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Ellis RJ, Chenna A, Lie Y, Curanovic D, Winslow J, Tang B, Marra CM, Rubin LH, Clifford DB, McCutchan JA, Gelman BB, Robinson-Papp J, Petropoulos CJ, Letendre SL. Higher Levels of Cerebrospinal Fluid and Plasma Neurofilament Light in Human Immunodeficiency Virus-Associated Distal Sensory Polyneuropathy. Clin Infect Dis 2023; 76:1103-1109. [PMID: 36310512 PMCID: PMC10226757 DOI: 10.1093/cid/ciac851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Neurofilament light (NFL) chain concentrations, reflecting axonal damage, are seen in several polyneuropathies but have not been studied in human immunodeficiency virus (HIV) distal sensory polyneuropathy (DSP). We evaluated NFL in cerebrospinal fluid (CSF) and plasma in relation to DSP in people with HIV (PWH) from 2 independent cohorts and in people without HIV (PWoH). METHODS Cohort 1 consisted of PWH from the CHARTER Study. Cohort 2 consisted of PWH and PWoH from the HIV Neurobehavioral Research Center (HNRC). We evaluated DSP signs and symptoms in both cohorts. Immunoassays measured NFL in CSF for all and for plasma as well in Cohort 2. RESULTS Cohort 1 consisted of 111 PWH, mean ± SD age 56.8 ± 8.32 years, 15.3% female, 38.7% Black, 49.6% White, current CD4+ T-cells (median, interquartile range [IQR]) 532/µL (295, 785), 83.5% with plasma HIV RNA ≤50 copies/mL. Cohort 2 consisted of 233 PWH of similar demographics to PWH in Cohort 1 but also 51 PWoH, together age 58.4 ± 6.68 years, 41.2% female, 18.0% Black, Hispanic, non-Hispanic White 52.0%, 6.00% White. In both cohorts of PWH, CSF and plasma NFL were significantly higher in both PWH with DSP signs. Findings were similar, albeit not significant, for PWoH. The observed relationships were not explained by confounds. CONCLUSIONS Both plasma and CSF NFL were elevated in PWH and PWoH with DSP. The convergence of our findings with others demonstrates that NFL is a reliable biomarker reflecting peripheral nerve injury. Biomarkers such as NFL might provide, validate, and optimize clinical trials of neuroregenerative strategies in HIV DSP.
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Affiliation(s)
- Ronald J Ellis
- Department of Neurosciences, University of California, San Diego, San Diego, California, USA
| | - Ahmed Chenna
- Monogram Biosciences, South San Francisco, California, USA
| | - Yolanda Lie
- Monogram Biosciences, South San Francisco, California, USA
| | | | - John Winslow
- Monogram Biosciences, South San Francisco, California, USA
| | - Bin Tang
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Christina M Marra
- Deparment of Neurology, University of Washington, Seattle, Washington, USA
| | - Leah H Rubin
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - David B Clifford
- Department of Neurology, Washington University at St. Louis, St. Louis, Missouri, USA
| | - J Allen McCutchan
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Benjamin B Gelman
- Department of Neuroscience and Cell Biology, UTMB, Galveston, Texas, USA
| | - Jessica Robinson-Papp
- Department of Neurology, Icahn School of Medicine at Mt. Sinai, New York, New York, USA
| | | | - Scott L Letendre
- Departments of Medicine and Psychiatry, University of California, San Diego, San Diego, California, USA
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Zhao J, Lie Y, Chen ZG, Li JJ, Bu JH. [Analysis of Injury Motivation and Its Application in the Characterization of Suspects]. Fa Yi Xue Za Zhi 2022; 38:328-330. [PMID: 36221822 DOI: 10.12116/j.issn.1004-5619.2021.410610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Bonnefond H, Lie Y, Lacour T, Saint-Jean B, Carrier G, Pruvost E, Talec A, Bernard O, Sciandra A. Dynamical Darwinian selection of a more productive strain of Tisochrysis lutea. ALGAL RES 2022. [DOI: 10.1016/j.algal.2022.102743] [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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Tomic A, Skelly DT, Ogbe A, O'Connor D, Pace M, Adland E, Alexander F, Ali M, Allott K, Azim Ansari M, Belij-Rammerstorfer S, Bibi S, Blackwell L, Brown A, Brown H, Cavell B, Clutterbuck EA, de Silva T, Eyre D, Lumley S, Flaxman A, Grist J, Hackstein CP, Halkerston R, Harding AC, Hill J, James T, Jay C, Johnson SA, Kronsteiner B, Lie Y, Linder A, Longet S, Marinou S, Matthews PC, Mellors J, Petropoulos C, Rongkard P, Sedik C, Silva-Reyes L, Smith H, Stockdale L, Taylor S, Thomas S, Tipoe T, Turtle L, Vieira VA, Wrin T, Pollard AJ, Lambe T, Conlon CP, Jeffery K, Travis S, Goulder P, Frater J, Mentzer AJ, Stafford L, Carroll MW, James WS, Klenerman P, Barnes E, Dold C, Dunachie SJ. Divergent trajectories of antiviral memory after SARS-CoV-2 infection. Nat Commun 2022; 13:1251. [PMID: 35273178 PMCID: PMC8913789 DOI: 10.1038/s41467-022-28898-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/17/2022] [Indexed: 12/17/2022] Open
Abstract
The trajectories of acquired immunity to severe acute respiratory syndrome coronavirus 2 infection are not fully understood. We present a detailed longitudinal cohort study of UK healthcare workers prior to vaccination, presenting April-June 2020 with asymptomatic or symptomatic infection. Here we show a highly variable range of responses, some of which (T cell interferon-gamma ELISpot, N-specific antibody) wane over time, while others (spike-specific antibody, B cell memory ELISpot) are stable. We use integrative analysis and a machine-learning approach (SIMON - Sequential Iterative Modeling OverNight) to explore this heterogeneity. We identify a subgroup of participants with higher antibody responses and interferon-gamma ELISpot T cell responses, and a robust trajectory for longer term immunity associates with higher levels of neutralising antibodies against the infecting (Victoria) strain and also against variants B.1.1.7 (alpha) and B.1.351 (beta). These variable trajectories following early priming may define subsequent protection from severe disease from novel variants.
