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Pendse AA, Maule JG, Neff JL, McCall S. Corrigendum to "Plasma cells are essentially absent in the luminal gastrointestinal tract of patients with "complete" 22q11.2 Deletion Syndrome (DiGeorge Syndrome)." [Human Pathology (2021) 117, 1e8]. Hum Pathol 2024:S0046-8177(24)00047-9. [PMID: 38556400 DOI: 10.1016/j.humpath.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Avani A Pendse
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA.
| | - Jake G Maule
- Foundation Medicine, Morrisville, NC, 27560, USA.
| | - Jadee L Neff
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA.
| | - Shannon McCall
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA.
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Wood K, Nussbaum D, Martz C, Waters A, Barrera A, Rutter J, Cerda-Smith C, Stewart A, Wu C, Cakir M, Levandowski C, Kantrowitz D, McCall S, Pierobon M, Petricoin E, Smith J, Der C, Taatjes D. Mediator Kinase Inhibition Impedes Transcriptional Plasticity and Prevents Resistance to ERK/MAPK-Targeted Therapy in KRAS-Mutant Cancers. Res Sq 2023:rs.3.rs-3511242. [PMID: 37961649 PMCID: PMC10635398 DOI: 10.21203/rs.3.rs-3511242/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Acquired resistance remains a major challenge for therapies targeting oncogene activated pathways. KRAS is the most frequently mutated oncogene in human cancers, yet strategies targeting its downstream signaling kinases have failed to produce durable treatment responses. Here, we developed multiple models of acquired resistance to dual-mechanism ERK/MAPK inhibitors across KRAS-mutant pancreatic, colorectal, and lung cancers, and then probed the long-term events enabling survival against this class of drugs. These studies revealed that resistance emerges secondary to large-scale transcriptional adaptations that are diverse and cell line-specific. Transcriptional reprogramming extends beyond the well-established early response, and instead represents a dynamic, evolved process that is refined to attain a stably resistant phenotype. Mechanistic and translational studies reveal that resistance to dual-mechanism ERK/MAPK inhibition is broadly susceptible to manipulation of the epigenetic machinery, and that Mediator kinase, in particular, can be co-targeted at a bottleneck point to prevent diverse, cell line-specific resistance programs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Chao Wu
- Memorial Sloan Kettering Cancer Center
| | | | | | | | | | - Mariaelena Pierobon
- Center for Applied Proteomics and Molecular Medicine, George Mason University
| | | | - J Smith
- Memorial Sloan Kettering Cancer Center
| | - Channing Der
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
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Marriott AE, Dagley JL, Hegde S, Steven A, Fricks C, DiCosty U, Mansour A, Campbell EJ, Wilson CM, Gusovsky F, Ward SA, Hong WD, O'Neill P, Moorhead A, McCall S, McCall JW, Taylor MJ, Turner JD. Dirofilariasis mouse models for heartworm preclinical research. Front Microbiol 2023; 14:1208301. [PMID: 37426014 PMCID: PMC10324412 DOI: 10.3389/fmicb.2023.1208301] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Dirofilariasis, including heartworm disease, is a major emergent veterinary parasitic infection and a human zoonosis. Currently, experimental infections of cats and dogs are used in veterinary heartworm preclinical drug research. Methods As a refined alternative in vivo heartworm preventative drug screen, we assessed lymphopenic mouse strains with ablation of the interleukin-2/7 common gamma chain (γc) as susceptible to the larval development phase of Dirofilaria immitis. Results Non-obese diabetic (NOD) severe combined immunodeficiency (SCID)γc-/- (NSG and NXG) and recombination-activating gene (RAG)2-/-γc-/- mouse strains yielded viable D. immitis larvae at 2-4 weeks post-infection, including the use of different batches of D. immitis infectious larvae, different D. immitis isolates, and at different laboratories. Mice did not display any clinical signs associated with infection for up to 4 weeks. Developing larvae were found in subcutaneous and muscle fascia tissues, which is the natural site of this stage of heartworm in dogs. Compared with in vitro-propagated larvae at day 14, in vivo-derived larvae had completed the L4 molt, were significantly larger, and contained expanded Wolbachia endobacteria titres. We established an ex vivo L4 paralytic screening system whereby assays with moxidectin or levamisole highlighted discrepancies in relative drug sensitivities in comparison with in vitro-reared L4 D. immitis. We demonstrated effective depletion of Wolbachia by 70%-90% in D. immitis L4 following 2- to 7-day oral in vivo exposures of NSG- or NXG-infected mice with doxycycline or the rapid-acting investigational drug, AWZ1066S. We validated NSG and NXG D. immitis mouse models as a filaricide screen by in vivo treatments with single injections of moxidectin, which mediated a 60%-88% reduction in L4 larvae at 14-28 days. Discussion Future adoption of these mouse models will benefit end-user laboratories conducting research and development of novel heartworm preventatives via increased access, rapid turnaround, and reduced costs and may simultaneously decrease the need for experimental cat or dog use.
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Affiliation(s)
- A. E. Marriott
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - J. L. Dagley
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - S. Hegde
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - A. Steven
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - C. Fricks
- TRS Laboratories Inc, Athens, GA, United States
| | - U. DiCosty
- TRS Laboratories Inc, Athens, GA, United States
| | - A. Mansour
- TRS Laboratories Inc, Athens, GA, United States
| | - E. J. Campbell
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - C. M. Wilson
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - F. Gusovsky
- Eisai Global Health, Cambridge, MA, United States
| | - S. A. Ward
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - W. D. Hong
- Department of Chemistry, University of Liverpool, Liverpool, United Kingdom
| | - P. O'Neill
- Department of Chemistry, University of Liverpool, Liverpool, United Kingdom
| | - A. Moorhead
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - S. McCall
- TRS Laboratories Inc, Athens, GA, United States
| | - J. W. McCall
- TRS Laboratories Inc, Athens, GA, United States
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - M. J. Taylor
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - J. D. Turner
- Department of Tropical Disease Biology, Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
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Dayanidhi DL, Somarelli JA, Mantyh JB, Rupprecht G, Roghani RS, Vincoff S, Shin I, Zhao Y, Kim SY, McCall S, Hong J, Hsu DS. Corrigendum: Psymberin, a marine-derived natural product, induces cancer cell growth arrest and protein translation inhibition. Front Med (Lausanne) 2023; 10:1193745. [PMID: 37324143 PMCID: PMC10265623 DOI: 10.3389/fmed.2023.1193745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fmed.2022.999004.].
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Affiliation(s)
- Divya L. Dayanidhi
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Jason A. Somarelli
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - John B. Mantyh
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Gabrielle Rupprecht
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Roham Salman Roghani
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Sophia Vincoff
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Iljin Shin
- Department of Chemistry, Duke University, Durham, NC, United States
| | - Yiquan Zhao
- Department of Chemistry, Duke University, Durham, NC, United States
| | - So Young Kim
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, United States
| | - Shannon McCall
- Department of Pathology, Duke University, Durham, NC, United States
| | - Jiyong Hong
- Department of Chemistry, Duke University, Durham, NC, United States
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, United States
| | - David S. Hsu
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
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Dayanidhi DL, Somarelli JA, Mantyh JB, Rupprecht G, Roghani RS, Vincoff S, Shin I, Zhao Y, Kim SY, McCall S, Hong J, Hsu DS. Psymberin, a marine-derived natural product, induces cancer cell growth arrest and protein translation inhibition. Front Med (Lausanne) 2022; 9:999004. [PMID: 36743670 PMCID: PMC9894252 DOI: 10.3389/fmed.2022.999004] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/18/2022] [Indexed: 01/20/2023] Open
Abstract
Colorectal cancer (CRC) is the third most prevalent form of cancer in the United States and results in over 50,000 deaths per year. Treatments for metastatic CRC are limited, and therefore there is an unmet clinical need for more effective therapies. In our prior work, we coupled high-throughput chemical screens with patient-derived models of cancer to identify new potential therapeutic targets for CRC. However, this pipeline is limited by (1) the use of cell lines that do not appropriately recapitulate the tumor microenvironment, and (2) the use of patient-derived xenografts (PDXs), which are time-consuming and costly for validation of drug efficacy. To overcome these limitations, we have turned to patient-derived organoids. Organoids are increasingly being accepted as a "standard" preclinical model that recapitulates tumor microenvironment cross-talk in a rapid, cost-effective platform. In the present work, we employed a library of natural products, intermediates, and drug-like compounds for which full synthesis has been demonstrated. Using this compound library, we performed a high-throughput screen on multiple low-passage cancer cell lines to identify potential treatments. The top candidate, psymberin, was further validated, with a focus on CRC cell lines and organoids. Mechanistic and genomics analyses pinpointed protein translation inhibition as a mechanism of action of psymberin. These findings suggest the potential of psymberin as a novel therapy for the treatment of CRC.
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Affiliation(s)
- Divya L. Dayanidhi
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Jason A. Somarelli
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - John B. Mantyh
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Gabrielle Rupprecht
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Roham Salman Roghani
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
| | - Sophia Vincoff
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Iljin Shin
- Department of Chemistry, Duke University, Durham, NC, United States
| | - Yiquan Zhao
- Department of Chemistry, Duke University, Durham, NC, United States
| | - So Young Kim
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, United States
| | - Shannon McCall
- Department of Pathology, Duke University, Durham, NC, United States
| | - Jiyong Hong
- Department of Chemistry, Duke University, Durham, NC, United States
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, United States
| | - David S. Hsu
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Center for Genomics and Computational Biology, Duke University, Durham, NC, United States
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6
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Brown LC, Zhu J, Desai K, Kinsey E, Kao C, Lee YH, Pabla S, Labriola MK, Tran J, Dragnev KH, Tafe LJ, Dayyani F, Gupta RT, McCall S, George DJ, Glenn ST, Nesline MK, George S, Zibelman M, Morrison C, Ornstein MC, Zhang T. Evaluation of tumor microenvironment and biomarkers of immune checkpoint inhibitor response in metastatic renal cell carcinoma. J Immunother Cancer 2022; 10:jitc-2022-005249. [PMID: 36252996 PMCID: PMC9577926 DOI: 10.1136/jitc-2022-005249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Immunotherapy combinations including ipilimumab and nivolumab are now the standard of care for untreated metastatic renal cell carcinoma (mRCC). Biomarkers of response are lacking to predict patients who will have a favorable or unfavorable response to immunotherapy. This study aimed to use the OmniSeq transcriptome-based platform to develop biomarkers of response to immunotherapy. METHODS Two cohorts of patients were retrospectively collected. These included an investigational cohort of patients with mRCC treated with immune checkpoint inhibitor therapy from five institutions, and a subsequent validation cohort of patients with mRCC treated with combination ipilimumab and nivolumab from two institutions (Duke Cancer Institute and Cleveland Clinic Taussig Cancer Center). Tissue-based RNA sequencing was performed using the OmniSeq Immune Report Card on banked specimens to identify gene signatures and immune checkpoints associated with differential clinical outcomes. A 5-gene expression panel was developed based on the investigational cohort and was subsequently evaluated in the validation cohort. Clinical outcomes including progression-free survival (PFS) and overall survival (OS) were extracted by retrospective chart review. Objective response rate (ORR) was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) V.1.1. RESULTS The initial investigation cohort identified 86 patients with mRCC who received nivolumab (80%, 69/86), ipilimumab/nivolumab (14%, 12/86), or pembrolizumab (6%, 5/86). A gene expression score was created using the top five genes found in responders versus non-responders (FOXP3, CCR4, KLRK1, ITK, TIGIT). The ORR in patients with high gene expression (GEhigh) on the 5-gene panel was 29% (14/48), compared with low gene expression (GElow) 3% (1/38, χ2 p=0.001). The validation cohort was comprised of 62 patients who received ipilimumab/nivolumab. There was no difference between GEhigh and GElow in terms of ORR (44% vs 38.5%), PFS (HR 1.5, 95% CI 0.58 to 3.89), or OS (HR 0.96, 95% CI 0.51 to 1.83). Similarly, no differences in ORR, PFS or OS were observed when patients were stratified by tumor mutational burden (high=top 20%), PD-L1 (programmed death-ligand 1) expression by immunohistochemistry or RNA expression, or CTLA-4 (cytotoxic T-lymphocytes-associated protein 4) RNA expression. The International Metastatic RCC Database Consortium (IMDC) risk score was prognostic for OS but not PFS. CONCLUSION A 5-gene panel that was associated with improved ORR in a predominantly nivolumab monotherapy population of patients with mRCC was not predictive for radiographic response, PFS, or OS among patients with mRCC treated with ipilimumab and nivolumab.
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Affiliation(s)
- Landon C Brown
- Levine Cancer Institute, Charlotte, North Carolina, USA,Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Jason Zhu
- Levine Cancer Institute, Charlotte, North Carolina, USA,Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Kunal Desai
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Emily Kinsey
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Chester Kao
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | | | | | - Matthew K Labriola
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Jennifer Tran
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland, Ohio, USA
| | | | - Laura J Tafe
- Department of Medicine, Dartmouth Cancer Center, Lebanon, Pennsylvania, USA
| | - Farshid Dayyani
- Department of Medicine, University of California-Irvine Health, Orange, California, USA
| | - Rajan T Gupta
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Shannon McCall
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Daniel J George
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA
| | - Sean T Glenn
- Center for Personalized Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA,OmniSeq, Inc, Buffalo, New York, USA
| | | | - Saby George
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Matthew Zibelman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | | | - Moshe C Ornstein
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Tian Zhang
- Department of Medicine, Duke Cancer Institute, Durham, North Carolina, USA,Hematology and Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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7
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Ding S, Hsu C, Wang Z, Natesh NR, Millen R, Negrete M, Giroux N, Rivera GO, Dohlman A, Bose S, Rotstein T, Spiller K, Yeung A, Sun Z, Jiang C, Xi R, Wilkin B, Randon PM, Williamson I, Nelson DA, Delubac D, Oh S, Rupprecht G, Isaacs J, Jia J, Chen C, Shen JP, Kopetz S, McCall S, Smith A, Gjorevski N, Walz AC, Antonia S, Marrer-Berger E, Clevers H, Hsu D, Shen X. Patient-derived micro-organospheres enable clinical precision oncology. Cell Stem Cell 2022; 29:905-917.e6. [PMID: 35508177 PMCID: PMC9177814 DOI: 10.1016/j.stem.2022.04.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 02/09/2023]
Abstract
Patient-derived xenografts (PDXs) and patient-derived organoids (PDOs) have been shown to model clinical response to cancer therapy. However, it remains challenging to use these models to guide timely clinical decisions for cancer patients. Here, we used droplet emulsion microfluidics with temperature control and dead-volume minimization to rapidly generate thousands of micro-organospheres (MOSs) from low-volume patient tissues, which serve as an ideal patient-derived model for clinical precision oncology. A clinical study of recently diagnosed metastatic colorectal cancer (CRC) patients using an MOS-based precision oncology pipeline reliably assessed tumor drug response within 14 days, a timeline suitable for guiding treatment decisions in the clinic. Furthermore, MOSs capture original stromal cells and allow T cell penetration, providing a clinical assay for testing immuno-oncology (IO) therapies such as PD-1 blockade, bispecific antibodies, and T cell therapies on patient tumors.
