC Institute of Molecular Oncology, Genome Diagnostics ProgramMilanItaly
| | - Kelly‐Anne Phillips
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of Medical OncologyPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Dijana Plaseska‐Karanfilska
- Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov'MASASkopjeRepublic of North Macedonia
| | - Eric C. Polley
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter OuluUniversity of OuluOuluFinland
- Laboratory of Cancer Genetics and Tumor BiologyNorthern Finland Laboratory Centre OuluOuluFinland
| | - Brigitte Rack
- Department of Gynaecology and ObstetricsUniversity Hospital UlmUlmGermany
| | - Paolo Radice
- Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori“Predictive Medicine: Molecular Bases of Genetic Risk”MilanItaly
| | - Muhammad U. Rashid
- Molecular Genetics of Breast CancerGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Department of Basic SciencesShaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC)LahorePakistan
| | - Valerie Rhenius
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Mark Robson
- Clinical Genetics Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Atocha Romero
- Medical Oncology DepartmentHospital Universitario Puerta de HierroMadridSpain
| | | | - Elinor J. Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's CampusKing's College LondonLondonUK
| | - Rita K. Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
| | - Sabine Schuetze
- Department of Gynaecology and ObstetricsUniversity Hospital UlmUlmGermany
| | - Christopher Scott
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Mitul Shah
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Snezhana Smichkoska
- Medical Faculty, University Clinic of Radiotherapy and OncologySs. Cyril and Methodius University in SkopjeSkopjeRepublic of North Macedonia
| | - Melissa C. Southey
- Precision Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
- Department of Clinical PathologyThe University of MelbourneMelbourneVictoriaAustralia
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
| | | | - Lauren R. Teras
- Department of Population ScienceAmerican Cancer SocietyAtlantaGeorgiaUSA
| | | | - Katarzyna Tomczyk
- The Breast Cancer Now Toby Robins Research CentreThe Institute of Cancer ResearchLondonUK
| | - Ian Tomlinson
- Cancer Research CentreThe University of EdinburghEdinburghUK
| | - Melissa A. Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Celine M. Vachon
- Division of Epidemiology, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Elke M. van Veen
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Academic Health Science CentreManchesterUK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Camilla Wendt
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
- Department of OncologySödersjukhusetStockholmSweden
| | - Hans Wildiers
- Department of Oncology, Leuven Multidisciplinary Breast Center, University Hospitals LeuvenLeuven Cancer InstituteLeuvenBelgium
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter OuluUniversity of OuluOuluFinland
- Laboratory of Cancer Genetics and Tumor BiologyNorthern Finland Laboratory Centre OuluOuluFinland
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research InstituteUniversity of California IrvineIrvineCaliforniaUSA
| | - Per Hall
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of OncologySödersjukhusetStockholmSweden
| | - Paul D. P. Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Muriel A. Adank
- Family Cancer ClinicThe Netherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdamthe Netherlands
| | | | - Marjanka K. Schmidt
- Division of Molecular PathologyThe Netherlands Cancer InstituteAmsterdamthe Netherlands
- Division of Psychosocial Research and EpidemiologyThe Netherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdamthe Netherlands
| | - Maartje J. Hooning
- Department of Medical OncologyErasmus MC Cancer InstituteRotterdamthe Netherlands
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6
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Figlioli G, Billaud A, Wang Q, Bolla MK, Dennis J, Lush M, Kvist A, Adank MA, Ahearn TU, Antonenkova NN, Auvinen P, Behrens S, Bermisheva M, Bogdanova NV, Bojesen SE, Bonanni B, Brüning T, Camp NJ, Campbell A, Castelao JE, Cessna MH, Czene K, Devilee P, Dörk T, Eriksson M, Fasching PA, Flyger H, Gabrielson M, Gago-Dominguez M, García-Closas M, Glendon G, Gómez Garcia EB, González-Neira A, Grassmann F, Guénel P, Hahnen E, Hamann U, Hillemanns P, Hooning MJ, Hoppe R, Howell A, Humphreys K, Jakubowska A, Khusnutdinova EK, Kristensen VN, Lindblom A, Loizidou MA, Lubiński J, Mannermaa A, Maurer T, Mavroudis D, Newman WG, Obi N, Panayiotidis MI, Radice P, Rashid MU, Rhenius V, Ruebner M, Saloustros E, Sawyer EJ, Schmidt MK, Schmutzler RK, Shah M, Southey MC, Tomlinson I, Truong T, van Veen EM, Wendt C, Yang XR, Michailidou K, Dunning AM, Pharoah PDP, Easton DF, Andrulis IL, Evans DG, Hollestelle A, Chang-Claude J, Milne RL, Peterlongo P. Spectrum and Frequency of Germline FANCM Protein-Truncating Variants in 44,803 European Female Breast Cancer Cases. Cancers (Basel) 2023; 15:3313. [PMID: 37444426 DOI: 10.3390/cancers15133313] [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: 04/17/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 07/15/2023] Open
Abstract
FANCM germline protein truncating variants (PTVs) are moderate-risk factors for ER-negative breast cancer. We previously described the spectrum of FANCM PTVs in 114 European breast cancer cases. In the present, larger cohort, we report the spectrum and frequency of four common and 62 rare FANCM PTVs found in 274 carriers detected among 44,803 breast cancer cases. We confirmed that p.Gln1701* was the most common PTV in Northern Europe with lower frequencies in Southern Europe. In contrast, p.Gly1906Alafs*12 was the most common PTV in Southern Europe with decreasing frequencies in Central and Northern Europe. We verified that p.Arg658* was prevalent in Central Europe and had highest frequencies in Eastern Europe. We also confirmed that the fourth most common PTV, p.Gln498Thrfs*7, might be a founder variant from Lithuania. Based on the frequency distribution of the carriers of rare PTVs, we showed that the FANCM PTVs spectra in Southwestern and Central Europe were much more heterogeneous than those from Northeastern Europe. These findings will inform the development of more efficient FANCM genetic testing strategies for breast cancer cases from specific European populations.
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Affiliation(s)
- Gisella Figlioli
- Genome Diagnostics Program, IFOM ETS-The AIRC Institute of Molecular Oncology, 20139 Milan, Italy
| | - Amandine Billaud
- Genome Diagnostics Program, IFOM ETS-The AIRC Institute of Molecular Oncology, 20139 Milan, Italy
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Anders Kvist
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, 22185 Lund, Sweden
| | - Muriel A Adank
- The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Family Cancer Clinic, 1066 CX Amsterdam, The Netherlands
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Natalia N Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040 Minsk, Belarus
| | - Päivi Auvinen
- Translational Cancer Research Area, University of Eastern Finland, 70210 Kuopio, Finland
- Institute of Clinical Medicine, Oncology, University of Eastern Finland, 70210 Kuopio, Finland
- Department of Oncology, Cancer Center, Kuopio University Hospital, 70210 Kuopio, Finland
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, 450054 Ufa, Russia
| | - Natalia V Bogdanova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040 Minsk, Belarus
- Department of Radiation Oncology, Hannover Medical School, 30625 Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, 30625 Hannover, Germany
| | - Stig E Bojesen
- Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), 44789 Bochum, Germany
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH16 4UX, UK
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, 36312 Vigo, Spain
| | | | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, 30625 Hannover, Germany
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Henrik Flyger
- Department of Breast Surgery, Copenhagen University Hospital, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS) Foundation, IDIS Cancer Genetics and Epidemiology Group, Genomic Medicine Group, Complejo Hospitalario Universitario de Santiago, SERGAS, 15706 Santiago de Compostela, Spain
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, ON M5G 1X5, Canada
- Laboratory Medicine Program, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Encarna B Gómez Garcia
- Department of Clinical Genetics, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Anna González-Neira
- Human Genotyping Unit-CeGen, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain
| | - Felix Grassmann
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 76 Stockholm, Sweden
- Department of Medicine, Institute for Clinical Research and Systems Medicine, Health and Medical University, 14467 Potsdam, Germany
| | - Pascal Guénel
- CESP U1018, Inserm "Exposome, Heredity, Cancer and Health" Team, UVSQ, University Paris-Saclay, Gustave Roussy, 94805 Villejuif, France
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Ute Hamann
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, 69120 Heidelberg, Germany
| | - Peter Hillemanns
- Gynaecology Research Unit, Hannover Medical School, 30625 Hannover, Germany
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
| | - Elza K Khusnutdinova
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, 450054 Ufa, Russia
- Department of Genetics and Fundamental Medicine, Ufa University of Science and Technology, 450076 Ufa, Russia
| | - Vessela N Kristensen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, 0379 Oslo, Norway
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Maria A Loizidou
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology & Genetics, 2371 Nicosia, Cyprus
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, 70210 Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, 70210 Kuopio, Finland
- Kuopio University Hospital, Biobank of Eastern Finland, 70210 Kuopio, Finland
| | - Tabea Maurer
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, 711 10 Heraklion, Greece
| | - William G Newman
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, UK
| | - Nadia Obi
- University Medical Center Hamburg-Eppendorf, Institute for Medical Biometry and Epidemiology, 20246 Hamburg, Germany
| | - Mihalis I Panayiotidis
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology & Genetics, 2371 Nicosia, Cyprus
| | - Paolo Radice
- Unit of 'Predictive Medicine: Molecular Bases of Genetic Risk', Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), 20133 Milan, Italy
| | - Muhammad U Rashid
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, 69120 Heidelberg, Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore 54000, Pakistan
| | - Valerie Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | | | - Elinor J Sawyer
- King's College London, School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, London SE1 9RT, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC 3000, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia
| | - Ian Tomlinson
- Cancer Research Centre, The University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Thérèse Truong
- CESP U1018, Inserm "Exposome, Heredity, Cancer and Health" Team, UVSQ, University Paris-Saclay, Gustave Roussy, 94805 Villejuif, France
| | - Elke M van Veen
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, UK
| | - Camilla Wendt
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, 2371 Nicosia, Cyprus
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA 90069, USA
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, ON M5G 1X5, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - D Gareth Evans
- Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, UK
| | - Antoinette Hollestelle
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Roger L Milne
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM ETS-The AIRC Institute of Molecular Oncology, 20139 Milan, Italy
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Kentistou KA, Kaisinger LR, Stankovic S, Vaudel M, de Oliveira EM, Messina A, Walters RG, Liu X, Busch AS, Helgason H, Thompson DJ, Santon F, Petricek KM, Zouaghi Y, Huang-Doran I, Gudbjartsson DF, Bratland E, Lin K, Gardner EJ, Zhao Y, Jia R, Terao C, Riggan M, Bolla MK, Yazdanpanah M, Yazdanpanah N, Bradfield JP, Broer L, Campbell A, Chasman DI, Cousminer DL, Franceschini N, Franke LH, Girotto G, He C, Järvelin MR, Joshi PK, Kamatani Y, Karlsson R, Luan J, Lunetta KL, Mägi R, Mangino M, Medland SE, Meisinger C, Noordam R, Nutile T, Concas MP, Polašek O, Porcu E, Ring SM, Sala C, Smith AV, Tanaka T, van der Most PJ, Vitart V, Wang CA, Willemsen G, Zygmunt M, Ahearn TU, Andrulis IL, Anton-Culver H, Antoniou AC, Auer PL, Barnes CLK, Beckmann MW, Berrington A, Bogdanova NV, Bojesen SE, Brenner H, Buring JE, Canzian F, Chang-Claude J, Couch FJ, Cox A, Crisponi L, Czene K, Daly MB, Demerath EW, Dennis J, Devilee P, Vivo ID, Dörk T, Dunning AM, Dwek M, Eriksson JG, Fasching PA, Fernandez-Rhodes L, Ferreli L, Fletcher O, Gago-Dominguez M, García-Closas M, García-Sáenz JA, González-Neira A, Grallert H, Guénel P, Haiman CA, Hall P, Hamann U, Hakonarson H, Hart RJ, Hickey M, Hooning MJ, Hoppe R, Hopper JL, Hottenga JJ, Hu FB, Hübner H, Hunter DJ, Jernström H, John EM, Karasik D, Khusnutdinova EK, Kristensen VN, Lacey JV, Lambrechts D, Launer LJ, Lind PA, Lindblom A, Magnusson PKE, Mannermaa A, McCarthy MI, Meitinger T, Menni C, Michailidou K, Millwood IY, Milne RL, Montgomery GW, Nevanlinna H, Nolte IM, Nyholt DR, Obi N, O’Brien KM, Offit K, Oldehinkel AJ, Ostrowski SR, Palotie A, Pedersen OB, Peters A, Pianigiani G, Plaseska-Karanfilska D, Pouta A, Pozarickij A, Radice P, Rennert G, Rosendaal FR, Ruggiero D, Saloustros E, Sandler DP, Schipf S, Schmidt CO, Schmidt MK, Small K, Spedicati B, Stampfer M, Stone J, Tamimi RM, Teras LR, Tikkanen E, Turman C, Vachon CM, Wang Q, Winqvist R, Wolk A, Zemel BS, Zheng W, van Dijk KW, Alizadeh BZ, Bandinelli S, Boerwinkle E, Boomsma DI, Ciullo M, Chenevix-Trench G, Cucca F, Esko T, Gieger C, Grant SFA, Gudnason V, Hayward C, Kolčić I, Kraft P, Lawlor DA, Martin NG, Nøhr EA, Pedersen NL, Pennell CE, Ridker PM, Robino A, Snieder H, Sovio U, Spector TD, Stöckl D, Sudlow C, Timpson NJ, Toniolo D, Uitterlinden A, Ulivi S, Völzke H, Wareham NJ, Widen E, Wilson JF, Pharoah PDP, Li L, Easton DF, Njølstad P, Sulem P, Murabito JM, Murray A, Manousaki D, Juul A, Erikstrup C, Stefansson K, Horikoshi M, Chen Z, Farooqi IS, Pitteloud N, Johansson S, Day FR, Perry JRB, Ong KK. Understanding the genetic complexity of puberty timing across the allele frequency spectrum. medRxiv 2023:2023.06.14.23291322. [PMID: 37503126 PMCID: PMC10371120 DOI: 10.1101/2023.06.14.23291322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Pubertal timing varies considerably and has been associated with a range of health outcomes in later life. To elucidate the underlying biological mechanisms, we performed multi-ancestry genetic analyses in ~800,000 women, identifying 1,080 independent signals associated with age at menarche. Collectively these loci explained 11% of the trait variance in an independent sample, with women at the top and bottom 1% of polygenic risk exhibiting a ~11 and ~14-fold higher risk of delayed and precocious pubertal development, respectively. These common variant analyses were supported by exome sequence analysis of ~220,000 women, identifying several genes, including rare loss of function variants in ZNF483 which abolished the impact of polygenic risk. Next, we implicated 660 genes in pubertal development using a combination of in silico variant-to-gene mapping approaches and integration with dynamic gene expression data from mouse embryonic GnRH neurons. This included an uncharacterized G-protein coupled receptor GPR83, which we demonstrate amplifies signaling of MC3R, a key sensor of nutritional status. Finally, we identified several genes, including ovary-expressed genes involved in DNA damage response that co-localize with signals associated with menopause timing, leading us to hypothesize that the ovarian reserve might signal centrally to trigger puberty. Collectively these findings extend our understanding of the biological complexity of puberty timing and highlight body size dependent and independent mechanisms that potentially link reproductive timing to later life disease.
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Affiliation(s)
- Katherine A Kentistou
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Lena R Kaisinger
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Stasa Stankovic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Marc Vaudel
- Mohn Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, NO-5020, Bergen, Norway
- Department of Genetics and Bioinformatics, Health Data and Digitalization, Norwegian Institute of Public Health, NO-0213, Oslo, Norway
| | - Edson M de Oliveira
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-MRC Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Andrea Messina
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Robin G Walters
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- MRC Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Xiaoxi Liu
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Alexander S Busch
- Department of General Pediatrics, University of Münster, Münster, Germany
- Deptartment of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Hannes Helgason
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Deborah J Thompson
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Federico Santon
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Konstantin M Petricek
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pharmacology, Berlin, Germany
| | - Yassine Zouaghi
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Isabel Huang-Doran
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-MRC Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Eirik Bratland
- Mohn Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, NO-5020, Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, NO-5021, Bergen, Norway
| | - Kuang Lin
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Eugene J Gardner
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Yajie Zhao
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Raina Jia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Clinical Research Center, Shizuoka General Hospital, Shizuoka, Japan
- The Department of Applied Genetics, The School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Margie Riggan
- Department of Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Mojgan Yazdanpanah
- Research Center of the Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Nahid Yazdanpanah
- Research Center of the Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Jonath P Bradfield
- Quantinuum Research, Wayne, PA, USA
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Linda Broer
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, UK
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA
| | - Diana L Cousminer
- Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Lude H Franke
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Giorgia Girotto
- Institute for Maternal and Child Health – IRCCS ‘‘Burlo Garofolo”, Trieste, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Chunyan He
- Department of Epidemiology and Biostatistics, Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
- Departments of Medical Oncology and Hematology, Sir Runrun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, UK
- Institute of Health Sciences, P.O.Box 5000, FI-90014 University of Oulu, Finland
- Biocenter Oulu, P.O.Box 5000, Aapistie 5A, FI-90014 University of Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Kajaanintie 50, P.O.Box 20, FI-90220 Oulu, 90029 OYS, Finland
- Department of Children and Young People and Families, National Institute for Health and Welfare, Aapistie 1, Box 310, FI-90101 Oulu, Finland
| | - Peter K Joshi
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jian’an Luan
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Kathryn L Lunetta
- Boston University School of Public Health, Department of Biostatistics. Boston, Massachusetts 02118, USA
- NHLBI’s and Boston University’s Framingham Heart Study, Framingham, Massachusetts 01702-5827, USA
| | - Reedik Mägi
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
- NIHR Biomedical Research Centre at Guy’s and St. Thomas’ Foundation Trust, London, UK
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Christa Meisinger
- Epidemiology, Medical Faculty, University of Augsburg, University Hospital of Augsburg, Augsburg, Germany
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Teresa Nutile
- Institute of Genetics and Biophysics “A. Buzzati-Traverso”, CNR, Naples, Italy
| | - Maria Pina Concas
- Institute for Maternal and Child Health – IRCCS ‘‘Burlo Garofolo”, Trieste, Italy
| | - Ozren Polašek
- University of Split School of Medicine, Split, Croatia
- Algebra University College, Zagreb, Croatia
| | - Eleonora Porcu
- Institute of Genetics and Biomedical Research, National Research Council, Cagliari, Sardinia 09042, Italy
- University of Sassari, Department of Biomedical Sciences, Sassari, Sassari 07100, Italy
| | - Susan M Ring
- MRC Integrative Epidemiology Unit at the University of Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, UK
| | - Cinzia Sala
- Division of Genetics and Cell Biology, San Raffele Hospital, Milano, Italy
| | - Albert V Smith
- Icelandic Heart Association, 201 Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Toshiko Tanaka
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Peter J van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Carol A Wang
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales 2305, Australia
| | - Gonneke Willemsen
- Dept of Biological Psychology, Vrije Universiteit, Amsterdam; Amsterdam Public Health (APH) research institute, The Netherlands
| | - Marek Zygmunt
- Clinic of Gynaecology and Obstetrics, University Medicine Greifswald, Germany
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services Bethesda, MD, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital Toronto, Ontario, Canada
- Department of Molecular Genetics University of Toronto Toronto, Ontario, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute University of California Irvine Irvine, CA, USA
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Paul L Auer
- Division of Biostatistics, Institute for Health and Equity, and Cancer Center Medical College of Wisconsin Milwaukee, WI, USA
| | - Catriona LK Barnes
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Amy Berrington
- Division of Genetics and Epidemiology The Institute of Cancer Research, London, UK
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital Copenhagen University Hospital, Herlev, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julie E Buring
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA
| | - Federico Canzian
- Genomic Epidemiology Group German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH) University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester, MN, USA
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Laura Crisponi
- Institute of Genetics and Biomedical Research, National Research Council, Cagliari, Sardinia 09042, Italy
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary B Daly
- Department of Clinical Genetics Fox Chase Cancer Center Philadelphia, PA, USA
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Healthcare, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | | | - Liana Ferreli
- Institute of Genetics and Biomedical Research, National Research Council, Cagliari, Sardinia 09042, Italy
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS Santiago de Compostela, Spain
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, Department of Health and Human Services Bethesda, MD, USA
| | - José A García-Sáenz
- Medical Oncology Department, Hospital Clínico San Carlos Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Anna González-Neira
- Human Genotyping Unit-CeGen, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
| | - Pascal Guénel
- Team “Exposome and Heredity”, CESP, Gustave Roussy INSERM, University Paris-Saclay, UVSQ Villejuif, France
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hakon Hakonarson
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Roger J Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology at the University of Melbourne and The Royal Women’s Hospital, Victoria, Australia
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne Melbourne, Victoria, Australia
| | - Jouke-Jan Hottenga
- Dept of Biological Psychology, Vrije Universiteit, Amsterdam; Amsterdam Public Health (APH) research institute, The Netherlands
| | - Frank B Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health School of Public Health, Boston, Massachusetts 02115, USA
| | - Hanna Hübner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
| | - ABCTB Investigators
- Australian Breast Cancer Tissue Bank, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Helena Jernström
- Oncology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine Stanford, CA, USA
- Department of Medicine, Division of Oncology Stanford Cancer Institute, Stanford University School of Medicine Stanford, CA, USA
| | - David Karasik
- Hebrew SeniorLife Institute for Aging Research, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Elza K Khusnutdinova
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope Duarte, CA, USA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, Maryland, 20892, USA
| | - Penelope A Lind
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik KE Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mark I McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology, & Metabolism, University of Oxford, Churchill Hospital, Oxford OX3 7LJ, UK
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, OX3 7LE Oxford, UK
| | - Thomas Meitinger
- Institute of Human Genetics, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Iona Y Millwood
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- MRC Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Roger L Milne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ilja M Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dale R Nyholt
- School of Biomedical Sciences, Faculty of Health, Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katie M O’Brien
- Epidemiology Branch National Institute of Environmental Health Sciences, NIH Research Triangle Park, NC, USA
| | - Kenneth Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics Memorial Sloan Kettering Cancer Center New York, NY, USA
- Clinical Genetics Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York, NY, USA
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Rigshospitalet - University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of health and medical sciences, University of Copenhagen, Denmark
| | - Aarno Palotie
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
- Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Ole B Pedersen
- Department of Clinical Medicine, Faculty of health and medical sciences, University of Copenhagen, Denmark
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Giulia Pianigiani
- Institute for Maternal and Child Health – IRCCS ‘‘Burlo Garofolo”, Trieste, Italy
| | - Dijana Plaseska-Karanfilska
- Research Centre for Genetic Engineering and Biotechnology “Georgi D. Efremov” MASA Skopje Republic of North Macedonia
| | - Anneli Pouta
- National Institute for Health and Welfare, Finland
| | - Alfred Pozarickij
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research Fondazione IRCCS, Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion, Faculty of Medicine, Haifa, Israel
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Daniela Ruggiero
- Institute of Genetics and Biophysics “A. Buzzati-Traverso”, CNR, Naples, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | - Dale P Sandler
- Epidemiology Branch National Institute of Environmental Health Sciences, NIH Research Triangle Park, NC, USA
| | - Sabine Schipf
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Carsten O Schmidt
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Kerrin Small
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Beatrice Spedicati
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Meir Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne Melbourne, Victoria, Australia
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia Perth, Western Australia, Australia
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Department of Population Health Sciences Weill Cornell Medicine New York, NY, USA
| | - Lauren R Teras
- Department of Population Science American Cancer Society Atlanta, GA, USA
| | - Emmi Tikkanen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Constance Turman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology Mayo Clinic Rochester, MN, USA
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Babette S Zemel
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center Vanderbilt University School of Medicine Nashville, TN, USA
| | - Ko W van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dorret I Boomsma
- Dept of Biological Psychology, Vrije Universiteit, Amsterdam; Amsterdam Public Health (APH) research institute, The Netherlands
- Amsterdam Reproduction & Development research institute, Amsterdam, The Netherlands
| | - Marina Ciullo
- Institute of Genetics and Biophysics “A. Buzzati-Traverso”, CNR, Naples, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | - Francesco Cucca
- Institute of Genetics and Biomedical Research, National Research Council, Cagliari, Sardinia 09042, Italy
- University of Sassari, Department of Biomedical Sciences, Sassari, Sassari 07100, Italy
| | - Tõnu Esko
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Struan FA Grant
- Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, 201 Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Ivana Kolčić
- University of Split School of Medicine, Split, Croatia
- Algebra University College, Zagreb, Croatia
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, UK
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Ellen A Nøhr
- Institute of Clinical Research, University of Southern Denmark, Department of Obstetrics & Gynecology, Odense University Hospital, Denmark
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Craig E Pennell
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales 2305, Australia
- Department of Maternity and Gynaecology, John Hunter Hospital, Newcastle, New South Wales 2305, Australia
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA
| | - Antonietta Robino
- Institute for Maternal and Child Health – IRCCS ‘‘Burlo Garofolo”, Trieste, Italy
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ulla Sovio
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, UK
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Doris Stöckl
- Gesundheitsamt Fürstenfeldbruck, Regierung von Oberbayern, Fürstenfeldbruck, Germany
| | - Cathie Sudlow
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, UK
- Centre for Medical Informatics, Usher Institute, University of Edinburgh
| | - Nic J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, UK
| | - Daniela Toniolo
- Division of Genetics and Cell Biology, San Raffele Hospital, Milano, Italy
| | - André Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Sheila Ulivi
- Institute for Maternal and Child Health – IRCCS ‘‘Burlo Garofolo”, Trieste, Italy
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - James F Wilson
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland
| | | | | | | | | | | | | | - Paul DP Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Pål Njølstad
- Mohn Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, NO-5020, Bergen, Norway
- Department of Pediatrics and Adolescents, Haukeland University Hospital, NO-5021, Bergen, Norway
| | | | - Joanne M Murabito
- NHLBI’s and Boston University’s Framingham Heart Study, Framingham, Massachusetts 01702-5827, USA
- Boston University Chobanian & Avedisian School of Medicine, Department of Medicine, Section of General Internal Medicine, Boston, MA 02118, USA
| | - Anna Murray
- Genetics of Complex Traits, University of Exeter Medical School, University of Exeter, RILD Level 3, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| | - Despoina Manousaki
- Research Center of the Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montreal, Montreal, Canada
- Department of Biochemistry and Molecular Medicine, University of Montreal, Montreal, Canada
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Momoko Horikoshi
- Laboratory for Genomics of Diabetes and Metabolism, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Zhengming Chen
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- MRC Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK
| | - I Sadaf Farooqi
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-MRC Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Nelly Pitteloud
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne 1005, Switzerland
| | - Stefan Johansson
- Mohn Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, NO-5020, Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, NO-5021, Bergen, Norway
| | - Felix R Day
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - John RB Perry
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
- Metabolic Research Laboratory, Wellcome-MRC Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Ken K Ong
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
- Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, UK
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8
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Muranen TA, Morra A, Khan S, Barnes DR, Bolla MK, Dennis J, Keeman R, Leslie G, Parsons MT, Wang Q, Ahearn TU, Aittomäki K, Andrulis IL, Arun BK, Behrens S, Bialkowska K, Bojesen SE, Camp NJ, Chang-Claude J, Czene K, Devilee P, Domchek SM, Dunning AM, Engel C, Evans DG, Gago-Dominguez M, García-Closas M, Gerdes AM, Glendon G, Guénel P, Hahnen E, Hamann U, Hanson H, Hooning MJ, Hoppe R, Izatt L, Jakubowska A, James PA, Kristensen VN, Lalloo F, Lindeman GJ, Mannermaa A, Margolin S, Neuhausen SL, Newman WG, Peterlongo P, Phillips KA, Pujana MA, Rantala J, Rønlund K, Saloustros E, Schmutzler RK, Schneeweiss A, Singer CF, Suvanto M, Tan YY, Teixeira MR, Thomassen M, Tischkowitz M, Tripathi V, Wappenschmidt B, Zhao E, Easton DF, Antoniou AC, Chenevix-Trench G, Pharoah PDP, Schmidt MK, Blomqvist C, Nevanlinna H. PREDICT validity for prognosis of breast cancer patients with pathogenic BRCA1/2 variants. NPJ Breast Cancer 2023; 9:37. [PMID: 37173335 PMCID: PMC10182045 DOI: 10.1038/s41523-023-00546-x] [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: 11/13/2022] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
We assessed the PREDICT v 2.2 for prognosis of breast cancer patients with pathogenic germline BRCA1 and BRCA2 variants, using follow-up data from 5453 BRCA1/2 carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and the Breast Cancer Association Consortium (BCAC). PREDICT for estrogen receptor (ER)-negative breast cancer had modest discrimination for BRCA1 carrier patients overall (Gönen & Heller unbiased concordance 0.65 in CIMBA, 0.64 in BCAC), but it distinguished clearly the high-mortality group from lower risk categories. In an analysis of low to high risk categories by PREDICT score percentiles, the observed mortality was consistently lower than the expected mortality, but the confidence intervals always included the calibration slope. Altogether, our results encourage the use of the PREDICT ER-negative model in management of breast cancer patients with germline BRCA1 variants. For the PREDICT ER-positive model, the discrimination was slightly lower in BRCA2 variant carriers (concordance 0.60 in CIMBA, 0.65 in BCAC). Especially, inclusion of the tumor grade distorted the prognostic estimates. The breast cancer mortality of BRCA2 carriers was underestimated at the low end of the PREDICT score distribution, whereas at the high end, the mortality was overestimated. These data suggest that BRCA2 status should also be taken into consideration with tumor characteristics, when estimating the prognosis of ER-positive breast cancer patients.
