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Huemer F, Weiss L, Regitnig P, Winder T, Schmitt CA, Thaler J, Wöll E, Greil R. Comment on: Incidence, clinicopathological features, and clinical outcomes of low HER2 expressed, inoperable, advanced, or recurrent gastric/gastroesophageal junction adenocarcinoma. ESMO Open 2024; 9:102973. [PMID: 38507896 PMCID: PMC10966168 DOI: 10.1016/j.esmoop.2024.102973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
- F Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Salzburg, Austria; Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria
| | - L Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Salzburg, Austria; Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria
| | - P Regitnig
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - T Winder
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Department of Internal Medicine II, Hospital Feldkirch, Feldkirch, Austria
| | - C A Schmitt
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Johannes Kepler University, Kepler University Hospital, Department of Hematology and Oncology, Linz, Austria
| | - J Thaler
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Department of Internal Medicine IV, Hematology and Oncology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - E Wöll
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; St. Vinzenz Krankenhaus Betriebs GmbH, Zams, Austria
| | - R Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Salzburg, Austria; Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Cancer Cluster Salzburg, Salzburg, Austria.
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Illini O, Fabikan H, Swalduz A, Krenbek D, Vikström A, Schumacher M, Dudnik E, Studnicka M, Öhman R, Wurm R, Wannesson L, Peled N, Kian W, Bar J, Daher S, Addeo A, Rotem O, Pall G, Zer A, Saad A, Cufer T, Sorotsky H, Hashemi S, Mohorcic K, Stoff R, Rovitsky Y, Keren-Rosenberg S, Winder T, Weinlinger C, Valipour A, Hochmair M. EP08.02-122 Real-world Experience with Capmatinib in MET Exon 14-mutated Non-small Cell Lung Cancer (RECAP). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.805] [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: 10/14/2022]
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3
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Stintzing S, Hübner G, Schröder J, Kisro J, Welslau M, Bürkle D, Göhler T, Schmidt B, Müller-Huesmann H, Krammer-Steiner B, von der Heyde E, Reichenbach F, Arnold D, Gerger A, Hegewisch-Becker S, Vogel A, Winder T, Prager G. P-58 Encorafenib and cetuximab in patients with metastatic, BRAF V600E-mutated, colorectal carcinoma: A multi-centric, multi-national, prospective, longitudinal, non-interventional study in Germany and Austria – BERING CRC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Donaldson C, Winder T, Caudron C, White RS. Crustal seismic velocity responds to a magmatic intrusion and seasonal loading in Iceland's Northern Volcanic Zone. Sci Adv 2019; 5:eaax6642. [PMID: 31807704 PMCID: PMC6881157 DOI: 10.1126/sciadv.aax6642] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/23/2019] [Indexed: 05/31/2023]
Abstract
Seismic noise interferometry is an exciting technique for studying volcanoes, providing a continuous measurement of seismic velocity changes (dv/v), which are sensitive to magmatic processes that affect the surrounding crust. However, understanding the exact mechanisms causing changes in dv/v is often difficult. We present dv/v measurements over 10 years in central Iceland, measured using single-station cross-component correlation functions from 51 instruments across a range of frequency bands. We observe a linear correlation between changes in dv/v and volumetric strain at stations in regions of both compression and dilatation associated with the 2014 Bárðarbunga-Holuhraun dike intrusion. Furthermore, a clear seasonal cycle in dv/v is modeled as resulting from elastic and poroelastic responses to changing snow thickness, atmospheric pressure, and groundwater level. This study comprehensively explains variations in dv/v arising from diverse crustal stresses and highlights the importance of deformation modeling when interpreting dv/v, with implications for volcano and environmental monitoring worldwide.
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Affiliation(s)
- C. Donaldson
- Department of Earth Sciences, Bullard Laboratories, University of Cambridge, Cambridge, UK
| | - T. Winder
- Department of Earth Sciences, Bullard Laboratories, University of Cambridge, Cambridge, UK
| | - C. Caudron
- Université Grenoble Alpes, University Savoie Mont Blanc, CNRS, IRD, IFSTTAR, ISTerre, 38000 Grenoble, France
| | - R. S. White
- Department of Earth Sciences, Bullard Laboratories, University of Cambridge, Cambridge, UK
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Riedl J, Posch F, Prager G, Eisterer W, Öhler L, Thamer S, Wilthoner K, Petzer A, Pichler P, Hubmann E, Winder T, Burgstaller S, Korger M, Andel J, Greil R, Pecherstorfer M, Philipp-Abbrederis K, Djanani A, Gruenberger B, Längle F, Wöll E, Gerger A. The AST/ALT (De Ritis) ratio predicts clinical outcome in pancreatic cancer patients treated with first-line nab-paclitaxel and gemcitabine: post-hoc analysis of an Austrian multicenter, non-interventional study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Karbeyaz F, Müllhaupt B, Winder T, Misselwitz B, Mertens J, Siebenhuener A. High rates of hepatocellular carcinoma within two years of starting treatment for chronic hepatitis C with direct antiviral agents but not with PEG-interferon/ Ribavirin (HORRID Study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.147] [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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7
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Eisterer W, Gerger A, Öhler L, Mlineritsch B, Sliwa T, Wilthoner K, Petzer A, Pichler P, Hubmann E, Winder T, Burgstaller S, Korger M, Andel J, Wöll E, Neumann H, Pecherstorfer M, Philipp-Abbrederis K, Djanani A, Gruenberger B, Längle F, Prager G. Austrian real world data in elderly and younger metastatic pancreatic cancer patients: Interim results of a multicenter non-interventional study with nab-paclitaxel/gemcitabine. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.033] [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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8
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Hartmann B, Oberaigner W, Frick H, Weiss L, Winder T, Philipp-Abbrederis K, Herrmann C, Huynh M, Spizzo G, Lang C, Seeber A, Schneider J, Wöll E, Mosler P, Greil R, Rössle M, Rumpold H, Gastl G, von Moos R, Lang A. Real life registry data of primary localisation of a well-defined colon cancer population of western Austria (Salzburg, Tyrol and Vorarlberg), eastern Switzerland (St. Gallen and Graubünden) and Liechtenstein. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.124] [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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Abstract
Tumor biopsy is currently the gold standard for diagnosis and in determining cell signaling pathways involved in the development of treatment resistance. However, there are major challenges with this technique, including the need for serial sampling to monitor treatment resistance, which is invasive and also has the potential for selection bias due to intra-tumoral and inter-tumoral heterogeneity. These challenges highlight the need for more effective methods for obtaining Tumor samples. Liquid biopsy analyzes genetic material or tumor cells shed into the blood from the primary tumor and metastatic sites and consequently provides a comprehensive, real-time picture of the tumor burden in an individual patient. Indeed, liquid biopsy has the potential to revolutionize cancer management. Here, we review recent studies on the potential clinical applications of liquid biopsy using circulating tumor DNA in colorectal cancer, including screening, diagnosis, detection of minimal residual disease after surgery, detection of recurrence, prognosis, predicting treatment response, monitoring tumor burden or response during treatment, and tracking resistance. We also discuss recent data demonstrating the utility of detecting KRAS-mutated circulating tumor DNA, both at diagnosis to determine an appropriate treatment strategy and during anti-epidermal growth factor receptor therapy to predict treatment resistance. The future integration of liquid biopsy into clinical practice is discussed, together with alternative approaches and key questions that need to be answered in future clinical studies before this technology can be implemented and used routinely.