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Affiliation(s)
- Shengli Ding
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA; Xilis, Inc., Durham, NC 27713, USA
| | - Carolyn Hsu
- College of Arts and Sciences, University of Chapel Hill, Chapel Hill, NC 27599, USA
| | - Zhaohui Wang
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA; Xilis, Inc., Durham, NC 27713, USA
| | - Naveen R Natesh
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Rosemary Millen
- Oncode, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW), University Medical Center (UMC) Utrecht, Uppsalalaan 8, 3584 CT Utrecht, the Netherlands
| | - Marcos Negrete
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Nicholas Giroux
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Grecia O Rivera
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Anders Dohlman
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Shree Bose
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Tomer Rotstein
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | | | - Athena Yeung
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Zhiguo Sun
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Chongming Jiang
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Rui Xi
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | | | - Peggy M Randon
- National Institute of Environmental Health Sciences (NIEHS), Durham, NC 27709, USA
| | - Ian Williamson
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | | | | | - Sehwa Oh
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC 27708, USA
| | - Gabrielle Rupprecht
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC 27708, USA
| | - James Isaacs
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC 27708, USA
| | - Jingquan Jia
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC 27708, USA
| | - Chao Chen
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - John Paul Shen
- Department of Gastrointestinal Medical Oncology, MD Anderson, Houston, TX 77030, USA
| | - Scott Kopetz
- Department of Gastrointestinal Medical Oncology, MD Anderson, Houston, TX 77030, USA
| | - Shannon McCall
- Department of Pathology, Duke University, Durham, NC 27708, USA
| | | | - Nikolche Gjorevski
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center, Basel 4058, Switzerland
| | - Antje-Christine Walz
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center, Basel 4058, Switzerland
| | - Scott Antonia
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC 27708, USA
| | - Estelle Marrer-Berger
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center, Basel 4058, Switzerland
| | - Hans Clevers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands; Oncode, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW), University Medical Center (UMC) Utrecht, Uppsalalaan 8, 3584 CT Utrecht, the Netherlands; Roche Pharmaceutical Research and Early Development, Roche Innovation Center, Basel 4058, Switzerland.
| | - David Hsu
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC 27708, USA.
| | - Xiling Shen
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA; Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.
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8
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Pendse AA, Maule JG, Neff JL, McCall S. Plasma cells are essentially absent in the luminal gastrointestinal tract of patients with "complete" 22q11.2 deletion syndrome (DiGeorge syndrome). Hum Pathol 2021; 117:1-8. [PMID: 34391747 DOI: 10.1016/j.humpath.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
Gastrointestinal symptoms are commonly reported in patients with 22q11.2 deletion syndrome or DiGeorge syndrome (DGS) in addition to the dominant cardiac manifestations and immunodeficiency. But literature providing specific morphologic details of the gastrointestinal tract pathology is very limited. Here, we provide the first comprehensive morphologic description of the luminal gastrointestinal tract changes in patients with DGS. Cytogenetically confirmed DGS patients were identified, clinical and laboratory data were reviewed to determine the severity of immunodeficiency, and patients were stratified into mildly immunocompromised, that is, partial DiGeorge anomaly or severely immunosuppressed, that is, complete DiGeorge anomaly groups. Gastrointestinal tract biopsies from these patients were retrospectively reviewed and compared with those from controls without the history of DGS. Patients with immunosuppressed DGS showed a near complete absence of plasma cells in the stomach, duodenum, and colon lamina propria by hematoxylin and eosin evaluation. Immunohistochemistry for CD138 used to highlight plasma cells confirmed this finding. The notable absence of plasma cells adds to the existing knowledge of the pathophysiology underlying DGS and expands the differential diagnostic considerations for this finding, which has been previously described in common variable immunodeficiency. It also provides a useful morphologic marker observable by the readily accessible light microscopy. Second, patients with DGS showed a mild increase in epithelial cell apoptosis in their colon. This finding is significant because of its overlap with morphologic features of gastrointestinal graft versus host disease as thymus transplantation is being used as a treatment option for patients with complete DGS.
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Affiliation(s)
- Avani A Pendse
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
| | - Jake G Maule
- Foundation Medicine, Morrisville, NC 27560, USA.
| | - Jadee L Neff
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
| | - Shannon McCall
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
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9
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Dov D, Assaad S, Syedibrahim A, Bell J, Huang J, Madden J, Bentley R, McCall S, Henao R, Carin L, Foo WC. A Hybrid Human-Machine Learning Approach for Screening Prostate Biopsies Can Improve Clinical Efficiency Without Compromising Diagnostic Accuracy. Arch Pathol Lab Med 2021; 146:727-734. [PMID: 34591085 DOI: 10.5858/arpa.2020-0850-oa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Prostate cancer is a common malignancy, and accurate diagnosis typically requires histologic review of multiple prostate core biopsies per patient. As pathology volumes and complexity increase, new tools to improve the efficiency of everyday practice are keenly needed. Deep learning has shown promise in pathology diagnostics, but most studies silo the efforts of pathologists from the application of deep learning algorithms. Very few hybrid pathologist-deep learning approaches have been explored, and these typically require complete review of histologic slides by both the pathologist and the deep learning system. OBJECTIVE.— To develop a novel and efficient hybrid human-machine learning approach to screen prostate biopsies. DESIGN.— We developed an algorithm to determine the 20 regions of interest with the highest probability of malignancy for each prostate biopsy; presenting these regions to a pathologist for manual screening limited the initial review by a pathologist to approximately 2% of the tissue area of each sample. We evaluated this approach by using 100 biopsies (29 malignant, 60 benign, 11 other) that were reviewed by 4 pathologists (3 urologic pathologists, 1 general pathologist) using a custom-designed graphical user interface. RESULTS.— Malignant biopsies were correctly identified as needing comprehensive review with high sensitivity (mean, 99.2% among all pathologists); conversely, most benign prostate biopsies (mean, 72.1%) were correctly identified as needing no further review. CONCLUSIONS.— This novel hybrid system has the potential to efficiently triage out most benign prostate core biopsies, conserving time for the pathologist to dedicate to detailed evaluation of malignant biopsies.
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Affiliation(s)
- David Dov
- From the Departments of Electrical and Computer Engineering (Dov, Assaad, Syedibrahim, Bell, Carin)
| | - Serge Assaad
- From the Departments of Electrical and Computer Engineering (Dov, Assaad, Syedibrahim, Bell, Carin)
| | - Ameer Syedibrahim
- From the Departments of Electrical and Computer Engineering (Dov, Assaad, Syedibrahim, Bell, Carin)
| | - Jonathan Bell
- From the Departments of Electrical and Computer Engineering (Dov, Assaad, Syedibrahim, Bell, Carin).,the Department of Pathology (Bell, Huang, Madden, Bentley, McCall, Foo), Duke University Medical Center, Durham, North Carolina
| | - Jiaoti Huang
- the Department of Pathology (Bell, Huang, Madden, Bentley, McCall, Foo), Duke University Medical Center, Durham, North Carolina
| | - John Madden
- the Department of Pathology (Bell, Huang, Madden, Bentley, McCall, Foo), Duke University Medical Center, Durham, North Carolina
| | - Rex Bentley
- the Department of Pathology (Bell, Huang, Madden, Bentley, McCall, Foo), Duke University Medical Center, Durham, North Carolina
| | - Shannon McCall
- the Department of Pathology (Bell, Huang, Madden, Bentley, McCall, Foo), Duke University Medical Center, Durham, North Carolina
| | - Ricardo Henao
- Biostatistics and Bioinformatics (Henao), Duke University, Durham, North Carolina
| | - Lawrence Carin
- From the Departments of Electrical and Computer Engineering (Dov, Assaad, Syedibrahim, Bell, Carin)
| | - Wen-Chi Foo
- the Department of Pathology (Bell, Huang, Madden, Bentley, McCall, Foo), Duke University Medical Center, Durham, North Carolina
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10
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Labriola MK, Zhu J, Gupta RT, McCall S, Jackson J, Kong EF, White JR, Cerqueira G, Gerding K, Simmons JK, George D, Zhang T. Characterization of tumor mutation burden, PD-L1 and DNA repair genes to assess relationship to immune checkpoint inhibitors response in metastatic renal cell carcinoma. J Immunother Cancer 2021; 8:jitc-2019-000319. [PMID: 32221016 PMCID: PMC7206964 DOI: 10.1136/jitc-2019-000319] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [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] [Accepted: 02/20/2020] [Indexed: 12/27/2022] Open
Abstract
Background Immune checkpoint inhibitors (ICIs) have expanded treatment options for metastatic renal cell carcinoma (mRCC); however, there are limited predictive biomarkers for response to ICIs in this indication, with programmed death-ligand 1 (PD-L1) status demonstrating little predictive utility in mRCC. While predictive of ICI response in other tumor types, the utility of tumor mutation burden (TMB) in mRCC is unclear. Here, we assess TMB, loss of antigen presentation genes and PD-L1 status correlated with outcomes to ICI treatment in mRCC. Methods Tumor samples from 34 patients with mRCC treated with ICI therapy at Duke Cancer Institute were retrospectively evaluated using Personal Genome Diagnostics elio tissue complete (RUO version), a tumor genomic profiling assay for somatic variants, TMB, microsatellite status and genomic status of antigen presentation genes. Tumor samples were also analyzed with the Dako 28-8 PD-L1 immunohistochemistry assay. Deidentified clinical information was extracted from the medical record, and tumor response was evaluated based on the Response Evaluation Criteria In Solid Tumors (RECIST) V.1.1 criteria. Results Patients were stratified by overall response following ICI therapy and designated as progressive disease (PD; n=18) or disease control groups (DC; n=16). TMB scores ranged from 0.36 to 12.24 mutations/Mb (mean 2.83 mutations/Mb) with no significant difference between the PD and DC groups (3.01 vs 2.63 mutations/Mb, respectively; p=0.7682). Interestingly, 33% of PD patients displayed loss of heterozygosity of major histocompatibility complex class I genes (LOH-MHC) vs 6% of DC patients. Nine of 34 samples were PD-L1-positive (4 in the PD group; 5 in the DC group), suggesting no correlation between PD-L1 expression and response to ICI therapy. Notably, the DC group displayed an enrichment of mutations in DNA repair genes (p=0.04), with 68.8% exhibiting at least one mutated homologous recombination repair (HRR)-related gene compared with only 38.9% of the PD group (p=0.03). Conclusions Overall, neither TMB nor PD-L1 correlated with ICI response and TMB was not significantly associated with PD-L1 expression. The higher incidence of LOH-MHC in PD group suggests that loss of antigen presentation may restrict response to ICIs. Separately, enrichment of HRR gene mutations in the DC group suggests potential utility in predicting ICI response and a potential therapeutic target, warranting future studies.
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Affiliation(s)
- Matthew Kyle Labriola
- Division of Medical Oncology, Department of Medicine, Duke University Health System, Durham, North Carolina, USA
| | - Jason Zhu
- Division of Medical Oncology, Department of Medicine, Duke University Health System, Durham, North Carolina, USA
| | - Rajan T Gupta
- Duke Cancer Institute, Durham, North Carolina, USA.,Department of Radiology, Duke University Health System, Durham, NC, United States
| | - Shannon McCall
- Duke Cancer Institute, Durham, North Carolina, USA.,Department of Pathology, Duke University Health System, Durham, NC, United States
| | | | - Eric F Kong
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - James R White
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | | | - Kelly Gerding
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | | | - Daniel George
- Division of Medical Oncology, Department of Medicine, Duke University Health System, Durham, North Carolina, USA.,Duke Cancer Institute, Durham, North Carolina, USA
| | - Tian Zhang
- Division of Medical Oncology, Department of Medicine, Duke University Health System, Durham, North Carolina, USA .,Duke Cancer Institute, Durham, North Carolina, USA
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11
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Devi GR, Finetti P, Morse MA, Lee S, de Nonneville A, Van Laere S, Troy J, Geradts J, McCall S, Bertucci F. Expression of X-Linked Inhibitor of Apoptosis Protein (XIAP) in Breast Cancer Is Associated with Shorter Survival and Resistance to Chemotherapy. Cancers (Basel) 2021; 13:2807. [PMID: 34199946 PMCID: PMC8200223 DOI: 10.3390/cancers13112807] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 11/16/2022] Open
Abstract
XIAP, the most potent inhibitor of cell death pathways, is linked to chemotherapy resistance and tumor aggressiveness. Currently, multiple XIAP-targeting agents are in clinical trials. However, the characterization of XIAP expression in relation to clinicopathological variables in large clinical series of breast cancer is lacking. We retrospectively analyzed non-metastatic, non-inflammatory, primary, invasive breast cancer samples for XIAP mRNA (n = 2341) and protein (n = 367) expression. XIAP expression was analyzed as a continuous value and correlated with clinicopathological variables. XIAP mRNA expression was heterogeneous across samples and significantly associated with younger patients' age (≤50 years), pathological ductal type, lower tumor grade, node-positive status, HR+/HER2- status, and PAM50 luminal B subtype. Higher XIAP expression was associated with shorter DFS in uni- and multivariate analyses in 909 informative patients. Very similar correlations were observed at the protein level. This prognostic impact was significant in the HR+/HER2- but not in the TN subtype. Finally, XIAP mRNA expression was associated with lower pCR rate to anthracycline-based neoadjuvant chemotherapy in both uni- and multivariate analyses in 1203 informative patients. Higher XIAP expression in invasive breast cancer is independently associated with poorer prognosis and resistance to chemotherapy, suggesting the potential therapeutic benefit of targeting XIAP.