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Affiliation(s)
- Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
- Research Program in Systems Oncology, Department of Biochemistry and Developmental Biology, University of Helsinki, Helsinki, Finland.
| | - Anna Morra
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sofia Khan
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Genetics, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Individualized Drug Therapy Research Program, University of Helsinki, Helsinki, Finland
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland
| | - Daniel R Barnes
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Michael T Parsons
- Population Health Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Kristiina Aittomäki
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Banu K Arun
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katarzyna Bialkowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Susan M Domchek
- Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - D Gareth Evans
- Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University Hospital Foundation NHS Trust, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Clinical Genetics Service, Manchester Centre for Genomic Medicine, Manchester University Hospitals Foundation Trust, Manchester, UK
- Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, Manchester, UK
| | - Manuela Gago-Dominguez
- Health Research Institute of Santiago de Compostela Foundation (FIDIS), SERGAS, Cancer Genetics and Epidemiology Group Santiago de Compostela, Santiago de Compostela, Spain
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gord Glendon
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Pascal Guénel
- Team "Exposome and Heredity", CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Helen Hanson
- SouthWest Thames Centre for Genomics, St George's University Hospital's NHS Foundation Trust, London, UK
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Paul A James
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Fiona Lalloo
- Clinical Genetics Service, Manchester Centre for Genomic Medicine, Manchester University Hospitals Foundation Trust, Manchester, UK
| | - Geoffrey J Lindeman
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Cancer Biology and Stem Cells Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Sara Margolin
- Department of Oncology, Stockholm South General Hospital (Södersjukhuset), Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM ETS - The AIRC Institute of Molecular Oncology, Milan, Italy
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Miquel Angel Pujana
- Translational Research Laboratory, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | | | - Karina Rønlund
- Department of Clinical Genetics, University Hospital of Southern Denmark, Vejle Hospital, Vejle, Denmark
| | | | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Christian F Singer
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Maija Suvanto
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Yen Yen Tan
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odence C, Denmark
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Vishakha Tripathi
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Barbara Wappenschmidt
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emily Zhao
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Morra A, Mavaddat N, Muranen TA, Ahearn TU, Allen J, Andrulis IL, Auvinen P, Becher H, Behrens S, Blomqvist C, Bojesen SE, Bolla MK, Brauch H, Camp NJ, Carvalho S, Castelao JE, Cessna MH, Chang-Claude J, Chenevix-Trench G, Czene K, Decker B, Dennis J, Dörk T, Dorling L, Dunning AM, Ekici AB, Eriksson M, Evans DG, Fasching PA, Figueroa JD, Flyger H, Gago-Dominguez M, García-Closas M, Geurts-Giele WRR, Giles GG, Guénel P, Gündert M, Hahnen E, Hall P, Hamann U, Harrington PA, He W, Heikkilä P, Hooning MJ, Hoppe R, Howell A, Humphreys K, Jakubowska A, Jung AY, Keeman R, Kristensen VN, Lubiński J, Mannermaa A, Manoochehri M, Manoukian S, Margolin S, Mavroudis D, Milne RL, Mulligan AM, Newman WG, Park-Simon TW, Peterlongo P, Pharoah PDP, Rhenius V, Saloustros E, Sawyer EJ, Schmutzler RK, Shah M, Spurdle AB, Tomlinson I, Truong T, van Veen EM, Vreeswijk MPG, Wang Q, Wendt C, Yang XR, Nevanlinna H, Devilee P, Easton DF, Schmidt MK. The impact of coding germline variants on contralateral breast cancer risk and survival. Am J Hum Genet 2023; 110:475-486. [PMID: 36827971 PMCID: PMC10027471 DOI: 10.1016/j.ajhg.2023.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/01/2023] [Indexed: 02/25/2023] Open
Abstract
Evidence linking coding germline variants in breast cancer (BC)-susceptibility genes other than BRCA1, BRCA2, and CHEK2 with contralateral breast cancer (CBC) risk and breast cancer-specific survival (BCSS) is scarce. The aim of this study was to assess the association of protein-truncating variants (PTVs) and rare missense variants (MSVs) in nine known (ATM, BARD1, BRCA1, BRCA2, CHEK2, PALB2, RAD51C, RAD51D, and TP53) and 25 suspected BC-susceptibility genes with CBC risk and BCSS. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox regression models. Analyses included 34,401 women of European ancestry diagnosed with BC, including 676 CBCs and 3,449 BC deaths; the median follow-up was 10.9 years. Subtype analyses were based on estrogen receptor (ER) status of the first BC. Combined PTVs and pathogenic/likely pathogenic MSVs in BRCA1, BRCA2, and TP53 and PTVs in CHEK2 and PALB2 were associated with increased CBC risk [HRs (95% CIs): 2.88 (1.70-4.87), 2.31 (1.39-3.85), 8.29 (2.53-27.21), 2.25 (1.55-3.27), and 2.67 (1.33-5.35), respectively]. The strongest evidence of association with BCSS was for PTVs and pathogenic/likely pathogenic MSVs in BRCA2 (ER-positive BC) and TP53 and PTVs in CHEK2 [HRs (95% CIs): 1.53 (1.13-2.07), 2.08 (0.95-4.57), and 1.39 (1.13-1.72), respectively, after adjusting for tumor characteristics and treatment]. HRs were essentially unchanged when censoring for CBC, suggesting that these associations are not completely explained by increased CBC risk, tumor characteristics, or treatment. There was limited evidence of associations of PTVs and/or rare MSVs with CBC risk or BCSS for the 25 suspected BC genes. The CBC findings are relevant to treatment decisions, follow-up, and screening after BC diagnosis.
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Affiliation(s)
- Anna Morra
- The Netherlands Cancer Institute, Division of Molecular Pathology, Plesmanlaan 121, 1066 Amsterdam, the Netherlands.
| | - Nasim Mavaddat
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Taru A Muranen
- University of Helsinki, Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Thomas U Ahearn
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Jamie Allen
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, ON, Canada; University of Toronto, Department of Molecular Genetics, Toronto, ON, Canada
| | - Päivi Auvinen
- University of Eastern Finland, Translational Cancer Research Area, Kuopio, Finland; University of Eastern Finland, Institute of Clinical Medicine, Oncology, Kuopio, Finland; Kuopio University Hospital, Department of Oncology, Cancer Center, Kuopio, Finland
| | - Heiko Becher
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany
| | - Sabine Behrens
- German Cancer Research Center, Division of Cancer Epidemiology, Heidelberg, Germany
| | - Carl Blomqvist
- University of Helsinki, Department of Oncology, Helsinki University Hospital, Helsinki, Finland
| | - Stig E Bojesen
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark; Copenhagen University Hospital, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Manjeet K Bolla
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany; University of Tübingen, iFIT-Cluster of Excellence, Tübingen, Germany; German Cancer Consortium and German Cancer Research Center, Partner Site Tübingen, Tübingen, Germany
| | - Nicola J Camp
- University of Utah, Department of Internal Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Sara Carvalho
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Jose E Castelao
- Instituto de Investigación Sanitaria Galicia Sur, Xerencia de Xestion Integrada de Vigo-SERGAS, Oncology and Genetics Unit, Vigo, Spain
| | | | - Jenny Chang-Claude
- German Cancer Research Center, Division of Cancer Epidemiology, Heidelberg, Germany; University Medical Center Hamburg-Eppendorf, Cancer Epidemiology Group, University Cancer Center Hamburg, Hamburg, Germany
| | - Georgia Chenevix-Trench
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, QLD, Australia
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- Oslo University Hospital-Radiumhospitalet, Department of Cancer Genetics, Institute for Cancer Research, Oslo, Norway; University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo, Norway; Vestre Viken Hospital, Department of Research, Drammen, Norway; Oslo University Hospital, Department of Tumor Biology, Institute for Cancer Research, Oslo, Norway; Oslo University Hospital-Radiumhospitalet, Department of Oncology, Division of Surgery, Cancer and Transplantation Medicine, Oslo, Norway; Akershus University Hospital, Department of Oncology, Lørenskog, Norway; Oslo University Hospital, Oslo Breast Cancer Research Consortium, Oslo, Norway; Oslo University Hospital and University of Oslo, Department of Medical Genetics, Oslo, Norway; The Arctic University of Norway, Department of Community Medicine, Tromsø, Norway; The Arctic University of Norway, Core Facility for Biobanking, Tromsø, Norway
| | - Kamila Czene
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Brennan Decker
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK; Foundation Medicine, Inc, Pathology, Cambridge, MA, USA
| | - Joe Dennis
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Thilo Dörk
- Hannover Medical School, Gynaecology Research Unit, Hannover, Germany
| | - Leila Dorling
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Alison M Dunning
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Arif B Ekici
- Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Institute of Human Genetics, Erlangen, Germany
| | - Mikael Eriksson
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - D Gareth Evans
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK; St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Peter A Fasching
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Jonine D Figueroa
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA; The University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK; The University of Edinburgh, Cancer Research UK Edinburgh Centre, Edinburgh, UK
| | - Henrik Flyger
- Copenhagen University Hospital, Department of Breast Surgery, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Manuela Gago-Dominguez
- Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago, SERGAS, Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Santiago de Compostela, Spain; University of California San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Montserrat García-Closas
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | | | - Graham G Giles
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC, Australia; The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC, Australia; Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, VIC, Australia
| | - Pascal Guénel
- INSERM, University Paris-Saclay, Center for Research in Epidemiology and Population Health, Team Exposome and Heredity, Villejuif, France
| | - Melanie Gündert
- German Cancer Research Center, Molecular Epidemiology Group, C080, Heidelberg, Germany; University of Heidelberg, Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, Heidelberg, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Diabetes Research, Neuherberg, Germany
| | - Eric Hahnen
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Familial Breast and Ovarian Cancer, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Integrated Oncology, Cologne, Germany
| | - Per Hall
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden; Södersjukhuset, Department of Oncology, Stockholm, Sweden
| | - Ute Hamann
- German Cancer Research Center, Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Patricia A Harrington
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Wei He
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Päivi Heikkilä
- University of Helsinki, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - Maartje J Hooning
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany; University of Tübingen, Tübingen, Germany
| | - Anthony Howell
- University of Manchester, Division of Cancer Sciences, Manchester, UK
| | - Keith Humphreys
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
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- Peter MacCallum Cancer Center, Research Department, Melbourne, VIC, Australia; The University of Melbourne, Sir Peter MacCallum Department of Oncology, Melbourne, VIC, Australia
| | - Anna Jakubowska
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Center, Szczecin, Poland; Pomeranian Medical University, Independent Laboratory of Molecular Biology and Genetic Diagnostics, Szczecin, Poland
| | - Audrey Y Jung
- German Cancer Research Center, Division of Cancer Epidemiology, Heidelberg, Germany
| | - Renske Keeman
- The Netherlands Cancer Institute, Division of Molecular Pathology, Plesmanlaan 121, 1066 Amsterdam, the Netherlands
| | - Vessela N Kristensen
- University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo, Norway; Oslo University Hospital and University of Oslo, Department of Medical Genetics, Oslo, Norway
| | - Jan Lubiński
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Center, Szczecin, Poland
| | - Arto Mannermaa
- University of Eastern Finland, Translational Cancer Research Area, Kuopio, Finland; University of Eastern Finland, Institute of Clinical Medicine, Pathology and Forensic Medicine, Kuopio, Finland; Kuopio University Hospital, Biobank of Eastern Finland, Kuopio, Finland
| | - Mehdi Manoochehri
- German Cancer Research Center, Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Siranoush Manoukian
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Unit of Medical Genetics, Department of Medical Oncology and Hematology, Milan, Italy
| | - Sara Margolin
- Södersjukhuset, Department of Oncology, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Dimitrios Mavroudis
- University Hospital of Heraklion, Department of Medical Oncology, Heraklion, Greece
| | - Roger L Milne
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC, Australia; The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC, Australia; Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, VIC, Australia
| | - Anna Marie Mulligan
- University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, ON, Canada; University Health Network, Laboratory Medicine Program, Toronto, ON, Canada
| | - William G Newman
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK; St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | | | - Paolo Peterlongo
- IFOM ETS - the AIRC Institute of Molecular Oncology, Genome Diagnostics Program, Milan, Italy
| | - Paul D P Pharoah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK; University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Valerie Rhenius
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | | | - Elinor J Sawyer
- King's College London, School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, London, UK
| | - Rita K Schmutzler
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Familial Breast and Ovarian Cancer, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Integrated Oncology, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Molecular Medicine Cologne, Cologne, Germany
| | - Mitul Shah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Amanda B Spurdle
- QIMR Berghofer Medical Research Institute, Population Health Program, Brisbane, QLD, Australia
| | - Ian Tomlinson
- University of Birmingham, Institute of Cancer and Genomic Sciences, Birmingham, UK; University of Oxford, Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Thérèse Truong
- INSERM, University Paris-Saclay, Center for Research in Epidemiology and Population Health, Team Exposome and Heredity, Villejuif, France
| | - Elke M van Veen
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK; St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Maaike P G Vreeswijk
- Leiden University Medical Center, Department of Human Genetics, Leiden, the Netherlands
| | - Qin Wang
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Camilla Wendt
- Södersjukhuset, Department of Oncology, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Xiaohong R Yang
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Heli Nevanlinna
- University of Helsinki, Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Peter Devilee
- Leiden University Medical Center, Department of Human Genetics, Leiden, the Netherlands; Leiden University Medical Center, Department of Pathology, Leiden, the Netherlands
| | - Douglas F Easton
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK; University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Marjanka K Schmidt
- The Netherlands Cancer Institute, Division of Molecular Pathology, Plesmanlaan 121, 1066 Amsterdam, the Netherlands; The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Psychosocial Research and Epidemiology, Amsterdam, the Netherlands.
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10
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Morra A, Schreurs MAC, Andrulis IL, Anton-Culver H, Augustinsson A, Beckmann MW, Behrens S, Bojesen SE, Bolla MK, Brauch H, Broeks A, Buys SS, Camp NJ, Castelao JE, Cessna MH, Chang-Claude J, Chung WK, Collaborators N, Colonna SV, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Dennis J, Devilee P, Dörk T, Dunning AM, Dwek M, Easton DF, Eccles DM, Eriksson M, Evans DG, Fasching PA, Fehm TN, Figueroa JD, Flyger H, Gabrielson M, Gago-Dominguez M, García-Closas M, García-Sáenz JA, Genkinger J, Grassmann F, Gündert M, Hahnen E, Haiman CA, Hamann U, Harrington PA, Hartikainen JM, Hoppe R, Hopper JL, Houlston RS, Howell A, Investigators A, Investigators KC, Jakubowska A, Janni W, Jernström H, John EM, Johnson N, Jones ME, Kristensen VN, Kurian AW, Lambrechts D, Marchand LL, Lindblom A, Lubiński J, Lux MP, Mannermaa A, Mavroudis D, Mulligan AM, Muranen TA, Nevanlinna H, Nevelsteen I, Neven P, Newman WG, Obi N, Offit K, Olshan AF, Park-Simon TW, Patel AV, Peterlongo P, Phillips KA, Plaseska-Karanfilska D, Polley EC, Presneau N, Pylkäs K, Rack B, Radice P, Rashid MU, Rhenius V, Robson M, Romero A, Saloustros E, Sawyer EJ, Schmutzler RK, Schuetze S, Scott C, Shah M, Smichkoska S, Southey MC, Tapper WJ, Teras LR, Tollenaar RAEM, Tomczyk K, Tomlinson I, Troester MA, Vachon CM, van Veen EM, Wang Q, Wendt C, Wildiers H, Winqvist R, Ziogas A, Hall P, Pharoah PDP, Adank MA, Hollestelle A, Schmidt MK, Hooning MJ. Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival. Res Sq 2023:rs.3.rs-2569372. [PMID: 36824750 PMCID: PMC9949248 DOI: 10.21203/rs.3.rs-2569372/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers. We aimed to assess the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS. Analyses were based on 82,701 women diagnosed with invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations of treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death. There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR(95%CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR(95%CI) :1.30 (1.09-1.56)]. In conclusion, systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk. (Main MS: 3201 words).
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11
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Figlioli G, Billaud A, Ahearn TU, Antonenkova NN, Becher H, Beckmann MW, Behrens S, Benitez J, Bermisheva M, Blok MJ, Bogdanova NV, Bonanni B, Burwinkel B, Camp NJ, Campbell A, Castelao JE, Cessna MH, Chanock SJ, Czene K, Devilee P, Dörk T, Engel C, Eriksson M, Fasching PA, Figueroa JD, Gabrielson M, Gago-Dominguez M, García-Closas M, González-Neira A, Grassmann F, Guénel P, Gündert M, Hadjisavvas A, Hahnen E, Hall P, Hamann U, Harrington PA, He W, Hillemanns P, Hollestelle A, Hooning MJ, Hoppe R, Howell A, Humphreys K, Jager A, Jakubowska A, Khusnutdinova EK, Ko YD, Kristensen VN, Lindblom A, Lissowska J, Lubiński J, Mannermaa A, Manoukian S, Margolin S, Mavroudis D, Newman WG, Obi N, Panayiotidis MI, Rashid MU, Rhenius V, Rookus MA, Saloustros E, Sawyer EJ, Schmutzler RK, Shah M, Sironen R, Southey MC, Suvanto M, Tollenaar RAEM, Tomlinson I, Truong T, van der Kolk LE, van Veen EM, Wappenschmidt B, Yang XR, Bolla MK, Dennis J, Dunning AM, Easton DF, Lush M, Michailidou K, Pharoah PDP, Wang Q, Adank MA, Schmidt MK, Andrulis IL, Chang-Claude J, Nevanlinna H, Chenevix-Trench G, Evans DG, Milne RL, Radice P, Peterlongo P. FANCM missense variants and breast cancer risk: a case-control association study of 75,156 European women. Eur J Hum Genet 2023; 31:578-587. [PMID: 36707629 PMCID: PMC10172381 DOI: 10.1038/s41431-022-01257-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
Evidence from literature, including the BRIDGES study, indicates that germline protein truncating variants (PTVs) in FANCM confer moderately increased risk of ER-negative and triple-negative breast cancer (TNBC), especially for women with a family history of the disease. Association between FANCM missense variants (MVs) and breast cancer risk has been postulated. In this study, we further used the BRIDGES study to test 689 FANCM MVs for association with breast cancer risk, overall and in ER-negative and TNBC subtypes, in 39,885 cases (7566 selected for family history) and 35,271 controls of European ancestry. Sixteen common MVs were tested individually; the remaining rare 673 MVs were tested by burden analyses considering their position and pathogenicity score. We also conducted a meta-analysis of our results and those from published studies. We did not find evidence for association for any of the 16 variants individually tested. The rare MVs were significantly associated with increased risk of ER-negative breast cancer by burden analysis comparing familial cases to controls (OR = 1.48; 95% CI 1.07-2.04; P = 0.017). Higher ORs were found for the subgroup of MVs located in functional domains or predicted to be pathogenic. The meta-analysis indicated that FANCM MVs overall are associated with breast cancer risk (OR = 1.22; 95% CI 1.08-1.38; P = 0.002). Our results support the definition from previous analyses of FANCM as a moderate-risk breast cancer gene and provide evidence that FANCM MVs could be low/moderate risk factors for ER-negative and TNBC subtypes. Further genetic and functional analyses are necessary to clarify better the increased risks due to FANCM MVs.
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Affiliation(s)
- Gisella Figlioli
- IFOM ETS - The AIRC Institute of Molecular Oncology, Genome Diagnostics Program, Milan, Italy
| | - Amandine Billaud
- IFOM ETS - The AIRC Institute of Molecular Oncology, Genome Diagnostics Program, Milan, Italy
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Natalia N Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
| | - Heiko Becher
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany
| | - Matthias W Beckmann
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sabine Behrens
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Javier Benitez
- Spanish National Cancer Research Centre (CNIO), Human Genetics Group, Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - Marinus J Blok
- Maastricht University Medical Center, Department of Clinical Genetics, Maastricht, the Netherlands
| | - Natalia V Bogdanova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
- Hannover Medical School, Department of Radiation Oncology, Hannover, Germany
- Hannover Medical School, Gynaecology Research Unit, Hannover, Germany
| | - Bernardo Bonanni
- IEO, European Institute of Oncology IRCCS, Division of Cancer Prevention and Genetics, Milan, Italy
| | - Barbara Burwinkel
- German Cancer Research Center (DKFZ), Molecular Epidemiology Group, C080, Heidelberg, Germany
- University of Heidelberg, Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, Heidelberg, Germany
| | - Nicola J Camp
- University of Utah, Department of Internal Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Archie Campbell
- University of Edinburgh, Centre for Genomic and Experimental Medicine, Institute of Genetics & Cancer, Edinburgh, UK
- The University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Jose E Castelao
- Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Oncology and Genetics Unit, Vigo, Spain
| | | | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | | | - Kamila Czene
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Peter Devilee
- Leiden University Medical Center, Department of Pathology, Leiden, the Netherlands
- Leiden University Medical Center, Department of Human Genetics, Leiden, the Netherlands
| | - Thilo Dörk
- Hannover Medical School, Gynaecology Research Unit, Hannover, Germany
| | - Christoph Engel
- University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology, Leipzig, Germany
- University of Leipzig, LIFE - Leipzig Research Centre for Civilization Diseases, Leipzig, Germany
| | - Mikael Eriksson
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Peter A Fasching
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
- The University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
- The University of Edinburgh, Cancer Research UK Edinburgh Centre, Edinburgh, UK
| | - Marike Gabrielson
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Santiago de Compostela, Spain
- University of California San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Anna González-Neira
- Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid, Spain
| | - Felix Grassmann
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
- Health and Medical University, Potsdam, Germany
| | - Pascal Guénel
- INSERM, University Paris-Saclay, Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Villejuif, France
| | - Melanie Gündert
- German Cancer Research Center (DKFZ), Molecular Epidemiology Group, C080, Heidelberg, Germany
- University of Heidelberg, Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, Heidelberg, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Diabetes Research, Neuherberg, Germany
| | - Andreas Hadjisavvas
- The Cyprus Institute of Neurology & Genetics, Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, Nicosia, Cyprus
| | - Eric Hahnen
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Familial Breast and Ovarian Cancer, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Integrated Oncology (CIO), Cologne, Germany
| | - Per Hall
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
- Södersjukhuset, Department of Oncology, Stockholm, Sweden
| | - Ute Hamann
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Patricia A Harrington
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Wei He
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | - Peter Hillemanns
- Hannover Medical School, Gynaecology Research Unit, Hannover, Germany
| | | | - Maartje J Hooning
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Anthony Howell
- University of Manchester, Division of Cancer Sciences, Manchester, UK
| | - Keith Humphreys
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden
| | | | - Agnes Jager
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands
| | - Anna Jakubowska
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Center, Szczecin, Poland
- Pomeranian Medical University, Independent Laboratory of Molecular Biology and Genetic Diagnostics, Szczecin, Poland
| | - Elza K Khusnutdinova
- Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Bashkir State University, Department of Genetics and Fundamental Medicine, Ufa, Russia
| | - Yon-Dschun Ko
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, Bonn, Germany
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Annika Lindblom
- Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden
- Karolinska University Hospital, Department of Clinical Genetics, Stockholm, Sweden
| | - Jolanta Lissowska
- M. Sklodowska-Curie National Research Oncology Institute, Department of Cancer Epidemiology and Prevention, Warsaw, Poland
| | - Jan Lubiński
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Center, Szczecin, Poland
| | - Arto Mannermaa
- University of Eastern Finland, Translational Cancer Research Area, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, Pathology and Forensic Medicine, Kuopio, Finland
- Kuopio University Hospital, Biobank of Eastern Finland, Kuopio, Finland
| | - Siranoush Manoukian
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Unit of Medical Genetics, Department of Medical Oncology and Hematology, Milan, Italy
| | - Sara Margolin
- Södersjukhuset, Department of Oncology, Stockholm, Sweden
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Dimitrios Mavroudis
- University Hospital of Heraklion, Department of Medical Oncology, Heraklion, Greece
| | - William G Newman
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Nadia Obi
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany
| | - Mihalis I Panayiotidis
- The Cyprus Institute of Neurology & Genetics, Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, Nicosia, Cyprus
| | - Muhammad U Rashid
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Department of Basic Sciences, Lahore, Pakistan
| | - Valerie Rhenius
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Matti A Rookus
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Division of Psychosocial Research and Epidemiology, Amsterdam, the Netherlands
| | | | - Elinor J Sawyer
- King's College London, School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, London, UK
| | - Rita K Schmutzler
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Familial Breast and Ovarian Cancer, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Integrated Oncology (CIO), Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Mitul Shah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Reijo Sironen
- University of Eastern Finland, Translational Cancer Research Area, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, Pathology and Forensic Medicine, Kuopio, Finland
- Kuopio University Hospital, Imaging Center, Department of Clinical Pathology, Kuopio, Finland
| | - Melissa C Southey
- Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
- The University of Melbourne, Department of Clinical Pathology, Melbourne, Victoria, Australia
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, Victoria, Australia
| | - Maija Suvanto
- University of Helsinki, Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Rob A E M Tollenaar
- Leiden University Medical Center, Department of Surgery, Leiden, the Netherlands
| | - Ian Tomlinson
- The University of Edinburgh, Cancer Research Centre, Edinburgh, UK
| | - Thérèse Truong
- INSERM, University Paris-Saclay, Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Villejuif, France
| | - Lizet E van der Kolk
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Family Cancer Clinic, Amsterdam, the Netherlands
| | - Elke M van Veen
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Barbara Wappenschmidt
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Familial Breast and Ovarian Cancer, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Integrated Oncology (CIO), Cologne, Germany
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Manjeet K Bolla
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Joe Dennis
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Alison M Dunning
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Douglas F Easton
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Michael Lush
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Kyriaki Michailidou
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
- The Cyprus Institute of Neurology & Genetics, Biostatistics Unit, Nicosia, Cyprus
| | - Paul D P Pharoah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Qin Wang
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - Muriel A Adank
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Family Cancer Clinic, Amsterdam, the Netherlands
| | - Marjanka K Schmidt
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Division of Psychosocial Research and Epidemiology, Amsterdam, the Netherlands
- The Netherlands Cancer Institute, Division of Molecular Pathology, Amsterdam, the Netherlands
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, Ontario, Canada
- University of Toronto, Department of Molecular Genetics, Toronto, Ontario, Canada
| | - Jenny Chang-Claude
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
- University Medical Center Hamburg-Eppendorf, Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Heli Nevanlinna
- University of Helsinki, Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Georgia Chenevix-Trench
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, Queensland, Australia
| | - D Gareth Evans
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester, UK
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Roger L Milne
- Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, Victoria, Australia
- The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Paolo Radice
- Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Experimental Oncology, Milan, Italy
| | - Paolo Peterlongo
- IFOM ETS - The AIRC Institute of Molecular Oncology, Genome Diagnostics Program, Milan, Italy.