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Affiliation(s)
- C Nadal
- 1 Department of Medical Oncology, Institut Clínic de Malalties Hemato-Oncològiques, Hospital Clínic de Barcelona, Barcelona, Spain.,2 Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd), Madrid, Spain.,3 August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - T Winder
- 4 Department of Oncology, University Hospital Zurich, Zurich, Switzerland
| | - A Gerger
- 5 Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,6 Center for Biomarker Research in Medicine, Graz, Austria
| | - David Tougeron
- 7 Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC)-EA 4331, Université de Poitiers, Poitiers, France.,8 Gastroenterology Department, Poitiers University Hospital, Poitiers, France.,9 Department of Oncology, CHU de Poitiers, Poitiers, France
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Winder T, Posch F, Asamer E, Stotz M, Siebenhüner A, Schlick K, Magnes T, Samaras P, Szkandera J, Clavien PA, Neureiter D, Greil R, Pestalozzi B, Stoeger H, Gerger A, Egle A, Pichler M. An elevated fibrinogen/CRP ratio predicts a remarkable survival advantage in patients with metastatic pancreatic cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.77] [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: 11/12/2022] Open
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11
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Riedl J, Posch F, Stotz M, Bezan A, Winder T, Schaberl-Moser R, Pichler M, Stoeger H, Gerger A. Patterns of venous thromboembolism risk in patients with localized colorectal cancer undergoing adjuvant chemotherapy or active surveillance. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.107] [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: 11/12/2022] Open
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12
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Hu Y, Donkervoot S, Stojkovic T, Voermans N, Foley A, Leach M, Dastgir J, Bolduc V, Cullup T, Becdelièvre A, Yang L, Su H, Meilleur K, Schindler A, Kamsteeg E, Richard P, Butterfield R, Winder T, Crawford T, Weiss R, Muntoni F, Allamand V, Bönnemann C. G.P.214. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.290] [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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Winder T, Giamas G, Wilson PM, Zhang W, Yang D, Bohanes P, Ning Y, Gerger A, Stebbing J, Lenz HJ. Insulin-like growth factor receptor polymorphism defines clinical outcome in estrogen receptor-positive breast cancer patients treated with tamoxifen. Pharmacogenomics J 2014; 14:28-34. [PMID: 23459444 DOI: 10.1038/tpj.2013.8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 01/10/2013] [Accepted: 02/04/2013] [Indexed: 02/07/2023]
Abstract
Compelling evidence points to a key role for insulin-like growth factor 1 (IGF1) signaling in breast cancer development and progression. In addition, IGF1 receptor (IGF1R) expression has been correlated and functionally linked with estrogen receptor (ER) signaling. Recent translational studies support a cross talk between IGF1R and ERα at different levels and data suggest enhanced IGF1R signaling as a causative mechanism of tamoxifen (TAM) resistance. We tested whether functional germline variations in the IGF pathway are associated with clinical outcome in ER-positive primary invasive breast cancer patients, who were treated with surgery and adjuvant TAM. Tissue samples of 222 patients with ER+ primary invasive breast cancer, who had undergone surgery at Charing Cross Hospital, London, UK between 1981 and 2003, were analyzed. Genomic DNA was extracted from formalin-fixed, paraffin-embedded tissue samples and six functional IGF1 pathway polymorphisms were analyzed using direct DNA sequencing and PCR-restriction fragment length polymorphism. In multivariable analysis, patients with primary invasive breast cancer carrying IGF1R_rs2016347 G allele had a significantly increased risk of early tumor progression (hazard ratio (HR) 2.01; adjusted P=0.004) and death (HR 1.84; adjusted P=0.023) compared with patients carrying G/T or T/T, independent of established clinicopathological determinants. This association remained significant after adjusting for multiple testing. In addition, we were able to demonstrate that IRS1_rs1801123 and IGFBP3_rs2854744 were significantly associated with lymph node involvement and tumor size, respectively. We provide the first evidence for IGF1R_rs2016347 as an independent prognostic marker for ER+ breast cancer patients treated with TAM and support a rational for combined treatment strategies.