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Affiliation(s)
- Gayathri R. Devi
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA;
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Pascal Finetti
- Laboratory of Predictive Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes, INSERM UMR1068, CNRS UMR725, Aix-Marseille University, 13009 Marseille, France; (P.F.); (A.d.N.)
| | - Michael A. Morse
- Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA;
| | - Seayoung Lee
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA;
| | - Alexandre de Nonneville
- Laboratory of Predictive Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes, INSERM UMR1068, CNRS UMR725, Aix-Marseille University, 13009 Marseille, France; (P.F.); (A.d.N.)
- Department of Medical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France
| | | | - Jesse Troy
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA;
| | - Joseph Geradts
- Department of Pathology and Laboratory Medicine, East Carolina University Brody School of Medicine, Greenville, NC 27858, USA;
| | - Shannon McCall
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Francois Bertucci
- Laboratory of Predictive Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes, INSERM UMR1068, CNRS UMR725, Aix-Marseille University, 13009 Marseille, France; (P.F.); (A.d.N.)
- Department of Medical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France
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12
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Allocca CM, Bledsoe MJ, Albert M, Anisimov SV, Bravo E, Castelhano MG, Cohen Y, De Wilde M, Furuta K, Kozlakidis Z, Martin D, Martins A, McCall S, Morrin H, Pugh RS, Schacter B, Simeon-Dubach D, Snapes E. Biobanking in the COVID-19 Era and Beyond: Part 1. How Early Experiences Can Translate into Actionable Wisdom. Biopreserv Biobank 2020; 18:533-546. [PMID: 33164554 DOI: 10.1089/bio.2020.0082] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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
The era of COVID-19 has brought about a number of novel challenges for the global biobanking community. To better position the biobanking community to cope with current and future challenges, the International Society for Biological and Environmental Repositories (ISBER) COVID-19 Response Task Force was convened to identify needs and gaps in biobanking tools (existing resources that support good practice), for example, standards, best practices, business, etc. and to make recommendations to benefit the community. Toward these goals, the Task Force assembled a set of questions to explore individual biobanks' experiences, with emphasis on identification of key challenges and approaches, including tools employed. A survey was designed with the use of these questions and administered by ISBER. This article presents a summary of the aggregated data obtained from the survey responses, illustrating some of the major issues encountered and identifying which tools the survey respondents found most useful. In particular, this article focuses on the challenges identified during the early months of the COVID-19 era. Recommendations are provided to support biobank emergency preparedness for the future, address lessons learned, and propose solutions to bridge identified gaps. The analysis and the complete survey dataset will also inform the larger Task Force goal to develop specific tool recommendations.
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Affiliation(s)
- Clare M Allocca
- Standards Coordination Office, National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Marianna J Bledsoe
- Independent Consultant and Deputy Editor, Biopreservation and Biobanking, Colorado Springs, Colorado, USA
| | - Monique Albert
- Ontario Tumour Bank, Ontario Institute for Cancer Research, Toronto, Canada
| | | | - Elena Bravo
- Research Coordination and Support Service, Italian National Institute of Health, Rome, Italy
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Yehudit Cohen
- MIDGAM-Israel National Biobank for Research, Rehovot, Israel
| | | | - Koh Furuta
- Urayasu Warakuen Clinic, Urayasu, Japan
- Laboratory Service and Biobank Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Zisis Kozlakidis
- Laboratory Service and Biobank Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Dunja Martin
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures GmbH, Braunschweig, Germany
| | - Anabela Martins
- Micoteca da Universidade do Minho, Centro de Engenharia Biológica, Braga, Portugal
| | - Shannon McCall
- Department of Pathology, Duke University Health System, Durham, North Carolina, USA
| | - Helen Morrin
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Rebecca S Pugh
- Chemical Sciences Division, National Institute of Standards and Technology, Charleston, South Carolina, USA
| | - Brent Schacter
- CancerCare Manitoba/University of Manitoba, Winnipeg, Canada
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13
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Altunel E, Roghani RS, Chen KY, Kim SY, McCall S, Ware KE, Shen X, Somarelli JA, Hsu DS. Development of a precision medicine pipeline to identify personalized treatments for colorectal cancer. BMC Cancer 2020; 20:592. [PMID: 32580713 PMCID: PMC7313200 DOI: 10.1186/s12885-020-07090-y] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metastatic colorectal cancer (CRC) continues to be a major health problem, and current treatments are primarily for disease control and palliation of symptoms. In this study, we developed a precision medicine strategy to discover novel therapeutics for patients with CRC. METHODS Six matched low-passage cell lines and patient-derived xenografts (PDX) were established from CRC patients undergoing resection of their cancer. High-throughput drug screens using a 119 FDA-approved oncology drug library were performed on these cell lines, which were then validated in vivo in matched PDXs. RNA-Seq analysis was then performed to identify predictors of response. RESULTS Our study revealed marked differences in response to standard-of-care agents across patients and pinpointed druggable pathways to treat CRC. Among these pathways co-targeting of fibroblast growth factor receptor (FGFR), SRC, platelet derived growth factor receptor (PDGFR), or vascular endothelial growth factor receptor (VEGFR) signaling was found to be an effective strategy. Molecular analyses revealed potential predictors of response to these druggable pathways. CONCLUSIONS Our data suggests that the use of matched low-passage cell lines and PDXs is a promising strategy to identify new therapies and pathways to treat metastatic CRC.
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Affiliation(s)
- Erdem Altunel
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, 3008 Snyderman Building, 905 S. LaSalle St., Durham, NC, 27710, USA
- Center for Genomics and Computational Biology, Duke University, Durham, North Carolina, USA
| | - Roham S Roghani
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, 3008 Snyderman Building, 905 S. LaSalle St., Durham, NC, 27710, USA
- Center for Genomics and Computational Biology, Duke University, Durham, North Carolina, USA
| | - Kai-Yuan Chen
- Center for Genomics and Computational Biology, Duke University, Durham, North Carolina, USA
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - So Young Kim
- Duke Functional Genomics Core, Duke University, Durham, North Carolina, USA
| | - Shannon McCall
- Department of Pathology, Duke University, Durham, North Carolina, USA
| | - Kathryn E Ware
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, 3008 Snyderman Building, 905 S. LaSalle St., Durham, NC, 27710, USA
| | - Xiling Shen
- Center for Genomics and Computational Biology, Duke University, Durham, North Carolina, USA
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Jason A Somarelli
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, 3008 Snyderman Building, 905 S. LaSalle St., Durham, NC, 27710, USA
| | - David S Hsu
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, 3008 Snyderman Building, 905 S. LaSalle St., Durham, NC, 27710, USA.
- Center for Genomics and Computational Biology, Duke University, Durham, North Carolina, USA.
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14
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Zhang T, Pabla S, Lenzo FL, Conroy JM, Nesline MK, Glenn ST, Papanicolau-Sengos A, Burgher B, Giamo V, Andreas J, Wang Y, Bshara W, Madden KG, Shirai K, Dragnev K, Tafe LJ, Gupta R, Zhu J, Labriola M, McCall S, George DJ, Ghatalia P, Dayyani F, Edwards R, Park MS, Singh R, Jacob R, George S, Xu B, Zibelman M, Kurzrock R, Morrison C. Proliferative potential and response to nivolumab in clear cell renal cell carcinoma patients. Oncoimmunology 2020; 9:1773200. [PMID: 32923131 PMCID: PMC7458647 DOI: 10.1080/2162402x.2020.1773200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/05/2023] Open
Abstract
Background Biomarkers predicting immunotherapy response in metastatic renal cell cancer (mRCC) are lacking. PD-L1 immunohistochemistry is a complementary diagnostic for immune checkpoint inhibitors (ICIs) in mRCC, but has shown minimal clinical utility and is not used in routine clinical practice. Methods Tumor specimens from 56 patients with mRCC who received nivolumab were evaluated for PD-L1, cell proliferation (targeted RNA-seq), and outcome. Results For 56 patients treated with nivolumab as a standard of care, there were 2 complete responses and 8 partial responses for a response rate of 17.9%. Dividing cell proliferation into tertiles, derived from the mean expression of 10 proliferation-associated genes in a reference set of tumors, poorly proliferative tumors (62.5%) were more common than moderately (30.4%) or highly proliferative (8.9%) counterparts. Moderately proliferative tumors were enriched for PD-L1 positive (41.2%), compared to poorly proliferative counterparts (11.4%). Objective response for moderately proliferative (29.4%) tumors was higher than that of poorly (11.4%) proliferative counterparts, but not statistically significant (p = .11). When cell proliferation and negative PD-L1 tumor proportion scores were combined statistically significant results were achieved (p = .048), showing that patients with poorly proliferative and PD-L1 negative tumors have a very low response rate (6.5%) compared to moderately proliferative PD-L1 negative tumors (30%). Conclusions Cell proliferation has value in predicting response to nivolumab in clear cell mRCC patients, especially when combined with PD-L1 expression. Further studies which include the addition of progression-free survival (PFS) along with sufficiently powered subgroups are required to further support these findings.
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Affiliation(s)
- Tian Zhang
- Department of Medicine, Duke University, Durham, NC, USA
| | | | | | - Jeffrey M Conroy
- R&D, OmniSeq, Inc, Buffalo, NY, USA.,Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | - Sean T Glenn
- R&D, OmniSeq, Inc, Buffalo, NY, USA.,Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | | | | | | | | | | | - Katherine G Madden
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Keisuke Shirai
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Konstantin Dragnev
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Laura J Tafe
- Department of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Rajan Gupta
- Department of Medicine, Duke University, Durham, NC, USA
| | - Jason Zhu
- Department of Medicine, Duke University, Durham, NC, USA
| | | | - Shannon McCall
- Department of Medicine, Duke University, Durham, NC, USA
| | | | - Pooja Ghatalia
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, US
| | - Farshid Dayyani
- Department of Medicine, University of California, Irvine, CA, USA
| | - Robert Edwards
- Department of Medicine, University of California, Irvine, CA, USA
| | - Michelle S Park
- Department of Medicine, University of California, Irvine, CA, USA
| | - Rajbir Singh
- Department of Medicine, Meharry Medical College, Nashville, TN, US
| | - Robin Jacob
- Department of Medicine, Meharry Medical College, Nashville, TN, US
| | - Saby George
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bo Xu
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Zibelman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, US
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, Moores Cancer Center, La Jolla, CA, USA
| | - Carl Morrison
- R&D, OmniSeq, Inc, Buffalo, NY, USA.,Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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15
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Arges K, Assimes T, Bajaj V, Balu S, Bashir MR, Beskow L, Blanco R, Califf R, Campbell P, Carin L, Christian V, Cousins S, Das M, Dockery M, Douglas PS, Dunham A, Eckstrand J, Fleischmann D, Ford E, Fraulo E, French J, Gambhir SS, Ginsburg GS, Green RC, Haddad F, Hernandez A, Hernandez J, Huang ES, Jaffe G, King D, Koweek LH, Langlotz C, Liao YJ, Mahaffey KW, Marcom K, Marks WJ, Maron D, McCabe R, McCall S, McCue R, Mega J, Miller D, Muhlbaier LH, Munshi R, Newby LK, Pak-Harvey E, Patrick-Lake B, Pencina M, Peterson ED, Rodriguez F, Shore S, Shah S, Shipes S, Sledge G, Spielman S, Spitler R, Schaack T, Swamy G, Willemink MJ, Wong CA. The Project Baseline Health Study: a step towards a broader mission to map human health. NPJ Digit Med 2020; 3:84. [PMID: 32550652 PMCID: PMC7275087 DOI: 10.1038/s41746-020-0290-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/19/2020] [Indexed: 12/27/2022] Open
Abstract
The Project Baseline Health Study (PBHS) was launched to map human health through a comprehensive understanding of both the health of an individual and how it relates to the broader population. The study will contribute to the creation of a biomedical information system that accounts for the highly complex interplay of biological, behavioral, environmental, and social systems. The PBHS is a prospective, multicenter, longitudinal cohort study that aims to enroll thousands of participants with diverse backgrounds who are representative of the entire health spectrum. Enrolled participants will be evaluated serially using clinical, molecular, imaging, sensor, self-reported, behavioral, psychological, environmental, and other health-related measurements. An initial deeply phenotyped cohort will inform the development of a large, expanded virtual cohort. The PBHS will contribute to precision health and medicine by integrating state of the art testing, longitudinal monitoring and participant engagement, and by contributing to the development of an improved platform for data sharing and analysis.