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Mueller SH, Lai AG, Valkovskaya M, Michailidou K, Bolla MK, Wang Q, Dennis J, Lush M, Abu-Ful Z, Ahearn TU, Andrulis IL, Anton-Culver H, Antonenkova NN, Arndt V, Aronson KJ, Augustinsson A, Baert T, Freeman LEB, Beckmann MW, Behrens S, Benitez J, Bermisheva M, Blomqvist C, Bogdanova NV, Bojesen SE, Bonanni B, Brenner H, Brucker SY, Buys SS, Castelao JE, Chan TL, Chang-Claude J, Chanock SJ, Choi JY, Chung WK, Colonna SV, Cornelissen S, Couch FJ, Czene K, Daly MB, Devilee P, Dörk T, Dossus L, Dwek M, Eccles DM, Ekici AB, Eliassen AH, Engel C, Evans DG, Fasching PA, Fletcher O, Flyger H, Gago-Dominguez M, Gao YT, García-Closas M, García-Sáenz JA, Genkinger J, Gentry-Maharaj A, Grassmann F, Guénel P, Gündert M, Haeberle L, Hahnen E, Haiman CA, Håkansson N, Hall P, Harkness EF, Harrington PA, Hartikainen JM, Hartman M, Hein A, Ho WK, Hooning MJ, Hoppe R, Hopper JL, Houlston RS, Howell A, Hunter DJ, Huo D, Ito H, Iwasaki M, Jakubowska A, Janni W, John EM, Jones ME, Jung A, Kaaks R, Kang D, Khusnutdinova EK, Kim SW, Kitahara CM, Koutros S, Kraft P, Kristensen VN, Kubelka-Sabit K, Kurian AW, Kwong A, Lacey JV, Lambrechts D, Le Marchand L, Li J, Linet M, Lo WY, Long J, Lophatananon A, Mannermaa A, Manoochehri M, Margolin S, Matsuo K, Mavroudis D, Menon U, Muir K, Murphy RA, Nevanlinna H, Newman WG, Niederacher D, O'Brien KM, Obi N, Offit K, Olopade OI, Olshan AF, Olsson H, Park SK, Patel AV, Patel A, Perou CM, Peto J, Pharoah PDP, Plaseska-Karanfilska D, Presneau N, Rack B, Radice P, Ramachandran D, Rashid MU, Rennert G, Romero A, Ruddy KJ, Ruebner M, Saloustros E, Sandler DP, Sawyer EJ, Schmidt MK, Schmutzler RK, Schneider MO, Scott C, Shah M, Sharma P, Shen CY, Shu XO, Simard J, Surowy H, Tamimi RM, Tapper WJ, Taylor JA, Teo SH, Teras LR, Toland AE, Tollenaar RAEM, Torres D, Torres-Mejía G, Troester MA, Truong T, Vachon CM, Vijai J, Weinberg CR, Wendt C, Winqvist R, Wolk A, Wu AH, Yamaji T, Yang XR, Yu JC, Zheng W, Ziogas A, Ziv E, Dunning AM, Easton DF, Hemingway H, Hamann U, Kuchenbaecker KB. Aggregation tests identify new gene associations with breast cancer in populations with diverse ancestry. Genome Med 2023; 15:7. [PMID: 36703164 PMCID: PMC9878779 DOI: 10.1186/s13073-022-01152-5] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 12/16/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Low-frequency variants play an important role in breast cancer (BC) susceptibility. Gene-based methods can increase power by combining multiple variants in the same gene and help identify target genes. METHODS We evaluated the potential of gene-based aggregation in the Breast Cancer Association Consortium cohorts including 83,471 cases and 59,199 controls. Low-frequency variants were aggregated for individual genes' coding and regulatory regions. Association results in European ancestry samples were compared to single-marker association results in the same cohort. Gene-based associations were also combined in meta-analysis across individuals with European, Asian, African, and Latin American and Hispanic ancestry. RESULTS In European ancestry samples, 14 genes were significantly associated (q < 0.05) with BC. Of those, two genes, FMNL3 (P = 6.11 × 10-6) and AC058822.1 (P = 1.47 × 10-4), represent new associations. High FMNL3 expression has previously been linked to poor prognosis in several other cancers. Meta-analysis of samples with diverse ancestry discovered further associations including established candidate genes ESR1 and CBLB. Furthermore, literature review and database query found further support for a biologically plausible link with cancer for genes CBLB, FMNL3, FGFR2, LSP1, MAP3K1, and SRGAP2C. CONCLUSIONS Using extended gene-based aggregation tests including coding and regulatory variation, we report identification of plausible target genes for previously identified single-marker associations with BC as well as the discovery of novel genes implicated in BC development. Including multi ancestral cohorts in this study enabled the identification of otherwise missed disease associations as ESR1 (P = 1.31 × 10-5), demonstrating the importance of diversifying study cohorts.
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Affiliation(s)
| | - Alvina G Lai
- Institute of Health Informatics, University College London, London, UK
| | | | - Kyriaki Michailidou
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, 2371, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, 2371, Nicosia, Cyprus
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Zomoruda Abu-Ful
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, 35254, Haifa, Israel
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, 92617, USA
| | - Natalia N Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040, Minsk, Belarus
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Kristan J Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Annelie Augustinsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, 222 42, Lund, Sweden
| | - Thais Baert
- Leuven Multidisciplinary Breast Center, Department of Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000, Louvain, Belgium
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Javier Benitez
- Biomedical Network On Rare Diseases (CIBERER), 28029, Madrid, Spain
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029, Madrid, Spain
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, 450054, Russia
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, 00290, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, 70185, Örebro, Sweden
| | - Natalia V Bogdanova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040, Minsk, Belarus
- Department of Radiation Oncology, Hannover Medical School, 30625, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, 30625, Hannover, Germany
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Sara Y Brucker
- Department of Gynecology and Obstetrics, University of Tübingen, 72076, Tübingen, Germany
| | - Saundra S Buys
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, 36312, Vigo, Spain
| | - Tsun L Chan
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong, China
- Department of Molecular Pathology, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Korea
- Cancer Research Institute, Seoul National University, Seoul, 03080, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, 03080, Korea
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, 10032, USA
| | - Sarah V Colonna
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
| | - Sten Cornelissen
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, 30625, Hannover, Germany
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research On Cancer (IARC-WHO), 69372, Lyon, France
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London, W1W 6UW, UK
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Arif B Ekici
- Institute of Human Genetics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107, Leipzig, Germany
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, 90095, USA
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW7 3RP, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730, Herlev, Denmark
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Fundación Pœblica Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, 15706, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, CA, 92037, USA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 20032, China
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - José A García-Sáenz
- Medical Oncology Department, Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040, Madrid, Spain
| | - Jeanine Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | | | - Felix Grassmann
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
- Health and Medical University, 14471, Potsdam, Germany
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, 94805, Villejuif, France
| | - Melanie Gündert
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), C08069120, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, 69120, Heidelberg, Germany
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Lothar Haeberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
- Department of Oncology, 118 83, Sšdersjukhuset, Stockholm, Sweden
| | - Elaine F Harkness
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PT, UK
- Nightingale and Genesis Prevention Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
- NIHR Manchester Biomedical Research Unit, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Patricia A Harrington
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Jaana M Hartikainen
- Translational Cancer Research Area, University of Eastern Finland, 70210, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, 70210, Kuopio, Finland
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, 119077, Singapore
- Department of Surgery, National University Health System, Singapore, 119228, Singapore
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | - Weang-Kee Ho
- Department of Mathematical Sciences, Faculty of Science and Engineering, University of Nottingham Malaysia Campus, 43500, Semenyih, Selangor, Malaysia
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, 47500, Selangor, Malaysia
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, 3015 GD, The Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, 70376, Stuttgart, Germany
- University of Tübingen, 72074, Tübingen, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Dezheng Huo
- Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL, 60637, USA
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Motoki Iwasaki
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center Institute for Cancer Control, Tokyo, 104-0045, Japan
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, 71-252, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, 71-252, Szczecin, Poland
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Hospital Ulm, 89075, Ulm, Germany
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Daehee Kang
- Cancer Research Institute, Seoul National University, Seoul, 03080, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Elza K Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, 450054, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, 450000, Russia
| | - Sung-Won Kim
- Department of Surgery, Daerim Saint Mary's Hospital, Seoul, 07442, Korea
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Vessela N Kristensen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0450, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, 0379, Oslo, Norway
| | - Katerina Kubelka-Sabit
- Department of Histopathology and Cytology, Clinical Hospital Acibadem Sistina, Skopje, 1000, Republic of North Macedonia
| | - Allison W Kurian
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - Ava Kwong
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong, China
- Department of Surgery, The University of Hong Kong, Hong Kong, China
- Department of Surgery and Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, 91010, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, 91010, USA
| | - Diether Lambrechts
- VIB Center for Cancer Biology, 3001, Louvain, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, 3000, Louvain, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, 96813, USA
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore, 138672, Singapore
| | - Martha Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Wing-Yee Lo
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, 70376, Stuttgart, Germany
- University of Tübingen, 72074, Tübingen, Germany
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, 70210, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, 70210, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, 118 83, Sšdersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Sšdersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Keitaro Matsuo
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, 711 10, Heraklion, Greece
| | - Usha Menon
- Institute of Clinical Trials and Methodology, University College London, London, WC1V 6LJ, UK
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- Cancer Control Research, BC Cancer, Vancouver, BC, V5Z 1L3, Canada
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, 00290, Helsinki, Finland
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Dieter Niederacher
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709, USA
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Kenneth Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | | | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, 222 42, Lund, Sweden
| | - Sue K Park
- Cancer Research Institute, Seoul National University, Seoul, 03080, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, 30303, USA
| | - Achal Patel
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles M Perou
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julian Peto
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Dijana Plaseska-Karanfilska
- Research Centre for Genetic Engineering and Biotechnology "Georgi D. Efremov", MASA, Skopje, 1000, Republic of North Macedonia
| | - Nadege Presneau
- School of Life Sciences, University of Westminster, London, W1W 6UW, UK
| | - Brigitte Rack
- Department of Gynaecology and Obstetrics, University Hospital Ulm, 89075, Ulm, Germany
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori (INT), 20133, Milan, Italy
| | - Dhanya Ramachandran
- Gynaecology Research Unit, Hannover Medical School, 30625, Hannover, Germany
| | - Muhammad U Rashid
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, 54000, Pakistan
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, 35254, Haifa, Israel
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, 28222, Madrid, Spain
| | - Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709, USA
| | - Elinor J Sawyer
- School of Cancer and Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, SE1 9RT, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
| | - Michael O Schneider
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Priyanka Sharma
- Department of Internal Medicine, Division of Medical Oncology, University of Kansas Medical Center, Westwood, KS, 66205, USA
| | - Chen-Yang Shen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 115, Taiwan
- School of Public Health, China Medical University, Taichung, Taiwan
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, G1V 4G2, Canada
| | - Harald Surowy
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), C08069120, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, 69120, Heidelberg, Germany
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - William J Tapper
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709, USA
| | - Soo Hwang Teo
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, 47500, Selangor, Malaysia
- Department of Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, 30303, USA
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH, 43210, USA
| | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Institute of Human Genetics, Pontificia Universidad Javeriana, 110231, Bogota, Colombia
| | - Gabriela Torres-Mejía
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thérèse Truong
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, 94805, Villejuif, France
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Joseph Vijai
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709, USA
| | - Camilla Wendt
- Department of Clinical Science and Education, Sšdersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, 90570, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, 90570, Oulu, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, 751 05, Uppsala, Sweden
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Taiki Yamaji
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center Institute for Cancer Control, Tokyo, 104-0045, Japan
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Jyh-Cherng Yu
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, 92617, USA
| | - Elad Ziv
- Department of Medicine, Diller Family Comprehensive Cancer Center, Institute for Human Genetics, UCSF Helen, University of California San Francisco, San Francisco, CA, 94115, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Harry Hemingway
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, University College London, London, UK
- University College London Hospitals Biomedical Research Centre (UCLH BRC), London, UK
- The Alan Turing Institute, London, UK
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Karoline B Kuchenbaecker
- Division of Psychiatry, University College London, London, UK.
- UCL Genetics Institute, University College London, London, UK.
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Jung AY, Ahearn TU, Behrens S, Middha P, Bolla MK, Wang Q, Arndt V, Aronson KJ, Augustinsson A, Beane Freeman LE, Becher H, Brenner H, Canzian F, Carey LA, Czene K, Eliassen AH, Eriksson M, Evans DG, Figueroa JD, Fritschi L, Gabrielson M, Giles GG, Guénel P, Hadjisavvas A, Haiman CA, Håkansson N, Hall P, Hamann U, Hoppe R, Hopper JL, Howell A, Hunter DJ, Hüsing A, Kaaks R, Kosma VM, Koutros S, Kraft P, Lacey JV, Le Marchand L, Lissowska J, Loizidou MA, Mannermaa A, Maurer T, Murphy RA, Olshan AF, Olsson H, Patel AV, Perou CM, Rennert G, Shibli R, Shu XO, Southey MC, Stone J, Tamimi RM, Teras LR, Troester MA, Truong T, Vachon CM, Wang SS, Wolk A, Wu AH, Yang XR, Zheng W, Dunning AM, Pharoah PDP, Easton DF, Milne RL, Chatterjee N, Schmidt MK, García-Closas M, Chang-Claude J. Distinct Reproductive Risk Profiles for Intrinsic-Like Breast Cancer Subtypes: Pooled Analysis of Population-Based Studies. J Natl Cancer Inst 2022; 114:1706-1719. [PMID: 35723569 PMCID: PMC9949579 DOI: 10.1093/jnci/djac117] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/22/2022] [Accepted: 05/03/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Reproductive factors have been shown to be differentially associated with risk of estrogen receptor (ER)-positive and ER-negative breast cancer. However, their associations with intrinsic-like subtypes are less clear. METHODS Analyses included up to 23 353 cases and 71 072 controls pooled from 31 population-based case-control or cohort studies in the Breast Cancer Association Consortium across 16 countries on 4 continents. Polytomous logistic regression was used to estimate the association between reproductive factors and risk of breast cancer by intrinsic-like subtypes (luminal A-like, luminal B-like, luminal B-HER2-like, HER2-enriched-like, and triple-negative breast cancer) and by invasiveness. All statistical tests were 2-sided. RESULTS Compared with nulliparous women, parous women had a lower risk of luminal A-like, luminal B-like, luminal B-HER2-like, and HER2-enriched-like disease. This association was apparent only after approximately 10 years since last birth and became stronger with increasing time (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.49 to 0.71; and OR = 0.36, 95% CI = 0.28 to 0.46 for multiparous women with luminal A-like tumors 20 to less than 25 years after last birth and 45 to less than 50 years after last birth, respectively). In contrast, parous women had a higher risk of triple-negative breast cancer right after their last birth (for multiparous women: OR = 3.12, 95% CI = 2.02 to 4.83) that was attenuated with time but persisted for decades (OR = 1.03, 95% CI = 0.79 to 1.34, for multiparous women 25 to less than 30 years after last birth). Older age at first birth (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) and breastfeeding (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) were associated with lower risk of triple-negative breast cancer but not with other disease subtypes. Younger age at menarche was associated with higher risk of all subtypes; older age at menopause was associated with higher risk of luminal A-like but not triple-negative breast cancer. Associations for in situ tumors were similar to luminal A-like. CONCLUSIONS This large and comprehensive study demonstrates a distinct reproductive risk factor profile for triple-negative breast cancer compared with other subtypes, with implications for the understanding of disease etiology and risk prediction.
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Affiliation(s)
- Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Thomas U Ahearn
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pooja Middha
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristan J Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen’s University, Kingston, ON, Canada
| | | | - Laura E Beane Freeman
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Heiko Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lisa A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - CTS Consortium
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jonine D Figueroa
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
| | - Lin Fritschi
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Pascal Guénel
- Institut national de la santé et de la recherche médicale (INSERM), University Paris-Saclay, Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Villejuif, France
| | - Andreas Hadjisavvas
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus Institute of Neurology and Genetics, Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Christopher A Haiman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anika Hüsing
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Veli-Matti Kosma
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Stella Koutros
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Oncology Institute, Warsaw, Poland
| | - Maria A Loizidou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus Institute of Neurology and Genetics, Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Tabea Maurer
- Cancer Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- BC Cancer Agency, Cancer Control Research, Vancouver, BC, Canada
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Håkan Olsson
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Charles M Perou
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gad Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Rana Shibli
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thérèse Truong
- Institut national de la santé et de la recherche médicale (INSERM), University Paris-Saclay, Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, Villejuif, France
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Sophia S Wang
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Xiaohong R Yang
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Nilanjan Chatterjee
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Department of Biostatistics, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
- Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Montserrat García-Closas
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg (UCCH), Hamburg, Germany
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14
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Dixon-Suen SC, Lewis SJ, Martin RM, English DR, Boyle T, Giles GG, Michailidou K, Bolla MK, Wang Q, Dennis J, Lush M, Investigators A, Ahearn TU, Ambrosone CB, Andrulis IL, Anton-Culver H, Arndt V, Aronson KJ, Augustinsson A, Auvinen P, Beane Freeman LE, Becher H, Beckmann MW, Behrens S, Bermisheva M, Blomqvist C, Bogdanova NV, Bojesen SE, Bonanni B, Brenner H, Brüning T, Buys SS, Camp NJ, Campa D, Canzian F, Castelao JE, Cessna MH, Chang-Claude J, Chanock SJ, Clarke CL, Conroy DM, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Devilee P, Dörk T, Dwek M, Eccles DM, Eliassen AH, Engel C, Eriksson M, Evans DG, Fasching PA, Fletcher O, Flyger H, Fritschi L, Gabrielson M, Gago-Dominguez M, García-Closas M, García-Sáenz JA, Goldberg MS, Guénel P, Gündert M, Hahnen E, Haiman CA, Häberle L, Håkansson N, Hall P, Hamann U, Hart SN, Harvie M, Hillemanns P, Hollestelle A, Hooning MJ, Hoppe R, Hopper J, Howell A, Hunter DJ, Jakubowska A, Janni W, John EM, Jung A, Kaaks R, Keeman R, Kitahara CM, Koutros S, Kraft P, Kristensen VN, Kubelka-Sabit K, Kurian AW, Lacey JV, Lambrechts D, Le Marchand L, Lindblom A, Loibl S, Lubiński J, Mannermaa A, Manoochehri M, Margolin S, Martinez ME, Mavroudis D, Menon U, Mulligan AM, Murphy RA, Collaborators N, Nevanlinna H, Nevelsteen I, Newman WG, Offit K, Olshan AF, Olsson H, Orr N, Patel A, Peto J, Plaseska-Karanfilska D, Presneau N, Rack B, Radice P, Rees-Punia E, Rennert G, Rennert HS, Romero A, Saloustros E, Sandler DP, Schmidt MK, Schmutzler RK, Schwentner L, Scott C, Shah M, Shu XO, Simard J, Southey MC, Stone J, Surowy H, Swerdlow AJ, Tamimi RM, Tapper WJ, Taylor JA, Terry MB, Tollenaar RAEM, Troester MA, Truong T, Untch M, Vachon CM, Joseph V, Wappenschmidt B, Weinberg CR, Wolk A, Yannoukakos D, Zheng W, Ziogas A, Dunning AM, Pharoah PDP, Easton DF, Milne RL, Lynch BM. Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study. Br J Sports Med 2022; 56:1157-1170. [PMID: 36328784 PMCID: PMC9876601 DOI: 10.1136/bjsports-2021-105132] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics. METHODS We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (nsnps=5) or sedentary time (nsnps=6), or accelerometer-measured (nsnps=1) or self-reported (nsnps=5) vigorous physical activity. RESULTS Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;~8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (~7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger). CONCLUSION Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women.
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Affiliation(s)
- Suzanne C Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah J Lewis
- Bristol Medical School, Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Richard M Martin
- Bristol Medical School, Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Kyriaki Michailidou
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Michael Lush
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Abctb Investigators
- Australian Breast Cancer Tissue Bank, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, California, USA
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristan J Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Annelie Augustinsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Päivi Auvinen
- Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, FSBSI Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russian Federation
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCCS, Milan, Italy
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University Bochum, Bochum, Germany
| | - Saundra S Buys
- Department of Internal Medicine and Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah, USA
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah, USA
| | - Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Biology, University of Pisa, Pisa, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Melissa H Cessna
- Department of Pathology, Intermountain Medical Center, Intermountain Healthcare, Salt Lake City, Utah, USA
- Intermountain Biorepository, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Christine L Clarke
- Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Don M Conroy
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, The University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London, UK
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California Los Angeles, Los Angeles, California, USA
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Lin Fritschi
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - José A García-Sáenz
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montréal, Québec, Canada
| | - Pascal Guénel
- Team 'Exposome and Heredity', Center for Research in Epidemiology and Population Health (CESP), Gustave Roussy, INSERM, University Paris-Saclay, Villejuif, France
| | - Melanie Gündert
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lothar Häberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Steven N Hart
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle Harvie
- Prevent Breast Cancer Research Unit, Manchester University Hospital Foundation NHS Trust, Manchester, UK
| | - Peter Hillemanns
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | | | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Reiner Hoppe
- Dr Margarete Fischer Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Howell
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renske Keeman
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katerina Kubelka-Sabit
- Department of Histopathology and Cytology, Clinical Hospital Acibadem Sistina, Skopje, Macedonia (the former Yugoslav Republic of)
| | - Allison W Kurian
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, USA
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, California, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, California, USA
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB, Gent, Oost-Vlaanderen, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | | | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Maria Elena Martinez
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Rachel A Murphy
- Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nbcs Collaborators
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ines Nevelsteen
- Leuven Multidisciplinary Breast Center, Department of Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kenneth Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Nick Orr
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
| | - Alpa Patel
- Department of Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Julian Peto
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Dijana Plaseska-Karanfilska
- Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', MASA, Skopje, Macedonia (the former Yugoslav Republic of)
| | - Nadege Presneau
- School of Life Sciences, University of Westminster, London, UK
| | - Brigitte Rack
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Hedy S Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina, USA
| | - Marjanka K Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, Québec, Canada
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Genetic Epidemiology Group, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Harald Surowy
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York City, New York, USA
| | | | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Thérèse Truong
- Team 'Exposome and Heredity', Center for Research in Epidemiology and Population Health (CESP), Gustave Roussy, INSERM, University Paris-Saclay, Villejuif, France
| | - Michael Untch
- Department of Gynecology and Obstetrics, Helios Clinics Berlin-Buch, Berlin, Germany
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Vijai Joseph
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Barbara Wappenschmidt
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research-Demokritos, Athens, Greece
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, California, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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15
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Dorling L, Carvalho S, Allen J, Parsons MT, Fortuno C, González-Neira A, Heijl SM, Adank MA, Ahearn TU, Andrulis IL, Auvinen P, Becher H, Beckmann MW, Behrens S, Bermisheva M, Bogdanova NV, Bojesen SE, Bolla MK, Bremer M, Briceno I, Camp NJ, Campbell A, Castelao JE, Chang-Claude J, Chanock SJ, Chenevix-Trench G, Collée JM, Czene K, Dennis J, Dörk T, Eriksson M, Evans DG, Fasching PA, Figueroa J, Flyger H, Gabrielson M, Gago-Dominguez M, García-Closas M, Giles GG, Glendon G, Guénel P, Gündert M, Hadjisavvas A, Hahnen E, Hall P, Hamann U, Harkness EF, Hartman M, Hogervorst FBL, Hollestelle A, Hoppe R, Howell A, Jakubowska A, Jung A, Khusnutdinova E, Kim SW, Ko YD, Kristensen VN, Lakeman IMM, Li J, Lindblom A, Loizidou MA, Lophatananon A, Lubiński J, Luccarini C, Madsen MJ, Mannermaa A, Manoochehri M, Margolin S, Mavroudis D, Milne RL, Mohd Taib NA, Muir K, Nevanlinna H, Newman WG, Oosterwijk JC, Park SK, Peterlongo P, Radice P, Saloustros E, Sawyer EJ, Schmutzler RK, Shah M, Sim X, Southey MC, Surowy H, Suvanto M, Tomlinson I, Torres D, Truong T, van Asperen CJ, Waltes R, Wang Q, Yang XR, Pharoah PDP, Schmidt MK, Benitez J, Vroling B, Dunning AM, Teo SH, Kvist A, de la Hoya M, Devilee P, Spurdle AB, Vreeswijk MPG, Easton DF. Breast cancer risks associated with missense variants in breast cancer susceptibility genes. Genome Med 2022; 14:51. [PMID: 35585550 PMCID: PMC9116026 DOI: 10.1186/s13073-022-01052-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 08/20/2021] [Accepted: 05/04/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Protein truncating variants in ATM, BRCA1, BRCA2, CHEK2, and PALB2 are associated with increased breast cancer risk, but risks associated with missense variants in these genes are uncertain. METHODS We analyzed data on 59,639 breast cancer cases and 53,165 controls from studies participating in the Breast Cancer Association Consortium BRIDGES project. We sampled training (80%) and validation (20%) sets to analyze rare missense variants in ATM (1146 training variants), BRCA1 (644), BRCA2 (1425), CHEK2 (325), and PALB2 (472). We evaluated breast cancer risks according to five in silico prediction-of-deleteriousness algorithms, functional protein domain, and frequency, using logistic regression models and also mixture models in which a subset of variants was assumed to be risk-associated. RESULTS The most predictive in silico algorithms were Helix (BRCA1, BRCA2 and CHEK2) and CADD (ATM). Increased risks appeared restricted to functional protein domains for ATM (FAT and PIK domains) and BRCA1 (RING and BRCT domains). For ATM, BRCA1, and BRCA2, data were compatible with small subsets (approximately 7%, 2%, and 0.6%, respectively) of rare missense variants giving similar risk to those of protein truncating variants in the same gene. For CHEK2, data were more consistent with a large fraction (approximately 60%) of rare missense variants giving a lower risk (OR 1.75, 95% CI (1.47-2.08)) than CHEK2 protein truncating variants. There was little evidence for an association with risk for missense variants in PALB2. The best fitting models were well calibrated in the validation set. CONCLUSIONS These results will inform risk prediction models and the selection of candidate variants for functional assays and could contribute to the clinical reporting of gene panel testing for breast cancer susceptibility.