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Affiliation(s)
- Adriana Tomic
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
| | - Donal T Skelly
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Dept of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Ane Ogbe
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Daniel O'Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Matthew Pace
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Emily Adland
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Frances Alexander
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
| | - Mohammad Ali
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Kirk Allott
- Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Azim Ansari
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | | | - Sagida Bibi
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Luke Blackwell
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Anthony Brown
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Helen Brown
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Breeze Cavell
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
| | | | - Thushan de Silva
- The Florey Institute for Host-Pathogen Interactions and Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, UK
| | - David Eyre
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Big Data Institute, Nuffield Dept. of Population Health, University of Oxford, Oxford, UK
| | - Sheila Lumley
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Amy Flaxman
- Jenner Institute, University of Oxford, Oxford, UK
| | - James Grist
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
| | - Carl-Philipp Hackstein
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Rachel Halkerston
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
| | - Adam C Harding
- James & Lillian Martin Centre, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Jennifer Hill
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Tim James
- Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Cecilia Jay
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Síle A Johnson
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Oxford University Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Barbara Kronsteiner
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford Centre For Global Health Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Yolanda Lie
- Monogram Biosciences LabCorp, San Francisco, CA, USA
| | - Aline Linder
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Stephanie Longet
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Spyridoula Marinou
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Philippa C Matthews
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Jack Mellors
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
| | | | - Patpong Rongkard
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Cynthia Sedik
- Monogram Biosciences LabCorp, San Francisco, CA, USA
| | - Laura Silva-Reyes
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Holly Smith
- Jenner Institute, University of Oxford, Oxford, UK
| | - Lisa Stockdale
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Stephen Taylor
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
| | - Stephen Thomas
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
| | - Timothy Tipoe
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
| | - Lance Turtle
- HPRU in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust (a member of Liverpool Health Partners), Liverpool, UK
| | - Vinicius Adriano Vieira
- Peter Medawar Building for Pathogen Research, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Terri Wrin
- Monogram Biosciences LabCorp, San Francisco, CA, USA
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Teresa Lambe
- Jenner Institute, University of Oxford, Oxford, UK
| | - Chris P Conlon
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Katie Jeffery
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Simon Travis
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Philip Goulder
- Peter Medawar Building for Pathogen Research, Department of Paediatrics, University of Oxford, Oxford, UK
| | - John Frater
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alex J Mentzer
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Lizzie Stafford
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Miles W Carroll
- United Kingdom Health Security Agency, Porton Down, Wiltshire, England
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - William S James
- James & Lillian Martin Centre, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK.
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
- NIHR Oxford Biomedical Research Centre, Oxford, UK.