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Affiliation(s)
| | | | - Vikram Bajaj
- Stanford University, School of Medicine, Stanford, CA USA
| | - Suresh Balu
- Duke University, School of Medicine, Durham, NC USA
| | | | - Laura Beskow
- Vanderbilt University, School of Medicine, Nashville, TN USA
| | | | | | | | - Larry Carin
- Duke University, School of Medicine, Durham, NC USA
| | | | | | - Millie Das
- Stanford University, School of Medicine, Stanford, CA USA
| | | | | | | | | | | | - Emily Ford
- Duke University, School of Medicine, Durham, NC USA
| | | | - John French
- Duke University, School of Medicine, Durham, NC USA
| | | | | | | | | | | | | | | | - Glenn Jaffe
- Duke University, School of Medicine, Durham, NC USA
| | - Daniel King
- Duke University, School of Medicine, Durham, NC USA
| | | | | | - Yaping J. Liao
- Stanford University, School of Medicine, Stanford, CA USA
| | | | - Kelly Marcom
- Duke University, School of Medicine, Durham, NC USA
| | - William J. Marks
- Stanford University, School of Medicine, Stanford, CA USA
- Verily Inc., South San Francisco, CA USA
| | - David Maron
- Stanford University, School of Medicine, Stanford, CA USA
| | - Reid McCabe
- Duke University, School of Medicine, Durham, NC USA
| | | | - Rebecca McCue
- Stanford University, School of Medicine, Stanford, CA USA
| | | | | | | | - Rajan Munshi
- Stanford University, School of Medicine, Stanford, CA USA
| | | | | | | | | | | | | | | | - Svati Shah
- Duke University, School of Medicine, Durham, NC USA
| | | | - George Sledge
- Stanford University, School of Medicine, Stanford, CA USA
| | - Susie Spielman
- Stanford University, School of Medicine, Stanford, CA USA
| | - Ryan Spitler
- Stanford University, School of Medicine, Stanford, CA USA
| | - Terry Schaack
- California Health and Longevity Institute, Westlake Village, CA USA
| | - Geeta Swamy
- Duke University, School of Medicine, Durham, NC USA
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16
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Salman Roghani R, Sanjari moghaddam A, Rupprecht G, Altunel E, Kim SY, McCall S, Thomas B, Ware K, Somarelli J, Hsu DS. A precision medicine drug discovery pipeline to identify dual CDK2/9 inhibition as a novel treatment for colorectal cancer. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e16056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16056 Background: Colorectal cancer (CRC) is the 3rdmost common form of cancer in the US, responsible for over 50,000 death each year. Therapeutic options for advanced colorectal cancer are limited, and there remains an unmet clinical need to identify new therapies to treat this deadly disease. To address this need, we have developed a precision medicine pipeline that integrates high throughput chemical screens with matched patient-derived cell lines and patient-derived xenografts (PDXs) to identify new treatments for CRC. Methods: We used high-throughput chemical screens of 2,100 compounds across five low-passage, patient-derived CRC cell lines. These results were validated using dose-response IC50curves for CDK1, CDK2, CDK9 or CDK1/2/9 inhibitors and by siRNA-mediated knockdown of CDK9 with or without CDK2 inhibition. Cell cycle arrest analysis was performed by flow cytometry and anaphase catastrophe was analyzed by immunofluorescence staining. For in vivo studies, matched PDXs were treated with either CDK2, CDK9 or dual CDK2/9 inhibitors. Results: We identified the CDK inhibitor drug class as among the most effective cytotoxic compounds across all five CRC lines. Further analysis of the CDK inhibitor class revealed that combined targeting of CDK1, 2, and 9 was the most effective, with IC50 in the range of 110 nM to 1.2 μM. We further validated the efficacy of combined CDK2/9 inhibition using siRNA-mediated knockdown of CDK9 in the presence of a CDK2 inhibitor(CVT-313), and showed that CDK9 knockdown acted synergistically with CDK2 inhibition. Dual CDK2/9 inhibition led to significant G2/M cell cycle arrest and anaphase catastrophe. Finally, combined CDK2/9 inhibition in vivo synergistically inhibited PDX tumor growth as compared to single-agent CDK inhibitors. Conclusions: Our precision medicine pipeline revealed CDK2/9 dual inhibition as a combinatorial therapy to treat CRC and can also be used to identify new and novel therapies
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Affiliation(s)
- Roham Salman Roghani
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
| | - Ali Sanjari moghaddam
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
| | - Gabrielle Rupprecht
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
| | - Erdem Altunel
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America;, Durham, NC
| | - So Young Kim
- Duke Functional Genomics Core, Duke University, Durham, North Carolina, United States of America, Durham, NC
| | - Shannon McCall
- Department of Pathology, Duke University, Durham, North Carolina, United States of America, Durham, NC
| | - Beatrice Thomas
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
| | - Katie Ware
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
| | - Jason Somarelli
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
| | - David S. Hsu
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, United States of America, Durham, NC
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17
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Schild MH, Leckey BD, Coulas A, McCall S. Incidental urothelial rest within the vermiform appendix of a paediatric male patient: an extremely rare entity. BMJ Case Rep 2020; 13:13/1/e233530. [PMID: 31919071 DOI: 10.1136/bcr-2019-233530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Michael H Schild
- Pathology, Duke University Hospital, Durham, North Carolina, USA
| | - Bruce D Leckey
- Pathology, Duke University Hospital, Durham, North Carolina, USA
| | - Aubrey Coulas
- Pathology, Duke University Hospital, Durham, North Carolina, USA
| | - Shannon McCall
- Pathology, Duke University Hospital, Durham, North Carolina, USA
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18
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Devi G, Finetti P, Geradts J, McCall S, Morse M, Van Laere S, Bertucci F. Expression of x-linked inhibitor of apoptosis protein (XIAP) and its association with clinicopathological parameters in invasive breast cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Devi GR, Hough H, Barrett N, Cristofanilli M, Overmoyer B, Spector N, Ueno NT, Woodward W, Kirkpatrick J, Vincent B, Williams KP, Finley C, Duff B, Worthy V, McCall S, Hollister BA, Palmer G, Force J, Westbrook K, Fayanju O, Suneja G, Dent SF, Hwang ES, Patierno SR, Marcom PK. Perspectives on Inflammatory Breast Cancer (IBC) Research, Clinical Management and Community Engagement from the Duke IBC Consortium. J Cancer 2019; 10:3344-3351. [PMID: 31293637 PMCID: PMC6603420 DOI: 10.7150/jca.31176] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/12/2019] [Indexed: 12/26/2022] Open
Abstract
Inflammatory breast cancer (IBC) is an understudied and aggressive form of breast cancer with a poor prognosis, accounting for 2-6% of new breast cancer diagnoses but 10% of all breast cancer-related deaths in the United States. Currently there are no therapeutic regimens developed specifically for IBC, and it is critical to recognize that all aspects of treating IBC - including staging, diagnosis, and therapy - are vastly different than other breast cancers. In December 2014, under the umbrella of an interdisciplinary initiative supported by the Duke School of Medicine, researchers, clinicians, research administrators, and patient advocates formed the Duke Consortium for IBC to address the needs of patients in North Carolina (an ethnically and economically diverse state with 100 counties) and across the Southeastern United States. The primary goal of this group is to translate research into action and improve both awareness and patient care through collaborations with local, national and international IBC programs. The consortium held its inaugural meeting on Feb 28, 2018, which also marked Rare Disease Day and convened national research experts, clinicians, patients, advocates, government representatives, foundation leaders, staff, and trainees. The meeting focused on new developments and challenges in the clinical management of IBC, research challenges and opportunities, and an interactive session to garner input from patients, advocates, and community partners that would inform a strategic plan toward continuing improvements in IBC patient care, research, and education.
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Affiliation(s)
- Gayathri R Devi
- Duke Cancer Institute, Duke University.,Department of Surgery, Duke University.,Department of Pathology, Duke University
| | - Holly Hough
- Duke Office of Clinical Research, Duke University
| | | | | | - Beth Overmoyer
- Department of Medical Oncology, Dana-Farber Cancer Institute
| | - Neil Spector
- Duke Cancer Institute, Duke University.,Department of Medicine, Duke University
| | - Naoto T Ueno
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center
| | - Wendy Woodward
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
| | - John Kirkpatrick
- Duke Cancer Institute, Duke University.,Department of Radiation Oncology, Duke University
| | - Benjamin Vincent
- Division of Hematology/Oncology, University of North Carolina at Chapel Hill
| | - Kevin P Williams
- Department of Pharmaceutical Sciences, North Carolina Central University
| | | | | | | | - Shannon McCall
- Duke Cancer Institute, Duke University.,Department of Pathology, Duke University
| | | | - Greg Palmer
- Duke Cancer Institute, Duke University.,Department of Radiation Oncology, Duke University
| | - Jeremy Force
- Duke Cancer Institute, Duke University.,Department of Medicine, Duke University
| | - Kelly Westbrook
- Duke Cancer Institute, Duke University.,Department of Medicine, Duke University
| | | | - Gita Suneja
- Duke Cancer Institute, Duke University.,Department of Radiation Oncology, Duke University
| | | | - E Shelley Hwang
- Duke Cancer Institute, Duke University.,Department of Surgery, Duke University
| | - Steven R Patierno
- Duke Cancer Institute, Duke University.,Department of Medicine, Duke University
| | - P Kelly Marcom
- Duke Cancer Institute, Duke University.,Department of Medicine, Duke University
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20
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Labriola M, Zhu J, Gupta R, McCall S, Jackson J, White JR, Weingartner E, Kong E, Simone P, Papp E, Gerding K, Simmons J, George DJ, Zhang T. Characterization of tumor mutational burden (TMB), PD-L1, and DNA repair genes to assess correlation with immune checkpoint inhibitors (ICIs) response in metastatic renal cell carcinoma (mRCC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e16079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16079 Background: ICIs have revolutionized treatment for mRCC; however there are limited predictive biomarkers for response to ICIs. PD-L1 status is still controversial, demonstrating little predictive utility in mRCC. TMB is predictive for response to ICIs in melanoma and non-small cell lung cancer (NSCLC), but has not been validated in mRCC. Here, we assess the correlations between TMB and PD-L1 status with outcomes to ICI treatment in mRCC. Methods: 34 patients (pts) with mRCC who had previously received ICIs at Duke Cancer Institute were identified. Tumor samples were retrospectively evaluated using a Personal Genome Diagnostics Assay for somatic variants across > 500 genes, as well as TMB and microsatellite status. PD-L1 status was tested via the Dako 28-8 PD-L1 IHC assay. Deidentified clinical information was extracted from the medical record and tumor response was evaluated based on RECIST criteria. Results: Pts were grouped by overall response following ICI therapy into either progressive disease (“PD”, n = 18) or disease control group (“DC”, n = 16), defined as either stable disease, partial response, or complete response. Pts displayed a TMB range from 0.36 to 12.24 mutations/Mb with a mean score of 2.83 muts/Mb, with no significant difference between the PD and DC groups (mean 3.01 muts/Mb vs. 2.63 muts/Mb, p > 0.05). 9 of 32 evaluable samples were PD-L1 positive, with 4 in the PD group and 5 in the DC group. Notably, the DC group displayed a significant enrichment of mutations in genes affiliated with DNA repair (including BRCA1, BRCA2, FANCA, FANCB, FANCG, FANCM, MSH3, MSH6, RAD50, RAD51C, RAD51D, RAD54B, RECQL4, and SLX4; p = 0.0444). DNA damage gene mutations were found in 8/10 (80%) metastatic tumor specimens and 14/24 (58%) primary tumors. Conclusions: Overall, in this mRCC cohort, neither TMB nor PD-L1 correlated with patient outcomes or with ICI response. Furthermore, high TMB was not significantly associated with PD-L1 expression within the samples. The higher frequency of mutations in DNA repair genes in the DC group suggests potential use as a predictive signature for ICI response, warranting future prospective studies. Further studies with matched primary-metastatic samples would be beneficial to determine if DNA repair mutations occur more frequently in metastatic versus primary tumor specimens.
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Affiliation(s)
| | - Jason Zhu
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | | | | | | | | | | | - Eric Kong
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | - Peter Simone
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | - Eniko Papp
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | | | - John Simmons
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | | | - Tian Zhang
- Duke Cancer Institute, Duke University, Durham, NC
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21
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Zhu J, Pabla S, Labriola M, Gupta RT, McCall S, George DJ, Dressman D, Glenn S, George S, Morrison C, Zhang T. Evaluation of tumor microenvironment and biomarkers of immune checkpoint inhibitor (ICI) response in metastatic renal cell carcinoma (mRCC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2595 Background: ICIs are now standard of care for mRCC; however, there are few biomarkers to predict ICI response. Recent data from atezolizumab/bevacizumab trials in mRCC suggest tumors with high Teffhigh/PD-L1+ are more likely to respond to ICI. Here, we use two gene panels as well as other inflammation markers in the tumor microenvironment to correlate with ICI responses. Methods: This multicenter study evaluated 86 patients (pts) with mRCC treated with ICIs. FFPE tumor samples were evaluated by RNA sequencing for Teff status. Two gene panels were analyzed: a Teff Gene Panel (CD8, CD27, IFNG, GZMA, GZMB, PRF1, EOMES, CXCL9, CXCL10, CXCL11, CD274, CTLA4, FOXP3, TIGIT, IDO1, PSMB9, TAP1) and a 5-Gene panel (FOXP3, CCR4, KLRK1, ITK, and TIGIT) based on the gene expression pattern of tumors in our cohort. Objective response rates (ORRs, defined as CRs and PRs) were correlated with PD-L1 status (positivity was defined as ≥1% TPS based on Dako 22C3 IHC assay), and TMB (0-10, 10-20, ≥20 mut/Mb), and tumor inflammation (high CD8 expression compared to a large reference population). Best responses to ICI was determined by an expert radiologist using RECIST 1.1 criteria. Inflamed tumor status, Teff gene panel, 5-gene panel, PD-L1 status, and TMB were associated with ORR and tested using a chi-squared test with Yates’s continuity correction. Results: ORR was 50% (4/8) for PD-L1 positive pts and 14% (9/65) for PD-L1 negative pts (p = 0.042). The majority of tumors (95%, 82/86) had TMB < 10 mut/mb. 43 pts (50%) were classified as Teffhigh and 43 pts were classified as Tefflow. ORR was 23% (10/43) in the Teffhigh cohort and 12% (5/43) in the Tefflow cohort (p = 0.256). ORR was 31% (14/45) in the 5-Gene high cohort and 2% (1/41) in the 5-Gene low cohort (p = 0.001). Conclusions: TMB and tumor inflammation based on CD8 did not reliably predict for objective responses in this study of mRCC pts treated with ICIs. Gene expression signatures provide a more comprehensive evaluation of the tumor microenvironment and may lead to better predictive biomarkers for ICI response than individual biomarkers such as PD-L1, TMB, or CD8 expression.