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Affiliation(s)
- Leila Dorling
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Sara Carvalho
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Jamie Allen
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Cristina Fortuno
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Anna González-Neira
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029, Madrid, Spain
| | | | - Muriel A Adank
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Päivi Auvinen
- Translational Cancer Research Area, University of Eastern Finland, 70210, Kuopio, Finland
- Institute of Clinical Medicine, Oncology, University of Eastern Finland, 70210, Kuopio, Finland
- Department of Oncology, Cancer Center, Kuopio University Hospital, 70210, Kuopio, Finland
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, 450054, Russia
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, 30625, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, 30625, Hannover, Germany
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040, Minsk, Belarus
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Michael Bremer
- Department of Radiation Oncology, Hannover Medical School, 30625, Hannover, Germany
| | - Ignacio Briceno
- Medical Faculty, Universidad de La Sabana, 140013, Bogota, Colombia
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, 84112, USA
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Cancer, The University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, 36312, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - J Margriet Collée
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, 3015 CN, The Netherlands
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, 30625, Hannover, Germany
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- Nightingale & Genesis Prevention Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, 90095, USA
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, EH16 4UX, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, EH4 2XR, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730, Herlev, Denmark
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, , 15706, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, CA, 92037, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
| | - Gord Glendon
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada
| | - Pascal Guénel
- Team "Exposome and Heredity", CESP, Inserm, Gustave Roussy, University Paris-Saclay, UVSQ, Villejuif, France
| | - Melanie Gündert
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, 69120, Heidelberg, Germany
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Andreas Hadjisavvas
- Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology & Genetics, 2371, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, 2371, Nicosia, Cyprus
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65, Stockholm, Sweden
- Department of Oncology, 118 83, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Elaine F Harkness
- Nightingale & Genesis Prevention Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PT, UK
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
- Department of Surgery, National University Health System, Singapore, 119228, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, 119228, Singapore
| | - Frans B L Hogervorst
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
| | - Antoinette Hollestelle
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, 3015 GD, The Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, 70376, Stuttgart, Germany
- University of Tübingen, 72074, Tübingen, Germany
| | - Anthony Howell
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- Division of Cancer Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, 71-252, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, 71-252, Szczecin, Poland
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, 450054, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, 450000, Russia
| | - Sung-Won Kim
- Department of Surgery, Daerim Saint Mary's Hospital, Seoul, 07442, Korea
| | - Yon-Dschun Ko
- Department of Internal Medicine, Johanniter GmbH Bonn, Johanniter Krankenhaus, 53113, Bonn, Germany
| | - Vessela N Kristensen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0450, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, 0379, Oslo, Norway
| | - Inge M M Lakeman
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Jingmei Li
- Department of Surgery, National University Health System, Singapore, 119228, Singapore
- Human Genetics Division, Genome Institute of Singapore, Singapore, 138672, Singapore
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Maria A Loizidou
- Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology & Genetics, 2371, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, 2371, Nicosia, Cyprus
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, 71-252, Szczecin, Poland
| | - Craig Luccarini
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Michael J Madsen
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, 84112, USA
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, 70210, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, 70210, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, 118 83, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, 711 10, Heraklion, Greece
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
| | - Nur Aishah Mohd Taib
- Breast Cancer Research Unit, Faculty of Medicine, University Malaya Cancer Research Institute, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, UK
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, 00290, Helsinki, Finland
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Jan C Oosterwijk
- Department of Genetics, University Medical Center Groningen, University Groningen, Groningen, 9713 GZ, The Netherlands
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
- Convergence Graduate Program in Innovative Medical Science, Seoul National University College of Medicine, Seoul, 03080, South Korea
- Cancer Research Institute, Seoul National University, Seoul, 03080, Korea
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC Institute of Molecular Oncology, 20139, Milan, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori (INT), 20133, Milan, Italy
| | | | - Elinor J Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, UK
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Harald Surowy
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, 69120, Heidelberg, Germany
| | - Maija Suvanto
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, 00290, Helsinki, Finland
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, OX3 7BN, UK
| | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Institute of Human Genetics, Pontificia Universidad Javeriana, 110231, Bogota, Colombia
| | - Thérèse Truong
- Team "Exposome and Heredity", CESP, Inserm, Gustave Roussy, University Paris-Saclay, UVSQ, Villejuif, France
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Regina Waltes
- Gynaecology Research Unit, Hannover Medical School, 30625, Hannover, Germany
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20850, USA
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, 1066 CX, The Netherlands
| | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029, Madrid, Spain
- Biomedical Network On Rare Diseases (CIBERER), 28029, Madrid, Spain
| | - Bas Vroling
- Bio-Prodict, Nijmegen, The Netherlands
- Centre for Molecular and Biomolecular Informatics (CMBI), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Soo Hwang Teo
- Breast Cancer Research Unit, Faculty of Medicine, University Malaya Cancer Research Institute, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, 47500, Selangor, Malaysia
| | - Anders Kvist
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, 22381, Lund, Sweden
| | - Miguel de la Hoya
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos), 28040, Madrid, Spain
| | - Peter Devilee
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Amanda B Spurdle
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Maaike P G Vreeswijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, CB1 8RN, UK.
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16
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Wang X, Kapoor PM, Auer PL, Dennis J, Dunning AM, Wang Q, Lush M, Michailidou K, Bolla MK, Aronson KJ, Murphy RA, Brooks-Wilson A, Lee DG, Cordina-Duverger E, Guénel P, Truong T, Mulot C, Teras LR, Patel AV, Dossus L, Kaaks R, Hoppe R, Lo WY, Brüning T, Hamann U, Czene K, Gabrielson M, Hall P, Eriksson M, Jung A, Becher H, Couch FJ, Larson NL, Olson JE, Ruddy KJ, Giles GG, MacInnis RJ, Southey MC, Le Marchand L, Wilkens LR, Haiman CA, Olsson H, Augustinsson A, Krüger U, Wagner P, Scott C, Winham SJ, Vachon CM, Perou CM, Olshan AF, Troester MA, Hunter DJ, Eliassen HA, Tamimi RM, Brantley K, Andrulis IL, Figueroa J, Chanock SJ, Ahearn TU, García-Closas M, Evans GD, Newman WG, van Veen EM, Howell A, Wolk A, Håkansson N, Anton-Culver H, Ziogas A, Jones ME, Orr N, Schoemaker MJ, Swerdlow AJ, Kitahara CM, Linet M, Prentice RL, Easton DF, Milne RL, Kraft P, Chang-Claude J, Lindström S. Genome-wide interaction analysis of menopausal hormone therapy use and breast cancer risk among 62,370 women. Sci Rep 2022; 12:6199. [PMID: 35418701 PMCID: PMC9007944 DOI: 10.1038/s41598-022-10121-2] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 03/11/2022] [Indexed: 02/02/2023] Open
Abstract
Use of menopausal hormone therapy (MHT) is associated with increased risk for breast cancer. However, the relevant mechanisms and its interaction with genetic variants are not fully understood. We conducted a genome-wide interaction analysis between MHT use and genetic variants for breast cancer risk in 27,585 cases and 34,785 controls from 26 observational studies. All women were post-menopausal and of European ancestry. Multivariable logistic regression models were used to test for multiplicative interactions between genetic variants and current MHT use. We considered interaction p-values < 5 × 10-8 as genome-wide significant, and p-values < 1 × 10-5 as suggestive. Linkage disequilibrium (LD)-based clumping was performed to identify independent candidate variants. None of the 9.7 million genetic variants tested for interactions with MHT use reached genome-wide significance. Only 213 variants, representing 18 independent loci, had p-values < 1 × 105. The strongest evidence was found for rs4674019 (p-value = 2.27 × 10-7), which showed genome-wide significant interaction (p-value = 3.8 × 10-8) with current MHT use when analysis was restricted to population-based studies only. Limiting the analyses to combined estrogen-progesterone MHT use only or to estrogen receptor (ER) positive cases did not identify any genome-wide significant evidence of interactions. In this large genome-wide SNP-MHT interaction study of breast cancer, we found no strong support for common genetic variants modifying the effect of MHT on breast cancer risk. These results suggest that common genetic variation has limited impact on the observed MHT-breast cancer risk association.
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Affiliation(s)
- Xiaoliang Wang
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Pooja Middha Kapoor
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University of Heidelberg, Faculty of Medicine, Heidelberg, Germany
| | - Paul L Auer
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Biostatistics, Institute for Health & Equity, and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Michael Lush
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- The Cyprus Institute of Neurology & Genetics, Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Kristan J Aronson
- Department of Public Health Sciences, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- BC Cancer, Cancer Control Research, Vancouver, BC, Canada
| | - Angela Brooks-Wilson
- Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Derrick G Lee
- BC Cancer, Cancer Control Research, Vancouver, BC, Canada
- Department of Mathematics and Statistics, St. Francis Xavier University, Antigonish, NS, Canada
| | - Emilie Cordina-Duverger
- Team Exposome and Heredity, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Saclay, Villejuif, France
| | - Pascal Guénel
- Team Exposome and Heredity, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Saclay, Villejuif, France
| | - Thérèse Truong
- Team Exposome and Heredity, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Saclay, Villejuif, France
| | - Claire Mulot
- INSERM UMR-S1147, Université Paris Sorbonné, Paris, France
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tÿbingen, Tÿbingen, Germany
| | - Wing-Yee Lo
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tÿbingen, Tÿbingen, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Håkan Olsson
- Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | - Annelie Augustinsson
- Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | - Ute Krüger
- Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | - Philippe Wagner
- Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Stacey J Winham
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Celine M Vachon
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles M Perou
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Heather A Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Kristen Brantley
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Jonine Figueroa
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Gareth D Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Elke M van Veen
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Nick Orr
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Ireland, UK
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Martha Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ross L Prentice
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Sara Lindström
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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17
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Wang X, Chen H, Kapoor PM, Su YR, Bolla MK, Dennis J, Dunning AM, Lush M, Wang Q, Michailidou K, Pharoah PD, Hopper JL, Southey MC, Koutros S, Freeman LEB, Stone J, Rennert G, Shibli R, Murphy RA, Aronson K, Guénel P, Truong T, Teras LR, Hodge JM, Canzian F, Kaaks R, Brenner H, Arndt V, Hoppe R, Lo WY, Behrens S, Mannermaa A, Kosma VM, Jung A, Becher H, Giles GG, Haiman CA, Maskarinec G, Scott C, Winham S, Simard J, Goldberg MS, Zheng W, Long J, Troester MA, Love MI, Peng C, Tamimi R, Eliassen H, García-Closas M, Figueroa J, Ahearn T, Yang R, Evans DG, Howell A, Hall P, Czene K, Wolk A, Sandler DP, Taylor JA, Swerdlow AJ, Orr N, Lacey JV, Wang S, Olsson H, Easton DF, Milne RL, Hsu L, Kraft P, Chang-Claude J, Lindström S. A genome-wide gene-based gene-environment interaction study of breast cancer in more than 90,000 women. Cancer Res Commun 2022; 2:211-219. [PMID: 36303815 PMCID: PMC9604427 DOI: 10.1158/2767-9764.crc-21-0119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Background Genome-wide association studies (GWAS) have identified more than 200 susceptibility loci for breast cancer, but these variants explain less than a fifth of the disease risk. Although gene-environment interactions have been proposed to account for some of the remaining heritability, few studies have empirically assessed this. Methods We obtained genotype and risk factor data from 46,060 cases and 47,929 controls of European ancestry from population-based studies within the Breast Cancer Association Consortium (BCAC). We built gene expression prediction models for 4,864 genes with a significant (P<0.01) heritable component using the transcriptome and genotype data from the Genotype-Tissue Expression (GTEx) project. We leveraged predicted gene expression information to investigate the interactions between gene-centric genetic variation and 14 established risk factors in association with breast cancer risk, using a mixed-effects score test. Results After adjusting for number of tests using Bonferroni correction, no interaction remained statistically significant. The strongest interaction observed was between the predicted expression of the C13orf45 gene and age at first full-term pregnancy (PGXE=4.44×10-6). Conclusion In this transcriptome-informed genome-wide gene-environment interaction study of breast cancer, we found no strong support for the role of gene expression in modifying the associations between established risk factors and breast cancer risk. Impact Our study suggests a limited role of gene-environment interactions in breast cancer risk.
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Affiliation(s)
- Xiaoliang Wang
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Hongjie Chen
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Pooja Middha Kapoor
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Yu-Ru Su
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Manjeet K. Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Alison M. Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Michael Lush
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Kyriaki Michailidou
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Paul D.P. Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melissa C. Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Victoria, Australia
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetic, NCI, NIH, Bethesda, Maryland
| | | | - Jennifer Stone
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Crawley, Australia
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Rana Shibli
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Rachel A. Murphy
- Cancer Control Research, BC Cancer and School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kristan Aronson
- Public Health Sciences, Queen's University, Kingston, Canada
| | - Pascal Guénel
- Université Paris-Saclay, Inserm, CESP, Team Exposome and Heredity, Villejuif, France
| | - Thérèse Truong
- Université Paris-Saclay, Inserm, CESP, Team Exposome and Heredity, Villejuif, France
| | - Lauren R. Teras
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - James M. Hodge
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, German
| | - Wing-Yee Lo
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, German
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Veli-Matti Kosma
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiko Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Graham G. Giles
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Christopher A. Haiman
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Stacey Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Québec City, Quebec, Canada
| | - Mark S. Goldberg
- Department of Medicine, McGill University, Montréal, Quebec, Canada; Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montréal, Quebec, Canada
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jirong Long
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Melissa A. Troester
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Michael I. Love
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cheng Peng
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts
| | - Rulla Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Jonine Figueroa
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh Medical School, Edinburgh, United Kingdom
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetic, NCI, NIH, Bethesda, Maryland
| | - Rose Yang
- Division of Cancer Epidemiology and Genetic, NCI, NIH, Bethesda, Maryland
| | - D. Gareth Evans
- Division of Evolution and Genomic Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Genomic Medicine, St Mary's Hospital, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Dale P. Sandler
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, North Carolina
| | - Jack A. Taylor
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, North Carolina
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Division of Breast Cancer Research, The Institute of Cancer Research, London, United K.ingdom
| | - Nick Orr
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, United Kingdom
| | - James V. Lacey
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Sophia Wang
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Håkan Olsson
- Departments of Oncology and Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
- Deceased
| | - Douglas F. Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Roger L. Milne
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Medical Centre Hamburg-Eppendorf, University Cancer Centre Hamburg (UCCH), Hamburg, Germany
| | - Sara Lindström
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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18
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Mavaddat N, Dorling L, Carvalho S, Allen J, González-Neira A, Keeman R, Bolla MK, Dennis J, Wang Q, Ahearn TU, Andrulis IL, Beckmann MW, Behrens S, Benitez J, Bermisheva M, Blomqvist C, Bogdanova NV, Bojesen SE, Briceno I, Brüning T, Camp NJ, Campbell A, Castelao JE, Chang-Claude J, Chanock SJ, Chenevix-Trench G, Christiansen H, Czene K, Dörk T, Eriksson M, Evans DG, Fasching PA, Figueroa JD, Flyger H, Gabrielson M, Gago-Dominguez M, Geisler J, Giles GG, Guénel P, Hadjisavvas A, Hahnen E, Hall P, Hamann U, Hartikainen JM, Hartman M, Hoppe R, Howell A, Jakubowska A, Jung A, Khusnutdinova EK, Kristensen VN, Li J, Lim SH, Lindblom A, Loizidou MA, Lophatananon A, Lubinski J, Madsen MJ, Mannermaa A, Manoochehri M, Margolin S, Mavroudis D, Milne RL, Mohd Taib NA, Morra A, Muir K, Obi N, Osorio A, Park-Simon TW, Peterlongo P, Radice P, Saloustros E, Sawyer EJ, Schmutzler RK, Shah M, Sim X, Southey MC, Thorne H, Tomlinson I, Torres D, Truong T, Yip CH, Spurdle AB, Vreeswijk MPG, Dunning AM, García-Closas M, Pharoah PDP, Kvist A, Muranen TA, Nevanlinna H, Teo SH, Devilee P, Schmidt MK, Easton DF. Pathology of Tumors Associated With Pathogenic Germline Variants in 9 Breast Cancer Susceptibility Genes. JAMA Oncol 2022; 8:e216744. [PMID: 35084436 PMCID: PMC8796069 DOI: 10.1001/jamaoncol.2021.6744] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Rare germline genetic variants in several genes are associated with increased breast cancer (BC) risk, but their precise contributions to different disease subtypes are unclear. This information is relevant to guidelines for gene panel testing and risk prediction. OBJECTIVE To characterize tumors associated with BC susceptibility genes in large-scale population- or hospital-based studies. DESIGN, SETTING, AND PARTICIPANTS The multicenter, international case-control analysis of the BRIDGES study included 42 680 patients and 46 387 control participants, comprising women aged 18 to 79 years who were sampled independently of family history from 38 studies. Studies were conducted between 1991 and 2016. Sequencing and analysis took place between 2016 and 2021. EXPOSURES Protein-truncating variants and likely pathogenic missense variants in ATM, BARD1, BRCA1, BRCA2, CHEK2, PALB2, RAD51C, RAD51D, and TP53. MAIN OUTCOMES AND MEASURES The intrinsic-like BC subtypes as defined by estrogen receptor, progesterone receptor, and ERBB2 (formerly known as HER2) status, and tumor grade; morphology; size; stage; lymph node involvement; subtype-specific odds ratios (ORs) for carrying protein-truncating variants and pathogenic missense variants in the 9 BC susceptibility genes. RESULTS The mean (SD) ages at interview (control participants) and diagnosis (cases) were 55.1 (11.9) and 55.8 (10.6) years, respectively; all participants were of European or East Asian ethnicity. There was substantial heterogeneity in the distribution of intrinsic subtypes by gene. RAD51C, RAD51D, and BARD1 variants were associated mainly with triple-negative disease (OR, 6.19 [95% CI, 3.17-12.12]; OR, 6.19 [95% CI, 2.99-12.79]; and OR, 10.05 [95% CI, 5.27-19.19], respectively). CHEK2 variants were associated with all subtypes (with ORs ranging from 2.21-3.17) except for triple-negative disease. For ATM variants, the association was strongest for the hormone receptor (HR)+ERBB2- high-grade subtype (OR, 4.99; 95% CI, 3.68-6.76). BRCA1 was associated with increased risk of all subtypes, but the ORs varied widely, being highest for triple-negative disease (OR, 55.32; 95% CI, 40.51-75.55). BRCA2 and PALB2 variants were also associated with triple-negative disease. TP53 variants were most strongly associated with HR+ERBB2+ and HR-ERBB2+ subtypes. Tumors occurring in pathogenic variant carriers were of higher grade. For most genes and subtypes, a decline in ORs was observed with increasing age. Together, the 9 genes were associated with 27.3% of all triple-negative tumors in women 40 years or younger. CONCLUSIONS AND RELEVANCE The results of this case-control study suggest that variants in the 9 BC risk genes differ substantially in their associated pathology but are generally associated with triple-negative and/or high-grade disease. Knowing the age and tumor subtype distributions associated with individual BC genes can potentially aid guidelines for gene panel testing, risk prediction, and variant classification and guide targeted screening strategies.
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Affiliation(s)
| | - Nasim Mavaddat
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Sara Carvalho
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Jamie Allen
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Anna González-Neira
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain
| | - Renske Keeman
- Division of Molecular Pathology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain.,Biomedical Network on Rare Diseases, Madrid, Spain
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany.,Gynaecology Research Unit, Hannover Medical School, Hannover, Germany.,N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum, Bochum, Germany
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, Scotland.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur, Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.,Cancer Epidemiology Group, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Hans Christiansen
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, England.,North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, England
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.,David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles
| | - Jonine D Figueroa
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland.,Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, Scotland
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain.,Moores Cancer Center, University of California San Diego, La Jolla
| | - Jürgen Geisler
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Campus at Akershus University Hospital, Norway
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Pascal Guénel
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Villejuif, France
| | - Andreas Hadjisavvas
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus.,Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Center for Integrated Oncology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center, Heidelberg, Germany
| | - Jaana M Hartikainen
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland.,Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Surgery, National University Health System, Singapore, Singapore
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, England
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.,Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Elza K Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia.,Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jingmei Li
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.,Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
| | - Swee Ho Lim
- Breast Department, KK Women's and Children's Hospital, Singapore, Singapore.,SingHealth Duke-NUS Breast Centre, Singapore, Singapore
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Maria A Loizidou
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus.,Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Michael J Madsen
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland.,Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.,Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center, Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine University of Malaya, UM Cancer Research Institute, Kuala Lumpur, Malaysia
| | - Anna Morra
- Division of Molecular Pathology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ana Osorio
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Raras, Madrid, Spain
| | | | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM-the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Elinor J Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, England
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Center for Integrated Oncology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, England
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Department of Clinical Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Heather Thorne
- Research Department, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England.,Wellcome Trust Centre for Human Genetics and Oxford National Institute for Health Research Biomedical Research Centre, University of Oxford, Oxford, England
| | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center, Heidelberg, Germany.,Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Thérèse Truong
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Villejuif, France
| | - Cheng Har Yip
- Department of Surgery, Faculty of Medicine University of Malaya, UM Cancer Research Institute, Kuala Lumpur, Malaysia.,Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Amanda B Spurdle
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Maaike P G Vreeswijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, England
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England.,Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, England
| | - Anders Kvist
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Soo Hwang Teo
- Department of Surgery, Faculty of Medicine University of Malaya, UM Cancer Research Institute, Kuala Lumpur, Malaysia.,Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Peter Devilee
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marjanka K Schmidt
- Division of Molecular Pathology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.,Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England.,Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, England
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19
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Almeida T, Schroth W, Nardin JM, Mürdter T, Picolotto S, Hoppe R, Kogin JP, Gaio ED, Dasenbrock A, Skrsypcsak RC, Noronha L, Brauch H, Casali-da-Rocha JC. Abstract P1-07-08: Endoxifen predicts early recurrence in breast cancer: A Brazilian prospective study. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p1-07-08] [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
Tamoxifen is widely used in adjuvant therapy for breast cancer patients, but up to one-third of patients recur within 15 years after surgery even with its regular use. Low plasma levels of (Z)-endoxifen, the most active tamoxifen metabolite, have been studied as a possible predictor of treatment failure. Here, we evaluated plasma (Z)-endoxifen as a predictor of response to adjuvant treatment in breast cancer patients. Methods: One hundred forty nine patients were selected from a prospective cohort of consecutive newly diagnosed breast cancer patients recruited at a national referral center for treatment of cancer in Curitiba, Southern Brazil. Inclusion criteria were breast cancer women on stage I - III, positive hormone receptor tumors, operable, undergoing or not (neo)adjuvant chemotherapy, and signed for adjuvant tamoxifen for at least five years. At diagnosis, peripheral blood samples were collected for CYP2D6 genotyping for *1 *2, *3, *4, *5, *6, *7, *8, *9, *10, *17, *29 and *41 and subsequent metabolic activity scores according to phenotypes assigned for each allele (poor metabolizer PM; intermediate, IM; extensive, EM and ultrarapid metabolizer, UM). After the tamoxifen initiation, patients were evaluated at months 3, 6, and 12 for adherence and drug interactions, and plasma (Z)-endoxifen quantification. They were followed from April 2014 to April 2019. The study's primary objective was to evaluate whether (Z)-endoxifen plasma levels predict early recurrence in patients on adjuvant tamoxifen. The secondary aim was to evaluate an association between (Z)-endoxifen levels and clinical and phenotypic CYP2D6 metabolism variables. A Cox model estimated hazard ratios (HR) comparing recurrence free survival (RFS) according to (Z)-endoxifen plasma levels. The survival was compared using the Kaplan-Meier method and the log-rank test. Results: The median follow-up period was 52.3 months and at that point, there were 20 recurrences of 149 patients. At 3 months there were no cases of low adherence to tamoxifen. The (Z)-endoxifen levels were established by quartiles, with the first lower quartile being used as a cutoff (14.72nM). High (Z)-endoxifen levels at 3 months (>14.72nM) were detected in 75.8% (n = 113) of cases and low levels (≤14.72nM) in 24.2% (n = 36). There was no statistically significant difference between the groups with low or high (Z)-endoxifen levels regarding clinical and pathological variables, but there was a higher CYP2D6 PM/IM frequency in the low (Z)-endoxifen levels group (p<0.001). High (Z)-endoxifen levels were associated with lower RFS compared to low (Z)-endoxifen levels (HR 2.5, 95% CI 1.00-6.22, p=0.041). Low (Z)-endoxifen levels increased the recurrence risk even when adjusted for staging and molecular subtypes (HR 2.55, 95% CI 1.00-6.48, p<0.001) or staging and CYP2D6 phenotype (UM/EM vs IM/PM; HR 4.38, 95% CI 1.66-11.59, p=0.003), or prior chemotherapy exposure (HR 2.65, 95% CI 1.06-6.61, p=0.036). Conclusion: This is the first Brazilian prospective trial evaluating the association of plasma (Z)-endoxifen levels, with the clinical outcome in breast cancer women treated with adjuvant tamoxifen, controlled by predictable confounding factors of plasma (Z)-endoxifen levels, such as tamoxifen adherence, and drug interaction with CYP2D6 inhibitors. In our study, a low plasma level of (Z)-endoxifen (≤ 14.72nM) after 3 months of tamoxifen treatment was a predictor of early recurrence in patients under adjuvant tamoxifen (p=0.041). A longer follow-up and a larger cohort may be needed to confirm the (Z)-endoxifen cutoff value that is a predictor of long-term recurrence.
Citation Format: Thais Almeida, Werner Schroth, Jeanine Marie Nardin, Thomas Mürdter, Solane Picolotto, Reiner Hoppe, Jenifer Primon Kogin, Elisa Daniele Gaio, Angela Dasenbrock, Raquel Cristina Skrsypcsak, Lucia Noronha, Hiltrud Brauch, José Claudio Casali-da-Rocha. Endoxifen predicts early recurrence in breast cancer: A Brazilian prospective study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-07-08.
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Affiliation(s)
| | - Werner Schroth
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | - Thomas Mürdter
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | | | | | | | - Lucia Noronha
- Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
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Dworkin M, No HJ, Wu Y, Binkley M, Rieger K, Graves E, Barcellos-Hoff M, Von Eyben R, Ashraf R, Manjappa R, Yu A, Skinner L, Surucu M, Kim Y, Loo B, Hoppe R. A RANDOMIZED SPLIT-BODY FEASIBILITY TRIAL OF SINGLE-FRACTION FLASH VS CONVENTIONAL ELECTRON RADIOTHERAPY USING A STANDARD CLINICAL LINEAR ACCELERATOR FOR ADULTS WITH MULTILESIONAL PRIMARY CUTANEOUS LYMPHOMAS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dennis J, Tyrer JP, Walker LC, Michailidou K, Dorling L, Bolla MK, Wang Q, Ahearn TU, Andrulis IL, Anton-Culver H, Antonenkova NN, Arndt V, Aronson KJ, Freeman LEB, Beckmann MW, Behrens S, Benitez J, Bermisheva M, Bogdanova NV, Bojesen SE, Brenner H, Castelao JE, Chang-Claude J, Chenevix-Trench G, Clarke CL, Collée JM, Couch FJ, Cox A, Cross SS, Czene K, Devilee P, Dörk T, Dossus L, Eliassen AH, Eriksson M, Evans DG, Fasching PA, Figueroa J, Fletcher O, Flyger H, Fritschi L, Gabrielson M, Gago-Dominguez M, García-Closas M, Giles GG, González-Neira A, Guénel P, Hahnen E, Haiman CA, Hall P, Hollestelle A, Hoppe R, Hopper JL, Howell A, Jager A, Jakubowska A, John EM, Johnson N, Jones ME, Jung A, Kaaks R, Keeman R, Khusnutdinova E, Kitahara CM, Ko YD, Kosma VM, Koutros S, Kraft P, Kristensen VN, Kubelka-Sabit K, Kurian AW, Lacey JV, Lambrechts D, Larson NL, Linet M, Ogrodniczak A, Mannermaa A, Manoukian S, Margolin S, Mavroudis D, Milne RL, Muranen TA, Murphy RA, Nevanlinna H, Olson JE, Olsson H, Park-Simon TW, Perou CM, Peterlongo P, Plaseska-Karanfilska D, Pylkäs K, Rennert G, Saloustros E, Sandler DP, Sawyer EJ, Schmidt MK, Schmutzler RK, Shibli R, Smeets A, Soucy P, Southey MC, Swerdlow AJ, Tamimi RM, Taylor JA, Teras LR, Terry MB, Tomlinson I, Troester MA, Truong T, Vachon CM, Wendt C, Winqvist R, Wolk A, Yang XR, Zheng W, Ziogas A, Simard J, Dunning AM, Pharoah PDP, Easton DF. Rare germline copy number variants (CNVs) and breast cancer risk. Commun Biol 2022; 5:65. [PMID: 35042965 PMCID: PMC8766486 DOI: 10.1038/s42003-021-02990-6] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
Germline copy number variants (CNVs) are pervasive in the human genome but potential disease associations with rare CNVs have not been comprehensively assessed in large datasets. We analysed rare CNVs in genes and non-coding regions for 86,788 breast cancer cases and 76,122 controls of European ancestry with genome-wide array data. Gene burden tests detected the strongest association for deletions in BRCA1 (P = 3.7E-18). Nine other genes were associated with a p-value < 0.01 including known susceptibility genes CHEK2 (P = 0.0008), ATM (P = 0.002) and BRCA2 (P = 0.008). Outside the known genes we detected associations with p-values < 0.001 for either overall or subtype-specific breast cancer at nine deletion regions and four duplication regions. Three of the deletion regions were in established common susceptibility loci. To the best of our knowledge, this is the first genome-wide analysis of rare CNVs in a large breast cancer case-control dataset. We detected associations with exonic deletions in established breast cancer susceptibility genes. We also detected suggestive associations with non-coding CNVs in known and novel loci with large effects sizes. Larger sample sizes will be required to reach robust levels of statistical significance.