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Affiliation(s)
- T Winder
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - G Giamas
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - P M Wilson
- 1] Department of Pathology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA [2] Department of Biochemistry and Molecular Biology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - W Zhang
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - D Yang
- Department of Preventive Medicine and Molecular Biology University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - P Bohanes
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - Y Ning
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - A Gerger
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - J Stebbing
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - H-J Lenz
- 1] Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA [2] Department of Preventive Medicine and Molecular Biology University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
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Santi M, Medne L, Bharucha-Goebel D, Bonnemann C, Dastgir J, Zukosky K, Shieh P, Winder T, Tennekoon G, Finkel R, Dowling J, Monnier N. P.4.9 Variable clinical and histological features in severe congenital RYR1 associated myopathy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.447] [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: 11/17/2022]
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Liewluck T, Dimberg E, Winder T, Milone M. Expanding the Spectrum of ANO5-Muscular Dystrophy: Skeletal Muscle Amyloidosis, Cardiac Arrhythmia and Novel Mutations (PD6.001). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.pd6.001] [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: 11/15/2022] Open
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Winder T, Wilson PM, Yang D, Zhang W, Ning Y, Power DG, Bohanes P, Gerger A, Tang LH, Shah M, Lenz HJ. An individual coding polymorphism and the haplotype of the SPARC gene predict gastric cancer recurrence. Pharmacogenomics J 2012; 13:342-8. [PMID: 22491017 DOI: 10.1038/tpj.2012.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 02/14/2012] [Accepted: 03/05/2012] [Indexed: 02/08/2023]
Abstract
The 5-year survival rate for gastric adenocarcinoma (GA) remains only 40% and biomarkers to identify patients at high risk of tumor recurrence are urgently needed. Secreted protein acidic and rich in cysteine (SPARC) is an extracellular matrix glycoprotein that mediates cell matrix interactions, and upregulation of SPARC can promote tumor progression and metastasis. This study investigated whether single-nucleotide polymorphisms (SNPs) in SPARC impact the prognosis of GA. Blood or formalin-fixed, paraffin-embedded tissues were obtained from 137 GA patients at the University of Southern California and Memorial Sloan-Kettering Cancer Center medical facilities. DNA was isolated and five SNPs in the SPARC 3'-untranslated region (UTR) were evaluated by DNA sequencing or PCR-restriction fragment length polymorphism. Associations between SNPs and time to tumor recurrence (TTR) were analyzed using Kaplan-Meier curves, log-rank tests, and likelihood-ratio test within logistic or Cox regression model as appropriate. Patients carrying at least one G allele of the SPARC rs1059829 polymorphism (GG, AG) showed a median TTR of 3.7 years compared with 2.1 years TTR for patients with AA (hazard ratio (HR) 0.57; P=0.033). In a multivariate analysis adjusted for T and N category as covariates and stratified by race, hospital and chemotherapy, patients with at least one SPARC rs1059829 G allele (GG, AG) remained significantly associated with superior TTR than patients with AA genotype (adjusted P=0.026). In addition, patients harboring the G-A-A haplotype had the highest risk of tumor recurrence (HR 1.892; adjusted P=0.016). Our findings suggest that SPARC 3'-UTR SNPs may be useful in predicting GA patients at increased risk of recurrence.
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Affiliation(s)
- T Winder
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
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Winder T, Wilson PM, Yang D, Zhang W, Ning Y, Power DG, Bohanes P, Gerger A, Tang LH, Shah M, Lenz HJ. An individual coding polymorphism and the haplotype of the SPARC gene predict gastric cancer recurrence. Pharmacogenomics J 2012. [PMID: 22491017 DOI: 10.1038/tpj.2012.11.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The 5-year survival rate for gastric adenocarcinoma (GA) remains only 40% and biomarkers to identify patients at high risk of tumor recurrence are urgently needed. Secreted protein acidic and rich in cysteine (SPARC) is an extracellular matrix glycoprotein that mediates cell matrix interactions, and upregulation of SPARC can promote tumor progression and metastasis. This study investigated whether single-nucleotide polymorphisms (SNPs) in SPARC impact the prognosis of GA. Blood or formalin-fixed, paraffin-embedded tissues were obtained from 137 GA patients at the University of Southern California and Memorial Sloan-Kettering Cancer Center medical facilities. DNA was isolated and five SNPs in the SPARC 3'-untranslated region (UTR) were evaluated by DNA sequencing or PCR-restriction fragment length polymorphism. Associations between SNPs and time to tumor recurrence (TTR) were analyzed using Kaplan-Meier curves, log-rank tests, and likelihood-ratio test within logistic or Cox regression model as appropriate. Patients carrying at least one G allele of the SPARC rs1059829 polymorphism (GG, AG) showed a median TTR of 3.7 years compared with 2.1 years TTR for patients with AA (hazard ratio (HR) 0.57; P=0.033). In a multivariate analysis adjusted for T and N category as covariates and stratified by race, hospital and chemotherapy, patients with at least one SPARC rs1059829 G allele (GG, AG) remained significantly associated with superior TTR than patients with AA genotype (adjusted P=0.026). In addition, patients harboring the G-A-A haplotype had the highest risk of tumor recurrence (HR 1.892; adjusted P=0.016). Our findings suggest that SPARC 3'-UTR SNPs may be useful in predicting GA patients at increased risk of recurrence.
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Affiliation(s)
- T Winder
- Division of Medical Oncology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
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Grimminger PP, Shi M, Barrett C, Lebwohl D, Danenberg KD, Brabender J, Vigen CLP, Danenberg PV, Winder T, Lenz HJ. TS and ERCC-1 mRNA expressions and clinical outcome in patients with metastatic colon cancer in CONFIRM-1 and -2 clinical trials. Pharmacogenomics J 2011; 12:404-11. [PMID: 21788964 DOI: 10.1038/tpj.2011.29] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To validate established cutoff levels of thymidylate synthase (TS) and excision repair cross-complementing (ERCC-1) intratumoral mRNA expressions in tumor samples from metastatic colorectal cancer (mCRC) patients treated with PTK787/ZK222584 (PTK/ZK). From 122 samples of patients with mCRC enrolled in CONFIRM-1 (Colorectal Oral Novel Therapy for the Inhibition of Angiogenesis and Retarding of Metastases) or CONFIRM-2, mRNA was isolated of microdissected formalin-fixed paraffin-embedded samples and quantitated using TaqMan-based technology. Existing TS and ERCC-1 cutoff levels were tested for their prognostic value in first-line and second-line therapy. TS expression was associated with overall survival (OS) in first-line, but not second-line therapy. ERCC-1 was associated with OS in patients treated with first-line and second-line FOLFOX4. In first-line FOLFOX4, combination of high TS and/or high ERCC-1 was associated with shorter OS. A correlation was observed between ERCC-1 expression and benefit from PTK/ZK+FOLFOX4 treatment. TS and ERCC-1 expression is associated with clinical outcome in mCRC. Baseline TS and ERCC-1 levels may allow the selection of patients who benefit from FOLFOX4 chemotherapy.