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Affiliation(s)
- Jason Zhu
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | | | | | | | | | | | | | | | | | | | - Tian Zhang
- Duke University Medical Center, Durham, NC
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22
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Labriola M, Zhu J, Cheris S, Liu X, Perkinson K, Su Z, McCall S, Huang J, Gupta RT, Armstrong AJ, George DJ, Zhang T. Concordance between PD-L1 assays for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14259 Background: Immune checkpoint inhibitors (ICIs) are standard of care for mRCC and mUC patients (pts). PD-L1 status is gaining importance as a predictive biomarker, particularly for cisplatin-ineligible mUC. PD-L1 positivity is defined differently by PD-L1 assay and tumor type, with limited concordance studies. Given real-world limitations in PD-L1 testing, assay concordance studies are needed to distinguish positive (pos)/negative (neg) results and treatment selection. We compared Dako 28–8 and Ventana SP142 assays in mRCC and Dako 22C3 and Ventana SP263 assays in mUC. Methods: 32 pts with mRCC and 18 pts with mUC who had received ICI therapy at Duke Cancer Institute were identified. FFPE archival tumor samples for pts with mRCC were evaluated with Dako 28–8 and Ventana SP142 PD-L1 immunohistochemistry (IHC) assays. For pts with mUC, FFPE archival tumor samples were evaluated with Dako 22C3 and Ventana SP263 PD-L1 IHC assays. Scoring was validated by two pathologists using the scoring system for each assay. PD-L1 status was subsequently correlated to best RECIST response (objective response rate (ORR) defined as stable disease or better). Results: Tissue was obtained from primary tissue in 72% of mRCC cases and in 61% of mUC cases, with remainder from metastatic biopsies. The majority of mRCC cases (29/32, 91%) were concordant between Dako 28-8 and Ventana SP142 assays (8 cases pos and 21 cases neg), with 3 discordant cases (1 case pos for Dako 28-8 but neg for Ventana SP142 and 2 cases neg for Dako 28-8 but pos for Ventana SP142), all from primary tissue. The majority of mUC cases (17/18, 94%) were also concordant between Dako 22C3 and Ventana SP263 assays (2 pos cases and 15 neg cases), with 1 indeterminate Dako 22C3 test on a metastatic biopsy due to background lymph node. In mRCC, the ORR for PD-L1 pos cases was 45% (5/11) versus 33% (8/24) for PD-L1 neg cases. In mUC, the ORR for PD-L1 positive cases was 50% (1/2) versus 31% (5/16) for PD-L1 neg cases. Conclusions: There was strong concordance between the clinically meaningful PD-L1 assays chosen for comparison in both mRCC and mUC. mUC results were limited by low PD-L1 expression in this cohort. Although PD-L1 status does not fully predict for response to ICIs, this suggests that PD-L1 testing could be used interchangeably for the majority of cases when selecting ICI treatment in mRCC and mUC.
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Affiliation(s)
| | - Jason Zhu
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | | | | | | | | | | | | | | | | | | | - Tian Zhang
- Duke Cancer Institute, Duke University, Durham, NC
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23
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Moreton E, Baron P, Tiplady S, McCall S, Clifford B, Langley-Evans S, Fone K, Voigt J. Impact of early exposure to a cafeteria diet on prefrontal cortex monoamines and novel object recognition in adolescent rats. Behav Brain Res 2019; 363:191-198. [DOI: 10.1016/j.bbr.2019.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/24/2019] [Accepted: 02/02/2019] [Indexed: 12/19/2022]
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24
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Zhu J, Pabla S, Labriola M, Gupta RT, McCall S, George DJ, Dressman D, Glenn ST, Nesline M, George S, Morrison C, Zhang T. Evaluation of tumor microenvironment and biomarkers of immune checkpoint inhibitor (ICI) response in metastatic renal cell carcinoma (mRCC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.8_suppl.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
63 Background: ICIs are now standard of care for mRCC; however, there are few biomarkers to predict ICI response. Recent data from atezolizumab/bevacizumab trials in mRCC suggest tumors with high Teffhigh/PD-L1+ are more likely to respond to ICI. Here, we use this Teff gene panel as well as other markers of inflammation in the tumor microenvironment to correlate with ICI responses. Methods: This multicenter study evaluated 69 pts with mRCC treated with ICIs. FFPE tumor samples were evaluated by RNA sequencing to measure transcript levels of genes related Teff status. Teff status was defined as the mRNA expression of 17 genes (CD8, CD27, IFNG, GZMA, GZMB, PRF1, EOMES, CXCL9, CXCL10, CXCL11, CD274, CTLA4, FOXP3, TIGIT, IDO1, PSMB9, TAP1), with Teffhigh/low separated at the median. PD-L1 positivity was defined as ≥1% TPS based on Dako 22C3 IHC assay, and TMB high as > 10 mutations per megabase. Inflamed tumors were defined as CD8 expression in the top 75th percentile compared to a large reference population of multiple tumor types. Best responses to ICI was determined by an expert radiologist using RECIST 1.1 criteria. Inflamed tumor status, Teff gene expression, PD-L1 positive, and TMB were associated with disease control (DC, defined as CR, PR, or stable disease). DC comparisons were tested using a chi-squared test with Yates’s continuity correction. Results: DC was 63% (5/8) amongst PD-L1 positive pts and 52% (31/60) in PD-L1 negative patients (p = 0.84). Only 2 pts were TMB high. The majority of mRCC tumors (97%, 67/69) were TMB low. 6-month DC in TMB high tumors was 50% (1/2) and 49.3% (33/67) in TMB low tumors (p = 1.0). 36 pts were classified as Teffhigh and 33 patients were classified as Tefflow. 6-month DC was 61% (22/36) in the Teffhigh cohort and 36% (12/33) in the Tefflow cohort (p = 0.069). 6-month DC was 64% of inflamed tumors (16/25) vs 41% of non-inflamed tumors (18/44) (p = 0.111). Conclusions: TMB high and PD-L1 expression do not reliably predict for DC in pts with mRCC. Utilizing a gene signature score may better predict ICI response.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Saby George
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | - Tian Zhang
- Duke University Medical Center, Durham, NC
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25
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Pabla S, Zhu J, Labriola M, Gupta R, George DJ, McCall S, Yau E, Conroy JM, Glenn ST, Nesline M, Papanicolau-Sengos A, Burgher B, Lenzo FL, Zhang T, Morrison C. Cell proliferation as a biomarker for response to immune checkpoint inhibitors in highly inflamed renal cell carcinoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.8_suppl.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
61 Background: Cell proliferation is an important marker of survival in many tumors and we hypothesized that this attribute could be related to response to immune checkpoint inhibitors in RCC. Previously we reported (SITC 2018) moderately proliferative lung cancer has a much higher response rate than either poorly or highly proliferative tumors. Methods: 69 FFPE tumor samples of RCC were evaluated by RNA-seq to measure transcript levels of 394 immune related genes, including 10 related to cell proliferation (BUB1, CCNB2, CDK1, CDKN3, FOXM1, KIAA0101, MAD2L1, MELK, MKI67, TOP2A). Cell proliferation, defined as the mean mRNA expression of these 10 genes was evaluated for association with ORR to ICIs by RECIST v1.1 criteria for both PD-L1 IHC positive and negative cases. Cell proliferation for each case was split into 3 tertiles of poorly ( < 33), moderately (33-66) and highly ( > 66) proliferative compared to a reference population. Poorly and highly proliferative were grouped for comparison to moderately proliferative tumors. Tumors were inflamed or non-inflamed based upon RNA‐seq analysis of CD8 compared to a reference population of more than 500 cases of multiple tumors. Non-inflamed, or immune desert tumors, defined as the lower 25th percentile of rank for CD8+ T-cells, and greater than 75th percentile of rank as inflamed. Results: In our cohort of 69 patient the overall ORR was 18.8%. 15.9% of tumors were non-inflamed with an ORR of 9.1%. For 36.2% inflamed tumor the ORR was 32%. For cell proliferation 62.2% were poorly proliferative, 8.7% were highly proliferative, and 29% were moderately. ORR in moderately proliferative tumors was 30% versus 14.2% in poorly/highly proliferative tumors. In inflamed tumors, ORR in moderately proliferative tumors was 37.5% as opposed to 17.6% in poorly/highly proliferative tumors. In 11 non-inflamed tumors, there was only one responder, which was a poorly/highly proliferative tumor. Conclusions: Cell proliferation may play a crucial role in distinguishing RCC patients who may have a clinical benefit to ICI, including the important subgroup of inflamed tumors. Moderately proliferative tumors have a higher ORR than their poorly/highly counterparts.
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Affiliation(s)
| | | | | | | | | | | | - Edwin Yau
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | | | | | | | | | | | - Tian Zhang
- Duke University Medical Center, Durham, NC
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26
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Glenn ST, Pabla S, Zhu J, Labriola M, Gupta R, George DJ, McCall S, Yau E, Conroy JM, Nesline M, Papanicolau-Sengos A, Burgher B, Lenzo FL, Zhang T, Morrison C. Cell proliferation as a biomarker for response to immune checkpoint inhibitors in PD-L1 negative renal cell carcinoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.8_suppl.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
62 Background: Cell proliferation is an important marker of survival in many tumors, and we hypothesized that this attribute could be related to response to immune checkpoint inhibitors (ICIs) in RCC. Previously we reported (SITC 2018) that moderately proliferative lung cancer have a much higher response rate than either poorly or highly proliferative tumors. Methods: 69 FFPE RCC tumor samples were evaluated by RNA-seq to measure transcript levels of 394 immune related genes. Cell proliferation was defined as the mean mRNA expression of 10 genes (BUB1, CCNB2, CDK1, CDKN3, FOXM1, KIAA0101, MAD2L1, MELK, MKI67, TOP2A) which was evaluated for association with ORR to ICIs by RECIST v1.1 criteria for both PD-L1 IHC positive and negative cases. Cell proliferation for each case was split into 3 tertiles of poorly ( < 33), moderately (33-66) and highly ( > 66) proliferative versus a reference population. Poorly and highly proliferative were grouped for comparison to moderately proliferative tumors. PD-L1 IHC was performed using DAKO 22C3 antibody and scored by FDA guidelines and considered positive if TPS ≥1% and negative if < 1%. Results: In our cohort of 69 patients, the overall ORR was 18.8. The majority, 91% of tumors were PD-L1 negative, with ORR of 14.8%, as opposed to ORR of 50% in PD-L1 positive cases. 62.2% of tumors were poorly proliferative, 8.7% were highly proliferative, and 29% were moderately proliferative. ORR in moderately proliferative tumors was 30% and 14.2% in poorly/highly proliferative tumors. In PD-L1 negative tumors the ORR in moderately proliferative tumors was 20% and 13% in poorly/highly proliferative tumors. For the 5 moderately proliferative, PD-L1 positive tumors, there were 2 PR and 1 CR, and in the 3 poorly/highly proliferative tumors there was 1 PR. Conclusions: Cell proliferation may play a crucial role in distinguishing RCC patients who may have a clinical benefit to ICI, including the important subgroup of PD-L1 negative tumors. Moderately proliferative tumors have a higher ORR than their poorly/highly counterparts.