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Affiliation(s)
- Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Jonathan P Tyrer
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Logan C Walker
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Natalia N Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristan J Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Javier Benitez
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - Natalia V Bogdanova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk, Belarus
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Christine L Clarke
- Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - J Margriet Collée
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuela Gago-Dominguez
- Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Anna González-Neira
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif, France
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | | | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Esther M John
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Yon-Dschun Ko
- Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany
| | - Veli-Matti Kosma
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katerina Kubelka-Sabit
- Department of Histopathology and Cytology, Clinical Hospital Acibadem Sistina, Skopje, Republic of North Macedonia
| | - Allison W Kurian
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Nicole L Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martha Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Alicja Ogrodniczak
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Cancer Control Research, BC Cancer, Vancouver, Canada
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | | | - Charles M Perou
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Dijana Plaseska-Karanfilska
- Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', MASA, Skopje, Republic of North Macedonia
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Elinor J Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Rana Shibli
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Ann Smeets
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Penny Soucy
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ian Tomlinson
- Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thérèse Truong
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif, France
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Camilla Wendt
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
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Escala-Garcia M, Canisius S, Keeman R, Beesley J, Anton-Culver H, Arndt V, Augustinsson A, Becher H, Beckmann MW, Behrens S, Bermisheva M, Bojesen SE, Bolla MK, Brenner H, Canzian F, Castelao JE, Chang-Claude J, Chanock SJ, Couch FJ, Czene K, Daly MB, Dennis J, Devilee P, Dörk T, Dunning AM, Easton DF, Ekici AB, Eliassen AH, Fasching PA, Flyger H, Gago-Dominguez M, García-Closas M, García-Sáenz JA, Geisler J, Giles GG, Grip M, Gündert M, Hahnen E, Haiman CA, Håkansson N, Hall P, Hamann U, Hartikainen JM, Heemskerk-Gerritsen BAM, Hollestelle A, Hoppe R, Hopper JL, Hunter DJ, Jacot W, Jakubowska A, John EM, Jung AY, Kaaks R, Khusnutdinova E, Koppert LB, Kraft P, Kristensen VN, Kurian AW, Lambrechts D, Le Marchand L, Lindblom A, Luben RN, Lubiński J, Mannermaa A, Manoochehri M, Margolin S, Mavroudis D, Muranen TA, Nevanlinna H, Olshan AF, Olsson H, Park-Simon TW, Patel AV, Peterlongo P, Pharoah PDP, Punie K, Radice P, Rennert G, Rennert HS, Romero A, Roylance R, Rüdiger T, Ruebner M, Saloustros E, Sawyer EJ, Schmutzler RK, Schoemaker MJ, Scott C, Southey MC, Surowy H, Swerdlow AJ, Tamimi RM, Teras LR, Thomas E, Tomlinson I, Troester MA, Vachon CM, Wang Q, Winqvist R, Wolk A, Ziogas A, Michailidou K, Chenevix-Trench G, Bachelot T, Schmidt MK. Germline variants and breast cancer survival in patients with distant metastases at primary breast cancer diagnosis. Sci Rep 2021; 11:19787. [PMID: 34611289 PMCID: PMC8492709 DOI: 10.1038/s41598-021-99409-3] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 09/07/2021] [Indexed: 02/02/2023] Open
Abstract
Breast cancer metastasis accounts for most of the deaths from breast cancer. Identification of germline variants associated with survival in aggressive types of breast cancer may inform understanding of breast cancer progression and assist treatment. In this analysis, we studied the associations between germline variants and breast cancer survival for patients with distant metastases at primary breast cancer diagnosis. We used data from the Breast Cancer Association Consortium (BCAC) including 1062 women of European ancestry with metastatic breast cancer, 606 of whom died of breast cancer. We identified two germline variants on chromosome 1, rs138569520 and rs146023652, significantly associated with breast cancer-specific survival (P = 3.19 × 10-8 and 4.42 × 10-8). In silico analysis suggested a potential regulatory effect of the variants on the nearby target genes SDE2 and H3F3A. However, the variants showed no evidence of association in a smaller replication dataset. The validation dataset was obtained from the SNPs to Risk of Metastasis (StoRM) study and included 293 patients with metastatic primary breast cancer at diagnosis. Ultimately, larger replication studies are needed to confirm the identified associations.
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Affiliation(s)
- Maria Escala-Garcia
- Division of Molecular Pathology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Sander Canisius
- Division of Molecular Pathology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Jonathan Beesley
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annelie Augustinsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - Stig E Bojesen
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev, Denmark
- Gentofte Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jose E Castelao
- Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Oncology and Genetics Unit, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Medical Center Hamburg-Eppendorf, Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Arif B Ekici
- Institute of Human Genetics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Henrik Flyger
- Department of Breast Surgery, Copenhagen University Hospital, Herlev, Denmark
| | - Manuela Gago-Dominguez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - José A García-Sáenz
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Jürgen Geisler
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Graham G Giles
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Melanie Gündert
- German Cancer Research Center (DKFZ), Molecular Epidemiology Group, C080, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
- Helmholtz Zentrum München, Institute of Diabetes Research, German Research Center for Environmental Health, Neuherberg, Germany
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Sšdersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Jaana M Hartikainen
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | | | | | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L Hopper
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - William Jacot
- Institut du Cancer de Montpellier, Montpellier University, Montpellier, France
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Esther M John
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, CA, USA
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Linetta B Koppert
- Department of Surgical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Program in Genetic Epidemiology and Statistical Genetics, Boston, MA, USA
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Allison W Kurian
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, CA, USA
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Loic Le Marchand
- University of Hawaii Cancer Center, Epidemiology Program, Honolulu, HI, USA
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Robert N Luben
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, England, UK
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Biobank of Eastern Finland, Kuopio, Finland
| | - Mehdi Manoochehri
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, Sšdersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Sšdersjukhuset, Stockholm, Sweden
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | | | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Paolo Peterlongo
- IFOM-The FIRC Institute of Molecular Oncology, Genome Diagnostics Program, Milan, Italy
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Kevin Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Gad Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Hedy S Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Thomas Rüdiger
- Institute of Pathology, Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | | | - Elinor J Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, King's College London, Guy's Campus, London, UK
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Melissa C Southey
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Harald Surowy
- German Cancer Research Center (DKFZ), Molecular Epidemiology Group, C080, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Emilie Thomas
- Plateforme de Bioinformatique Gilles Thomas, Centre de recherche en cancérologie de Lyon, Fondation Synergie Lyon Cancer, Université Claude Bernard Lyon 1, Lyon, France
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Celine M Vachon
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, University of Oulu, Biocenter Oulu, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Thomas Bachelot
- Département de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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23
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Morra A, Escala-Garcia M, Beesley J, Keeman R, Canisius S, Ahearn TU, Andrulis IL, Anton-Culver H, Arndt V, Auer PL, Augustinsson A, Beane Freeman LE, Becher H, Beckmann MW, Behrens S, Bojesen SE, Bolla MK, Brenner H, Brüning T, Buys SS, Caan B, Campa D, Canzian F, Castelao JE, Chang-Claude J, Chanock SJ, Cheng TYD, Clarke CL, Colonna SV, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Dennis J, Dörk T, Dossus L, Dunning AM, Dwek M, Eccles DM, Ekici AB, Eliassen AH, Eriksson M, Evans DG, Fasching PA, Flyger H, Fritschi L, Gago-Dominguez M, García-Sáenz JA, Giles GG, Grip M, Guénel P, Gündert M, Hahnen E, Haiman CA, Håkansson N, Hall P, Hamann U, Hart SN, Hartikainen JM, Hartmann A, He W, Hooning MJ, Hoppe R, Hopper JL, Howell A, Hunter DJ, Jager A, Jakubowska A, Janni W, John EM, Jung AY, Kaaks R, Keupers M, Kitahara CM, Koutros S, Kraft P, Kristensen VN, Kurian AW, Lacey JV, Lambrechts D, Le Marchand L, Lindblom A, Linet M, Luben RN, Lubiński J, Lush M, Mannermaa A, Manoochehri M, Margolin S, Martens JWM, Martinez ME, Mavroudis D, Michailidou K, Milne RL, Mulligan AM, Muranen TA, Nevanlinna H, Newman WG, Nielsen SF, Nordestgaard BG, Olshan AF, Olsson H, Orr N, Park-Simon TW, Patel AV, Peissel B, Peterlongo P, Plaseska-Karanfilska D, Prajzendanc K, Prentice R, Presneau N, Rack B, Rennert G, Rennert HS, Rhenius V, Romero A, Roylance R, Ruebner M, Saloustros E, Sawyer EJ, Schmutzler RK, Schneeweiss A, Scott C, Shah M, Smichkoska S, Southey MC, Stone J, Surowy H, Swerdlow AJ, Tamimi RM, Tapper WJ, Teras LR, Terry MB, Tollenaar RAEM, Tomlinson I, Troester MA, Truong T, Vachon CM, Wang Q, Hurson AN, Winqvist R, Wolk A, Ziogas A, Brauch H, García-Closas M, Pharoah PDP, Easton DF, Chenevix-Trench G, Schmidt MK. Association of germline genetic variants with breast cancer-specific survival in patient subgroups defined by clinic-pathological variables related to tumor biology and type of systemic treatment. Breast Cancer Res 2021; 23:86. [PMID: 34407845 PMCID: PMC8371820 DOI: 10.1186/s13058-021-01450-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Given the high heterogeneity among breast tumors, associations between common germline genetic variants and survival that may exist within specific subgroups could go undetected in an unstratified set of breast cancer patients. METHODS We performed genome-wide association analyses within 15 subgroups of breast cancer patients based on prognostic factors, including hormone receptors, tumor grade, age, and type of systemic treatment. Analyses were based on 91,686 female patients of European ancestry from the Breast Cancer Association Consortium, including 7531 breast cancer-specific deaths over a median follow-up of 8.1 years. Cox regression was used to assess associations of common germline variants with 15-year and 5-year breast cancer-specific survival. We assessed the probability of these associations being true positives via the Bayesian false discovery probability (BFDP < 0.15). RESULTS Evidence of associations with breast cancer-specific survival was observed in three patient subgroups, with variant rs5934618 in patients with grade 3 tumors (15-year-hazard ratio (HR) [95% confidence interval (CI)] 1.32 [1.20, 1.45], P = 1.4E-08, BFDP = 0.01, per G allele); variant rs4679741 in patients with ER-positive tumors treated with endocrine therapy (15-year-HR [95% CI] 1.18 [1.11, 1.26], P = 1.6E-07, BFDP = 0.09, per G allele); variants rs1106333 (15-year-HR [95% CI] 1.68 [1.39,2.03], P = 5.6E-08, BFDP = 0.12, per A allele) and rs78754389 (5-year-HR [95% CI] 1.79 [1.46,2.20], P = 1.7E-08, BFDP = 0.07, per A allele), in patients with ER-negative tumors treated with chemotherapy. CONCLUSIONS We found evidence of four loci associated with breast cancer-specific survival within three patient subgroups. There was limited evidence for the existence of associations in other patient subgroups. However, the power for many subgroups is limited due to the low number of events. Even so, our results suggest that the impact of common germline genetic variants on breast cancer-specific survival might be limited.
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Affiliation(s)
- Anna Morra
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, 1066 CX The Netherlands
| | - Maria Escala-Garcia
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, 1066 CX The Netherlands
| | - Jonathan Beesley
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland Australia
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, 1066 CX The Netherlands
| | - Sander Canisius
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, 1066 CX The Netherlands
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Thomas U. Ahearn
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, ON Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA USA
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul L. Auer
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA USA
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI USA
| | - Annelie Augustinsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Laura E. Beane Freeman
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stig E. Bojesen
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Manjeet K. Bolla
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Thomas Brüning
- Institute of the Ruhr University Bochum (IPA), Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Bochum, Germany
| | - Saundra S. Buys
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT USA
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, CA USA
| | - Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Biology, University of Pisa, Pisa, Italy
| | - Federico Canzian
- German Cancer Research Center (DKFZ), Genomic Epidemiology Group, Heidelberg, Germany
| | - Jose E. Castelao
- Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Oncology and Genetics Unit, Vigo, Spain
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephen J. Chanock
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Ting-Yuan David Cheng
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY USA
| | - Christine L. Clarke
- Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales Australia
| | - Sarah V. Colonna
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT USA
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Angela Cox
- Department of Oncology and Metabolism, University of Sheffield, Sheffield Institute for Nucleic Acids (SInFoNiA), Sheffield, UK
| | - Simon S. Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
| | - Joe Dennis
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Alison M. Dunning
- Department of Oncology, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London, UK
| | - Diana M. Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Arif B. Ekici
- Institute of Human Genetics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - A. Heather Eliassen
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Channing Division of Network Medicine, Boston, MA USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D. Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
- Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA USA
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia Australia
| | - Manuela Gago-Dominguez
- Galician Public Foundation of Genomic Medicine (FPGMX), Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
- University of California San Diego, Moores Cancer Center, La Jolla, CA USA
| | - José A. García-Sáenz
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Graham G. Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Pascal Guénel
- Team Exposome and Heredity, INSERM, University Paris-Saclay, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
| | - Melanie Gündert
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
- German Research Center for Environmental Health, Institute of Diabetes Research, Helmholtz Zentrum München, Neuherberg, Germany
| | - Eric Hahnen
- Faculty of Medicine and University Hospital Cologne, Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO), University of Cologne, Cologne, Germany
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Steven N. Hart
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA
| | - Jaana M. Hartikainen
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen Nuremberg, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maartje J. Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
| | - Anthony Howell
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - David J. Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - kConFab Investigators
- Research Department, Peter MacCallum Cancer Center, Melbourne, Victoria Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria Australia
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Esther M. John
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | - Audrey Y. Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Machteld Keupers
- Department of Radiation Oncology, University Hospitals Leuven, , University of Leuven, Leuven, Belgium
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD USA
| | - Stella Koutros
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Vessela N. Kristensen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Allison W. Kurian
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA USA
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | - James V. Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA USA
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA USA
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI USA
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Martha Linet
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD USA
| | - Robert N. Luben
- Clinical Gerontology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Michael Lush
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Biobank of Eastern Finland, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - John W. M. Martens
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Maria Elena Martinez
- University of California San Diego, Moores Cancer Center, La Jolla, CA USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA USA
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- The Cyprus Institute of Neurology & Genetics, Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
- University Health Network, Laboratory Medicine Program, Toronto, ON Canada
| | - Taru A. Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - William G. Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Sune F. Nielsen
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Børge G. Nordestgaard
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Nick Orr
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | | | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Dijana Plaseska-Karanfilska
- MASA, Research Centre for Genetic Engineering and Biotechnology ‘Georgi D. Efremov’, Skopje, Republic of North Macedonia
| | - Karolina Prajzendanc
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Ross Prentice
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Nadege Presneau
- School of Life Sciences, University of Westminster, London, UK
| | - Brigitte Rack
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Gad Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Hedy S. Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Valerie Rhenius
- Department of Oncology, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | | | - Elinor J. Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy’s Campus, King’s College London, London, UK
| | - Rita K. Schmutzler
- Faculty of Medicine and University Hospital Cologne, Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO), University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Andreas Schneeweiss
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
- University Hospital and German Cancer Research Center, National Center for Tumor Diseases, Heidelberg, Germany
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA
| | - Mitul Shah
- Department of Oncology, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Snezhana Smichkoska
- Medical Faculty, University Clinic of Radiotherapy and Oncology, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Melissa C. Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, Western Australia Australia
| | - Harald Surowy
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY USA
| | | | - Lauren R. Teras
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | | | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- University of Oxford, Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Melissa A. Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Thérèse Truong
- Team Exposome and Heredity, INSERM, University Paris-Saclay, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
| | - Celine M. Vachon
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN USA
| | - Qin Wang
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Amber N. Hurson
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA USA
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- iFIT-Cluster of Excellence, University of Tübingen, Tübingen, Germany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) Partner Site Tübingen, Tübingen, Germany
| | - Montserrat García-Closas
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Paul D. P. Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
- Department of Oncology, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Douglas F. Easton
- Department of Public Health and Primary Care, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
- Department of Oncology, University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland Australia
| | - Marjanka K. Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, 1066 CX The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Schaefer B, Weller S, Beigl T, Boepple K, Hoppe R, Schulze-Osthoff K, Kopp HG, Aulitzky WE, Essmann F. Abstract 1946: Synergistic cell death induction in breast cancer cell lines by combining ABT-199 and cisplatin irrespective of estrogen receptor and p53 expression. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1946] [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
50 Years after the generation of the most studied human breast cancer cell line, MCF-7, many research results fundamentally changed patient outcomes for the better. The mortality of breast cancer in women has decreased significantly, especially in the last 30 years. But the total number of deaths is rising again in the last ten years. Considering that breast cancer is the most common cancer in women and the second most common cancer overall, with incidences of 24,2% and 11,6%, respectively, total numbers of new cases are in the millions every year.
First line drugs for the treatment of breast cancer often target microtubules (e.g. Vinblastine and Paclitaxel) or induce DNA damage (e.g. Carboplatin and Cisplatin (CisPt)). In addition to these classic therapeutic drugs new compounds that specifically target cancer-driving molecular alterations have been developed. Among these is the group of BH3-mimetics. The efficacy of several BH3-mimetics is investigated in numerous clinical trials while the BCL-2 specific inhibitor ABT-199 (Venetoclax) is already approved for clinical application in chronic lymphatic leukemia (CLL), acute myeloid leukemia (AML) and small lymphocytic lymphoma (SLL). BH3-mimetics target the apoptosis machinery by interacting with anti-apoptotic Bcl-2 proteins, mimicking the function of pro-apoptotic BH3-only proteins. In turn, the pro-apoptotic potential of pore-forming BCL-2 effectors BAX, BAK and BOK is released inducing mitochondrial outer membrane permeabilization and cell death.
Recently we reported synergistic cell death induction by ABT-199 in combination with the proteasome inhibitor Bortezomib (BOZ) in soft tissue sarcoma (STS) cells. ABT-199 and BOZ induce accumulation of BOK and the BH3-only protein NOXA (Muenchow et al. 2020). Here, we combined ABT-199, CisPt and Nutlin-3 in breast cancer cell lines that differ in expression of the estrogen receptor (ER) and p53 activity. Similar to the results in STS cells synergistic induction of apoptotic cell death was observed by FACS analysis of the mitochondrial membrane potential (TMRM) and exposure of phosphatidyl serine (Annexin-V). Western blot analysis revealed that ABT-199 induced accumulation of NOXA and MCL-1, irrespective of the ER status or p53 mutation. Simultaneous treatment with ABT-199 and CisPt or Nutlin-3 further increased expression of NOXA and MCL-1. Interestingly, qRT-PCR revealed enhanced expression of NOXA and MCL-1 mRNA in ABT-199 treated cells indicating transcriptional regulation. However, transcriptional induction of NOXA was also detected independent of p53 activity. Thus, combined therapeutic approaches using CisPt and ABT-199 should be effective irrespective of ER and p53 expression. Nevertheless, in p53 proficient tumors Nutlins might increase therapeutic efficacy.
Citation Format: Benjamin Schaefer, Sandra Weller, Tobias Beigl, Kathrin Boepple, Reiner Hoppe, Klaus Schulze-Osthoff, Hans-Georg Kopp, Walter E. Aulitzky, Frank Essmann. Synergistic cell death induction in breast cancer cell lines by combining ABT-199 and cisplatin irrespective of estrogen receptor and p53 expression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1946.
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Affiliation(s)
- Benjamin Schaefer
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Sandra Weller
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Tobias Beigl
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Kathrin Boepple
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | | | - Hans-Georg Kopp
- 3Robert Bosch Hospital and Robert Bosch Centrum for Tumor Diseases, Stuttgart, Germany
| | | | - Frank Essmann
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
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25
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Baxter JS, Johnson N, Tomczyk K, Gillespie A, Maguire S, Brough R, Fachal L, Michailidou K, Bolla MK, Wang Q, Dennis J, Ahearn TU, Andrulis IL, Anton-Culver H, Antonenkova NN, Arndt V, Aronson KJ, Augustinsson A, Becher H, Beckmann MW, Behrens S, Benitez J, Bermisheva M, Bogdanova NV, Bojesen SE, Brenner H, Brucker SY, Cai Q, Campa D, Canzian F, Castelao JE, Chan TL, Chang-Claude J, Chanock SJ, Chenevix-Trench G, Choi JY, Clarke CL, Colonna S, Conroy DM, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Devilee P, Dörk T, Dossus L, Dwek M, Eccles DM, Ekici AB, Eliassen AH, Engel C, Fasching PA, Figueroa J, Flyger H, Gago-Dominguez M, Gao C, García-Closas M, García-Sáenz JA, Ghoussaini M, Giles GG, Goldberg MS, González-Neira A, Guénel P, Gündert M, Haeberle L, Hahnen E, Haiman CA, Hall P, Hamann U, Hartman M, Hatse S, Hauke J, Hollestelle A, Hoppe R, Hopper JL, Hou MF, Ito H, Iwasaki M, Jager A, Jakubowska A, Janni W, John EM, Joseph V, Jung A, Kaaks R, Kang D, Keeman R, Khusnutdinova E, Kim SW, Kosma VM, Kraft P, Kristensen VN, Kubelka-Sabit K, Kurian AW, Kwong A, Lacey JV, Lambrechts D, Larson NL, Larsson SC, Le Marchand L, Lejbkowicz F, Li J, Long J, Lophatananon A, Lubiński J, Mannermaa A, Manoochehri M, Manoukian S, Margolin S, Matsuo K, Mavroudis D, Mayes R, Menon U, Milne RL, Mohd Taib NA, Muir K, Muranen TA, Murphy RA, Nevanlinna H, O'Brien KM, Offit K, Olson JE, Olsson H, Park SK, Park-Simon TW, Patel AV, Peterlongo P, Peto J, Plaseska-Karanfilska D, Presneau N, Pylkäs K, Rack B, Rennert G, Romero A, Ruebner M, Rüdiger T, Saloustros E, Sandler DP, Sawyer EJ, Schmidt MK, Schmutzler RK, Schneeweiss A, Schoemaker MJ, Shah M, Shen CY, Shu XO, Simard J, Southey MC, Stone J, Surowy H, Swerdlow AJ, Tamimi RM, Tapper WJ, Taylor JA, Teo SH, Teras LR, Terry MB, Toland AE, Tomlinson I, Truong T, Tseng CC, Untch M, Vachon CM, van den Ouweland AMW, Wang SS, Weinberg CR, Wendt C, Winham SJ, Winqvist R, Wolk A, Wu AH, Yamaji T, Zheng W, Ziogas A, Pharoah PDP, Dunning AM, Easton DF, Pettitt SJ, Lord CJ, Haider S, Orr N, Fletcher O. Functional annotation of the 2q35 breast cancer risk locus implicates a structural variant in influencing activity of a long-range enhancer element. Am J Hum Genet 2021; 108:1190-1203. [PMID: 34146516 PMCID: PMC8322933 DOI: 10.1016/j.ajhg.2021.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/25/2021] [Indexed: 12/21/2022] Open
Abstract
A combination of genetic and functional approaches has identified three independent breast cancer risk loci at 2q35. A recent fine-scale mapping analysis to refine these associations resulted in 1 (signal 1), 5 (signal 2), and 42 (signal 3) credible causal variants at these loci. We used publicly available in silico DNase I and ChIP-seq data with in vitro reporter gene and CRISPR assays to annotate signals 2 and 3. We identified putative regulatory elements that enhanced cell-type-specific transcription from the IGFBP5 promoter at both signals (30- to 40-fold increased expression by the putative regulatory element at signal 2, 2- to 3-fold by the putative regulatory element at signal 3). We further identified one of the five credible causal variants at signal 2, a 1.4 kb deletion (esv3594306), as the likely causal variant; the deletion allele of this variant was associated with an average additional increase in IGFBP5 expression of 1.3-fold (MCF-7) and 2.2-fold (T-47D). We propose a model in which the deletion allele of esv3594306 juxtaposes two transcription factor binding regions (annotated by estrogen receptor alpha ChIP-seq peaks) to generate a single extended regulatory element. This regulatory element increases cell-type-specific expression of the tumor suppressor gene IGFBP5 and, thereby, reduces risk of estrogen receptor-positive breast cancer (odds ratio = 0.77, 95% CI 0.74-0.81, p = 3.1 × 10-31).
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Affiliation(s)
- Joseph S Baxter
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK.
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK
| | - Katarzyna Tomczyk
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK
| | - Andrea Gillespie
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK
| | - Sarah Maguire
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Ireland BT7 1NN, UK
| | - Rachel Brough
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK; The CRUK Gene Function Laboratory, The Institute of Cancer Research, London SW3 6JB, UK
| | - Laura Fachal
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Kyriaki Michailidou
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia 2371, Cyprus; Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia 2371, Cyprus; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20850, USA
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA 92617, USA
| | - Natalia N Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk 223040, Belarus
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Kristan J Aronson
- Department of Public Health Sciences, and Cancer Research Institute, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Annelie Augustinsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund 222 42, Sweden
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen 91054, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Javier Benitez
- Biomedical Network on Rare Diseases (CIBERER), Madrid 28029, Spain; Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - Marina Bermisheva
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa 450054, Russia
| | - Natalia V Bogdanova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk 223040, Belarus; Department of Radiation Oncology, Hannover Medical School, Hannover 30625, Germany; Gynaecology Research Unit, Hannover Medical School, Hannover 30625, Germany
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg 69120, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Sara Y Brucker
- Department of Gynecology and Obstetrics, University of Tübingen, Tübingen 72076, Germany
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; Department of Biology, University of Pisa, Pisa 56126, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Jose E Castelao
- Oncology and Genetics Unit, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Vigo 36312, Spain
| | - Tsun L Chan
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong; Department of Molecular Pathology, Hong Kong Sanatorium and Hospital, Hong Kong
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20850, USA
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; Cancer Research Institute, Seoul National University, Seoul 03080, Korea; Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Christine L Clarke
- Westmead Institute for Medical Research, University of Sydney, Sydney, NSW 2145, Australia
| | - Sarah Colonna
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
| | - Don M Conroy
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, University of Sheffield, Sheffield S10 2TN, UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield S10 2TN, UK
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 65, Sweden
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden 2333 ZA, the Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden 2333 ZA, the Netherlands
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover 30625, Germany
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon 69372, France
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London W1B 2HW, UK
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Arif B Ekici
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen 91054, Germany
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig 04107, Germany; LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig 04103, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen 91054, Germany; David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20850, USA; Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh EH16 4UX, UK; Cancer Research UK Edinburgh Centre, The University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark
| | - Manuela Gago-Dominguez
- Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela 15706, Spain; Moores Cancer Center, University of California San Diego, La Jolla, CA 92037, USA
| | - Chi Gao
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20850, USA
| | - José A García-Sáenz
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid 28040, Spain
| | - Maya Ghoussaini
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; Open Targets, Core Genetics Team, Wellcome Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montréal, QC H4A 3J1, Canada; Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montréal, QC H4A 3J1, Canada
| | - Anna González-Neira
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif 94805, France
| | - Melanie Gündert
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg 69120, Germany; Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany
| | - Lothar Haeberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen 91054, Germany
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany; Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 65, Sweden; Department of Oncology, Södersjukhuset, Stockholm 118 83, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 119077, Singapore; Department of Surgery, National University Hospital, Singapore 119228, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Sigrid Hatse
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, Leuven Cancer Institute, Leuven 3000, Belgium
| | - Jan Hauke
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany; Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50931, Germany
| | - Antoinette Hollestelle
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam 3015 GD, the Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart 70376, Germany; University of Tübingen, Tübingen 72074, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Ming-Feng Hou
- Department of Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan
| | - Hidemi Ito
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan; Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Motoki Iwasaki
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam 3015 GD, the Netherlands
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 71-252, Poland; Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin 71-252, Poland
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm 89075, Germany
| | - Esther M John
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Vijai Joseph
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Renske Keeman
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, the Netherlands
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa 450054, Russia; Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa 450000, Russia
| | - Sung-Won Kim
- Department of Surgery, Daerim Saint Mary's Hospital, Seoul 07442, Korea
| | - Veli-Matti Kosma
- Translational Cancer Research Area, University of Eastern Finland, Kuopio 70210, Finland; Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio 70210, Finland; Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Vessela N Kristensen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo 0450, Norway; Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo 0379, Norway
| | - Katerina Kubelka-Sabit
- Department of Histopathology and Cytology, Clinical Hospital Acibadem Sistina, Skopje 1000, Republic of North Macedonia
| | - Allison W Kurian
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Ava Kwong
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong; Department of Surgery, The University of Hong Kong, Hong Kong; Department of Surgery and Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Hong Kong
| | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA 91010, USA; City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA 91010, USA
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven 3001, Belgium; Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven 3000, Belgium
| | - Nicole L Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Susanna C Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala 751 05, Sweden
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Flavio Lejbkowicz
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa 35254, Israel
| | - Jingmei Li
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; Human Genetics Division, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 71-252, Poland
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio 70210, Finland; Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio 70210, Finland; Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan 20133, Italy
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm 118 83, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm 118 83, Sweden
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan; Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion 711 10, Greece
| | - Rebecca Mayes
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Usha Menon
- Institute of Clinical Trials & Methodology, University College London, London WC1V 6LJ, UK
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
| | - Nur Aishah Mohd Taib
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki 00290, Finland
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki 00290, Finland
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709, USA
| | - Kenneth Offit
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund 222 42, Sweden
| | - Sue K Park
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea; Convergence Graduate Program in Innovative Medical Science, Seoul National University College of Medicine, Seoul 03080, Korea
| | | | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC Institute of Molecular Oncology, Milan 20139, Italy
| | - Julian Peto
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Dijana Plaseska-Karanfilska
- Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', MASA, Skopje 1000, Republic of North Macedonia
| | - Nadege Presneau
- School of Life Sciences, University of Westminster, London W1B 2HW, UK
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu 90570, Finland; Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu 90570, Finland
| | - Brigitte Rack
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm 89075, Germany
| | - Gad Rennert
- Clalit National Cancer Control Center, Carmel Medical Center and Technion Faculty of Medicine, Haifa 35254, Israel
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid 28222, Spain
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen 91054, Germany
| | - Thomas Rüdiger
- Institute of Pathology, Staedtisches Klinikum Karlsruhe, Karlsruhe 76133, Germany
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709, USA
| | - Elinor J Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, the Netherlands; Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam 1066 CX, the Netherlands
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany; Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50931, Germany
| | - Andreas Schneeweiss
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg 69120, Germany; National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg 69120, Germany
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Chen-Yang Shen
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan; School of Public Health, China Medical University, Taichung, Taiwan
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC G1V 4G2, Canada
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia; Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Jennifer Stone
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia; Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia, Perth, WA 6000, Australia
| | - Harald Surowy
- Molecular Epidemiology Group, C080, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany; Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg 69120, Germany
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK; Division of Breast Cancer Research, The Institute of Cancer Research, London SW7 3RP, UK
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
| | - William J Tapper
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709, USA; Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709, USA
| | - Soo Hwang Teo
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, Selangor 47500, Malaysia; Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Lauren R Teras
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH 43210, USA
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK; Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford OX3 7BN, UK
| | - Thérèse Truong
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif 94805, France
| | - Chiu-Chen Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Michael Untch
- Department of Gynecology and Obstetrics, Helios Clinics Berlin-Buch, Berlin 13125, Germany
| | - Celine M Vachon
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ans M W van den Ouweland
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam 3015 GD, the Netherlands
| | - Sophia S Wang
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA 91010, USA; City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA 91010, USA
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC 27709, USA
| | - Camilla Wendt
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm 118 83, Sweden
| | - Stacey J Winham
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu 90570, Finland; Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu 90570, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala 751 05, Sweden
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Taiki Yamaji
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA 92617, USA
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Stephen J Pettitt
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK; The CRUK Gene Function Laboratory, The Institute of Cancer Research, London SW3 6JB, UK
| | - Christopher J Lord
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK; The CRUK Gene Function Laboratory, The Institute of Cancer Research, London SW3 6JB, UK
| | - Syed Haider
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK
| | - Nick Orr
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Ireland BT7 1NN, UK
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK.