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Affiliation(s)
- P P Grimminger
- Department of Molecular Biology and Biochemistry, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
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Wilson PM, Bohanes PO, Rankin CJ, Benedetti JK, Ulrich CM, Smalley SR, Makar KW, Zhang W, Winder T, Ning Y, Gerger A, Benhaim L, El-Khoueiry R, Labonte MJ, Blanke CD, Lenz H. The final results of the SWOG S9304 phase III intergroup trial’s pharmacogenetic analysis: Association of polymorphisms with survival and toxicity in stage II/III rectal cancer patients treated with 5-fluorouracil (5-FU) and pelvic radiation (RT). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3542] [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] Open
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Lang A, Geller-Rhomberg S, Winder T, Hartmann BL, Gasser K, Kohler B, Grizelj I, Stark N, Tschann P, Drexel H, Muendlein A. Evaluation of the association between tagging polymorphisms of the MACC1 locus and overall survival in patients with colorectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3594] [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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Winder T, Giamas G, Zhang W, Yang D, Bohanes PO, Ning Y, Gerger A, Labonte MJ, Stebbing J, Lenz H. Use of insulin-like growth factor (IGF) pathway polymorphism IGF1R_rs2016347 to predict tumor recurrence in estrogen receptor–positive breast cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.538] [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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Ladner RD, Zhang W, Labonte MJ, Yang D, Ning Y, Gerger A, Bohanes PO, Winder T, El-Khoueiry AB, Iqbal S, Petasis N, Lenz H. Prediction of tumor recurrence in stage II colon cancer through genetic variants in formyl peptide receptor 2 (FPR2). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3604] [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] Open
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Gerger A, Zhang W, Yang D, Bohanes PO, Ning Y, Winder T, Labonte MJ, Wilson PM, Benhaim L, El-Khoueiry R, Absenger G, El-Khoueiry AB, Iqbal S, Lenz H. Angiogenesis gene polymorphisms and clinical outcome of metastatic colorectal cancer treated with first-line bevacizumab and oxaliplatin-based chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3592] [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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Gasser K, Muendlein A, Stark N, Winder T, Rein P, Saely CH, Geiger K, Geller-Rhomberg S, Hartmann BL, Kohler B, Drexel H, Lang A. Evaluation of the JAK2 V617F mutational status in coronary patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6585] [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] Open
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25
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Benhaim L, Gerger A, Zhang W, Yang D, Bohanes PO, Ning Y, Winder T, Labonte MJ, Wilson PM, El-Khoueiry R, El-Khoueiry AB, Iqbal S, Lenz H. Cancer stem cell gene variants associated with colon cancer recurrence. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3612] [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] Open
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26
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Winder T, Bohanes P, Zhang W, Yang D, Power DG, Ning Y, Gerger A, Wilson PM, Tang LH, Shah M, Lee AS, Lenz HJ. GRP78 promoter polymorphism rs391957 as potential predictor for clinical outcome in gastric and colorectal cancer patients. Ann Oncol 2011; 22:2431-2439. [PMID: 21382870 DOI: 10.1093/annonc/mdq771] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Recently, the analysis of gastric and colorectal tumor specimens determined that 78-kiloDalton glucose-regulated protein (GRP78), an endoplasmic reticulum chaperone, up-regulation serves as an efficient mechanism protecting cells against apoptosis and can confer drug resistance. We tested whether functional polymorphisms within the GRP78 gene are related to clinical outcome in gastric and colorectal cancer (CRC) patients. PATIENTS AND METHODS Blood samples of 234 stage II/III CRC patients at the University of Southern California (USC) and formalin-fixed paraffin-embedded tissues of 137 patients with localized gastric adenocarcinoma (GA) at USC and Memorial Sloan-Kettering Cancer Centers were obtained. GRP78 polymorphisms analyzed on germline DNA were correlated with clinical outcome using univariate and multivariate analyses. RESULTS GA patients with the combined GRP78 rs391957 C/T and T/T genotype were at higher risk for tumor recurrence and death [hazard ratio (HR) 2.61; P < 0.001 and HR 3.17; P < 0.001, respectively], than those with C/C. These findings were subsequently tested in a CRC cohort where patients with the homozygous T/T genotype were at highest risk for tumor recurrence (HR 2.61; P = 0.015). The results remained significant after adjusting for clinicopathologic determinants. CONCLUSION These data provide the first evidence that the GRP78 rs391957 polymorphism can predict clinical outcome in localized GA and locally advanced CRC patients.
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Affiliation(s)
- T Winder
- Department of Internal Medicine, Division of Medical Oncology
| | - P Bohanes
- Department of Internal Medicine, Division of Medical Oncology
| | - W Zhang
- Department of Internal Medicine, Division of Medical Oncology
| | - D Yang
- Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles
| | - D G Power
- Gastrointestinal Oncology Service, Memorial Sloan-Kettering Cancer Center, Cornell University, New York
| | - Y Ning
- Department of Internal Medicine, Division of Medical Oncology
| | - A Gerger
- Department of Internal Medicine, Division of Medical Oncology
| | - P M Wilson
- Department of Pathology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles
| | - L H Tang
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, Cornell University, New York
| | - M Shah
- Gastrointestinal Oncology Service, Memorial Sloan-Kettering Cancer Center, Cornell University, New York
| | - A S Lee
- Department of Biochemistry and Molecular Biology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, USA
| | - H-J Lenz
- Department of Internal Medicine, Division of Medical Oncology; Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles.