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Affiliation(s)
| | | | | | | | | | | | | | - Edwin Yau
- Univ of California San Diego School of Medicine, La Jolla, CA
| | | | | | | | | | | | - Tian Zhang
- Duke University Medical Center, Durham, NC
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27
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Zhu J, Labriola M, Cheris S, Liu X, Perkinson K, Su Z, McCall S, Huang J, Gupta R, Armstrong AJ, George DJ, Zhang T. Concordance between PD-L1 assays for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
577 Background: Immune checkpoint inhibitors (ICIs) are now standard of care for mRCC and mUC patients (pts). PD-L1 status is gaining importance as a predictive biomarker, particularly for cisplatin-ineligible mUC. Four different PD-L1 assays vary in thresholds of PD-L1 positivity dependent on tumor type, with limited concordance studies. Given real-world limitations in PD-L1 testing, concordance between assays are needed to distinguish positive (pos)/negative (neg) results and treatment selection. We undertook comparisons of Dako 28–8 and Ventana SP142 assays in mRCC and Dako 22C3 and Ventana SP263 assays in mUC. Methods: 32 patients with mRCC and 18 patients with mUC who had received ICI therapy at Duke Cancer Institute were identified. FFPE archival tumor samples for pts with mRCC were evaluated with Dako 28–8 and Ventana SP142 PD-L1 immunohistochemistry (IHC) assays. For pts with mUC, FFPE archival tumor samples were evaluated with Dako 22C3 and Ventana SP263 PD-L1 IHC assays. Scoring was validated by two pathologists using the scoring system for each assay. PD-L1 status was subsequently correlated to best RECIST response (objective response rate (ORR) defined as stable disease or better)). Results: The majority of mRCC cases (29/32, 91%) were concordant between Dako 28-8 and Ventana SP142 assays (8 cases pos and 21 cases neg), with 3 discordant cases (1 case pos for Dako 28-8 but neg for Ventana SP142 and 2 cases neg for Dako 28-8 but pos for Ventana SP142). The majority of mUC cases (17/18, 94%) were also concordant between Dako 22C3 and Ventana SP263 assays (2 pos cases and 15 neg cases), with 1 indeterminate Dako 22C3 test due to background lymph node. In mRCC, the ORR for PD-L1 pos cases was 45% (5/11) versus 33% (8/24) for PD-L1 neg cases. In mUC, the ORR for PD-L1 positive cases was 50% (1/2) versus 31% (5/16) for PD-L1 neg cases. Conclusions: There was strong concordance between PD-L1 tumor/immune cell assays chosen for comparison in both mRCC and mUC with similar performance characteristics. Although PD-L1 positivity enriches for response to ICIs, many patients respond who are PD-L1 negative. PD-L1 status could be used interchangeably for the majority of cases when selecting treatment in mRCC and mUC.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Andrew J. Armstrong
- Duke Cancer Institute and the Duke Prostate and Urologic Cancer Center, Durham, NC
| | | | - Tian Zhang
- Duke University Medical Center, Durham, NC
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Labriola M, Zhu J, Gupta R, McCall S, Jackson J, White JR, Weingartner E, Kong E, Simone P, Papp E, Gerding K, Simmons J, George DJ, Zhang T. Characterization of genomic alterations as biomarkers of immune checkpoint inhibitor (ICI) response in metastatic urothelial carcinoma (mUC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
400 Background: ICIs have expanded therapeutic options for mUC patients (pts); however, biomarkers such as PD-L1 have not served as reliable predictors of treatment efficacy. High tumor mutation burden (TMB) has been previously described as a potential biomarker for predicting ICI response in several indications, but its utility is still being explored in mUC. Here, we compare the genomic landscapes and clinical outcomes of mUC pts following ICI therapy using an investigational solid tissue-based next-generation sequencing assay to assess TMB and identify genetic correlates of ICI response. Methods: 20 pts with mUC treated with ICIs at Duke Cancer Institute were identified. Tumor samples were retrospectively evaluated with a Personal Genome Diagnostics Assay for somatic variants across > 500 genes, as well as TMB and microsatellite status. Tumor samples were also stained for PD-L1 status using the Dako 22C3 IHC assay. Deidentified clinical information was extracted from the medical record and tumor response was evaluated using RECIST 1.1 criteria. Results: Pts were grouped by overall response following ICI therapy as either responders (“R”, n = 6) or non-responders (“NR”, n = 13). Pts exhibited a wide range of TMB scores (0.7 to 30.4 mutations/Mb), with a mean TMB score of 9.60 vs. 3.87 mut/Mb in R vs NR groups, respectively; however, this difference was not statistically significant ( p = 0.284). 18 pts were evaluated for PD-L1 status, with only 2 positive samples (one in each group). Rs had significantly more mutations in histone methylation genes (KDM6A, KMT2C, and KMT2D), (67% vs 15% in NRs, p = 0.0039). FGFR3 mutations were also more frequent in R vs NR (67% vs 5%, p = 0.0339). Finally, there was a higher frequency of mutations in TP53 and BRCA1 in the NRs. Conclusions: In this mUC cohort, neither TMB nor PD-L1 correlated with response to ICI therapy. Histone modifying genes and FGFR3 mutations were more frequent in responders, whereas BRCA1 and TP53 mutations were enriched in non-responders, warranting future prospective studies to understand underlying mechanisms of ICI response and resistance in mUC.
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Affiliation(s)
| | | | | | | | | | | | | | - Eric Kong
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | - Peter Simone
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | - Eniko Papp
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | | | - John Simmons
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | | | - Tian Zhang
- Duke Cancer Institute, Duke University, Durham, NC
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Zhu J, Pabla S, Labriola M, Gupta RT, McCall S, George DJ, Dressman D, Glenn S, Nesline M, George S, Morrison C, Zhang T. Evaluation of tumor microenvironment and biomarkers of immune checkpoint inhibitor (ICI) response in metastatic renal cell carcinoma (mRCC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
607 Background: ICIs are now standard of care for mRCC; however, there are few biomarkers to predict ICI response. Recent data from atezolizumab/bevacizumab trials in mRCC suggest tumors with high Teffhigh/PD-L1+ are more likely to respond to ICI. Here, we use this Teff gene panel as well as other markers of inflammation in the tumor microenvironment to correlate with ICI responses. Methods: This multicenter study evaluated 69 pts with mRCC treated with ICIs. FFPE tumor samples were evaluated by RNA sequencing to measure transcript levels of genes related Teff status. Teff status was defined as the mRNA expression of 17 genes (CD8, CD27, IFNG, GZMA, GZMB, PRF1, EOMES, CXCL9, CXCL10, CXCL11, CD274, CTLA4, FOXP3, TIGIT, IDO1, PSMB9, TAP1), with Teffhigh/low separated at the median. PD-L1 positivity was defined as ≥1% TPS based on Dako 22C3 IHC assay, and TMB high as > 10 mutations per megabase. Inflamed tumors were defined as CD8 expression in the top 75th percentile compared to a large reference population of multiple tumor types. Best responses to ICI was determined by an expert radiologist using RECIST 1.1 criteria. Inflamed tumor status, Teff gene expression, PD-L1 positive, and TMB were associated with disease control (DC, defined as CR, PR, or stable disease). DC comparisons were tested using a chi-squared test with Yates’s continuity correction. Results: DC was 63% (5/8) amongst PD-L1 positive pts and 52% (31/60) in PD-L1 negative patients (p = 0.84). Only 2 pts were TMB high. The majority of mRCC tumors (97%, 67/69) were TMB low. 6-month DC in TMB high tumors was 50% (1/2) and 49.3% (33/67) in TMB low tumors (p = 1.0). 36 pts were classified as Teffhigh and 33 patients were classified as Tefflow. 6-month DC was 61% (22/36) in the Teffhigh cohort and 36% (12/33) in the Tefflow cohort (p = 0.069). 6-month DC was 64% of inflamed tumors (16/25) vs 41% of non-inflamed tumors (18/44) (p = 0.111). Conclusions: TMB high and PD-L1 expression do not reliably predict for DC in pts with mRCC. Utilizing a gene signature score may better predict ICI response.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Saby George
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | - Tian Zhang
- Duke University Medical Center, Durham, NC
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Labriola M, Zhu J, Gupta R, McCall S, Jackson J, White JR, Weingartner E, Kong E, Simone P, Papp E, Gerding K, Simmons J, George DJ, Zhang T. Characterization of tumor mutational burden (TMB), PD-L1, and DNA repair genes to assess correlation with immune checkpoint inhibitors (ICIs) response in metastatic renal cell carcinoma (mRCC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
589 Background: ICIs have revolutionized treatment for mRCC; however there are limited predictive biomarkers for response to ICIs. PD-L1 status is still controversial demonstrating little predictive utility in mRCC. TMB is predictive for response to ICIs in melanoma and non-small cell lung cancer (NSCLC), but has not been validated in mRCC. Here, we assess the correlations between TMB and PD-L1 status with outcomes to ICI treatment in mRCC. Methods: 34 patients (pts) with mRCC who had previously received ICI therapy at Duke Cancer Institute were identified. Tumor samples were retrospectively evaluated using a Personal Genome Diagnostics Assay for somatic variants across > 500 genes, as well as TMB and microsatellite status. Tumor samples were also analyzed with the Dako 28-8 PD-L1 IHC assay. Deidentified clinical information was extracted from the medical record and tumor response was evaluated based on RECIST criteria. Results: Pts were grouped by overall response following ICI therapy into either progressive disease (“PD”, n = 18) or disease control group (“DC”, n = 16), defined as either stable disease, partial response, or complete response. Pts displayed a TMB range from 0.36 to 12.24 mutations/Mb with a mean score of 2.83 muts/Mb, with no significant difference between the PD and DC groups (mean 3.01 muts/Mb vs. 2.63 muts/Mb, p > 0.05). 9 of 32 evaluable samples were PD-L1 positive, with 4 in the PD group and 5 in the DC group. Notably, the DC group displayed a significant enrichment of mutations in genes affiliated with DNA repair (including BRCA1, BRCA2, FANCA, FANCB, FANCG, FANCM, MSH3, MSH6, RAD50, RAD51C, RAD51D, RAD54B, RECQL4, and SLX4; p = 0.0444). Conclusions: Overall, in this mRCC cohort, neither TMB nor PD-L1 correlated with patient outcomes or with ICI response. Furthermore, high TMB was not significantly associated with PD-L1 expression within the samples. The higher frequency of mutations in DNA repair genes in the DC group suggests potential use as a predictive signature for ICI response, warranting future prospective studies.
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Affiliation(s)
| | - Jason Zhu
- Duke Cancer Institute, Duke University, Durham, NC
| | | | | | | | | | | | - Eric Kong
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | - Peter Simone
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | - Eniko Papp
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | | | - John Simmons
- Personal Genome Diagnostics, Inc., Baltimore, MD
| | | | - Tian Zhang
- Duke Cancer Institute, Duke University, Durham, NC
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Pabla S, Conroy JM, Nesline MK, Glenn ST, Papanicolau-Sengos A, Burgher B, Hagen J, Giamo V, Andreas J, Lenzo FL, Yirong W, Dy GK, Yau E, Early A, Chen H, Bshara W, Madden KG, Shirai K, Dragnev K, Tafe LJ, Marin D, Zhu J, Clarke J, Labriola M, McCall S, Zhang T, Zibelman M, Ghatalia P, Araujo-Fernandez I, Singavi A, George B, MacKinnon AC, Thompson J, Singh R, Jacob R, Dressler L, Steciuk M, Binns O, Kasuganti D, Shah N, Ernstoff M, Odunsi K, Kurzrock R, Gardner M, Galluzzi L, Morrison C. Proliferative potential and resistance to immune checkpoint blockade in lung cancer patients. J Immunother Cancer 2019; 7:27. [PMID: 30709424 PMCID: PMC6359802 DOI: 10.1186/s40425-019-0506-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/13/2019] [Indexed: 02/04/2023] Open
Abstract
Background Resistance to immune checkpoint inhibitors (ICIs) has been linked to local immunosuppression independent of major ICI targets (e.g., PD-1). Clinical experience with response prediction based on PD-L1 expression suggests that other factors influence sensitivity to ICIs in non-small cell lung cancer (NSCLC) patients. Methods Tumor specimens from 120 NSCLC patients from 10 institutions were evaluated for PD-L1 expression by immunohistochemistry, and global proliferative profile by targeted RNA-seq. Results Cell proliferation, derived from the mean expression of 10 proliferation-associated genes (namely BUB1, CCNB2, CDK1, CDKN3, FOXM1, KIAA0101, MAD2L1, MELK, MKI67, and TOP2A), was identified as a marker of response to ICIs in NSCLC. Poorly, moderately, and highly proliferative tumors were somewhat equally represented in NSCLC, with tumors with the highest PD-L1 expression being more frequently moderately proliferative as compared to lesser levels of PD-L1 expression. Proliferation status had an impact on survival in patients with both PD-L1 positive and negative tumors. There was a significant survival advantage for moderately proliferative tumors compared to their combined highly/poorly counterparts (p = 0.021). Moderately proliferative PD-L1 positive tumors had a median survival of 14.6 months that was almost twice that of PD-L1 negative highly/poorly proliferative at 7.6 months (p = 0.028). Median survival in moderately proliferative PD-L1 negative tumors at 12.6 months was comparable to that of highly/poorly proliferative PD-L1 positive tumors at 11.5 months, but in both instances less than that of moderately proliferative PD-L1 positive tumors. Similar to survival, proliferation status has impact on disease control (DC) in patients with both PD-L1 positive and negative tumors. Patients with moderately versus those with poorly or highly proliferative tumors have a superior DC rate when combined with any classification schema used to score PD-L1 as a positive result (i.e., TPS ≥ 50% or ≥ 1%), and best displayed by a DC rate for moderately proliferative tumors of no less than 40% for any classification of PD-L1 as a negative result. While there is an over representation of moderately proliferative tumors as PD-L1 expression increases this does not account for the improved survival or higher disease control rates seen in PD-L1 negative tumors. Conclusions Cell proliferation is potentially a new biomarker of response to ICIs in NSCLC and is applicable to PD-L1 negative tumors. Electronic supplementary material The online version of this article (10.1186/s40425-019-0506-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarabjot Pabla
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | - Jeffrey M Conroy
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA.,Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Mary K Nesline
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | - Sean T Glenn
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA.,Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | | | - Blake Burgher
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | - Jacob Hagen
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | - Vincent Giamo
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | | | | | - Wang Yirong
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | - Grace K Dy
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Edwin Yau
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Amy Early
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Hongbin Chen
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Wiam Bshara
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | | | - Keisuke Shirai
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | | | - Laura J Tafe
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | | | - Jason Zhu
- Duke University, Durham, NC, 27708, USA
| | | | | | | | | | | | | | | | - Arun Singavi
- Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Ben George
- Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | | | | | - Rajbir Singh
- Meharry Medical College, Nashville, TN, 37208, USA
| | - Robin Jacob
- Meharry Medical College, Nashville, TN, 37208, USA
| | | | - Mark Steciuk
- Mission Health System, Asheville, NC, 28801, USA
| | - Oliver Binns
- Mission Health System, Asheville, NC, 28801, USA
| | | | - Neel Shah
- Community Hospital, Munster, IN, 46321, USA
| | - Marc Ernstoff
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Kunle Odunsi
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, Moores Cancer Center, La Jolla, CA, 92093, USA
| | - Mark Gardner
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA
| | - Lorenzo Galluzzi
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, 10065, USA.,Sandra and Edward Meyer Cancer Center, New York, NY, 10065, USA.,Université Paris Descartes/Paris V, 75006, Paris, France
| | - Carl Morrison
- OmniSeq, Inc., 700 Ellicott Street, Buffalo, NY, 14203, USA. .,Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14206, USA.
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Patierno B, Glover W, Ribar T, Kittles R, Foo WC, McCall S, Huang J, George D, Freedman J, Patierno S, Wood K, Hsu D. Abstract A79: Establishment of African American prostate cancer patient-derived primary cell lines and xenografts. Cancer Epidemiol Biomarkers Prev 2018. [DOI: 10.1158/1538-7755.disp17-a79] [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] Open
Abstract
Abstract
Background: Prostate cancer (PCa) is a clinically and molecularly heterogeneous disease, with differences in incidence and mortality among and between racial groups, which are only partially predicted by grade and stage. Age-adjusted incidence and mortality rates for PCa among African American (AA) men are 1.6- and 2.4-fold greater, respectively, than among white men. Preclinical models of AA PCa, including cell lines and xenografts, are severely lacking. This work addresses the urgent need to generate such models for study of the biology of AA PCa and for testing of novel therapeutic agents in models that are expected to be reflective of the clinical setting.