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Park J, Choi JY, Choi J, Chung S, Song N, Park SK, Han W, Noh DY, Ahn SH, Lee JW, Kim MK, Jee SH, Wen W, Bolla MK, Wang Q, Dennis J, Michailidou K, Shah M, Conroy DM, Harrington PA, Mayes R, Czene K, Hall P, Teras LR, Patel AV, Couch FJ, Olson JE, Sawyer EJ, Roylance R, Bojesen SE, Flyger H, Lambrechts D, Baten A, Matsuo K, Ito H, Guénel P, Truong T, Keeman R, Schmidt MK, Wu AH, Tseng CC, Cox A, Cross SS, Andrulis IL, Hopper JL, Southey MC, Wu PE, Shen CY, Fasching PA, Ekici AB, Muir K, Lophatananon A, Brenner H, Arndt V, Jones ME, Swerdlow AJ, Hoppe R, Ko YD, Hartman M, Li J, Mannermaa A, Hartikainen JM, Benitez J, González-Neira A, Haiman CA, Dörk T, Bogdanova NV, Teo SH, Mohd Taib NA, Fletcher O, Johnson N, Grip M, Winqvist R, Blomqvist C, Nevanlinna H, Lindblom A, Wendt C, Kristensen VN, Tollenaar RAEM, Heemskerk-Gerritsen BAM, Radice P, Bonanni B, Hamann U, Manoochehri M, Lacey JV, Martinez ME, Dunning AM, Pharoah PDP, Easton DF, Yoo KY, Kang D. Gene-Environment Interactions Relevant to Estrogen and Risk of Breast Cancer: Can Gene-Environment Interactions Be Detected Only among Candidate SNPs from Genome-Wide Association Studies? Cancers (Basel) 2021; 13:2370. [PMID: 34069208 PMCID: PMC8156547 DOI: 10.3390/cancers13102370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/24/2022] Open
Abstract
In this study we aim to examine gene-environment interactions (GxEs) between genes involved with estrogen metabolism and environmental factors related to estrogen exposure. GxE analyses were conducted with 1970 Korean breast cancer cases and 2052 controls in the case-control study, the Seoul Breast Cancer Study (SEBCS). A total of 11,555 SNPs from the 137 candidate genes were included in the GxE analyses with eight established environmental factors. A replication test was conducted by using an independent population from the Breast Cancer Association Consortium (BCAC), with 62,485 Europeans and 9047 Asians. The GxE tests were performed by using two-step methods in GxEScan software. Two interactions were found in the SEBCS. The first interaction was shown between rs13035764 of NCOA1 and age at menarche in the GE|2df model (p-2df = 1.2 × 10-3). The age at menarche before 14 years old was associated with the high risk of breast cancer, and the risk was higher when subjects had homozygous minor allele G. The second GxE was shown between rs851998 near ESR1 and height in the GE|2df model (p-2df = 1.1 × 10-4). Height taller than 160 cm was associated with a high risk of breast cancer, and the risk increased when the minor allele was added. The findings were not replicated in the BCAC. These results would suggest specificity in Koreans for breast cancer risk.
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Affiliation(s)
- JooYong Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; (J.P.); (S.C.); (S.K.P.); (D.K.)
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; (J.P.); (S.C.); (S.K.P.); (D.K.)
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul 03080, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul 03080, Korea;
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea; (W.H.); (D.-Y.N.)
| | - Jaesung Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul 03080, Korea;
| | - Seokang Chung
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; (J.P.); (S.C.); (S.K.P.); (D.K.)
| | - Nan Song
- College of Pharmacy, Chungbuk National University, Cheongju-si 28160, Korea;
| | - Sue K. Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; (J.P.); (S.C.); (S.K.P.); (D.K.)
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea; (W.H.); (D.-Y.N.)
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Wonshik Han
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea; (W.H.); (D.-Y.N.)
- Department of Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Dong-Young Noh
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea; (W.H.); (D.-Y.N.)
- Department of Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sei-Hyun Ahn
- Department of Surgery, Medicine and ASAN Medical Center, University of Ulsan College, Seoul 05505, Korea; (S.-H.A.); (J.W.L.)
| | - Jong Won Lee
- Department of Surgery, Medicine and ASAN Medical Center, University of Ulsan College, Seoul 05505, Korea; (S.-H.A.); (J.W.L.)
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Management, National Cancer Center, Goyang-si 10408, Korea;
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea;
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Manjeet K. Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (M.K.B.); (Q.W.); (J.D.); (K.M.); (P.D.P.P.); (D.F.E.)
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (M.K.B.); (Q.W.); (J.D.); (K.M.); (P.D.P.P.); (D.F.E.)
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (M.K.B.); (Q.W.); (J.D.); (K.M.); (P.D.P.P.); (D.F.E.)
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (M.K.B.); (Q.W.); (J.D.); (K.M.); (P.D.P.P.); (D.F.E.)
- Biostatistics Unit, The Cyprus Institute of Neurology & Genetics, Nicosia 2371, Cyprus
- Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia 23462, Cyprus
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Don M. Conroy
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Patricia A. Harrington
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Rebecca Mayes
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65 Stockholm, Sweden; (K.C.); (P.H.)
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 65 Stockholm, Sweden; (K.C.); (P.H.)
- Department of Oncology, Södersjukhuset, 118 83 Stockholm, Sweden
| | - Lauren R. Teras
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA;
| | - Alpa V. Patel
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (A.V.P.); (F.J.C.)
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (A.V.P.); (F.J.C.)
| | - Janet E. Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA;
| | - Elinor J. Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy’s Campus, King’s College London, London SE1 9RT, UK;
| | - Rebecca Roylance
- Department of Oncology, UCLH Foundation Trust, London NW1 2PG, UK;
| | - Stig E. Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730 Herlev, Denmark;
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730 Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, 2730 Herlev, Denmark;
| | - Diether Lambrechts
- VIB Center for Cancer Biology, 3001 Leuve, Belgium;
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, 3000 Leuven, Belgium
| | - Adinda Baten
- Department of Radiotherapy Oncology, KU Leuven—University of Leuven, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan;
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan;
| | - Hidemi Ito
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan;
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, 94805 Villejuif, France; (P.G.); (T.T.)
| | - Thérèse Truong
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, 94805 Villejuif, France; (P.G.); (T.T.)
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands; (R.K.); (M.K.S.)
| | - Marjanka K. Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands; (R.K.); (M.K.S.)
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.H.W.); (C.-C.T.); (C.A.H.)
| | - Chiu-Chen Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.H.W.); (C.-C.T.); (C.A.H.)
| | - Angela Cox
- Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, University of Sheffield, Sheffield S10 2TN, UK;
| | - Simon S. Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield S10 2TN, UK;
| | - kConFab Investigators
- Peter MacCallum Cancer Center, Melbourne, VIC 3000, Australia;
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Irene L. Andrulis
- Fred A, Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada;
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Melissa C. Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia;
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC 3010, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia
| | - Pei-Ei Wu
- Taiwan Biobank, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan;
| | - Chen-Yang Shen
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan;
- School of Public Health, China Medical University, Taichung 404, Taiwan
| | - Peter A. Fasching
- Department of Medicine Division of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany;
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK; (K.M.); (A.L.)
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK; (K.M.); (A.L.)
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (H.B.); (V.A.)
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (H.B.); (V.A.)
| | - Michael E. Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK; (M.E.J.); (A.J.S.)
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SM2 5NG, UK; (M.E.J.); (A.J.S.)
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW7 3RP, UK
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, 70376 Stuttgart, Germany;
- University of Tübingen, 72074 Tübingen, Germany
| | - Yon-Dschun Ko
- Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, 53177 Bonn, Germany;
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore;
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
- Department of Surgery, National University Health System, Singapore 119228, Singapore
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672, Singapore;
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, 70210 Kuopio, Finland; (A.M.); (J.M.H.)
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, 70210 Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, 70210 Kuopio, Finland
| | - Jaana M. Hartikainen
- Translational Cancer Research Area, University of Eastern Finland, 70210 Kuopio, Finland; (A.M.); (J.M.H.)
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, 70210 Kuopio, Finland
| | - Javier Benitez
- Biomedical Network on Rare Diseases (CIBERER), 28029 Madrid, Spain;
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain;
| | - Anna González-Neira
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain;
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (A.H.W.); (C.-C.T.); (C.A.H.)
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, 30625 Hannover, Germany; (T.D.); (N.V.B.)
| | - Natalia V. Bogdanova
- Gynaecology Research Unit, Hannover Medical School, 30625 Hannover, Germany; (T.D.); (N.V.B.)
- Department of Radiation Oncology, Hannover Medical School, 30625 Hannover, Germany
- NN Alexandrov Research Institute of Oncology and Medical Radiology, 223040 Minsk, Belarus
| | - Soo Hwang Teo
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya 47500, Malaysia;
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Nur Aishah Mohd Taib
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK; (O.F.); (N.J.)
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW7 3RP, UK; (O.F.); (N.J.)
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, 90220 Oulu, Finland;
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, 90570 Oulu, Finland;
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu 90570, Finland
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland;
- Department of Oncology, Örebro University Hospital, 70185 Örebro, Sweden
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland;
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden;
- Department of Clinical Genetics, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Camilla Wendt
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83 Stockholm, Sweden;
| | - Vessela N. Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, 0450 Oslo, Norway; (V.N.K.); (NBCS Collaborators)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
| | - NBCS Collaborators
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, 0450 Oslo, Norway; (V.N.K.); (NBCS Collaborators)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Research, Vestre Viken Hospital, 3004 Drammen, Norway
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0450 Oslo, Norway
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital-Radiumhospitalet, 0450 Oslo, Norway
- Section for Breast- and Endocrine Surgery, Department of Cancer, Division of Surgery, Cancer and Transplantation Medicine, Oslo University Hospital-Ullevål, 0450 Oslo, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0450 Oslo, Norway
- Department of Pathology at Akershus University Hospital, 1478 Lørenskog, Norway
- Department of Oncology, Division of Surgery and Cancer and Transplantation Medicine, University Hospital-Radiumhospitalet, 0405 Oslo, Norway
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, 0405 Oslo, Norway
- Department of Oncology, Akershus University Hospital, 1478 Lørenskog, Norway
- Oslo Breast Cancer Research Consortium, Oslo University Hospital, 0405 Oslo, Norway
| | - Rob A. E. M. Tollenaar
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | | | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), 20133 Milan, Italy;
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (U.H.); (M.M.)
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (U.H.); (M.M.)
| | - James V. Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA 91010, USA;
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, CA 91010, USA
| | - Maria Elena Martinez
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92037, USA;
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA 92161, USA
| | - Alison M. Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Paul D. P. Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (M.K.B.); (Q.W.); (J.D.); (K.M.); (P.D.P.P.); (D.F.E.)
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; (M.K.B.); (Q.W.); (J.D.); (K.M.); (P.D.P.P.); (D.F.E.)
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge CB1 8RN, UK; (M.S.); (D.M.C.); (P.A.H.); (R.M.); (A.M.D.)
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Daehee Kang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; (J.P.); (S.C.); (S.K.P.); (D.K.)
- Cancer Research Institute, Seoul National University, Seoul 03080, Korea; (W.H.); (D.-Y.N.)
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea;
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Morra A, Jung AY, Behrens S, Keeman R, Ahearn TU, Anton-Culver H, Arndt V, Augustinsson A, Auvinen PK, Beane Freeman LE, Becher H, Beckmann MW, Blomqvist C, Bojesen SE, Bolla MK, Brenner H, Briceno I, Brucker SY, Camp NJ, Campa D, Canzian F, Castelao JE, Chanock SJ, Choi JY, Clarke CL, Couch FJ, Cox A, Cross SS, Czene K, Dörk T, Dunning AM, Dwek M, Easton DF, Eccles DM, Egan KM, Evans DG, Fasching PA, Flyger H, Gago-Dominguez M, Gapstur SM, García-Sáenz JA, Gaudet MM, Giles GG, Grip M, Guénel P, Haiman CA, Håkansson N, Hall P, Hamann U, Han SN, Hart SN, Hartman M, Heyworth JS, Hoppe R, Hopper JL, Hunter DJ, Ito H, Jager A, Jakimovska M, Jakubowska A, Janni W, Kaaks R, Kang D, Kapoor PM, Kitahara CM, Koutros S, Kraft P, Kristensen VN, Lacey JV, Lambrechts D, Le Marchand L, Li J, Lindblom A, Lubiński J, Lush M, Mannermaa A, Manoochehri M, Margolin S, Mariapun S, Matsuo K, Mavroudis D, Milne RL, Muranen TA, Newman WG, Noh DY, Nordestgaard BG, Obi N, Olshan AF, Olsson H, Park-Simon TW, Petridis C, Pharoah PDP, Plaseska-Karanfilska D, Presneau N, Rashid MU, Rennert G, Rennert HS, Rhenius V, Romero A, Saloustros E, Sawyer EJ, Schneeweiss A, Schwentner L, Scott C, Shah M, Shen CY, Shu XO, Southey MC, Stram DO, Tamimi RM, Tapper W, Tollenaar RAEM, Tomlinson I, Torres D, Troester MA, Truong T, Vachon CM, Wang Q, Wang SS, Williams JA, Winqvist R, Wolk A, Wu AH, Yoo KY, Yu JC, Zheng W, Ziogas A, Yang XR, Eliassen AH, Holmes MD, García-Closas M, Teo SH, Schmidt MK, Chang-Claude J. Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium. Cancer Epidemiol Biomarkers Prev 2021; 30:623-642. [PMID: 33500318 PMCID: PMC8026532 DOI: 10.1158/1055-9965.epi-20-0924] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/31/2020] [Accepted: 01/08/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND It is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype. METHODS We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype. RESULTS There was no evidence of heterogeneous associations between risk factors and mortality by subtype (P adj > 0.30). The strongest associations were between all-cause mortality and BMI ≥30 versus 18.5-25 kg/m2 [HR (95% confidence interval (CI), 1.19 (1.06-1.34)]; current versus never smoking [1.37 (1.27-1.47)], high versus low physical activity [0.43 (0.21-0.86)], age ≥30 years versus <20 years at first pregnancy [0.79 (0.72-0.86)]; >0-<5 years versus ≥10 years since last full-term birth [1.31 (1.11-1.55)]; ever versus never use of oral contraceptives [0.91 (0.87-0.96)]; ever versus never use of menopausal hormone therapy, including current estrogen-progestin therapy [0.61 (0.54-0.69)]. Similar associations with breast cancer mortality were weaker; for example, 1.11 (1.02-1.21) for current versus never smoking. CONCLUSIONS We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype. IMPACT Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.
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Affiliation(s)
- Anna Morra
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Thomas U Ahearn
- National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Hoda Anton-Culver
- Department of Epidemiology, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, California
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annelie Augustinsson
- Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | - Päivi K Auvinen
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Oncology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Cancer Center, Department of Oncology, Kuopio University Hospital, Kuopio, Finland
| | - Laura E Beane Freeman
- National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Biometry and Clinical Epidemiology, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Stig E Bojesen
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark
- Copenhagen University Hospital, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | | | - Sara Y Brucker
- Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Biology, University of Pisa, Pisa, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jose E Castelao
- Oncology and Genetics Unit, Xerencia de Xestion Integrada de Vigo-SERGAS, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Vigo, Spain
| | - Stephen J Chanock
- National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | | | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Angela Cox
- Department of Oncology and Metabolism, Sheffield Institute for Nucleic Acids (SInFoNiA), University of Sheffield, Sheffield, United Kingdom
| | - Simon S Cross
- Department of Neuroscience, Academic Unit of Pathology, University of Sheffield, Sheffield, United Kingdom
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London, United Kingdom
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Kathleen M Egan
- Division of Population Sciences, Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - D Gareth Evans
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, United Kingdom
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
- Division of Hematology and Oncology, Department of Medicine David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Henrik Flyger
- Copenhagen University Hospital, Department of Breast Surgery, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Manuela Gago-Dominguez
- Galician Public Foundation of Genomic Medicine (FPGMX), Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, California
| | - Susan M Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
| | - José A García-Sáenz
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Mia M Gaudet
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif, France
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Sileny N Han
- Department of Gynaecological Oncology, Leuven Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Steven N Hart
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Surgery, National University Health System, Singapore, Singapore
| | - Jane S Heyworth
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - David J Hunter
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hidemi Ito
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Milena Jakimovska
- MASA, Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje, Republic of North Macedonia
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daehee Kang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Pooja Middha Kapoor
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Stella Koutros
- National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - James V Lacey
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, California
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, California
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Michael Lush
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Pathology and Forensic Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Mehdi Manoochehri
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Sara Margolin
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Shivaani Mariapun
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
- Department of Mathematical Sciences, Faculty of Science and Engineering, University of Nottingham Malaysia Campus, Semenyih, Selangor, Malaysia
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, United Kingdom
| | - Dong-Young Noh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Børge G Nordestgaard
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark
- Copenhagen University Hospital, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nadia Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Håkan Olsson
- Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | | | - Christos Petridis
- Research Oncology, King's College London, Guy's Hospital, London, United Kingdom
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Dijana Plaseska-Karanfilska
- MASA, Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje, Republic of North Macedonia
| | - Nadege Presneau
- School of Life Sciences, University of Westminster, London, United Kingdom
| | - Muhammad U Rashid
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Gad Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Hedy S Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Valerie Rhenius
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Atocha Romero
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Elinor J Sawyer
- School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, United Kingdom
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Mitul Shah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Chen-Yang Shen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- School of Public Health, China Medical University, Taichung, Taiwan
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Daniel O Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - William Tapper
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
- Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Diana Torres
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Thérèse Truong
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif, France
| | - Celine M Vachon
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, Minnesota
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Sophia S Wang
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, California
- City of Hope Comprehensive Cancer Center, City of Hope, Duarte, California
| | - Justin A Williams
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland
- Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Keun-Young Yoo
- Seoul National University College of Medicine, Seoul, Korea
- Armed Forces Capital Hospital, Seongnam, Korea
| | - Jyh-Cherng Yu
- Department of Surgery, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Argyrios Ziogas
- Department of Epidemiology, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, California
| | - Xiaohong R Yang
- National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Montserrat García-Closas
- National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Soo Hwang Teo
- Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Volpato M, Cummings M, Shaaban AM, Abderrahman B, Hull MA, Maximov PY, Broom BM, Hoppe R, Fan P, Brauch H, Jordan VC, Speirs V. Downregulation of 15-hydroxyprostaglandin dehydrogenase during acquired tamoxifen resistance and association with poor prognosis in ERα-positive breast cancer. Explor Target Antitumor Ther 2020; 1:355-371. [PMID: 33210098 PMCID: PMC7116369 DOI: 10.37349/etat.2020.00021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Aim: Tamoxifen (TAM) resistance remains a clinical issue in breast cancer. The authors previously reported that 15-hydroxyprostaglandin dehydrogenase (HPGD) was significantly downregulated in tamoxifen-resistant (TAMr) breast cancer cell lines. Here, the authors investigated the relationship between HPGD expression, TAM resistance and prediction of outcome in breast cancer. Methods: HPGD overexpression and silencing studies were performed in isogenic TAMr and parental human breast cancer cell lines to establish the impact of HPGD expression on TAM resistance. HPGD expression and clinical outcome relationships were explored using immunohistochemistry and in silico analysis. Results: Restoration of HPGD expression and activity sensitised TAMr MCF-7 cells to TAM and 17β-oestradiol, whilst HPGD silencing in parental MCF-7 cells reduced TAM sensitivity. TAMr cells released more prostaglandin E2 (PGE2) than controls, which was reduced in TAMr cells stably transfected with HPGD. Exogenous PGE2 signalled through the EP4 receptor to reduce breast cancer cell sensitivity to TAM. Decreased HPGD expression was associated with decreased overall survival in ERα-positive breast cancer patients. Conclusions: HPGD downregulation in breast cancer is associated with reduced response to TAM therapy via PGE2-EP4 signalling and decreases patient survival. The data offer a potential target to develop combination therapies that may overcome acquired tamoxifen resistance.
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Affiliation(s)
- Milene Volpato
- Leeds Institute of Medical Research, University of Leeds, St James's University Hospital, LS9 7TF Leeds, UK
| | - Michele Cummings
- Leeds Institute of Medical Research, University of Leeds, St James's University Hospital, LS9 7TF Leeds, UK
| | - Abeer M Shaaban
- Institute of Cancer and Genomic Sciences, University of Birmingham, B15 2TT Birmingham, UK
| | - Balkees Abderrahman
- Leeds Institute of Medical Research, University of Leeds, St James's University Hospital, LS9 7TF Leeds, UK.,Department of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mark A Hull
- Leeds Institute of Medical Research, University of Leeds, St James's University Hospital, LS9 7TF Leeds, UK
| | - Philipp Y Maximov
- Department of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Bradley M Broom
- Department of Bioinformatics and Computational Biology, UT MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen, Auerbachstr. 112, D-70376 Stuttgart, Germany.,Germany iFIT Cluster of Excellence, University of Tübingen, Auerbachstr. 112, D-70376 Stuttgart, Germany
| | - Ping Fan
- Department of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tübingen, Auerbachstr. 112, D-70376 Stuttgart, Germany.,Germany iFIT Cluster of Excellence, University of Tübingen, Auerbachstr. 112, D-70376 Stuttgart, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - V Craig Jordan
- Department of Bioinformatics and Computational Biology, UT MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Valerie Speirs
- Leeds Institute of Medical Research, University of Leeds, St James's University Hospital, LS9 7TF Leeds, UK.,Institute of Medical Sciences, University of Aberdeen, Foresterhill, AB25 2ZD Aberdeen, UK
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29
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Schroth W, Büttner FA, Kandabarau S, Hoppe R, Fritz P, Kumbrink J, Kirchner T, Brauer HA, Ren Y, Henderson D, Madden SF, Sauer G, Fehm T, Wallwiener D, Fasching PA, Mürdter T, Schwab M, Brauch H. Gene Expression Signatures of BRCAness and Tumor Inflammation Define Subgroups of Early-Stage Hormone Receptor-Positive Breast Cancer Patients. Clin Cancer Res 2020; 26:6523-6534. [PMID: 33008814 DOI: 10.1158/1078-0432.ccr-20-1923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Patients with estrogen receptor- and/or progesterone receptor-positive, early breast cancer benefit from hormonal treatment, yet high global death burdens due to high prevalence and long-term recurrence risk call for biomarkers to guide additional treatment approaches. EXPERIMENTAL DESIGN From a prospective, observational study of postmenopausal early breast cancer patients treated with tamoxifen or aromatase inhibitors, gene expression analyses of 612 tumors was performed using the NanoString Breast Cancer 360 panel to interrogate 23 breast cancer pathways. Candidate signatures associated with disease subtype and event-free survival (EFS) were obtained by cluster analysis, Cox modeling, and conditional inference trees, and were independently tested in 613 patients from BreastMark. Tumor-infiltrating lymphocytes (TIL) were assessed on tissue sections, and mutational burden was assessed in 36 tumors by whole-exome sequencing. RESULTS PAM50-derived classification distinguished lower-risk (Luminal A) from higher-risk subtypes (Luminal B, P = 0.04; HER2, P = 0.006; Basal, P = 0.008). In higher-risk patients, shorter EFS was associated with low androgen receptor [HR = 3.61; 95% confidence interval (CI), 1.72-7.56; P = 0.001] or high BRCAness signature expression (HR = 3.58; 95% CI, 1.19-10.7; P = 0.023). BRCAness was independently confirmed as a predictor of shorter EFS (HR = 2.64; 95% CI, 1.31-5.34; P = 0.007). About 13%-15% of patients, enriched for high-grade, higher-risk subtypes (P ≤ 0.0001), had strong expression of the Tumor Inflammation Signature (TIS) suggestive of an inhibited antitumor immune response. TIS scores were strongly associated with TIL numbers (P < 1e-30) but not with tumor mutation status. CONCLUSIONS BRCA-related DNA repair deficiency and suppressed tumor immune responses may be clinically relevant predictors of endocrine therapy complementing treatment options in subgroups of hormone-sensitive early breast cancer.