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Christina Dold
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Susanna J Dunachie
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Oxford Centre For Global Health Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
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5
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Landais E, Murrell B, Briney B, Murrell S, Rantalainen K, Berndsen ZT, Ramos A, Wickramasinghe L, Smith ML, Eren K, de Val N, Wu M, Cappelletti A, Umotoy J, Lie Y, Wrin T, Algate P, Chan-Hui PY, Karita E, Ward AB, Wilson IA, Burton DR, Smith D, Pond SLK, Poignard P. HIV Envelope Glycoform Heterogeneity and Localized Diversity Govern the Initiation and Maturation of a V2 Apex Broadly Neutralizing Antibody Lineage. Immunity 2017; 47:990-1003.e9. [PMID: 29166592 PMCID: PMC5736302 DOI: 10.1016/j.immuni.2017.11.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/08/2017] [Accepted: 10/31/2017] [Indexed: 01/16/2023]
Abstract
Understanding how broadly neutralizing antibodies (bnAbs) to HIV envelope (Env) develop during natural infection can help guide the rational design of an HIV vaccine. Here, we described a bnAb lineage targeting the Env V2 apex and the Ab-Env co-evolution that led to development of neutralization breadth. The lineage Abs bore an anionic heavy chain complementarity-determining region 3 (CDRH3) of 25 amino acids, among the shortest known for this class of Abs, and achieved breadth with only 10% nucleotide somatic hypermutation and no insertions or deletions. The data suggested a role for Env glycoform heterogeneity in the activation of the lineage germline B cell. Finally, we showed that localized diversity at key V2 epitope residues drove bnAb maturation toward breadth, mirroring the Env evolution pattern described for another donor who developed V2-apex targeting bnAbs. Overall, these findings suggest potential strategies for vaccine approaches based on germline-targeting and serial immunogen design.
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Affiliation(s)
- Elise Landais
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA; International AIDS Vaccine Initiative, New York, NY 10004, USA.
| | - Ben Murrell
- Department of Medicine, University of California San Diego, San Diego, CA 92103, USA
| | - Bryan Briney
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Sasha Murrell
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Kimmo Rantalainen
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Zachary T Berndsen
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Alejandra Ramos
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; International AIDS Vaccine Initiative, New York, NY 10004, USA
| | - Lalinda Wickramasinghe
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; International AIDS Vaccine Initiative, New York, NY 10004, USA
| | - Melissa Laird Smith
- Icahn School of Medicine and Icahn Institute for Genomics and Multiscale Biology at Mount Sinai, New York, NY 10029, USA
| | - Kemal Eren
- Biomedical Informatics, University of California San Diego, San Diego, CA 92103, USA; Bioinformatics and Systems Biology, University of California San Diego, San Diego, CA 92103, USA
| | - Natalia de Val
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Mengyu Wu
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Audrey Cappelletti
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Institut de Biologie Structurale, Université Grenoble Alpes, Commissariat a l'Energie Atomique, Centre National de Recherche Scientifique and Centre Hospitalier Universitaire Grenoble Alpes, 38044 Grenoble, France
| | - Jeffrey Umotoy
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; International AIDS Vaccine Initiative, New York, NY 10004, USA
| | - Yolanda Lie
- Monogram Biosciences Inc., Laboratory Corporation of America Holdings, San Francisco CA 94080, USA
| | - Terri Wrin
- Monogram Biosciences Inc., Laboratory Corporation of America Holdings, San Francisco CA 94080, USA
| | - Paul Algate
- Theraclone Sciences, Inc., Seattle, WA 98104, USA
| | | | - Etienne Karita
- Rwanda-Zambia HIV Research Group, Project San Francisco, Kigali, Rwanda
| | | | | | - Andrew B Ward
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Ian A Wilson
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA; Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Dennis R Burton
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA; Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery, The Scripps Research Institute, La Jolla, CA 92037, USA; Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard, Cambridge, MA 02114, USA
| | - Davey Smith
- Department of Medicine, University of California San Diego, San Diego, CA 92103, USA; Veterans Affairs Healthcare System, San Diego, CA 92161, USA
| | | | - Pascal Poignard
- International AIDS Vaccine Initiative Neutralizing Antibody Center, The Scripps Research Institute, La Jolla, CA 92037, USA; Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA; International AIDS Vaccine Initiative, New York, NY 10004, USA; Institut de Biologie Structurale, Université Grenoble Alpes, Commissariat a l'Energie Atomique, Centre National de Recherche Scientifique and Centre Hospitalier Universitaire Grenoble Alpes, 38044 Grenoble, France.