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Gerger A, Bohanes PO, Yang D, Winder T, Ning Y, Labonte MJ, Mauro DJ, Langer C, Rowinsky EK, Lenz H. Human epidermal growth factor receptor-2 (HER2) Ile655Val single nucleotide polymorphism (SNP) is associated with gender-specific outcome in patients with metastatic colorectal cancer (mCRC) treated with cetuximab in a phase II study (IMCL-0144). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
441 Background: HER2 pathway is an important growth-regulatory pathway in many malignancies. In-vitro data from various cell lines suggest that activation of HER family members predicts resistance to cetuximab. HER2 also interacts with hormone receptors and estrogen, promoting tumor proliferation in breast cancer models. We previously demonstrated that polymorphisms in HER1 and ER-β were associated with gender-specific survival in colorectal cancer patients. HER2 Ile655Val (rs1136201) SNP's functionality was shown in breast cell lines with Val-expressing cells exhibiting increase growth capacity. We tested whether this SNP may predict gender-specific clinical outcome in mCRC treated with cetuximab. Methods: Tissue samples of 130 patients, 64 males and 66 females, with mCRC, enrolled in a phase II trial of cetuximab monotherapy were analyzed. Genomic DNA was extracted from FFPE tumor tissue. K-Ras mutation status and HER2 Ile655Val (rs1136201) SNP were analyzed using direct DNA-sequencing and PCR-RFLP. 23 out of 130 patients were still alive at the time of data analysis with a median follow-up of 12.3 months. Results: Females with the low activity HER2 Ile/Ile (n = 41) genotype had better progression-free survival (PFS) when compared to Ile/Val or Val/Val (n = 21) genotypes (median PFS = 2.4 vs. 1.2 months; HR = 2.06 (95% CI: 1.08-3.92), p = 0.0281) based on the multivariable Cox regression model adjusting for KRAS, performance status and severity of skin rash and stratified by race. In KRAS wild-type females, 15 patients out of 20 (75%) with HER2 Ile/Ile genotype responded or had stable disease when compared to 4 out of 12 (33%) Ile/Val or Val/Val genotypes (exact conditional test p = 0.143). In males, HER2 Ile655Val SNP is not associated with outcome. HER2 Ile655Val SNP is not associated with gender-specific overall survival. Conclusions: Our data suggest that HER2 Ile655Val SNP may identify females with mCRC likely to experience better outcome when treated with cetuximab. Prospective biomarker-embedded clinical trials are needed to validate our results. [Table: see text]
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Affiliation(s)
- A. Gerger
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - P. O. Bohanes
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - D. Yang
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - T. Winder
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - Y. Ning
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - M. J. Labonte
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - D. J. Mauro
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - C. Langer
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - E. K. Rowinsky
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
| | - H. Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Merck, North Wales, PA; Genentech, South San Francisco, CA; ImClone Systems, Branchburg, NJ
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Zhang W, Labonte MJ, Yang D, Ning Y, Gerger A, Bohanes PO, Winder T, El-Khoueiry AB, Iqbal S, Lenz H. Use of genetic variants in formyl peptide receptor 2 (FPR2) to predict tumor recurrence in stage II colon cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.408] [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
408 Background: The formyl peptide receptor (FPR) is a G-protein-coupled receptor (GPCR) that mediates chemotaxis of phagocytic leucocytes induced by bacterial and host-derived chemotactic peptides. Recent studies found that it is selectively expressed in highly malignant gliomas and contributes to tumor growth and angiogenesis by mediating tumor cell chemotaxis, proliferation and production of chemokines and VEGF. Previously we demonstrated that polymorphisms in the VEGF pathway predict tumor recurrence in adjuvant colon cancer. Here we tested the hypothesis that two genetic variants in the FPR2 gene (rs17834679 and rs17694990) may predict tumor recurrence in a cohort of adjuvant colon cancer patients. Methods: Between 1992 and 2007, blood samples were obtained from 234 adjuvant colon caner patients (109 with stage II and 125 with stage III) at the USC medical facilities. Genomic DNA was extracted from peripheral blood and two potentially functional genotypes (rs17834679 and rs17694990) within the FPR2 gene were determined utilizing the PCR-RFLP technique. The median follow-up was 4.4 years (range: 0.3- 16.8). Ninety of 234 patients (38.5%) developed tumor recurrence with a 3-year probability of 0.34 ± 0.05. Results: In multivariable Cox proportional hazards regression analysis, FPR2 polymorphism rs17834679 was significantly associated with time to tumor recurrence (TTR) in stage II colon cancer (adjusted P = 0.027). Patients with CC genotype were at greatest risk of developing tumor recurrence (adjusted hazard ratio [HR]: 2.819 [95%CI: 1.127-7.051]) compared to those with GC and GG genotypes. In the dominant inheritance model, patients with any G allele had longer TTR (16.8 years+, median was not reached) compared to those with CC genotype (median TTR 5.4 years [95%CI: 3.2-10.7]; p=0.007, log-rank test). There are no significantly associations between FPR2 polymorphisms and TTR in stage III colon cancer. Conclusions: Polymorphisms in the FPR2 gene may serve as molecular markers for tumor recurrence in stage II colon cancer, indicating that the analysis of genetic variants of FPR2 may help to identify patient subgroups at high risk for tumor recurrence. No significant financial relationships to disclose.
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Affiliation(s)
- W. Zhang
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - M. J. Labonte
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - D. Yang
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Y. Ning
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - A. Gerger
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - P. O. Bohanes
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - T. Winder
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - A. B. El-Khoueiry
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - S. Iqbal
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - H. Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
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Winder T, Schuster A, Becherer A, Gasser K, De Vries A, Gruber-Moesenbacher U, Muendlein A, Drexel H, Lang A. Advanced inoperable type B3 thymoma: monitoring of a novel therapeutic approach with radio-chemotherapy and sorafenib by FDG-PET and CT. Nuklearmedizin 2010; 49:N41-N43. [PMID: 20931150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 05/21/2010] [Indexed: 05/30/2023]
Affiliation(s)
- T Winder
- Department of Medicine, Academic Teaching Hospital Feldkirch, Australia
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30
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Foley A, Hu Y, Zou Y, Yang M, Medne L, Leach M, Conlin L, Spinner N, Shaikh T, Neumeyer A, Bliss L, Winder T, Bönnemann C. P1.11 Large genomic deletions as a novel type of mutation in Ullrich CMD. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Zhang W, Winder T, Ning Y, Pohl A, Yang D, Kahn M, Lurje G, LaBonte MJ, Wilson PM, Gordon MA, Hu-Lieskovan S, Mauro DJ, Langer C, Rowinsky EK, Lenz HJ. A let-7 microRNA-binding site polymorphism in 3'-untranslated region of KRAS gene predicts response in wild-type KRAS patients with metastatic colorectal cancer treated with cetuximab monotherapy. Ann Oncol 2010. [PMID: 20603437 DOI: 10.1093/annonc/mdg315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE recent studies have found that KRAS mutations predict resistance to monoclonal antibodies targeting the epidermal growth factor receptor in metastatic colorectal cancer (mCRC). A polymorphism in a let-7 microRNA complementary site (lcs6) in the KRAS 3' untranslated region (UTR) is associated with an increased cancer risk in non-small-cell lung cancer and reduced overall survival (OS) in oral cancers. We tested the hypothesis whether this polymorphism may be associated with clinical outcome in KRAS wild-type (KRASwt) mCRC patients treated with cetuximab monotherapy. PATIENTS AND METHODS the presence of KRAS let-7 lcs6 polymorphism was evaluated in 130 mCRC patients who were enrolled in a phase II study of cetuximab monotherapy (IMCL-0144). Genomic DNA was extracted from dissected formalin-fixed paraffin-embedded tumor tissue, KRAS mutation status and polymorphism were assessed using direct sequencing and PCR restriction fragment length polymorphism technique. RESULTS KRAS let-7 lcs6 polymorphism was found to be related to object response rate (ORR) in mCRC patients whose tumors had KRASwt. The 12 KRASwt patients harboring at least a variant G allele (TG or GG) had a 42% ORR compared with a 9% ORR in 55 KRASwt patients with let-7 lcs6 TT genotype (P = 0.02, Fisher's exact test). KRASwt patients with TG/GG genotypes had trend of longer median progression-free survival (3.9 versus 1.3 months) and OS (10.7 versus 6.4 months) compared to those with TT genotypes. CONCLUSIONS these results are the first to indicate that the KRAS 3'UTR polymorphism may predict for cetuximab responsiveness in KRASwt mCRC patients, which warrants validation in other clinical trials.