Methods: To generate AA PCa patient-derived primary cell lines, we have used the fibroblast feeder cell system established at Georgetown University. In this method, human tumor cells are cocultivated with irradiated mouse fibroblasts in medium with addition of ROCK inhibitor. For generation of AA PCa patient-derived xenografts, we have collected sections of human prostate tumors, minced, suspended, and implanted in the renal capsule of immunodeficient mice. Tumor specimens have been collected and formalin-fixed, paraffin-embedded for histologic evaluation. Sections of such blocks have been stained using hematoxylin and eosin. DNA from the tumor specimens has been used to perform ancestral genotyping.
Results: We have established eight AA PCa patient-derived primary cell lines and two AA PCa patient-derived xenografts. The AA PCa patient-derived primary cell lines have grown throughout the feeder layer and directly onto the plastic of the flasks. Currently, these lines are growing without addition of fibroblast feeder cells. The two AA PCa patient-derived xenografts have been passaged beyond three generations and key histologic features have been found to be consistent between the patient tumor and the patient-derived explant. In addition, African ancestry of the patient has been confirmed by ancestral genotyping. Further studies to more fully characterize the AA PCa patient-derived primary cell lines and xenografts at the pathologic, biologic, and molecular levels are currently under way. Procurement of individual AA PCa patient tissues continues for establishment of additional AA PCa patient-derived primary cell lines and xenografts.
Conclusions: Strategies designed to maximize PCa specimen availability and tumor content enable the establishment of AA PCa patient-derived primary cell lines and xenografts. Such preclinical models of AA PCa will enable a more rigorous interrogation of the molecular mechanisms underlying AA PCa and aid in the development of new biomarkers and therapeutic agents for AA PCa.
Citation Format: Brendon Patierno, Wayne Glover, Thomas Ribar, Rick Kittles, Wen-Chi Foo, Shannon McCall, Jiaoti Huang, Daniel George, Jennifer Freedman, Steven Patierno, Kris Wood, David Hsu. Establishment of African American prostate cancer patient-derived primary cell lines and xenografts [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A79.
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Affiliation(s)
| | | | | | - Rick Kittles
- 2The University of Arizona Health Sciences, Tucson, AZ
| | - Wen-Chi Foo
- 1Duke University Medical Center, Durham, NC,
| | | | | | | | | | | | - Kris Wood
- 1Duke University Medical Center, Durham, NC,
| | - David Hsu
- 1Duke University Medical Center, Durham, NC,
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Harrison G, Hemmerich A, Guy C, Perkinson K, Fleming D, McCall S, Cardona D, Zhang X. Overexpression of SOX11 and TFE3 in Solid-Pseudopapillary Neoplasms of the Pancreas. Am J Clin Pathol 2017; 149:67-75. [PMID: 29272888 DOI: 10.1093/ajcp/aqx142] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To characterize the expression of SOX11 and TFE3 proteins in solid-pseudopapillary neoplasms (SPNs) and their histologic mimickers. METHODS Immunohistochemistry for SOX11, TFE3, and β-catenin was performed on 31 cases of surgically resected SPNs. Neuroendocrine tumors, acinar cell carcinomas, and pancreatoblastomas served as controls. RESULTS Nuclear immunoreactivity for SOX11 was detected in all SPNs and five of 31 control tumors. Nuclear immunoreactivity for TFE3 was detected in 30 SPNs and three control tumors. Nuclear immunoreactivity for β-catenin was detected in all SPNs and four control tumors. The combination of three markers as immunohistochemical panels resulted in optimal sensitivity and specificity. CONCLUSIONS Both SOX11 and TFE3 were overexpressed in SPNs and may be involved in the pathogenesis. Clinically, SOX11 and TFE3 can be potentially used as diagnostic markers in distinguishing indeterminate SPNs from their histologic mimickers.
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Affiliation(s)
- Grant Harrison
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Amanda Hemmerich
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Cynthia Guy
- Department of Pathology, Duke University Medical Center, Durham, NC
| | | | - Debra Fleming
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Shannon McCall
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Diana Cardona
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Xuefeng Zhang
- Department of Pathology, Duke University Medical Center, Durham, NC
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Suetterlin K, Sud R, Burge J, McCall S, Fialho D, Haworth A, Sweeney M, Houlden H, Schorge S, Matthews E, Hanna M, Mannikko R. Large scale validation of functional expression of ClC-1 variants in genetic counselling of myotonia congenital. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.260] [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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Andry C, Duffy E, Moskaluk CA, McCall S, Roehrl MHA, Remick D. Biobanking-Budgets and the Role of Pathology Biobanks in Precision Medicine. Acad Pathol 2017; 4:2374289517702924. [PMID: 28725790 PMCID: PMC5497908 DOI: 10.1177/2374289517702924] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/28/2017] [Accepted: 03/04/2017] [Indexed: 12/29/2022] Open
Abstract
Biobanks have become an important component of the routine practice of pathology. At the 2016 meeting of the Association of Pathology Chairs, a series of presentations covered several important aspects of biobanking. An often overlooked aspect of biobanking is the fiscal considerations. A biobank budget must address the costs of consenting, procuring, processing, and preserving high-quality biospecimens. Multiple revenue streams will frequently be necessary to create a sustainable biobank; partnering with other key stakeholders has been shown to be successful at academic institutions which may serve as a model. Biobanking needs to be a deeply science-driven and innovating process so that specimens help transform patient-centered clinical and basic research (ie, fulfill the promise of precision medicine). Pathology’s role must be at the center of the biobanking process. This ensures that optimal research samples are collected while guaranteeing that clinical diagnostics are never impaired. Biobanks will continue to grow as important components in the mission of pathology, especially in the era of precision medicine.
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Affiliation(s)
- Chris Andry
- Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth Duffy
- Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | | | - Shannon McCall
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | | | - Daniel Remick
- Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
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Suetterlin K, Sud R, Burge J, McCall S, Fialho D, Haworth A, Sweeney M, Houlden H, Schorge S, Matthews E, Hanna M, Männikkö R. Improving genetic diagnosis and counselling for patients with myotoniacongenita. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30320-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Greaney J, Arter C, Hill E, Mason H, McCall S, Stone J, Tobin M, Greaney J, Arter C, Hill E, Mason H, McCall S, Stone J, Tobin M. The development of a new test of children's braille-reading ability. British Journal of Visual Impairment 2016. [DOI: 10.1177/026461969401200205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article outlines a project (School of Education, University of Birmingham) which aims to develop a new comprehensive test of children's braille-reading skills. The Project Management Group has decided to adapt the new print Neale Analysis of Reading Ability (1989) for braille users. This diagnostic test of prose-reading ability yields measures of reading speed, accuracy and comprehension. When adapting narratives for use by braillists, several key areas require careful consideration including assessing comparative difficulties, capitalization and the replacement of pictures. These areas are addressed, as well as other matters concerned with the standardization sample and the rationale behind the decision to opt for the Neale test.
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Affiliation(s)
| | | | | | | | | | | | | | - J. Greaney
- School of Education, University of Birmingham and of the Project Management Group
| | - C. Arter
- School of Education, University of Birmingham and of the Project Management Group
| | - E. Hill
- School of Education, University of Birmingham and of the Project Management Group
| | - H. Mason
- School of Education, University of Birmingham and of the Project Management Group
| | - S. McCall
- School of Education, University of Birmingham and of the Project Management Group
| | - J. Stone
- School of Education, University of Birmingham and of the Project Management Group
| | - M. Tobin
- School of Education, University of Birmingham and of the Project Management Group
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Corcoran C, Douglas G, Pavey S, Fielding A, McLinden M, McCall S. Network 1000: the changing needs and circumstances of visually-impaired people: project overview. British Journal of Visual Impairment 2016. [DOI: 10.1177/0264619604050045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article outlines the progress of a newly-commissioned three year study known as Network 1000. It is a three-year project funded through the Community Fund and is being carried out by the University of Birmingham on behalf of Vision 2020. The project’s aim is to create a panel survey of 1000 visually-impaired people to be interviewed regularly over the three-year period, and hopefully beyond, enabling their changing needs and circumstances to be monitored over time. The findings will be used to influence policy-makers and service-providers, and will also be disseminated to a wider audience of people with an interest in visual impairment. Building on the longitudinal nature of the project enables the project team to develop a methodology that is both democratic and inclusive. The underlying research philosophy is one of inclusion and participation and in this respect the people this research affects the most - those who are visually impaired - are involved in all stages of the research process. People with a visual impairment have played a key role in generating the data and the themes that will drive the construction of the main survey instrument. The article is divided into five sections that describe the progress of the project to date: first, it briefly outlines the background to the project; second, it describes the underlying philosophy behind the democratic approach to inclusion and participant involvement; third, it presents preliminary results from generative interviews; fourth, it discusses how the team will recruit participants to the project with particular reference to the two-stage sample design that has been adopted; and finally, it describes how this two-stage approach will be operationalized. The article concludes by outlining the next phase of the project and with a short reflection on the research process to date.
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Affiliation(s)
- C. Corcoran
- VICTAR, School of Education, University of Birmingham, Birmingham B15 2TT, UK,
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Kapadia A, Morris R, Albanese K, Spencer J, McCall S, Greenberg J. TH-AB-209-10: Breast Cancer Identification Through X-Ray Coherent Scatter Spectral Imaging. Med Phys 2016. [DOI: 10.1118/1.4958101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Easaw JC, Azim A, McCall S, Huiser T, Lim S. PO-42 - A novel approach to a common problem: after-hours care of cancer patients diagnosed with VTE. Thromb Res 2016; 140 Suppl 1:S192. [PMID: 27161732 DOI: 10.1016/s0049-3848(16)30175-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Oncologists often receive phone calls from radiologists after regular working hours or while on call, informing them that a cancer patient has been diagnosed with a blood clot. In these situations, there may not be nursing staff available to contact the patient and provide teaching for Low Molecular Weight Heparin (LMWH) injections. As a result, patients are often sent to the emergency for injection and teaching, taxing an already overburdened emergency department. This problem constitutes an important care gap. AIM In Alberta, Canada, pharmacists are able to prescribe medications including LMWH. We designed an after-hours program to provide care for cancer patients diagnosed with VTE. MATERIALS AND METHODS Once the oncologist is made aware of the patient with a clot, a simple one page document is filled out and faxed to a 24-hour outpatient pharmacy outlining the following: patient demographics, clot location, systemic therapy, current anticoagulant and anti-platelet agents. The oncologist has the option to specify desired LMWH. The patient goes to the pharmacy where the pharmacist weighs the patient, reviews blood work electronically and prescribes the LMWH. Also provided are injection teaching and telephone follow-up. A specific algorithm is followed with the pharmacist able to contact the on call oncologist in specific situations where the patient's condition falls outside of the algorithm guideline. The pharmacist is able to order blood work, particularly to evaluate for Heparin Induced Thrombocytopenia. Patients must follow up with their oncologist within 7 days of diagnosis. RESULTS This program has been run as a pilot and preliminary data will be presented at the ICTHIC meeting. Specifically, we will assess usage of the program, appropriateness of therapy chosen according to Canadian practice guidelines, as well as patient, pharmacist and physician satisfaction with the program. CONCLUSIONS We believe that this outpatient pharmacy program is innovative, will decrease burden on emergency departments, and takes advantage of our pharmacists' ability to independently assess patients and write prescriptions. This program may serve as a model for other cancer centers looking for a novel way to provide after-hours care of patients diagnosed with VTE.
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Affiliation(s)
- J C Easaw
- Tom Baker Cancer Center, University of Calgary
| | - A Azim
- Shoppers Drug Mart;Calgary, Alberta, Canada
| | | | - T Huiser
- Tom Baker Cancer Center, University of Calgary
| | - S Lim
- Tom Baker Cancer Center, University of Calgary
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42
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Strickler JH, McCall S, Nixon AB, Brady JC, Pang H, Rushing C, Cohn A, Starodub A, Arrowood C, Haley S, Meadows KL, Morse MA, Uronis HE, Blobe GC, Hsu SD, Zafar SY, Hurwitz HI. Phase I study of dasatinib in combination with capecitabine, oxaliplatin and bevacizumab followed by an expanded cohort in previously untreated metastatic colorectal cancer. Invest New Drugs 2014; 32:330-9. [PMID: 24173967 PMCID: PMC4108590 DOI: 10.1007/s10637-013-0042-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 09/03/2013] [Accepted: 10/16/2013] [Indexed: 01/07/2023]
Abstract
PURPOSE Dasatinib inhibits src family kinases and has anti-angiogenic properties. We conducted a phase I study of dasatinib, capecitabine, oxaliplatin, and bevacizumab (CapeOx/bevacizumab), with an expansion cohort in metastatic colorectal cancer (CRC). METHODS Patients were enrolled in a dose escalation cohort to establish the maximum tolerated dose (MTD) and the recommended phase II dose (RP2D). Using a "3 + 3" design, twelve patients with advanced solid tumors received dasatinib (50 mg twice daily or 70 mg daily), capecitabine (850 mg/m(2) twice daily, days 1-14), oxaliplatin (130 mg/m(2) on day 1) and bevacizumab (7.5 mg/kg on day1), every 3 weeks. Ten patients with previously untreated metastatic CRC were then enrolled in an expansion cohort. Activated src (src(act)) expression was measured by immunohistochemistry, using an antibody that selectively recognizes the active conformation of src (clone 28). RESULTS Twenty-two patients were enrolled between June 2009 and May 2011. Two DLTs were observed in the 50 mg bid dasatinib cohort, and one DLT was observed in the 70 mg daily dasatinib cohort. The MTD and RP2D for dasatinib was 70 mg daily. The most common treatment-related adverse events were fatigue (20; 91 %) and diarrhea (18; 82 %). Biomarker analysis of src(act) expression demonstrated that the overall response rate (ORR) was 75 % (6/8) for patients with high src(act) expression (IHC ≥ 2), compared to 0 % (0/8) for patients with low srcact expression (IHC 0 or 1); (p = 0.007). CONCLUSIONS The RP2D of dasatinib is 70 mg daily in combination with CapeOx/bevacizumab. High levels of srcact expression may predict those patients most likely to benefit from dasatinib.