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Akiyama M, Reeves J, Lie Y, Agyemang L, Litwin A. Hepatitis C Resistance-Associated Variants Among People Who Inject Drugs Treated With Direct-Acting Antiviral-Containing Regimens. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Matthew Akiyama
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Jacqueline Reeves
- Monogram Biosciences, Laboratory Corporation of America Holdings, San Francisco, California
| | - Yolanda Lie
- Monogram Biosciences, Laboratory Corporation of America Holdings, San Francisco, California
| | - Linda Agyemang
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Alain Litwin
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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Porter DP, Toma J, Tan Y, Solberg O, Cai S, Kulkarni R, Andreatta K, Lie Y, Chuck SK, Palella F, Miller MD, White KL. Clinical Outcomes of Virologically-Suppressed Patients with Pre-existing HIV-1 Drug Resistance Mutations Switching to Rilpivirine/Emtricitabine/Tenofovir Disoproxil Fumarate in the SPIRIT Study. HIV Clin Trials 2016; 17:29-37. [PMID: 26899540 DOI: 10.1080/15284336.2015.1115585] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Antiretroviral regimen switching may be considered for HIV-1-infected, virologically-suppressed patients to enable treatment simplification or improve tolerability, but should be guided by knowledge of pre-existing drug resistance. The current study examined the impact of pre-existing drug resistance mutations on virologic outcomes among virologically-suppressed patients switching to Rilpivirine (RPV)/emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF). METHODS SPIRIT was a phase 3b study evaluating the safety and efficacy of switching to RPV/FTC/TDF in virologically-suppressed HIV-1-infected patients. Pre-existing drug resistance at baseline was determined by proviral DNA genotyping for 51 RPV/FTC/TDF-treated patients with known mutations by historical RNA genotype and matched controls and compared with clinical outcome at Week 48. RESULTS Drug resistance mutations in protease or reverse transcriptase were detected in 62.7% of patients by historical RNA genotype and in 68.6% by proviral DNA genotyping at baseline. Proviral DNA sequencing detected 89% of occurrences of NRTI and NNRTI resistance-associated mutations reported by historical genotype. Mutations potentially affecting RPV activity, including E138A/G/K/Q, Y181C, and H221Y, were detected in isolates from 11 patients by one or both assays. None of the patients with single mutants had virologic failure through Week 48. One patient with pre-existing Y181Y/C and M184I by proviral DNA genotyping experienced virologic failure. Nineteen patients with K103N present by historical genotype were confirmed by proviral DNA sequencing and 18/19 remained virologically-suppressed. DISCUSSION Virologic success rates were high among virologically-suppressed patients with pre-existing NRTI and NNRTI resistance-associated mutations who switched to RPV/FTC/TDF in the SPIRIT study. While plasma RNA genotyping remains preferred, proviral DNA genotyping may provide additional value in virologically-suppressed patients for whom historical resistance data are unavailable.
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Chumsri S, Sperinde J, Liu H, Gligorov J, Spano JP, Moreno-Aspitia A, McLaughlin SA, Winslow JW, Petropoulos CJ, Chenna A, Bates MP, Weidler JM, Lie Y, Huang W, Perez EA. Correlation of high p95HER2:HER2 ratio with poor outcome in two phase II clinical trials of trastuzumab-treated HER2-positive metastatic breast cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Heshan Liu
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | | | - Ahmed Chenna
- Monogram Biosciences, Inc., South San Francisco, CA
| | | | | | - Yolanda Lie
- Monogram Biosciences, South San Francisco, CA
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Sperinde J, Bachmeier B, Weidler JM, Lie Y, Chenna A, Winslow J, Engel J, Schubert-Fritschle G, Sommerhoff C, Petropoulos C, Bates M, Huang W, Nerlich A. Abstract P3-07-09: Quantitative p95HER2 protein expression is predictive of trastuzumab response in HER2-positive metastatic breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Expression of p95HER2 (p95), a truncated form of the HER2 receptor that lacks the trastuzumab binding site but retains kinase activity, has been reported as a prognostic biomarker for poor outcome in trastuzumab-treated HER2-positive metastatic breast cancer (MBC). However, the ability of p95 to predict trastuzumab benefit has not been demonstrated due to the difficulty in obtaining the appropriate control group, namely HER2+ MBC patients not treated with trastuzumab. In the current study, the predictive value of p95 expression was tested in a cohort comprised of HER2-positive MBC patients treated before the availability of trastuzumab and trastuzumab-treated HER2-positive MBC patients.
Methods: The current cohort was derived from 206 HER2-positive MBC patients in the Munich Cancer Registry with a median follow up of 64 months. Cases were divided between those that received trastuzumab (n=115) and those that were treated before the availability of trastuzumab (n=91). Quantitative p95 protein expression was measured in formalin-fixed paraffin-embedded samples using the p95 VeraTag® assay (Monogram Biosciences), which is specific for the active M611 form of p95. Quantitative total HER2 protein expression was measured using the HERmark® assay (Monogram Biosciences). p95 and HERmark cutoffs were pre-specified (Duchnowska, Clin Cancer Res, 20:2805, 2014 and Huang, Am J Clin Pathol, 134:303, 2010). Analyses with p95 were restricted to samples with confirmed HER2 overexpression by HERmark. All hazard ratios (HR) were stratified by estrogen receptor status and grade.
Results: Consistent with previous training (Sperinde, Clin Cancer Res, 16:4226, 2010) and validation (Duchnowska, Clin Cancer Res, 20:2805, 2014) datasets, subjects treated with trastuzumab experienced a shorter time to progression (TTP) when p95 expression levels were above the cutoff versus below the cutoff (HR = 3.8, p = 0.019). However, only a trend was observed between p95 expression levels and overall survival (HR = 2.2, p = 0.20), possibly due to a lower frequency of events and relatively small sample size. The predictive value of p95 was assessed by determining the benefit of adding trastuzumab to chemotherapy treatment in subsets below and above the p95 cutoff. As expected, patients with p95 below the cutoff experienced significant benefit in TTP from adding trastuzumab (HR = 0.13, p<0.001), whereas patients with p95 above the cutoff experienced less benefit (HR = 0.70, p=0.47). p95 expression level was predictive of trastuzumab response with an interaction p-value of 0.015. The results for OS were similar, however trastuzumab benefit was less distinct between the two groups (interaction p = 0.18); HR = 0.23, p = 0.0013 below the p95 cutoff versus HR = 0.50, p = 0.14 above the p95 cutoff.