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Affiliation(s)
- W Zhang
- Division of Medical Oncology
| | | | - Y Ning
- Division of Medical Oncology
| | - A Pohl
- Division of Medical Oncology
| | - D Yang
- Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - M Kahn
- Division of Medical Oncology
| | - G Lurje
- Department of Visceral- and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
| | - M J LaBonte
- Department of Pathology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - P M Wilson
- Department of Pathology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | | | | | - C Langer
- Early Oncology, Bristol-Myers Squibb Pharmaceuticals Limited, New York
| | | | - H-J Lenz
- Division of Medical Oncology; Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA.
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Zhang W, Winder T, Ning Y, Pohl A, Yang D, Kahn M, Lurje G, LaBonte MJ, Wilson PM, Gordon MA, Hu-Lieskovan S, Mauro DJ, Langer C, Rowinsky EK, Lenz HJ. A let-7 microRNA-binding site polymorphism in 3'-untranslated region of KRAS gene predicts response in wild-type KRAS patients with metastatic colorectal cancer treated with cetuximab monotherapy. Ann Oncol 2010; 22:104-109. [PMID: 20603437 DOI: 10.1093/annonc/mdq315] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE recent studies have found that KRAS mutations predict resistance to monoclonal antibodies targeting the epidermal growth factor receptor in metastatic colorectal cancer (mCRC). A polymorphism in a let-7 microRNA complementary site (lcs6) in the KRAS 3' untranslated region (UTR) is associated with an increased cancer risk in non-small-cell lung cancer and reduced overall survival (OS) in oral cancers. We tested the hypothesis whether this polymorphism may be associated with clinical outcome in KRAS wild-type (KRASwt) mCRC patients treated with cetuximab monotherapy. PATIENTS AND METHODS the presence of KRAS let-7 lcs6 polymorphism was evaluated in 130 mCRC patients who were enrolled in a phase II study of cetuximab monotherapy (IMCL-0144). Genomic DNA was extracted from dissected formalin-fixed paraffin-embedded tumor tissue, KRAS mutation status and polymorphism were assessed using direct sequencing and PCR restriction fragment length polymorphism technique. RESULTS KRAS let-7 lcs6 polymorphism was found to be related to object response rate (ORR) in mCRC patients whose tumors had KRASwt. The 12 KRASwt patients harboring at least a variant G allele (TG or GG) had a 42% ORR compared with a 9% ORR in 55 KRASwt patients with let-7 lcs6 TT genotype (P = 0.02, Fisher's exact test). KRASwt patients with TG/GG genotypes had trend of longer median progression-free survival (3.9 versus 1.3 months) and OS (10.7 versus 6.4 months) compared to those with TT genotypes. CONCLUSIONS these results are the first to indicate that the KRAS 3'UTR polymorphism may predict for cetuximab responsiveness in KRASwt mCRC patients, which warrants validation in other clinical trials.
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Affiliation(s)
- W Zhang
- Division of Medical Oncology
| | | | - Y Ning
- Division of Medical Oncology
| | - A Pohl
- Division of Medical Oncology
| | - D Yang
- Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
| | - M Kahn
- Division of Medical Oncology
| | - G Lurje
- Department of Visceral- and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
| | - M J LaBonte
- Department of Pathology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - P M Wilson
- Department of Pathology, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | | | | | - C Langer
- Early Oncology, Bristol-Myers Squibb Pharmaceuticals Limited, New York
| | | | - H-J Lenz
- Division of Medical Oncology; Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA.