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Affiliation(s)
| | | | | | - John C. Brady
- Duke University Medical Center, Durham, NC, 27710, USA
| | - Herbert Pang
- Duke University Medical Center, Durham, NC, 27710, USA
| | | | - Allen Cohn
- Rocky Mountain Cancer Centers Denver, CO, 80218, USA
| | - Alexander Starodub
- Duke University Medical Center, Durham, NC, 27710, USA
- Indiana University Health Goshen Cancer Center, Goshen, IN, 46526, USA
| | | | - Sherri Haley
- Duke University Medical Center, Durham, NC, 27710, USA
| | | | | | | | | | - S. David Hsu
- Duke University Medical Center, Durham, NC, 27710, USA
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Strickler JH, McCall S, Nixon AB, Pang H, Rushing C, Arrowood C, Haley S, Meadows K, Hurwitz H. Correlation of Src activation with response to dasatinib, capecitabine, oxaliplatin, and bevacizumab in advanced solid tumors. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.11036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11036 Background: Src inhibition may augment sensitivity to chemotherapy, but in unselected patients (pts) with advanced solid tumors, src inhibitors have shown limited clinical activity. Biomarkers to predict benefit from src inhibitors in advanced solid tumors are not yet known. Methods: 22 pts (dose escalation cohort= 12 pts; colorectal cancer [CRC] expansion cohort= 10 pts) were enrolled in a phase I study to determine the safety and tolerability of the src inhibitor dasatinib with capecitabine, oxaliplatin, and bevacizumab (J Clin Oncol 29: 2011 [suppl; abstr 3586]). Src activation (src-a) was assessed in tumors from 16 evaluable pts. Src-a was measured by immunohistochemistry (IHC) in formalin-fixed, paraffin-embedded tumor samples using an antibody that selectively recognizes the active conformation of src (clone 28). A GI pathologist who was blinded to pt outcomes graded membranous src-a using a standard semi-quantitative method. The endpoint of this exploratory analysis was objective response rate ([ORR]= PR+CR). 2-sided Fisher’s Exact test was used to evaluate the association between ORR and src-a. Results: Across all tumor types, 8 tumors had no/faint src-a (IHC=0/1); 8 tumors had moderate/strong src-a (IHC≥2). Benign colonic epithelium had no src-a (IHC=0). The ORR was 75% (6/8) for pts with moderate/strong src-a versus (vs) 0% (0/8) for pts with no/faint src-a (p =0.007). In the CRC expansion cohort, the ORR was 83% (5/6) for patients with moderate/strong src-a vs 0% (0/2) for pts with no/faint src-a (p=0.107); progression free survival range was 7.9-24.4 months for pts with moderate/strong src-a. Conclusions: In this small phase I study, src-a is associated with benefit from the combination of dasatinib and oxaliplatin-based chemotherapy. Further evaluation of dasatinib in patients whose tumors demonstrate high levels of src-a may be warranted. Clinical trial information: NCT00920868.
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Affiliation(s)
| | | | | | - Herbert Pang
- Cancer and Leukemia Group B Statistical Center, Durham, NC
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Uronis JM, Osada T, McCall S, Yang XY, Mantyh C, Morse MA, Lyerly HK, Clary BM, Hsu DS. Histological and molecular evaluation of patient-derived colorectal cancer explants. PLoS One 2012; 7:e38422. [PMID: 22675560 PMCID: PMC3366969 DOI: 10.1371/journal.pone.0038422] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 05/09/2012] [Indexed: 12/02/2022] Open
Abstract
Mouse models have been developed to investigate colorectal cancer etiology and evaluate new anti-cancer therapies. While genetically engineered and carcinogen-induced mouse models have provided important information with regard to the mechanisms underlying the oncogenic process, tumor xenograft models remain the standard for the evaluation of new chemotherapy and targeted drug treatments for clinical use. However, it remains unclear to what extent explanted colorectal tumor tissues retain inherent pathological features over time. In this study, we have generated a panel of 27 patient-derived colorectal cancer explants (PDCCEs) by direct transplantation of human colorectal cancer tissues into NOD-SCID mice. Using this panel, we performed a comparison of histology, gene expression and mutation status between PDCCEs and the original human tissues from which they were derived. Our findings demonstrate that PDCCEs maintain key histological features, basic gene expression patterns and KRAS/BRAF mutation status through multiple passages. Altogether, these findings suggest that PDCCEs maintain similarity to the patient tumor from which they are derived and may have the potential to serve as a reliable preclinical model that can be incorporated into future strategies to optimize individual therapy for patients with colorectal cancer.
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Affiliation(s)
- Joshua M. Uronis
- Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina, United States of America
| | - Takuya Osada
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Shannon McCall
- Department of Pathology, Duke University, Durham, North Carolina, United States of America
| | - Xiao Yi Yang
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Christopher Mantyh
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Michael A. Morse
- Division of Medical Oncology, Duke University, Durham, North Carolina, United States of America
| | - H. Kim Lyerly
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - Bryan M. Clary
- Department of Surgery, Duke University, Durham, North Carolina, United States of America
| | - David S. Hsu
- Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina, United States of America
- Division of Medical Oncology, Duke University, Durham, North Carolina, United States of America
- * E-mail:
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Raja Rayan D, Haworth A, Sud R, McCall S, Tan SV, Durran S, Davis M, Hanna MG. 015 Identifying the cause of phenotypic variability in a family with non-dystrophic myotonia. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Czito BG, Willett C, Palta M, McCall S, Gee N, Hurwitz H, Coleman RE, Zafar Y, Kennedy-Newton P, Uronis H. A phase I/II study of capecitabine (Cape), oxaliplatin (Ox), panitumumab (Pmab), and external beam radiation therapy (RT) for patients with esophagogastric carcinoma (EC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
68 Background: EC is commonly managed with concurrent chemoradiotherapy, with or without surgical resection. The optimal combination and dose of agents is the subject of continued investigation. This study examines chemotherapeutic agents with known efficacy in EC in combination with the EGFR inhibitor panitumumab. Methods: Eligible pts received RT (1.8 Gy qd to 50.4 Gy) combined with concurrent chemotherapy. Dose-level (DL) 1 was cape (625 mg/m2/bid RT days), ox (40 mg/m2 weekly X 6 weeks), and pmab (3.6 mg/kg, weeks 1, 3 and 5). Chemotherapy doses were escalated barring dose limiting toxicity (DLT). The primary endpoint was defining the maximally tolerated dose with this combination. Secondary endpoints included toxicity and radiographic/pathologic response rates. Results: Twenty-nine pts were enrolled. Twenty-five had adenocarcinoma, 24 (83%) were cN+ and 9 (31%) had M1a/b disease. DLT was not encountered in DL 1. Two of 6 patients at DL 2 (cape 825 mg/m2/bid RT days, ox 50 mg/m2 weekly, pmab 4.8 mg/kg, weeks 1, 3 and 5) developed DLT (one hospitalization due to dehydration; one with drug reaction requiring hospitalization). Twenty additional pts were enrolled at DL1. Primary toxicities were EGFR-rash, esophagitis, nausea/vomiting and fatigue. On repeat endoscopy, 16 (55%) had CR, 10 (35%) PR and 2 (7%) SD. Using PERCIST criteria, 12 (41%), 11 (38%), 2 (7%) and 3 (10%) had CR, PR, SD and PD response on restaging PET, respectively. Twenty pts underwent esophagectomy, revealing Gr 0 response (no residual disease) in 9 (45%), Gr 1 (single/microscopic cells) in 3 (15%), Gr 2 (fibrosis > gross disease) in 4 (20%) and Gr 3 (gross residual > fibrosis or no evident response) in 4 (20%). Seven pts (35%) experienced anastomotic leak (2 requiring reoperation and 3 stent placement). Conclusions: Concurrent chemoradiotherapy utilizing capecitabine, oxaliplatin, panitumumab is reasonably well-tolerated and associated with high rates of radiographic, endoscopic and pathologic response. Postoperative anastomotic leak rates were higher than expected. Further study of this regimen in the operative and nonoperative settings is warranted.
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Affiliation(s)
| | | | | | | | - Nathan Gee
- Duke University Medical Center, Durham, NC
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Clifton GT, Sears AK, Patil R, Shumway NM, Carmichael MG, Van Echo DC, Holmes JP, McCall S, Merrill GA, Ponniah S, Peoples GE, Mittendorf EA. Monitoring of circulating tumor cell trends in a prospective, randomized, placebo-controlled HER2 /neu peptide vaccine trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Omenetti A, Bass LM, Anders RA, Clemente MG, Francis H, Guy CD, McCall S, Choi SS, Alpini G, Schwarz KB, Diehl AM, Whitington PF. Hedgehog activity, epithelial-mesenchymal transitions, and biliary dysmorphogenesis in biliary atresia. Hepatology 2011; 53:1246-58. [PMID: 21480329 PMCID: PMC3074103 DOI: 10.1002/hep.24156] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
UNLABELLED Biliary atresia (BA) is notable for marked ductular reaction and rapid development of fibrosis. Activation of the Hedgehog (Hh) pathway promotes the expansion of populations of immature epithelial cells that coexpress mesenchymal markers and may be profibrogenic. We examined the hypothesis that in BA excessive Hh activation impedes ductular morphogenesis and enhances fibrogenesis by promoting accumulation of immature ductular cells with a mesenchymal phenotype. Livers and remnant extrahepatic ducts from BA patients were evaluated by quantitative reverse-transcription polymerase chain reaction (QRT-PCR) and immunostaining for Hh ligands, target genes, and markers of mesenchymal cells or ductular progenitors. Findings were compared to children with genetic cholestatic disease, age-matched deceased donor controls, and adult controls. Ductular cells isolated from adult rats with and without bile duct ligation were incubated with Hh ligand-enriched medium ± Hh-neutralizing antibody to determine direct effects of Hh ligands on epithelial to mesenchymal transition (EMT) marker expression. Livers from pediatric controls showed greater innate Hh activation than adult controls. In children with BA, both intra- and extrahepatic ductular cells demonstrated striking up-regulation of Hh ligand production and increased expression of Hh target genes. Excessive accumulation of Hh-producing cells and Hh-responsive cells also occurred in other infantile cholestatic diseases. Further analysis of the BA samples demonstrated that immature ductular cells with a mesenchymal phenotype were Hh-responsive. Treating immature ductular cells with Hh ligand-enriched medium induced mesenchymal genes; neutralizing Hh ligands inhibited this. CONCLUSION BA is characterized by excessive Hh pathway activity, which stimulates biliary EMT and may contribute to biliary dysmorphogenesis. Other cholestatic diseases show similar activation, suggesting that this is a common response to cholestatic injury in infancy.
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Affiliation(s)
- Alessia Omenetti
- Division of Gastroenterology, Duke University Medical Center, Durham, NC, United States
| | - Lee M Bass
- Pediatrics, Feinberg Medical School of Northwestern University, Children's Memorial Research Center, Chicago, Illinois, United States
| | - Robert A. Anders
- Pathology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Maria G Clemente
- Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Heather Francis
- R&E, Scott & White Digestive Disease, Medicine, Scott & White, Texas A&M HSC COM, Temple, TX,United States
| | - Cinthya D Guy
- Pathology, Duke University Medical Center, Durham, NC, United States
| | - Shannon McCall
- Pathology, Duke University Medical Center, Durham, NC, United States
| | - Steve S Choi
- Division of Gastroenterology, Duke University Medical Center, Durham, NC, United States., Section of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, NC, United States
| | - Gianfranco Alpini
- Scott & White Digestive Disease Research Center, Research, Medicine, Division Research, Central Texas. Veterans Health Care System, Texas A&M HSC COM, Scott & White, Temple, TX, United States
| | - Kathleen B Schwarz
- Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Anna Mae Diehl
- Division of Gastroenterology, Duke University Medical Center, Durham, NC, United States
| | - Peter F Whitington
- Pediatrics, Feinberg Medical School of Northwestern University, Children's Memorial Research Center, Chicago, Illinois, United States
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Gates JD, Benavides LC, Stojadinovic A, Mittendorf EA, Holmes JP, Carmichael MG, McCall S, Milford AL, Merrill GA, Ponniah S, Peoples GE. Monitoring circulating tumor cells in cancer vaccine trials. Hum Vaccin 2008; 4:389-92. [PMID: 18437056 DOI: 10.4161/hv.4.5.6115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The presence of circulating tumor cells (CTC) from various cancers has provided a wealth of information and possibilities. As the role of CTC detection in the treatment assessment of metastatic breast cancer becomes standard, there is interest in applying this tool in cancer vaccine development and clinical trial monitoring. Since we lack a proven immunologic assay that correlates with clinical response, CTC detection, quantification and phenotypic characterization may be a useful surrogate for clinical outcome. The Cancer Vaccine Development Program is involved in the development of HER2/neu peptide based vaccine development for the prevention of recurrence in HER2/neu expressing cancers like breast cancer. The CellSearch System (Veridex, LLC Warren, NJ) has been used by our lab in conjunction with in vivo and/or in vitro immunologic measurements to define a monitoring tool that could predict clinical response. Once validated, this assay could significantly shorten clinical trials and lead to more efficient assessment of potentially promising cancer vaccines.
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Affiliation(s)
- J D Gates
- Department of Surgery, General Surgery Service, Brooke Army Medical Center, Ft. Sam Houston, Texas 78234, USA
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Marini AM, Banaudha K, McCall S, Zhu D, Lipsky R. α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-mediated neuroprotection requires TRKB receptor activation. J Neurochem 2008. [DOI: 10.1046/j.1471-4159.81.s1.11_6.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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