Conclusions: In this dataset, quantitative p95 expression was predictive of trastuzumab treatment benefit in MBC. Patients with high p95 expression may be particularly good candidates for dual HER2 blockade, as reported in the NeoALTTO trial (Scaltriti, Clin Cancer Res, 21:569, 2015), or other additional therapies.
Citation Format: Sperinde J, Bachmeier B, Weidler JM, Lie Y, Chenna A, Winslow J, Engel J, Schubert-Fritschle G, Sommerhoff C, Petropoulos C, Bates M, Huang W, Nerlich A. Quantitative p95HER2 protein expression is predictive of trastuzumab response in HER2-positive metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-09.
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Affiliation(s)
- J Sperinde
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - B Bachmeier
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - JM Weidler
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - Y Lie
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - A Chenna
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - J Winslow
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - J Engel
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - G Schubert-Fritschle
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - C Sommerhoff
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - C Petropoulos
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - M Bates
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - W Huang
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
| | - A Nerlich
- Monogram Biosicences, Integrated Oncology, LabCorp, South San Francisco, CA; Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany; Formerly Monogram Biosicences, South San Francisco, CA; Munich Cancer Registry (MCR) of the Munich Tumour Centre, Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany; Munich Municipal Hospital, Munich, Germany
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Bachmeier B, Sperinde J, Weidler JM, Lie Y, Chenna A, Winslow J, Engel J, Schubert-Fritschle G, Sommerhoff C, Petropoulos CJ, Bates MP, Huang W, Nerlich A. Correlation of trastuzumab treatment benefit with quantitative HER2 expression levels in HER2 positive metastatic breast cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Beatrice Bachmeier
- Institute of laboratory medicine, Ludwig-Maximilians-University, Munich, Germany
| | | | | | - Yolanda Lie
- Monogram Biosciences, South San Francisco, CA
| | - Ahmed Chenna
- Monogram Biosciences, Inc., South San Francisco, CA
| | | | - Jutta Engel
- Institute of Medical Informatics, Biostatistics, and Epidemiology, LMU München, Munich, Germany
| | - Gabriele Schubert-Fritschle
- Institute of Medical Informatics, Biometry and Epidemiology (IBE), University Hospital of Munich, Munich, Germany
| | - Christian Sommerhoff
- Institute of laboratory medicine, Ludwig-Maximilians-University, Munich, Germany
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Sperinde J, Huang W, Vehtari A, Chenna A, Kellokumpu-Lehtinen PL, Winslow J, Bono P, Lie Y, Weidler J, Joensuu H. Abstract P3-06-03: Quantitative p95HER2 and HER2 correlations with outcome in the FinHer trial. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p3-06-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Expression of p95HER2 (p95), a truncated form of the HER2 receptor that lacks the trastuzumab binding site but retains kinase activity, appears to be a prognostic biomarker for poor trastuzumab treatment outcome in HER2-positive metastatic breast cancer. The impact of p95 expression on trastuzumab treatment efficacy in early HER2-positive breast cancer is less clear. In the current study, p95 expression levels were measured in HER2-positive patients from the phase III FinHer adjuvant trastuzumab trial and correlated with treatment outcome.
Methods: In the FinHer phase III trial, 232 HER2-positive early breast cancer patients were randomized to receive 9-weeks of trastuzumab treatment versus no trastuzumab treatment (control). Quantitative p95 protein expression was measured in formalin-fixed paraffin-embedded samples using the p95 VeraTag® assay (Monogram Biosciences), specific for the M611 form of p95. Quantitative HER2 protein expression was measured using the HERmark® assay (Monogram Biosciences). Time to distant recurrence (TDR) was used as the primary outcome measure.
Results: Sufficient tissue was available to measure p95 in 192 HER2-positive patients randomized to receive chemotherapy vs chemotherapy plus trastuzumab. The chemotherapy only (n=97) and chemotherapy plus trastuzumab (n=95) arms were first analyzed separately. In the chemotherapy only arm, increasing log(p95) correlated with shorter TDR (HR = 2.0; p = 0.02) when stratified by hormone receptor status, nodal status and chemotherapy regimen. In the chemotherapy plus trastuzumab arm, increasing log(p95) was not correlated with a shorter TDR (HR = 0.58; p = 0.19). Log(HER2) was not significantly correlated with TDR in either arm. In a combined analysis of both treatment arms, log(p95) was significantly correlated with trastuzumab treatment outcome in a multivariate model that included hormone receptor status, nodal status, chemotherapy regimen, log(p95) and treatment arm. Subset analyses of hormone receptor positive and negative groups indicated that the interaction of p95 expression with trastuzumab treatment was largely driven by the hormone receptor negative subset.