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Bohanes PO, Winder T, Power DG, Yang D, Zhang W, Ning Y, Lurje G, Tang LH, Shah MA, Lenz H. Association of GRP78 gene polymorphism rs391957 with tumor recurrence in gastric and colon cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10524] [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] Open
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Lenz H, Zhang W, Yang D, El-Khoueiry AB, Ning Y, Pohl A, Bohanes PO, Danenberg KD, Winder T. Association of GRP78 polymorphisms with response and TTP in patients with mCRC treated with FOLFOX/BV or XELOX/BV. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3590] [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] Open
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35
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Winder T, Zhang W, Yang D, Ning Y, Bohanes PO, Hu-Lieskovan S, Mauro DJ, Langer C, Rowinsky EK, Lenz H. Use of germ-line polymorphisms in genes involved in the IGF pathway to predict efficacy of cetuximab independent of K-ras in mCRC patients (IMCL-0144). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3562] [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] Open
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36
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Ning Y, Winder T, Power DG, Yang D, Zhang W, Bohanes PO, Lurje G, Tang LH, Shah MA, Lenz H. Association of germline polymorphisms in genes involved in the CD44 pathway and clinical outcome in localized gastric adenocarcinoma (GA). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4047] [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] Open
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37
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Yang D, Zhang W, Winder T, Bohanes PO, Ning Y, Danenberg KD, El-Khoueiry AB, Wilson PM, Labonte MJ, Lenz H. Correlations of mRNA expression levels of genes in the targeted pathways and Kras mutation status in patients with colorectal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10641] [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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Lin EY, Bohanes PO, Yang D, Lurje G, Winder T, Ning Y, Ho E, Tang LH, Shah MA, Lenz H. Association of human epidermal growth factor receptor 2 (HER2) Ile655Val polymorphism (plrm) and gender-specific time to tumor recurrence (TTR) in patients (pts) with localized gastric adenocarcinoma (GA). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4093] [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] Open
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Wilson PM, Winder T, Power DG, Yang D, Zhang W, Ning Y, Bohanes PO, Tang LH, Shah MA, Lenz H. Association of germline polymorphism in the SPARC gene and tumor recurrence in patients with resected gastric cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4054] [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] Open
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40
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Labonte MJ, Yang D, Zhang W, Wilson PM, Ladner RD, Winder T, Bohanes PO, Ning Y, Lenz H. Correlation of cyclin D1, A870G, polymorphism, and clinical outcome in patients with HER2-positive, metastatic breast cancer treated with lapatinib plus capecitabine. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1015] [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] Open
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41
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Pohl A, Azuma M, Zhang W, Yang D, Ning Y, Winder T, Danenberg K, Lenz HJ. Pharmacogenetic profiling of Aurora kinase B is associated with overall survival in metastatic colorectal cancer. Pharmacogenomics J 2010; 11:93-9. [PMID: 20368716 DOI: 10.1038/tpj.2010.18] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aurora kinases are conserved eukaryotic serine-threonine kinases, which serve as key regulators of mammalian mitosis. Several studies revealed a distinct correlation between inaccurate chromosome segregation, leading to chromosomal number instability, cancer progression and poor outcome. The aim of this study was to investigate the correlation of Aurora kinases A (AURKA) and B (AURKB) with overall survival (OS) by quantifying gene expression analysis and evaluation of single-nucleotide polymorphisms (SNPs) in human colorectal cancer samples and assessing the associations with clinicopathological features. We evaluated intratumoral gene expression levels and SNPs of AURKA and -B from 41 patients with metastatic colorectal cancer (mCRC). Patients with a high expression level of AURKB (>1.28) lived significantly shorter (n=11, median OS=6.4 months, 95% confidence interval (CI): 3.0-14.5 months) compared with patients with a low expression level (≤ 1.28) (n=30, median OS=18.4 months, 95% CI: 14.7-27.8 months, P=0.026, Wald's test). Patients harboring any G-allele in AURKB 885A>G showed a significantly decreased OS (P=0.05, log-rank test). We did not find any associations with clinicopathological variables and AURKA gene expression levels. Our results suggest a potential role for AURKB inhibition in patients with mCRC; thereby supporting its potential role as a target in mCRC.
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Affiliation(s)
- A Pohl
- Division of Medical Oncology, Sharon A. Carpenter Laboratory, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Winder T, Schuster A, Becherer A, Gasser K, De Vries A, Gruber-Moesenbacher U, Muendlein A, Drexel H, Lang A. Advanced inoperable type B3 thymoma: Monitoring of a novel therapeutic approach with radio-chemo therapy and sorafenib by FDG-PET and CT. Nuklearmedizin 2010. [DOI: 10.1055/s-0038-1626515] [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: 10/28/2022]
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Knauer M, Haid A, Schneider Y, Köberle-Wührer R, Lang A, Winder T, Alton R, Jasarevic Z, Säly C, Offner F, Wenzl E, deVries A. Adjuvant extension of chemotherapy after neoadjuvant therapy may not improve outcome in early-stage breast cancer. Eur J Surg Oncol 2009; 35:798-804. [DOI: 10.1016/j.ejso.2008.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 10/01/2008] [Accepted: 10/02/2008] [Indexed: 10/21/2022] Open
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Muendlein A, Saely C, Rhomberg S, Sonderegger G, Rein P, Winder T, Beer S, Breuss J, Vonbank A. Abstract: P1256 TYPE 2 DIABETES SIGNIFICANTLY MODULATES THE IMPACT OF TCF7L2 RS7903146 VARIANT ON THE RISK OF CORONARY ATHEROSCLEROSIS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71273-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hartmann BL, Winder T, Sandholzer M, Gasser K, Jäger I, Lang AH, Längle M, Hartmann G, Bartenstein C, Luger C. JC papovavirus leukencephalopathy in a patient with B-CLL receiving long-term chemotherapy in combination with an anti-CD20-antibody. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e18007] [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
e18007 Background: Progressive multifocal leukencaphalopathy (PML) is a rare demyelinating infection of the central nervous system caused by viruses (CMV, JC, BK). It is almost exclusively described in profound immunocompromised patients developed as a primary infection or by reactivation of the virus after a latent infection. PML is typically observed among patients with severe immunodeficiency like HIV or in the setting of autologous or allogenic transplantation. Methods: Our patient was a 64-year-old woman with B-CLL diagnosed in 2000 in state B of Binet treated with 12 cycles of fludarabin until July 2007 in a B-cell and lymphoma-reducing manner. For the reason of progressive disease 3 cycles of rituximab, fludarabin, mitoxantrone, and cyclophosphamide were added (dose reduced causing hematologic toxicity) until October 2007 continuing rituximab once a month up to Mai 2008. Results: In a CT scan mixed response was observed with progressive disease infradiafragmatic and regression supradiafragmatic. Corticosteroids could stop B-symptoms and leads to a distinct shrinkage of the lymphomas within 2 weeks. Later on she presented with confusion and disorientation. An MRI of the brain showed subcortical and periventricular lesions with increased signal on T2-weighted and fluid attentuated inversion recovery (FLAIR) suggestive of a vascular origin. Her symptoms progressed by aphasia and weakness of the right leg corresponding to increased size and number of cerebral lesions. A lumbar puncture showed no malignant cells and no evidence of inflammation. A PCR analysis was negative for Toxoplasma gondii, HSV, VCV, CMV, EBV, and enterovirus but positive for JC-DNA (215.000 copies/ml). A rapid progression leads to death two months after onset of symptoms. Conclusions: Antibody deficiency syndrome corresponding to CLL under treatment with chemotherapy and rituximab lead to a severe immunosuppression enabling unusual viral infections such as PML. No significant financial relationships to disclose.