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Affiliation(s)
- Werner Schroth
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany. .,University of Tübingen, Tübingen, Germany
| | - Florian A Büttner
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Siarhei Kandabarau
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Peter Fritz
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,Institute of Pathology, Robert-Bosch Hospital, Stuttgart, Germany
| | - Jörg Kumbrink
- Institute of Pathology, Faculty of Medicine, Ludwig Maximilian University, Munich, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Munich, Munich Germany
| | - Thomas Kirchner
- Institute of Pathology, Faculty of Medicine, Ludwig Maximilian University, Munich, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Munich, Munich Germany
| | | | - Yuqi Ren
- NanoString Technologies Inc., Seattle, Washington
| | | | - Stephen F Madden
- Data Science Center, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Georg Sauer
- Department of Obstetrics and Gynecology, Robert-Bosch Hospital, Stuttgart, Germany
| | - Tanja Fehm
- Department of Gynecology and Obstetrics, University of Düsseldorf, Düsseldorf, Germany
| | - Diethelm Wallwiener
- Department of Obstetrics and Gynecology, University Hospital of Tübingen, Tübingen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen and Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Thomas Mürdter
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | | | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK), Partner Site Tübingen, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Hoppe R, Kandabarau S, Fan P, Winter S, Abderrahman B, Cunliffe H, Schroth W, Jordan VC, Brauch HB. Abstract 144: Genome-wide DNA methylation changes in AI-resistant breast cancer models during E2-treatment. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-144] [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
Disruption of estrogen signaling with tamoxifen or aromatase inhibitors (AI) is the clinical standard for the treatment of estrogen receptor-positive breast cancer, yet resistance to antiestrogen therapies is inevitable. The long-term E2-deprived breast cancer models MCF-7:5C and MCF-7:2A mimic AI resistance and moreover are vulnerable to E2-induced apoptosis due to the reconfiguration of their survival signaling. E2-induced apoptosis which results from the accumulation of endoplasmic reticulum (ER), oxidative, and inflammatory stresses, is a new paradigm to subvert endocrine resistance, with sensors of the unfolded protein response (UPR) being important mediators of ER stress (Ariazi et al. 2011; Fan et al. 2013, 2015). Here we asked whether epigenetic modifications may play a role in this and investigated genome-wide changes of 5C and 2A DNA methylation patterns that occurred during E2 stimulation during a 72h time course with WS8 cells as a reference. Methylation patterns were established using the Illumina Infinium HumanMethylation450 BeadChip (Service XS, Leiden, NL), and raw intensities were normalized and filtered using the bioconductor minfi package. A linear model (bioconductor limma package) has been built to detect differentially methylated CpGs. F-statistics were calculated by empirical Bayes moderation of standard errors with "trend" and "robust" set “on”. We also performed whole-genome bisulfite sequencing (WGBS) in untreated cells using the Illumina HiSeq platform (GATC Biotech, Konstanz, DE) to obtain maximum baseline CpG coverage. Trimmed WGBS reads were aligned to the hg38 genome (Bismarck, PMC3102221), duplicates removed, and methylation levels extracted with MethylDackel (https://github.com/dpryan79/MethylDackel) with a 3x coverage threshold (Wreczycka et al. 2017). Raw methylation levels were smoothed and differential methylation called using the bsseq package (Hansen et al. 2012). At baseline, WGBS-derived profiles showed a 2-fold higher degree of hypomethylation (beta <0.2) in 5C compared to 2A and WS8. In time course E2-treatments we identified 134 dynamic CpGs across all three models (Padj < 0.05). Methylation status mainly decreased, with few specific changes in 5C and 2A. Among 120 affected CpG sites matching to GeneHancer regulatory elements 23 locate to ERE sites suggesting a direct control of inferred target genes (UCSC genome browser). Their matching to ER stress-, UPR- and apoptosis-related gene sets identified among others ATF6B, EIF2AK4, HSPB1, TNF, GANAB and PPIA. Currently, we are performing functional enrichment analyses and E2-responsive CpGs are being correlated with respective transcriptome signatures. Our preliminary data suggest that E2-triggered methylation changes in cell models vulnerable to E2-induced apoptosis may aid the identification of potential therapeutic targets towards overcoming endocrine resistance.
Citation Format: Reiner Hoppe, Siarhei Kandabarau, Ping Fan, Stefan Winter, Balkees Abderrahman, Heather Cunliffe, Werner Schroth, V. Craig Jordan, Hiltrud B. Brauch. Genome-wide DNA methylation changes in AI-resistant breast cancer models during E2-treatment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 144.
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Affiliation(s)
- Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Germany
| | - Siarhei Kandabarau
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Germany
| | - Ping Fan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Stefan Winter
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Germany
| | | | - Heather Cunliffe
- 3Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Werner Schroth
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Germany
| | - V. Craig Jordan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Hiltrud B. Brauch
- 4Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and iFIT Cluster of Excellence, University of Tübingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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31
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Mohr CJ, Schroth W, Mürdter TE, Gross D, Maier S, Stegen B, Dragoi A, Steudel FA, Stehling S, Hoppe R, Madden S, Ruth P, Huber SM, Brauch H, Lukowski R. Subunits of BK channels promote breast cancer development and modulate responses to endocrine treatment in preclinical models. Br J Pharmacol 2020; 179:2906-2924. [PMID: 32468618 DOI: 10.1111/bph.15147] [Citation(s) in RCA: 12] [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: 08/25/2019] [Revised: 03/20/2020] [Accepted: 05/13/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND PURPOSE Pore-forming α subunits of the voltage- and Ca2+ -activated K+ channel with large conductance (BKα) promote malignant phenotypes of breast tumour cells. Auxiliary subunits such as the leucine-rich repeat containing 26 (LRRC26) protein, also termed BKγ1, may be required to permit activation of BK currents at a depolarized resting membrane potential that frequently occur in non-excitable tumour cells. EXPERIMENTAL APPROACH Anti-tumour effects of BKα loss were investigated in breast tumour-bearing MMTV-PyMT transgenic BKα knockout (KO) mice, primary MMTV-PyMT cell cultures, and in a syngeneic transplantation model of breast cancer derived from these cells. The therapeutic relevance of BK channels in the context of endocrine treatment was assessed in human breast cancer cell lines expressing either low (MCF-7) or high (MDA-MB-453) levels of BKα and BKγ1, as well as in BKα-negative MDA-MB-157. KEY RESULTS BKα promoted breast cancer onset and overall survival in preclinical models. Conversely, lack of BKα and/or knockdown of BKγ1 attenuated proliferation of murine and human breast cancer cells in vitro. At low concentrations, tamoxifen and its major active metabolites stimulated proliferation of BKα/γ1-positive breast cancer cells, independent of the genomic signalling controlled by the oestrogen receptor. Finally, tamoxifen increased the relative survival time of BKα KO but not of wild-type tumour cell recipient mice. CONCLUSION AND IMPLICATIONS Breast cancer initiation, progression, and tamoxifen sensitivity depend on functional BK channels thereby providing a rationale for the future exploration of the oncogenic actions of BK channels in clinical outcomes with anti-oestrogen therapy.
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Affiliation(s)
- Corinna J Mohr
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany.,Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Werner Schroth
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Thomas E Mürdter
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Dominic Gross
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Selina Maier
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany.,Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Benjamin Stegen
- Department of Radiation Oncology, University of Tuebingen, Tuebingen, Germany
| | - Alice Dragoi
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Friederike A Steudel
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Severine Stehling
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Stephen Madden
- RCSI Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Peter Ruth
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Stephan M Huber
- Department of Radiation Oncology, University of Tuebingen, Tuebingen, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,iFIT-Cluster of Excellence, University of Tuebingen, Tuebingen, Germany
| | - Robert Lukowski
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Tuebingen, Germany
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da Rocha JCC, Nardin JM, Schroth W, Almeida TA, Mürdter T, Picolotto S, Vendramini ECL, Hoppe R, Kogin JP, Miqueleto D, Moraes SDR, Schwab M, Pecoits-Filho RF, Brauch H. Abstract P2-11-12: The influences of adherence to tamoxifen and CYP2D6 pharmacogenetics on plasma concentrations of the active metabolite (Z)-endoxifen in breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-11-12] [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
One-third of early breast cancer patients with estrogen receptor (ER) positive tumors treated with the selective estrogen receptor modulator tamoxifen either relapse or die from the disease in the following decade. Improvement of tamoxifen efficacy requires a better knowledge of factors determining outcome of which the medication-taking behavior, i.e. adherence, is a strong suspect. Discontinuation and non-adherence to tamoxifen are frequent and result in increased mortality. Commonly used methods to assess drug adherence such as prescription-refill patterns infer that the medication is taken exactly as prescribed yet, partial adherence or actual use of the medication cannot be controlled. An objective surrogate of tamoxifen adherence is the monitoring of drug concentrations in the patients’ plasma including the parent drug and its active metabolite (Z)-endoxifen (endoxifen), however individual concentrations depend on pharmacogene polymorphisms particularly those of the liver enzyme cytochrome P450 2D6 (CYP2D6). Patients without CYP2D6 variants have normal enzyme function (extensive metabolizer, EM) and achieve high endoxifen concentrations compared to patients with variants conferring absent activity (poor metabolizer, PM) or reduced activity (intermediate metabolizer, IM) who have significantly lower plasma concentrations of the active metabolite. A putative threshold of 5.9 ng/mL endoxifen has been proposed suggesting that patients with endoxifen concentration above or below threshold have lower or higher risk for recurrence, assuming that low endoxifen exposure in the tumor likely results in incomplete inhibition of ER-dependent growth signaling. During tamoxifen treatment it is therefore important that patients achieve clinically relevant endoxifen levels while at the same time avoid confounders of which adherence is a prime candidate. To this end, we investigated patients’ ability to achieve relevant plasma concentrations during tamoxifen treatment in relation to their CYP2D6 metabolizer status and their tamoxifen adherence behavior. Our prospective study included 192 Brazilian breast cancer patients treated with 20 mg tamoxifen daily. Two-thirds of the patients were premenopausal. Plasma levels of tamoxifen and its metabolites were measured by LC-MS/MS at 3, 6 and 12 months of treatment. Adherence to tamoxifen was evaluated by the questionnaire-based Morisky medication adherence scale. CYP2D6 polymorphisms were determined by MALDI-TOF mass spectrometry and real-time PCR. Adherence to tamoxifen decreased from 74% at month 3 to 64% at month 12, and explained 47% of the variability of tamoxifen plasma concentrations (P<.001). Accordingly, plasma monitoring of tamoxifen is useful to inform on tamoxifen adherence. Endoxifen concentrations were associated with CYP2D6 status and adherence. While CYP2D6 explained 26.4% of endoxifen variability at 12 months, the combination with adherence explained 40% (P<.001). The influence of low adherence to not achieving therapeutic endoxifen levels was highest in patients with non-compromised CYP2D6 function (EM phenotype, RR 3.65; 95% CI: 1.48-8.99). we conclude that for patients with intact CYP2D6 function adherence to tamoxifen is critical to achieve therapeutic endoxifen plasma levels. CYP2D6 phenotyping and endoxifen plasma monitoring may help to guide EM (and IM) patients to adhere to tamoxifen which is particularly relevant for premenopausal women who are at higher risk to not adhere to tamoxifen.
Citation Format: Jose Claudio Casali da Rocha, Jeanine M Nardin, Werner Schroth, Thais A Almeida, Thomas Mürdter, Solange Picolotto, Evelyn CL Vendramini, Reiner Hoppe, Jenifer P Kogin, Diandra Miqueleto, Silvia DR Moraes, Matthias Schwab, Roberto F Pecoits-Filho, Hiltrud Brauch. The influences of adherence to tamoxifen and CYP2D6 pharmacogenetics on plasma concentrations of the active metabolite (Z)-endoxifen in breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-11-12.
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Affiliation(s)
| | | | - Werner Schroth
- 2Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | - Thomas Mürdter
- 2Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | | | - Reiner Hoppe
- 2Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | | | | | - Matthias Schwab
- 2Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | - Hiltrud Brauch
- 2Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
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Nardin JM, Schroth W, Almeida TA, Mürdter T, Picolotto S, Vendramini ECL, Hoppe R, Kogin JP, Miqueleto D, de Moraes SDR, Schwab M, Pecoits-Filho RF, Brauch H, Casali-da-Rocha JC. The Influences of Adherence to Tamoxifen and CYP2D6 Pharmacogenetics on Plasma Concentrations of the Active Metabolite (Z)-Endoxifen in Breast Cancer. Clin Transl Sci 2019; 13:284-292. [PMID: 31573754 PMCID: PMC7070802 DOI: 10.1111/cts.12707] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/12/2022] Open
Abstract
Tamoxifen efficacy in breast cancer is suspected to depend on adherence and intact drug metabolism. We evaluated the role of adherence behavior and pharmacogenetics on the formation rate of (Z)-endoxifen. In 192 Brazilian patients, we assessed plasma levels of tamoxifen and its metabolites at 3, 6, and 12 months of treatment (liquid-chromatography tandem mass spectrometry), adherence behavior (Morisky, Green, and Levine medication adherence scale), and cytochrome P450 2D6 (CYP2D6) and other pharmacogene polymorphisms (matrix-assisted laser-desorption-ionization time of flight) mass spectrometry, real-time polymerase chain reaction). Adherence explained 47% of the variability of tamoxifen plasma concentrations (P < 0.001). Although CYP2D6 alone explained 26.4%, the combination with adherence explained 40% of (Z)-endoxifen variability at 12 months (P < 0.001). The influence of low adherence to not achieving relevant (Z)-endoxifen levels was highest in patients with noncompromised CYP2D6 function (relative risk 3.65; 95% confidence interval 1.48-8.99). As a proof-of-concept, we demonstrated that (Z)-endoxifen levels are influenced both by patient adherence to tamoxifen and CYP2D6, which is particularly relevant for patients with full CYP2D6 function.
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Affiliation(s)
- Jeanine Marie Nardin
- Clinical Research Department, Erasto Gaertner Hospital, Curitiba, Brazil.,School of Health Science, UniBrasil, Curitiba, Brazil.,Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Werner Schroth
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | | | - Thomas Mürdter
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | | | | | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | | | | | | | - Matthias Schwab
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,Departments of Clinical Pharmacology, Pharmacy and Biochemistry, University of Tuebingen, Tuebingen, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,iFIT Cluster of Excellence, University of Tuebingen, Tuebingen, Germany
| | | | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,iFIT Cluster of Excellence, University of Tuebingen, Tuebingen, Germany
| | - José Claudio Casali-da-Rocha
- Pontifical Catholic University of Parana, Curitiba, Brazil.,Department of Oncogenetics, Erasto Gaertner Hospital, Curitiba, Brazil
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Hoppe R, Kandabarau S, Fan P, Jordan VC, Cunliffe H, Brauch HB. Abstract 1689: Comparative whole genome analyses of breast cancer aromatase inhibitor resistance models. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1689] [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
One third of breast cancer patients treated with Aromatase Inhibitors (AI) or Tamoxifen acquire resistance leading to disease recurrence and death. The clinically observed AI resistance is mimicked by in vitro models MCF-7:5C and MCF-7:2A that are susceptible to apoptosis upon E2-treatment. These models have been instrumental to the current understanding of underlying mechanisms such as the reconfiguration of survival signaling, alterations of stress-related pathways (Ariazi et al. 2011; Fan et al. 2013, 2015), and changes in miRNA expression profiles (Hoppe et al. 2016). How the model phenotypes relate to a specific genomic background is poorly understood. In order to identify somatic variants indicative of AI resistance and potentially useful as novel therapeutic targets we performed NGS analyses of the 5C and 2A clones compared to the non-resistant WS8 and MCF-7 (ATCC). Whole genome/exome libraries were sequenced on Illumina HiSeq/NovaSeq platforms, respectively. Previously we reported first results from a preliminary analysis of gains and losses of variants in both resistant derivatives (Hoppe at al. AACR 2018). Here we report an updated analysis of raw reads trimmed and aligned to GRCh38 reference using BWAkit v 0.7.15. Duplicates were removed by Picard MarkDuplicates. Base quality scores were recalibrated using GATK4 BQSR. WGS and WES alignments were merged and tested for somatic variants using GATK4 Mutect2 (Tumor-only mode) with population variation data from gnomAD as a germline source. Called and filtered variants were uploaded to IVA for functional and clinical annotation. Copy number segments were modeled using both read- and allele-counts from WGS alignments by Gaussian-kernel binary-segmentation algorithm applied in GATK4 ModelSegments tool. To interpret copy number events causative for LOH we recovered germline variants and annotated CNVs that led to loss of the corresponding wild-type allele. In line with the COSMIC database we confirmed 461 mutated loci of which 228 were lost in both resistant derivatives. Examples of 5C-specific coding mutations classified as pathogenic include splice site alterations (i.e. SEMA3A), frameshifts (i.e. ARID1A), and stop gains (i.e. CACNA1S, CDH2, NOTCH4). 2A-specific mutations include for example a stop gain affecting ADGRV1. Copy number variation analyses revealed that both resistance models share prominent genetic defects such as amplified regions at Chr6q25.1 and Chr21q22.2. A 5C-specific aberration is a large Chr18 deletion affecting most of the q-arm, and a 2A-specific aberration is the amplification of most parts of Chr6q23.3-q24.3. We will present the status of this currently ongoing comparative genome analysis of AI resistance models and discuss the putative effects of homozygous mutations at loci with copy number aberrations within the context of AI resistance.
Citation Format: Reiner Hoppe, Siarhei Kandabarau, Ping Fan, V. Craig Jordan, Heather Cunliffe, Hiltrud B. Brauch. Comparative whole genome analyses of breast cancer aromatase inhibitor resistance models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1689.
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Affiliation(s)
- Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen, Germany
| | - Siarhei Kandabarau
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen, Germany
| | - Ping Fan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - V. Craig Jordan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Heather Cunliffe
- 3Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Hiltrud B. Brauch
- 4Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Quaglino P, Maule M, Prince HM, Porcu P, Horwitz S, Duvic M, Talpur R, Vermeer M, Bagot M, Guitart J, Papadavid E, Sanches JA, Hodak E, Sugaya M, Berti E, Ortiz-Romero P, Pimpinelli N, Servitje O, Pileri A, Zinzani PL, Estrach T, Knobler R, Stadler R, Fierro MT, Alberti Violetti S, Amitay-Laish I, Antoniou C, Astrua C, Chaganti S, Child F, Combalia A, Fabbro S, Fava P, Grandi V, Jonak C, Martinez-Escala E, Kheterpal M, Kim EJ, McCormack C, Miyagaki T, Miyashiro D, Morris S, Muniesa C, Nikolaou V, Ognibene G, Onida F, Osella-Abate S, Porkert S, Postigo-Llorente C, Ram-Wolff C, Ribero S, Rogers K, Sanlorenzo M, Stranzenbach R, Spaccarelli N, Stevens A, Zugna D, Rook AH, Geskin LJ, Willemze R, Whittaker S, Hoppe R, Scarisbrick J, Kim Y. Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium. Ann Oncol 2019; 30:494. [PMID: 29947731 DOI: 10.1093/annonc/mdy207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Quaglino
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Maule
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - H M Prince
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - P Porcu
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Horwitz
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Duvic
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - R Talpur
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Vermeer
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Bagot
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - J Guitart
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - E Papadavid
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - J A Sanches
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - E Hodak
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Sugaya
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - E Berti
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - P Ortiz-Romero
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - N Pimpinelli
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - O Servitje
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - A Pileri
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - P L Zinzani
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - T Estrach
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - R Knobler
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - R Stadler
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M T Fierro
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Alberti Violetti
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - I Amitay-Laish
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C Antoniou
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C Astrua
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Chaganti
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - F Child
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - A Combalia
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Fabbro
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - P Fava
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - V Grandi
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C Jonak
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - E Martinez-Escala
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Kheterpal
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - E J Kim
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C McCormack
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - T Miyagaki
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - D Miyashiro
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Morris
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C Muniesa
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - V Nikolaou
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - G Ognibene
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - F Onida
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Osella-Abate
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Porkert
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C Postigo-Llorente
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - C Ram-Wolff
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Ribero
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - K Rogers
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - M Sanlorenzo
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - R Stranzenbach
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - N Spaccarelli
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - A Stevens
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - D Zugna
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - A H Rook
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - L J Geskin
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - R Willemze
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - S Whittaker
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - R Hoppe
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - J Scarisbrick
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
| | - Y Kim
- Dermatologic Clinic, Department of Medical Sciences; Cancer Epidemiology Uni, Department of Medical Sciences, University of Torino, Torino, Italy; Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne; University of Melbourne, Melbourne, Australia; Division of Hematologic Malignancies, Ohio State University; Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York; Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands; Dermatology Department, Hospital St Louis, Paris, France; Department of Dermatology and Pathology, Northwestern University, Chicago, USA; 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece; Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil; Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Dermatolog, Faculty of Medicine, University of Tokyo, Tokyo, Japan; Department of Dermatology, Fondazione Ca' Granda, IRCCS, OMP, Milano, Italy; Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain; Dermatologic Clinic, University of Florence, Florence, Italy; Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain; Dermatologic Clinic, University of Bologna, Bologna; Seragnoli Institute of Haematology, Bologna, Italy; Department of Dermatolog, Hospital Clinico, University of Barcelona, Barcelona, Spain; Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria; University Clinic for Dermatolog, Venereology, Allergology and Phlebology, Minden, Germany; Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham; Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK; Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia; Comprehensive Skin Cancer Center, Columbia University Medical Center; Department of Dermatology, Stanford University Medical Centre, USA
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Abstract
Abstract
Acquired endocrine resistance is a severe barrier in the anti-hormonal treatment of breast cancer and is responsible for its failure in about half of the treated patients. In vitro models of long-term estrogen deprived breast cancer cells serve as laboratory tools to explore new therapeutic strategies. The models MCF-7:5C and MCF-7:2A mimic clinical AI resistance but regress with E2 due to the reconfiguration of survival signaling known as E2-inducible apoptosis (5C rapid, 2A delayed reaction). Alterations of stress related pathways including the accumulation of endoplasmic reticulum stress, oxidative stress, and inflammatory stress that occur prior to E2-induced apoptosis (Ariazi et al. 2011; Fan et al. 2013, 2015; Sweeney et al. 2014) and specific miRNA expression profiles (Hoppe et al Oncotarget 2016) have been linked with these resistance and E2-inducible apoptosis phenotypes. Little is known on their underlying genetic variability. Here we compare the mutational profiles of 5C and 2A clones with those of the estradiol stimulated growth sensitive MCF-7:WS8 and standard MCF-7 (ATCC) cells. Whole genome libraries were sequenced on the Illumina HiSeq platform (2x150bp reads). Alignments were manually inspected (bcftools mpileup) to avoid false negative variant calling in poorly (<20x) covered regions. Loci with at least 10x coverage and absence of any variant reads were classified as wildtype. The coding genome positions defined as mutant or wildtype in all four cell types served as a basis to select candidate mutations for the verification of MCF-7 variants via comparison to the COSMIC database (http://cancer.sanger.ac.uk/cosmic) and identification of novel mutations by variant calling (GATK HaplotypeCaller). Putative protein effects of variants were predicted by the SnpEff tool. We verified 421 point mutations in MCF-7 (COSMIC) of which 203 mutations were lost in our models, with additional specific losses of 4, 4, and 18 mutations in WS8, 2A and 5C, respectively. In 5C cells new mutations affected 261 genes with 31 high impact mutations based on splice site alterations in 7 genes (i.e. CERS2, SEMA3A, TDRD7, ATP5H) and gain of stop codons in 24 genes (i.e. CACNA1S, NOTCH4, SUN1, JPH3, SERPINB2). Similarly, in 2A cells there were 12 high impact mutations among 122 affected genes (e.g. ARHGEF5, ARHGAP35, ARAP2). We will report on the integrative genomic analysis including larger structural variants (short indels and CNVs) towards the evolution of these models for a comprehensive understanding of the biology of E2-inducible apoptosis.
Citation Format: Reiner Hoppe, Siarhei Kandabarau, Ping Fan, V Craig Jordan, Hiltrud B. Brauch. Evolving genomes of breast cancer aromatase inhibitor resistance models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3432.
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Affiliation(s)
- Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, Germany
| | - Siarhei Kandabarau
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, Germany
| | - Ping Fan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - V Craig Jordan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Hiltrud B. Brauch
- 3Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Hoppe R, Fan P, Büttner F, Winter S, Tyagi AK, Cunliffe H, Jordan VC, Brauch H. Profiles of miRNAs matched to biology in aromatase inhibitor resistant breast cancer. Oncotarget 2018; 7:71235-71254. [PMID: 27659519 PMCID: PMC5342075 DOI: 10.18632/oncotarget.12103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/02/2016] [Indexed: 12/13/2022] Open
Abstract
Aromatase inhibitor (AI) resistance during breast cancer treatment is mimicked by MCF-7:5C (5C) and MCF-7:2A (2A) cell lines that grow spontaneously. Survival signaling is reconfigured but cells are vulnerable to estradiol (E2)-inducible apoptosis. These model systems have alterations of stress related pathways including the accumulation of endoplasmic reticulum, oxidative, and inflammatory stress that occur prior to E2-induced apoptosis. We investigated miRNA expression profiles of 5C and 2A to characterize their AI resistance phenotypes. Affymetrix GeneChip miRNA2.0 arrays identified 184 miRNAs differentially expressed in 2A and 5C compared to E2-free wild-type MCF-7:WS8. In 5C, 34 miRNAs of the DLK1-DIO3 locus and miR-31 were overexpressed, whereas miR-222 was low. TCGA data revealed poor and favorable overall survival for low miR-31 and miR-222 levels, respectively (HR=3.0, 95% CI:1.9-4.8; HR=0.3, 95% CI:0.1-0.6). Targets of deregulated miRNAs were identified using CLIP-confirmed TargetScan predictions. KEGG enrichment analyses for 5C- and 2A-specific target gene sets revealed pathways associated with cell proliferation including insulin, mTOR, and ErbB signaling as well as immune response and metabolism. Key genes overrepresented in 5C- and 2A-specific pathway interaction networks including EGFR, IGF1R and PIK3R1 had lower protein levels in 5C compared to 2A and were found to be differentially modulated by respective miRNA sets. Distinct up-regulated miRNAs from the DLK1-DIO3 locus may cause these attenuative effects as they are predicted to interact with corresponding 3′ untranslated regions. These new miRNA profiles become an important regulatory database to explore E2-induced apoptotic mechanisms of clinical relevance for the treatment of resistant breast cancer.
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Affiliation(s)
- Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Ping Fan
- Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Florian Büttner
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan Winter
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Amit K Tyagi
- Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Heather Cunliffe
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - V Craig Jordan
- Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Bernert C, Hoppe R, Wittwer F, Woike T, Schroer CG. Ptychographic analysis of the photorefractive effect in LiNbO 3:Fe. Opt Express 2017; 25:31640-31650. [PMID: 29245835 DOI: 10.1364/oe.25.031640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/24/2017] [Indexed: 06/07/2023]
Abstract
We present light induced refractive index changes in iron doped lithium niobate detected with a novel microscopy technique called ptychography. This method determines the change of the refractive index together with the intensity distribution of the writing beam from a single scan with a reconstructed spatial resolution of 3 μm and a sensitivity of the refractive index change of 10-5. We show that the light induced refractive index change is strongly connected to the intensity shape of the writing beam and that it shows the expected nonlocal behaviour. Applying the novel method to the investigation of the photorefractive effect offers an excellent opportunity to study this nonlocal response to the spatial distribution of the writing beam.
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Quaglino P, Maule M, Prince HM, Porcu P, Horwitz S, Duvic M, Talpur R, Vermeer M, Bagot M, Guitart J, Papadavid E, Sanches JA, Hodak E, Sugaya M, Berti E, Ortiz-Romero P, Pimpinelli N, Servitje O, Pileri A, Zinzani PL, Estrach T, Knobler R, Stadler R, Fierro MT, Alberti Violetti S, Amitay-Laish I, Antoniou C, Astrua C, Chaganti S, Child F, Combalia A, Fabbro S, Fava P, Grandi V, Jonak C, Martinez-Escala E, Kheterpal M, Kim EJ, McCormack C, Miyagaki T, Miyashiro D, Morris S, Muniesa C, Nikolaou V, Ognibene G, Onida F, Osella-Abate S, Porkert S, Postigo-Llorente C, Ram-Wolff C, Ribero S, Rogers K, Sanlorenzo M, Stranzenbach R, Spaccarelli N, Stevens A, Zugna D, Rook AH, Geskin LJ, Willemze R, Whittaker S, Hoppe R, Scarisbrick J, Kim Y. Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium. Ann Oncol 2017; 28:2517-2525. [PMID: 28961843 DOI: 10.1093/annonc/mdx352] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Advanced-stage mycosis fungoides (MF)/Sézary syndrome (SS) patients are weighted by an unfavorable prognosis and share an unmet clinical need of effective treatments. International guidelines are available detailing treatment options for the different stages but without recommending treatments in any particular order due to lack of comparative trials. The aims of this second CLIC study were to retrospectively analyze the pattern of care worldwide for advanced-stage MF/SS patients, the distribution of treatments according to geographical areas (USA versus non-USA), and whether the heterogeneity of approaches has potential impact on survival. PATIENTS AND METHODS This study included 853 patients from 21 specialist centers (14 European, 4 USA, 1 each Australian, Brazilian, and Japanese). RESULTS Heterogeneity of treatment approaches was found, with up to 24 different modalities or combinations used as first-line and 36% of patients receiving four or more treatments. Stage IIB disease was most frequently treated by total-skin-electron-beam radiotherapy, bexarotene and gemcitabine; erythrodermic and SS patients by extracorporeal photochemotherapy, and stage IVA2 by polychemotherapy. Significant differences were found between USA and non-USA centers, with bexarotene, photopheresis and histone deacetylase inhibitors most frequently prescribed for first-line treatment in USA while phototherapy, interferon, chlorambucil and gemcitabine in non-USA centers. These differences did not significantly impact on survival. However, when considering death and therapy change as competing risk events and the impact of first treatment line on both events, both monochemotherapy (SHR = 2.07) and polychemotherapy (SHR = 1.69) showed elevated relative risks. CONCLUSION This large multicenter retrospective study shows that there exist a large treatment heterogeneity in advanced MF/SS and differences between USA and non-USA centers but these were not related to survival, while our data reveal that chemotherapy as first treatment is associated with a higher risk of death and/or change of therapy and thus other therapeutic options should be preferable as first treatment approach.