Conclusions: In the FinHer phase III adjuvant breast cancer trial, HER2-positive patients with elevated breast tumor p95HER2 expression experienced poor outcomes when treated with chemotherapy alone, whereas patients with elevated p95 expression experienced the most benefit when trastuzumab was added to chemotherapy. The different influence between hormone receptor subsets of p95 expression on trastuzumab response resembles the effect of HER2 expression on trastuzumab response in the NSABP B-31 trial (JNCI 105:1782, 2013).
Citation Format: Jeff Sperinde, Weidong Huang, Aki Vehtari, Ahmed Chenna, Pirkko-Liisa Kellokumpu-Lehtinen, John Winslow, Petri Bono, Yolanda Lie, Jodi Weidler, Heikki Joensuu. Quantitative p95HER2 and HER2 correlations with outcome in the FinHer trial [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-06-03.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Heikki Joensuu
- 5Helsinki University Central Hospital & Helsinki University
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Yardley DA, Kaufman PA, Huang W, Krekow L, Savin M, Lawler WE, Zrada S, Starr A, Einhorn H, Schwartzberg LS, Adams JW, Lie Y, Paquet AC, Sperinde J, Haddad M, Anderson S, Brigino M, Pesano R, Bates MP, Weidler J, Bosserman L. Quantitative measurement of HER2 expression in breast cancers: comparison with 'real-world' routine HER2 testing in a multicenter Collaborative Biomarker Study and correlation with overall survival. Breast Cancer Res 2015; 17:41. [PMID: 25886996 PMCID: PMC4391602 DOI: 10.1186/s13058-015-0543-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/27/2015] [Indexed: 01/09/2023] Open
Abstract
Introduction Accurate assessment of HER2 status is critical in determining appropriate therapy for breast cancer patients but the best HER2 testing methodology has yet to be defined. In this study, we compared quantitative HER2 expression by the HERmark™ Breast Cancer Assay (HERmark) with routine HER2 testing by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), and correlated HER2 results with overall survival (OS) of breast cancer patients in a multicenter Collaborative Biomarker Study (CBS). Methods Two hundred and thirty-two formalin-fixed, paraffin-embedded breast cancer tissues and local laboratory HER2 testing results were provided by 11 CBS sites. HERmark assay and central laboratory HER2 IHC retesting were retrospectively performed in a blinded fashion. HER2 results by all testing methods were obtained in 192 cases. Results HERmark yielded a continuum of total HER2 expression (H2T) ranging from 0.3 to 403 RF/mm2 (approximately 3 logs). The distribution of H2T levels correlated significantly (P <0.0001) with all routine HER2 testing results. The concordance of positive and negative values (equivocal cases excluded) between HERmark and routine HER2 testing was 84% for local IHC, 96% for central IHC, 85% for local FISH, and 84% for local HER2 status. OS analysis revealed a significant correlation of shorter OS with HER2 positivity by local IHC (HR = 2.6, P = 0.016), central IHC (HR = 3.2, P = 0.015), and HERmark (HR = 5.1, P <0.0001) in this cohort of patients most of whom received no HER2-targeted therapy. The OS curve of discordant low (HER2 positive but H2T low, 10% of all cases) was aligned with concordant negative (HER2 negative and H2T low, HR = 1.9, P = 0.444), but showed a significantly longer OS than concordant positive (HER2 positive and H2T high, HR = 0.31, P = 0.024). Conversely, the OS curve of discordant high (HER2 negative but H2T high, 9% of all cases) was aligned with concordant positive (HR = 0.41, P = 0.105), but showed a significantly shorter OS than concordant negative (HR = 41, P <0.0001). Conclusions Quantitative HER2 measurement by HERmark is highly sensitive, accurately quantifies HER2 protein expression and correlates well with routine HER2 testing. When HERmark and local HER2 results were discordant, HERmark more accurately predicted overall survival.