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Affiliation(s)
- B. L. Hartmann
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - T. Winder
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - M. Sandholzer
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - K. Gasser
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - I. Jäger
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - A. H. Lang
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - M. Längle
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - G. Hartmann
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - C. Bartenstein
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
| | - C. Luger
- Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Krankenhaus der Elisabethinen, Linz, Austria
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Winder T, Zhang W, El-Khoueiry A, Yang D, Pohl A, Lurje G, Rowinsky E, Khambata-Ford S, Langer C, Awad M, Lenz H. Association of a germ-line variant in the K-ras 3’ untranslated region with response and progression-free survival in patients with mCRC treated with single-agent cetuximab (IMCL-0144) or in combination with cetuximab (EPIC) independent of K-ras mutation status. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4061] [Citation(s) in RCA: 3] [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
4061 Background: Recent studies have found K-ras mutation status predicts response to EGFR inhibitors in mCRC. An in vitro study demonstrated let-7 microRNA family can regulate RAS expression by binding to the 3’UTR of RAS gene. Chin et al found a SNP in a let-7 microRNA complementary site (LCS) in the K-ras 3’ UTR increases cancer risk in NSCLC. We tested the hypothesis whether this SNP may be associated with clinical outcome in 130 mCRC patients enrolled in IMCL-0144 trial and in 186 pts enrolled in EPIC trial independent of K-Ras mutation status in the tumor. Methods: K-ras lcs 6 SNP was tested in 130 mCRC patients enrolled in IMC-0144 phase II clinical trial (single agent cetuximab) and in 186 mCRC patients enrolled in a second line phase III trial of cetuximab plus irinotecan versus irinotecan alone (EPIC). Genomic DNA was extracted from dissected formalin fixed paraffin embedded tumor tissue and K-ras mutation status and the polymorphism were analyzed using direct sequencing and PCR-RFLP technique. Results: The G harboring allele frequency in K-ras lcs6 was 8% in IMC-0144 and 11% in EPIC. K-ras lcs6 polymorphism was significantly associated with tumor response in patients with wild type K-ras in IMC-0144. The 12 pts harboring a G allele (TG+GG) had a 42% partial response (PR) rate compared to 55 pts with TT genotype with only 9% PR.(p=0.02, Fisher's-exact test). However, pts with TT genotype enrolled in EPIC treated with CPT-11 and cetuximab with mutant K-ras had a significantly better PFS of 12 weeks (95% CI 6.4–18) compared to those harboring the a G allele with median PFS of 6.4 weeks (95% 5.7–7) (p=0.037. log-rank test). There was no association between this polymorphism and clinical outcome in patients with wild type K-ras enrolled in EPIC. In a multivariate analysis the polymorphism remained independently associated with PFS in EPIC. Conclusions: Our data suggest for the first time that the functional germline polymorphism in K-ras lcs6 may be a potential predictive marker in mCRC patients treated with cetuximab-based chemotherapy independent of K-ras mutation status. This finding warranted further confirmative clinical trials. [Table: see text]
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Affiliation(s)
- T. Winder
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - W. Zhang
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - A. El-Khoueiry
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - D. Yang
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - A. Pohl
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - G. Lurje
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - E. Rowinsky
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - S. Khambata-Ford
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - C. Langer
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - M. Awad
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
| | - H. Lenz
- USC Norris Comprehensive Cancer Center, Los Angeles, CA; ImClone Systems, New York, NY; Bristol-Myers Squibb Pharmaceutical Research Institute, New York, NY
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Figueroa-Colon R, Mayo MS, Aldridge RA, Winder T, Weinsier RL. Body composition changes in Caucasian and African American children and adolescents with obesity using dual-energy X-ray absorptiometry measurements after a 10-week weight loss program. Obes Res 1998; 6:326-31. [PMID: 9738547 DOI: 10.1002/j.1550-8528.1998.tb00359.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Changes in body composition during a weight loss program have not been described in children. We wanted to test the hypothesis that weight loss can be achieved while maintaining total body fat-free mass. RESEARCH METHODS AND PROCEDURES We determined body composition changes by using dual-energy X-ray absorptiometry measured at baseline and after the first 10 weeks of a multidisciplinary weight loss program. The program consisted of 10 weekly group sessions where the children were provided instruction in lifestyle modification, including diet and exercise. Program leaders included a pediatrician, psychologist, registered dietitian, and exercise instructor. RESULTS We studied 59 obese children, mean (+/-SD) age 12.8+/-2.6 years, 29% boys and 71% girls, 49% Caucasian, and 51% African American. At enrollment, the children's mean height and body mass index were 157 cm and 38.9 kg/m2, respectively. The children's dual-energy X-ray absorptiometry-derived mean at baseline and at 10 weeks and corresponding p values were: weight (94.6 kg vs. 92.3 kg, p<0.0001), total body fat mass (46.9 kg vs. 44.3 kg, p<0.0001), percentage total body fat (49.2% vs. 47.5%, p<0.0001), total trunk mass (43.0 kg vs. 41.5 kg, p<0.0001), total trunk fat (21.2 kg vs. 20.0 kg, p<0.0001), total body fat-free mass (47.6 kg vs. 47.9 kg, p=0.33), total body bone mass (2.7 kg vs. 2.7 kg, p=0.99), and total body bone mineral density (1.14 g/cm2 vs. 1.15 g/cm2, p=0.0119). The children's race, gender, or Tanner stage did not affect these changes. DISCUSSION Decreases in total body fat mass was achieved, and total body fat-free mass was maintained among boy and girl Caucasian and African American children participating in this lifestyle modification weight loss program.
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Affiliation(s)
- R Figueroa-Colon
- Department of Pediatrics, Children's Hospital, University of Alabama at Birmingham, 35233, USA
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Winder T. Lipid profiles. Br J Hosp Med (Lond) 1994; 51:102-4. [PMID: 8193830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Lipid profiles are only part of the cardiovascular status of the patient. Treatment should be directed at the cause and not the lipid profile numbers. The minority of patients with serious problems should be defined and treated and the others should be left alone. There is no single magic drug and dietary advice can work well if given by experienced, personable professionals.
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Affiliation(s)
- T Winder
- Department of Chemical Pathology and Human Metabolism, Royal Free NHS Hospital Trust and School of Medicine, London
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Winder T. Consensus conferences as drug promotion. Lancet 1993; 341:368-9. [PMID: 8094129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Winder T. Cholesterol testing. Br J Hosp Med (Lond) 1992; 48:515. [PMID: 1422566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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