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Affiliation(s)
- P Quaglino
- Dermatologic Clinic, Department of Medical Sciences;.
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - H M Prince
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne;; University of Melbourne, Melbourne, Australia
| | - P Porcu
- Division of Hematologic Malignancies, Ohio State University
| | - S Horwitz
- Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York
| | - M Duvic
- Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA
| | - R Talpur
- Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA
| | - M Vermeer
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - M Bagot
- Dermatology Department, Hospital St Louis, Paris, France
| | - J Guitart
- Department of Dermatology and Pathology, Northwestern University, Chicago, USA
| | - E Papadavid
- 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - J A Sanches
- Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - E Hodak
- Beilinson Hospital, Petach Tikva;; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Sugaya
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - E Berti
- Dermatologic Clinic, University of Milano, Milano, Italy
| | - P Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain
| | - N Pimpinelli
- Dermatologic Clinic, University of Florence, Florence, Italy
| | - O Servitje
- Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A Pileri
- Dermatologic Clinic, University of Bologna, Bologna
| | - P L Zinzani
- Seragnoli Institute of Haematology, Bologna, Italy
| | - T Estrach
- Department of Dermatology, Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - R Knobler
- Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria
| | - R Stadler
- University Clinic for Dermatology, Venereology, Allergology and Phlebology, Minden, Germany
| | - M T Fierro
- Dermatologic Clinic, Department of Medical Sciences
| | | | - I Amitay-Laish
- Beilinson Hospital, Petach Tikva;; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C Antoniou
- 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - C Astrua
- Dermatologic Clinic, Department of Medical Sciences
| | - S Chaganti
- Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham
| | - F Child
- Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK
| | - A Combalia
- Department of Dermatology, Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - S Fabbro
- Division of Hematologic Malignancies, Ohio State University
| | - P Fava
- Dermatologic Clinic, Department of Medical Sciences
| | - V Grandi
- Dermatologic Clinic, University of Florence, Florence, Italy
| | - C Jonak
- Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria
| | - E Martinez-Escala
- Department of Dermatology and Pathology, Northwestern University, Chicago, USA
| | - M Kheterpal
- Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York
| | - E J Kim
- Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia
| | - C McCormack
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne;; University of Melbourne, Melbourne, Australia
| | - T Miyagaki
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - D Miyashiro
- Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - S Morris
- Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK
| | - C Muniesa
- Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - V Nikolaou
- 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - G Ognibene
- Comprehensive Skin Cancer Center, Columbia University Medical Center
| | - F Onida
- Dermatologic Clinic, University of Milano, Milano, Italy
| | | | - S Porkert
- Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria
| | | | - C Ram-Wolff
- Dermatology Department, Hospital St Louis, Paris, France
| | - S Ribero
- Dermatologic Clinic, Department of Medical Sciences
| | - K Rogers
- Comprehensive Skin Cancer Center, Columbia University Medical Center
| | - M Sanlorenzo
- Dermatologic Clinic, Department of Medical Sciences
| | - R Stranzenbach
- University Clinic for Dermatology, Venereology, Allergology and Phlebology, Minden, Germany
| | - N Spaccarelli
- Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia
| | - A Stevens
- Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham
| | - D Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A H Rook
- Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia
| | - L J Geskin
- Comprehensive Skin Cancer Center, Columbia University Medical Center
| | - R Willemze
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - S Whittaker
- Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK
| | - R Hoppe
- Department of Dermatology, Stanford University Medical Centre, USA
| | - J Scarisbrick
- Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham
| | - Y Kim
- Department of Dermatology, Stanford University Medical Centre, USA
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Hoppe R, Fan P, Winter S, Büttner F, Jordan VC, Brauch HB. Abstract 474: Estrogen-responsive miRNAs as modulators of E2-induced apoptosis in AI-resistant breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-474] [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
Long-term estrogen deprivation with tamoxifen or aromatase inhibitors (AI) is the basic principle of endocrine treatment of ER-positive breast cancer. Acquired resistance is however a major obstacle in treatment success. Based on clinical observations and in vitro as well as animal in vivo experiments it has been suggested that tumor cell clones evolve over time and become vulnerable to E2-induced apoptosis, thereby potentially providing a promising second line treatment option. In vitro, this vulnerability is mimicked in the AI-resistant breast cancer models MCF-7:5C and MCF-7:2A, which during long-term E2-deprivation reconfigure their survival signaling including endoplasmic reticulum, oxidative and inflammatory stress related pathways. E2-stimulation of these cells initiates an unfolded protein response which in turn triggers apoptosis through the intrinsic and subsequently extrinsic pathway (Jordan VC 2015). Recently, we identified miRNA profiles matching the biology of AI resistance and vulnerability to E2-induced apoptosis (Hoppe R et al. 2016). Here we investigate the modulatory role of miRNAs in E2-induced apoptosis through the identification of their global expression changes in E2-stimulated 5C and 2A models compared to MCF-7:WS8 reference. Each cell line was treated with 10-9 M E2 or vehicle over a 72h time course (6, 12, 24, 72 h). miRNA profiles were generated using Affymetrix GeneChip miRNA2.0 arrays. At each time point relative miRNA expression changes (E2/control) were evaluated resulting in a total of 72 (5C), 104 (2A) and 94 (WS8) differentially expressed miRNAs (FC > 1.5 or < 1/1.5, Pt-test < 0.05). Differential expression analyses between consecutive time points revealed 16 (5C), 43 (2A) and 27 (WS8) miRNAs (maximum absolute FC difference > 1.5, PF-test < 0.05). Differential area under the curve (dAUC) analyses at 6-72, 6-24, and 24-72 h mined the overall, early, and late-responding miRNAs of the different phenotypes (Ppermutation test < 0.05). Representative early down-regulated miRNA candidates potentially modulating E2-induced apoptosis in 5C cells are miR-543 and miR-432 of the DLK1-DIO3 locus on Chr. 14q32.31. Late responding up-regulated miRNA candidates are miR-150* and miR-149* the low expression of which in tumor tissues registered in The Cancer Genome Atlas (miRNA-Seq v. 3.1.17.0) was associated with worse outcome in all PAM50 breast cancer subtypes and Lum B, respectively (HR = 2.1, 95% CI: 1.4-3.2; P = 0.00017; HR = 6.8, 95% CI: 1.5-3.0; P = 0.0036). We are currently in the process to subject respective miRNA sets to functional enrichment analyses (KEGG, GO) and to correlate E2-responsive miRNA candidates with respective transcriptome signatures. In summary, we will present miRNAs matching to the biological processes inherent to E2-induced apoptosis. These may serve as potential targets for the amplification of the apoptotic trigger upon E2-treatment.
Citation Format: Reiner Hoppe, Ping Fan, Stefan Winter, Florian Büttner, V. Craig Jordan, Hiltrud B. Brauch. Estrogen-responsive miRNAs as modulators of E2-induced apoptosis in AI-resistant breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 474. doi:10.1158/1538-7445.AM2017-474
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Affiliation(s)
- Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, Tuebingen, Germany
| | - Ping Fan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Stefan Winter
- 1Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, Tuebingen, Germany
| | - Florian Büttner
- 3Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, Tuebingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - V. Craig Jordan
- 2MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Hiltrud B. Brauch
- 3Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tuebingen, Tuebingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Steudel FA, Mohr CJ, Stegen B, Nguyen HY, Barnert A, Steinle M, Beer-Hammer S, Koch P, Lo WY, Schroth W, Hoppe R, Brauch H, Ruth P, Huber SM, Lukowski R. SK4 channels modulate Ca 2+ signalling and cell cycle progression in murine breast cancer. Mol Oncol 2017; 11:1172-1188. [PMID: 28557306 PMCID: PMC5579333 DOI: 10.1002/1878-0261.12087] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 12/15/2016] [Revised: 04/27/2017] [Accepted: 05/16/2017] [Indexed: 01/08/2023] Open
Abstract
Oncogenic signalling via Ca2+‐activated K+ channels of intermediate conductance (SK4, also known as KCa3.1 or IK) has been implicated in different cancer entities including breast cancer. Yet, the role of endogenous SK4 channels for tumorigenesis is unclear. Herein, we generated SK4‐negative tumours by crossing SK4‐deficient (SK4 KO) mice to the polyoma middle T‐antigen (PyMT) and epidermal growth factor receptor 2 (cNeu) breast cancer models in which oncogene expression is driven by the retroviral promoter MMTV. Survival parameters and tumour progression were studied in cancer‐prone SK4 KO in comparison with wild‐type (WT) mice and in a syngeneic orthotopic mouse model following transplantation of SK4‐negative or WT tumour cells. SK4 activity was modulated by genetic or pharmacological means using the SK4 inhibitor TRAM‐34 in order to establish the role of breast tumour SK4 for cell growth, electrophysiological signalling, and [Ca2+]i oscillations. Ablation of SK4 and TRAM‐34 treatment reduced the SK4‐generated current fraction, growth factor‐dependent Ca2+ entry, cell cycle progression and the proliferation rate of MMTV‐PyMT tumour cells. In vivo, PyMT oncogene‐driven tumorigenesis was only marginally affected by the global lack of SK4, whereas tumour progression was significantly delayed after orthotopic implantation of MMTV‐PyMT SK4 KO breast tumour cells. However, overall survival and progression‐free survival time in the MMTV‐cNeu mouse model were significantly extended in the absence of SK4. Collectively, our data from murine breast cancer models indicate that SK4 activity is crucial for cell cycle control. Thus, the modulation of this channel should be further investigated towards a potential improvement of existing antitumour strategies in human breast cancer.
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Affiliation(s)
- Friederike A Steudel
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany
| | - Corinna J Mohr
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany.,Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Benjamin Stegen
- Department of Radiation Oncology, University of Tuebingen, Germany
| | - Hoang Y Nguyen
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany
| | - Andrea Barnert
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany
| | - Marc Steinle
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany
| | - Sandra Beer-Hammer
- Department of Pharmacology and Experimental Therapy, Institute of Experimental and Clinical Pharmacology and Toxicology, University Hospital Tuebingen, Germany
| | - Pierre Koch
- Pharmaceutical and Medicinal Chemistry, Institute of Pharmacy, University of Tuebingen, Germany
| | - Wing-Yee Lo
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Werner Schroth
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Ruth
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany
| | - Stephan M Huber
- Department of Radiation Oncology, University of Tuebingen, Germany
| | - Robert Lukowski
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tuebingen, Germany
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Geller S, Dai J, Myskowski P, Kim Y, Moskowitz A, Pulitzer M, Hoppe R, Horwitz S, Kheterpal M. 335 Utility of imaging in cutaneous marginal zone lymphoma. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.352] [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: 11/24/2022]
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Hoppe R, Fan P, Büttner F, Winter S, Cunliffe H, Jordan VC, Brauch HB. Abstract 1073: Modulation of aromatase inhibitor resistance by miRNAs in breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-1073] [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
The blockade of E2 signaling by either tamoxifen or aromatase inhibitors (AI) is the standard treatment of patients with estrogen receptor (ER)-positive breast cancer. However, acquired resistance to antiestrogen therapies remains a big clinical challenge. The in vitro breast cancer models MCF-7:5C and MCF-7:2A mimic clinical AI resistance in that they grow under tamoxifen, but can rapidly regress with E2 due to the reconfiguration of survival signaling known as E2-inducible apoptosis. This principle is currently explored in clinical trials in order to develop strategies to overcome endocrine resistance. To better understand the biology of AI resistance we previously ascertained a wide range of alterations of stress related pathways including the accumulation of endoplasmic reticulum stress, oxidative stress, and inflammatory stress that occur prior to E2-induced apoptosis (Ariazi et al. 2011; Fan et al. 2013, 2015; Sweeney et al. 2014). In this current work we investigated miRNA expression profiles of the 5C and 2A models (both compared to MCF-7:WS8 reference) in order to further elucidate the molecular scenario that characterizes the AI resistance phenotypes and their susceptibility to E2-induced apoptosis. Using Affymetrix GeneChip miRNA2.0 arrays we identified 184 miRNAs differentially expressed between 2A and 5C (FC > 1.5 or < 1/1.5, P < 0.05). Of these, 30 miRNAs were specific for 2A, 99 for 5C, and 55 overlapped. Common miRNAs include upregulated oncogenic miRNAs of the miR-17-92 cluster (Chr. 13q31) and the paralogous 106a-363 cluster (Chr. X), as well as downregulated tumor suppressive miRNAs such as miR-342-5p. Thirty-four miRNAs that cluster at Chr. 14q32 were overexpressed in 5C cells and highly correlate with the downregulated miR-99a and miR-125b (Chr. 21q21). At the clinical level based on data from The Cancer Genome Atlas (miRNA-Seq v. 3.1.17.0), low expression of miR-31 was associated with poor (HR = 3.0, 95% CI: 1.9-4.8; Padj = 8.7E-5), and low miR-222 expression was associated with better outcome (HR = 0.3, 95% CI: 0.1-0.6; Padj. = 4.4E-3). As miR-31 expression is high and miR-222 expression is low in 5C cells compared to the MCF-7:WS8 reference, we suggest protective roles. Functions of miRNAs were deciphered via analyses of their predicted targets (CLIP-confirmed). Using KEGG and GO databases functional enrichment analyses of 5C and 2A specific miRNA sets revealed pathways associated with cell proliferation for both models including insulin, mTOR, and ErbB signaling as well as immune response and metabolism associated pathways. While the 2A specific miRNA set revealed additional metabolic pathways, the 5C specific miRNA set points to pathways involved in apoptosis. Thus, we confirmed the biological processes inherent to AI resistance and provide critical evidence for miRNA profiles as an important regulatory principle in these AI resistance models.
Citation Format: Reiner Hoppe, Ping Fan, Florian Büttner, Stefan Winter, Heather Cunliffe, V. Craig Jordan, Hiltrud B. Brauch. Modulation of aromatase inhibitor resistance by miRNAs in breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1073.
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Affiliation(s)
- Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, University of Tuebingen, Germany
| | - Ping Fan
- 2Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Florian Büttner
- 3Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, University of Tuebingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan Winter
- 1Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, University of Tuebingen, Germany
| | - Heather Cunliffe
- 4Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - V. Craig Jordan
- 2Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Hiltrud B. Brauch
- 3Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, University of Tuebingen, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Lo WY, Mohr C, Steudel F, Schmidt M, Easton D, Hoppe R, Schroth W, Ruth P, Lukowski R, Brauch H. Abstract 2030: The role of genetic variation in calcium-activated potassium channels in breast cancer patients treated with tamoxifen. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-2030] [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
Potassium channels control membrane voltage and are essential for cell proliferation. Abnormal regulation and/or expression of these channels have been reported in cancer and result in dysregulated cell cycle progression, cell proliferation and migration. In breast cancer, clinical correlations of potassium channels have been associated with brain metastases, high stage, high grade, high proliferation, nodal status and poor prognosis. Interestingly, they have been associated with increased estrogen receptor (ER) expression. The selective ER modulator, tamoxifen, blocks estrogen from binding to the ER and is commonly used to treat patients with ER-positive breast cancer. However, up to 33% of patients treated with tamoxifen relapse or dies at 15 years of follow up. Both estrogen and tamoxifen have been demonstrated to activate potassium channels which then cause an increase in cell proliferation. In preliminary animal in vivo studies, we observed a better breast cancer prognosis in those with a knockout in potassium channel genes. Therefore, any alterations in the potassium channels may help to explain why patients treated with tamoxifen fail therapy. We hypothesized that genetic variation in potassium channels may affect breast cancer risk as well as tamoxifen treatment outcome. Genotyping was conducted on 45,290 breast cancer patients and 41,880 controls of European ancestry from 41 studies with the custom Illumina Infinium array (iCOGS). More than 200,000 SNPs were genotyped with over 11 million SNPs estimated using genotype imputation with SHAPEIT and IMPUTEv2 and the 1000 Genomes Project March 2012 release as the reference panel (Michailidou et al. Nature Genetics 2015). Variants from 13 potassium channels including KCNMA1, KCNMB1-4, KCNN1-4, LRRC26, LRRC38, LRRC52 and LRRC55 were analyzed. Of these, 3 imputed SNPs from KCNN4 have shown decreased breast cancer risk with GWAS significance (rs12463319, rs12609846, rs1685191; OR 0.94, P < 1.0E-08). In particular, these SNPs were significant in ER-positive breast cancer (OR 0.93, P < 1.0E-09), but was not observed in ER-negative patients (P > 0.05). These findings encouraged us to now further investigate the outcomes of patients with ER-positive breast cancer treated with tamoxifen. Survival data for 49,751 patients with a median follow-up of 8 years has been completed and released in November 2015. Of these, 32,571 were ER-positive and 10,383 have been treated with tamoxifen. Current efforts are underway in order to determine the effects of genetic variations in potassium channels on the survival of patients treated with tamoxifen. Our work will provide a better understanding of the potential clinical relevance of potassium channels in tamoxifen treatment in breast cancer.
Citation Format: Wing-Yee Lo, Corinna Mohr, Friederike Steudel, Marjanka Schmidt, Douglas Easton, Reiner Hoppe, Werner Schroth, Peter Ruth, Robert Lukowski, Hiltrud Brauch, in collaboration with the Breast Cancer Association Consortium. The role of genetic variation in calcium-activated potassium channels in breast cancer patients treated with tamoxifen. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2030.
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Affiliation(s)
- Wing-Yee Lo
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Tuebingen, Germany
| | - Corinna Mohr
- 2Department of Pharmacology, Toxicology and Clinical Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Friederike Steudel
- 2Department of Pharmacology, Toxicology and Clinical Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Marjanka Schmidt
- 3Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Douglas Easton
- 4Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Tuebingen, Germany
| | - Werner Schroth
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Tuebingen, Germany
| | - Peter Ruth
- 2Department of Pharmacology, Toxicology and Clinical Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Robert Lukowski
- 2Department of Pharmacology, Toxicology and Clinical Pharmacy, University of Tuebingen, Tuebingen, Germany
| | - Hiltrud Brauch
- 5Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Tuebingen and German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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Saladores PH, Hoppe R, Lo WY, Cocciardi S, Hofmann U, Hamann U, Fasching P, Schmidt M, Brauch H, Schroth W. Abstract 5485: Coactivator PPARGC1B Ala203Pro polymorphism is linked with estrogen-related receptor function and breast cancer outcome. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-5485] [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
The estrogen-related receptors (ERRs) are orphan nuclear receptors (NRs) with high sequence similarity to the estrogen receptor (ER). Peroxisome proliferator-activated receptor gamma coactivator-1 beta (PERC) specifically activates ER and ERRs, thus providing a link with breast cancer growth. Here we functionally characterized a non-synonymous PERC polymorphism, rs7732671, previously associated with increased risk for familial breast cancer, and tested its clinical relevance for breast cancer progression.
Methods
A mammalian two-hybrid assay was used to identify protein interactions using full-length and truncated NR (ERα, ERRα, ERRγ) and PERC. PERC rs7732671 variant allele (649G>C_A203P) was created by site-directed mutagenesis. Expression of genes involved in cell glycolysis and/or direct ERR targets Eno1, PKM, LDHA and IDH3A, were analyzed in breast cancer cells and in breast tumors (N = 84). Cell supernatants were quantitated for lactate formation using liquid chromatography coupled mass spectrometry. PERC rs7732671 was genotyped in 896 postmenopausal early breast cancer patients treated with adjuvant tamoxifen and clinical outcome was analyzed using Kaplan-Meier and Cox regression analyses.
Results
Truncated PERC (aa129-426) containing the 649G>C_A203P variant did not interact with ERα, but ERRα and ERRγ ligand-binding domains were activated. The PERC129-426-C allele enhanced ERRα activity by 21% and ERRγ by 67%, compared to the PERC129-426-G major allele (P<0.005). Expression of ERR downstream genes Eno1, LDHA, IDH3A and lactate concentrations were increased in MCF7 and MDA-MB-231 overexpressing PERC-C as compared to PERC-G. In breast tumors, glycolytic or ERR target gene expression was increased in patients carrying the PERC-C allele. Patients carrying the PERC-C showed higher distant recurrence rates compared with patients of the G/G genotype (P = 0.01), which was confirmed in Cox regression adjusted to tumor size, nodal status, and grade (Hazard Ratio 2.06; 95% CI 1.26-3.38, P = 0.005 per C allele).
Conclusion
PERC rs7732671 variant 649C_203P enhances ERRα and ERRγ signaling independent of ER. Higher lactate concentrations in cells and increased ERR target gene expression in vitro and in patients with the PERC-C allele point to a modulation of aerobic glycolysis. The ERR/PERC axis is possibly linked with disease progression in breast cancer.
Citation Format: Pilar H. Saladores, Reiner Hoppe, Wing-Yee Lo, Sibylle Cocciardi, Ute Hofmann, Ute Hamann, Peter Fasching, Marcus Schmidt, Hiltrud Brauch, Werner Schroth. Coactivator PPARGC1B Ala203Pro polymorphism is linked with estrogen-related receptor function and breast cancer outcome. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5485. doi:10.1158/1538-7445.AM2015-5485
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Affiliation(s)
- Pilar H. Saladores
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Wing-Yee Lo
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | - Ute Hofmann
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Ute Hamann
- 3German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Fasching
- 4Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Marcus Schmidt
- 5Department of Gynecology and Obstetrics, University of Mainz, Mainz, Germany
| | - Hiltrud Brauch
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Werner Schroth
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
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Lo WY, Schroth W, Hoppe R, Schmidt M, Garcia-Closas M, Pharaoh P, Hall P, Easton D, Fasching P, Brauch H. Abstract 5483: CYP19A1 genetic variation is a potential predictor of outcome in ER-positive postmenopausal early breast cancer patients treated with tamoxifen. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-5483] [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
Tamoxifen is a selective estrogen receptor modulator which blocks estrogen from binding to the estrogen receptor (ER). Although estrogens are natural hormones vital for development, they are also critical growth factors responsible for cell proliferation and DNA synthesis, thus enhancing the growth of estrogen-responsive breast tumors. With breast cancer being the most frequent cancer in women, the carcinogenic effects of estrogen are mediated by ER which is expressed in approximately 75% of all tumors. Hence tamoxifen is commonly used to treat patients with ER-positive breast cancer. Our group has a long standing interest in the investigation of potential tamoxifen outcome predictors as up to 33% of treated patients relapse or dies at 15 years of follow up. Therefore it is crucial to determine which patient will benefit from tamoxifen or not. In a pilot study of 915 patients, we previously identified a single nucleotide polymorphism (SNP) at the aromatase gene (CYP19A1) which could potentially predict the outcome of postmenopausal patients treated with tamoxifen. Aromatase is a key enzyme in the estrogen biosynthesis pathway and in postmenopausal women, estrogen levels are low with the aromatase being responsible for estrogen synthesis from adipose tissue following the cessation of ovarian function. Therefore any alterations in aromatase function may affect the inhibitory capacity of tamoxifen for estrogen at the ER, resulting in variation of outcome in patients treated with tamoxifen. We hypothesized that genetic variation in CYP19A1 may influence aromatase expression and function, thus affecting the outcome of ER-positive postmenopausal early breast cancer patients treated with tamoxifen. Genotyping was conducted on 55,540 breast cancer patients from 50 studies with the custom Illumina Infinium array (iCOGS) by the Breast Cancer Association Consortium. More than 200,000 SNPs were genotyped of which 89 SNPs are located in the CYP19A1 genomic region. We included patients that are female with European ancestry, available follow up and vital status, invasive breast tumor, ascertained for their first tumor, stage I-III disease, postmenopausal, ER-positive, right truncation at 15 years of follow up, left censoring for study entry and those treated with tamoxifen. Furthermore, studies with less than 10 events for relapse or death were excluded leaving a total of 1313 patients for outcome analyses with distant metastasis-free survival as the endpoint. We identified rs7172156 being associated with poor outcome of which carriers of the minor A allele had a higher risk of distant metastasis or death (P = 0.007). Multivariate Cox regression stratified by study and adjusted for age, node status, tumor size and grade confirmed this observation (HR = 1.30, 95% CI 1.00-1.68, P = 0.049). Our data suggest that rs7172156 could be clinically relevant as a tamoxifen outcome predictor in early breast cancer.
Citation Format: Wing-Yee Lo, Werner Schroth, Reiner Hoppe, Marjanka Schmidt, Montserrat Garcia-Closas, Paul Pharaoh, Per Hall, Douglas Easton, Peter Fasching, Hiltrud Brauch, in collaboration with the Breast Cancer Association Consortium. CYP19A1 genetic variation is a potential predictor of outcome in ER-positive postmenopausal early breast cancer patients treated with tamoxifen. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5483. doi:10.1158/1538-7445.AM2015-5483
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Affiliation(s)
- Wing-Yee Lo
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Werner Schroth
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Reiner Hoppe
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Marjanka Schmidt
- 2Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Montserrat Garcia-Closas
- 3Division of Genetics and Epidemiology and Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, United Kingdom
| | - Paul Pharaoh
- 4Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Per Hall
- 5Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Douglas Easton
- 4Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Peter Fasching
- 6Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Hiltrud Brauch
- 1Dr. Margarete Fischer-Bosch - Institute of Clinical Pharmacology, Stuttgart, Germany
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Chin E, Otto K, Hoppe R, Million L, Loo B, Koong A, Xing L, Hsu A, Fahimian B. TU-CD-304-01: FEATURED PRESENTATION and BEST IN PHYSICS (THERAPY): Trajectory Modulated Arc Therapy: Development of Novel Arc Delivery Techniques Integrating Dynamic Table Motion for Extended Volume Treatments. Med Phys 2015. [DOI: 10.1118/1.4925570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Scandling JD, Busque S, Shizuru JA, Lowsky R, Hoppe R, Dejbakhsh-Jones S, Jensen K, Shori A, Strober JA, Lavori P, Turnbull BB, Engleman EG, Strober S. Chimerism, graft survival, and withdrawal of immunosuppressive drugs in HLA matched and mismatched patients after living donor kidney and hematopoietic cell transplantation. Am J Transplant 2015; 15:695-704. [PMID: 25693475 DOI: 10.1111/ajt.13091] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/03/2014] [Accepted: 10/04/2014] [Indexed: 01/25/2023]
Abstract
Thirty-eight HLA matched and mismatched patients given combined living donor kidney and enriched CD34(+) hematopoietic cell transplants were enrolled in tolerance protocols using posttransplant conditioning with total lymphoid irradiation and anti-thymocyte globulin. Persistent chimerism for at least 6 months was associated with successful complete withdrawal of immunosuppressive drugs in 16 of 22 matched patients without rejection episodes or kidney disease recurrence with up to 5 years follow up thereafter. One patient is in the midst of withdrawal and five are on maintenance drugs. Persistent mixed chimerism was achieved in some haplotype matched patients for at least 12 months by increasing the dose of T cells and CD34(+) cells infused as compared to matched recipients in a dose escalation study. Success of drug withdrawal in chimeric mismatched patients remains to be determined. None of the 38 patients had kidney graft loss or graft versus host disease with up to 14 years of observation. In conclusion, complete immunosuppressive drug withdrawal could be achieved thus far with the tolerance induction regimen in HLA matched patients with uniform long-term graft survival in all patients.
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Affiliation(s)
- J D Scandling
- Department of Medicine (Nephrology), Stanford University School of Medicine, Stanford, CA
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Dabaja B, Tsang R, Qi S, Allen P, Hodgson D, Ricardi U, Hoppe R, Ng A, Mauch P, Specht L, Li Y, Terezakis S, Wirth A, Reinartz G, Eich H, Aleman B, Constine L, Yahalom J. Favorable Outcome in Stage I-II Mantle Cell Lymphoma: A Report of 160 Patients From the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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50
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King M, Donaldson S, Link M, Advani R, Hoppe R. Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL): Management in the Modern Era. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.226] [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]
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