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Affiliation(s)
- Denise A Yardley
- Sarah Cannon Research Institute, 3322 West End Avenue, Nashville, TN, 37203, USA. .,Tennessee Oncology, PLLC, 250 25th Avenue North, Nashville, TN, 37203, USA.
| | - Peter A Kaufman
- Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03766, USA.
| | - Weidong Huang
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Lea Krekow
- Texas Oncology Bedford, 1615 Hospital Parkway, Bedford, TX, 76022, USA.
| | - Michael Savin
- Texas Oncology and Medical City, 7777 Forest Lane, Dallas, TX, 75230, USA.
| | - William E Lawler
- St. Jude Heritage Medical Group, 2720 Harbor Boulevard, Fullerton, CA, 92835, USA.
| | - Stephen Zrada
- The Center for Cancer and Hematologic Disease, 1930 New Jersey 70 (East), Cherry Hill, NJ, 08003, USA.
| | - Alexander Starr
- Monroe Medical Associates, 71 Ald Taylor Way, Harvey, IL, 60426, USA.
| | - Harvey Einhorn
- Swedish American Regional Medical Center, 1401 East State Street, Rockford, IL, 61104, USA.
| | | | - John W Adams
- Arlington Cancer Center, 906 West Randol Mill Road, Arlington, TX, 76012, USA.
| | - Yolanda Lie
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Agnes C Paquet
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Institut de Pharmacologie Moléculaire et Cellulaire-IPMC, Sophia Antipolis, 660 Route des Lucioles, 06560, Valbonne, France.
| | - Jeff Sperinde
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Mojgan Haddad
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: HealthTell, 3130 Crow Canyon Place, San Ramon, CA, 94583, USA.
| | - Steve Anderson
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA.
| | - Marlon Brigino
- Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc, Research Triangle Park, NC, 27709, USA.
| | - Rick Pesano
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Quest Diagnostics, 33608 Ortega Highway, San Juan Capistrano, CA, 92675, USA.
| | - Michael P Bates
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Cepheid, 904 East Caribbean Drive, Sunnyvale, CA, 94089, USA.
| | - Jodi Weidler
- Monogram Biosciences, Inc., 345 Oyster Point Boulevard, South San Francisco, CA, 37203, USA. .,Present address: Cepheid, 904 East Caribbean Drive, Sunnyvale, CA, 94089, USA.
| | - Linda Bosserman
- Wilshire Oncology Medical Group, 8283 Grove Avenue, Rancho Cucamonga, CA, 91730, USA. .,Present address: City of Hope, 1500 East Duarte Road, Rancho Cucamonga, CA, 91010, USA.
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Quashie PK, Oliviera M, Veres T, Osman N, Han YS, Hassounah S, Lie Y, Huang W, Mesplède T, Wainberg MA. Differential effects of the G118R, H51Y, and E138K resistance substitutions in different subtypes of HIV integrase. J Virol 2015. [PMID: 25552724 DOI: 10.1128/jvi.03353-3314] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2023] Open
Abstract
UNLABELLED Dolutegravir (DTG) is the latest antiretroviral (ARV) approved for the treatment of human immunodeficiency virus (HIV) infection. The G118R substitution, previously identified with MK-2048 and raltegravir, may represent the initial substitution in a dolutegravir resistance pathway. We have found that subtype C integrase proteins have a low enzymatic cost associated with the G118R substitution, mostly at the strand transfer step of integration, compared to either subtype B or recombinant CRF02_AG proteins. Subtype B and circulating recombinant form AG (CRF02_AG) clonal viruses encoding G118R-bearing integrases were severely restricted in their viral replication capacity, and G118R/E138K-bearing viruses had various levels of resistance to dolutegravir, raltegravir, and elvitegravir. In cell-free experiments, the impacts of the H51Y and E138K substitutions on resistance and enzyme efficiency, when present with G118R, were highly dependent on viral subtype. Sequence alignment and homology modeling showed that the subtype-specific effects of these mutations were likely due to differential amino acid residue networks in the different integrase proteins, caused by polymorphic residues, which significantly affect native protein activity, structure, or function and are important for drug-mediated inhibition of enzyme activity. This preemptive study will aid in the interpretation of resistance patterns in dolutegravir-treated patients. IMPORTANCE Recognized drug resistance mutations have never been reported for naive patients treated with dolutegravir. Additionally, in integrase inhibitor-experienced patients, only R263K and other previously known integrase resistance substitutions have been reported. Here we suggest that alternate resistance pathways may develop in non-B HIV-1 subtypes and explain how "minor" polymorphisms and substitutions in HIV integrase that are associated with these subtypes can influence resistance against dolutegravir. This work also highlights the importance of phenotyping versus genotyping when a strong inhibitor such as dolutegravir is being used. By characterizing the G118R substitution, this work also preemptively defines parameters for a potentially important pathway in some non-B HIV subtype viruses treated with dolutegravir and will aid in the inhibition of such a virus, if detected. The general inability of strand transfer-related substitutions to diminish 3' processing indicates the importance of the 3' processing step and highlights a therapeutic angle that needs to be better exploited.
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Affiliation(s)
- Peter K Quashie
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maureen Oliviera
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Tamar Veres
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nathan Osman
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ying-Shan Han
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Said Hassounah
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Yolanda Lie
- Monogram Biosciences, South San Francisco, California, USA
| | - Wei Huang
- Monogram Biosciences, South San Francisco, California, USA
| | - Thibault Mesplède
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Mark A Wainberg
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Duchnowska R, Sperinde J, Chenna A, Huang W, Weidler JM, Winslow J, Haddad M, Paquet A, Lie Y, Trojanowski T, Mandat T, Kowalczyk A, Czartoryska-Arłukowicz B, Radecka B, Jarosz B, Staszkiewicz R, Kalinka-Warzocha E, Chudzik M, Biernat W, Jassem J. Quantitative HER2 and p95HER2 levels in primary breast cancers and matched brain metastases. Neuro Oncol 2015; 17:1241-9. [PMID: 25681308 DOI: 10.1093/neuonc/nov012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/15/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Patients with advanced breast cancer positive for human epidermal growth factor receptor 2 (HER2) are at high risk for brain metastasis (BM). The prevalence and significance of expression of HER2 and its truncated form p95HER2 (p95) in BM is unknown. METHODS Seventy-five pairs of formalin-fixed paraffin-embedded samples from matched primary breast cancers (PBCs) and BM were assayed for quantitative p95 and HER2-total (H2T) protein expression using the p95 VeraTag and HERmark assays, respectively. RESULTS There was a net increase in p95 and H2T expression in BM relative to the matched PBC (median 1.5-fold, P = .0007 and 2.1-fold, P < .0001, respectively). Cases with H2T-positive tumors were more likely to have the largest (≥5-fold) increase in p95 (odds ratio = 6.3, P = .018). P95 positivity in PBC correlated with progression-free survival (hazard ratio [HR] = 2.2, P = .013), trended with shorter time to BM (HR = 1.8, P = .070), and correlated with overall survival (HR = 2.1, P = .042). P95 positivity in BM correlated with time to BM (HR = 2.0, P = .016) but did not correlate with overall survival from the time of BM diagnosis (HR = 1.2, P = .61). CONCLUSIONS This is the first study of quantitative p95 and HER2 expression in matched PBC and BM. BM of breast cancer shows significant increases in expression of both biomarkers compared with matched PBC. These data provide a rationale for future correlative studies on p95 and HER2 levels in BM.
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Affiliation(s)
- Renata Duchnowska
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Jeff Sperinde
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Ahmed Chenna
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Weidong Huang
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Jodi M Weidler
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - John Winslow
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Mojgan Haddad
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Agnes Paquet
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Yolanda Lie
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Tomasz Trojanowski
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Tomasz Mandat
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Anna Kowalczyk
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Bogumiła Czartoryska-Arłukowicz
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Barbara Radecka
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Bożena Jarosz
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Rafal Staszkiewicz
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Ewa Kalinka-Warzocha
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Małgorzata Chudzik
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Wojciech Biernat
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
| | - Jacek Jassem
- Military Institute of Medicine, Warsaw, Poland (R.D.); Monogram Biosciences, Inc, South San Francisco, California (J.S., A.C., W.H., J.M.W., J.W., M.H., A.P., Y.L.); Medical University of Lublin, Lublin, Poland (T.T., B.J.); Institute of Oncology, Warsaw, Poland (T.M.); Białystok Oncology Center, Białystok, Poland (B.C.-A.); Opole Oncology Center, Opole, Poland (B.R.); Interior Affairs Hospital, Olsztyn, Poland (R.S.); Regional Oncology Center, Łódź, Poland (E.K.-W.); Oncology Center, Warsaw, Poland (M.C.); Medical University of Gdańsk, Gdańsk, Poland (A.K., W.B., J.J.)
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15
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Arruda LB, Araújo MLD, Martinez ML, Gonsalez CR, Duarte AJDS, Coakley E, Lie Y, Casseb J. Determination of viral tropism by genotyping and phenotyping assays in Brazilian HIV-1-infected patients. Rev Inst Med Trop Sao Paulo 2014; 56:287-90. [PMID: 25076427 PMCID: PMC4131812 DOI: 10.1590/s0036-46652014000400003] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 01/30/2014] [Indexed: 12/03/2022] Open
Abstract
The clinical application of CCR5 antagonists involves first determining
the coreceptor usage by the infecting viral strain. Bioinformatics programs that
predict coreceptor usage could provide an alternative method to screen candidates for
treatment with CCR5 antagonists, particularly in countries with limited financial
resources. Thus, the present study aims to identify the best approach using
bioinformatics tools for determining HIV-1 coreceptor usage in clinical practice.
Proviral DNA sequences and Trofile results from 99 HIV-1-infected subjects under
clinical monitoring were analyzed in this study. Based on the Trofile results, the
viral variants present were 81.1% R5, 21.4% R5X4 and 1.8% X4. Determination of
tropism using a Geno2pheno[coreceptor] analysis with a false positive rate
of 10% gave the most suitable performance in this sampling: the R5 and X4 strains
were found at frequencies of 78.5% and 28.4%, respectively, and there was 78.6%
concordance between the phenotypic and genotypic results. Further studies are needed
to clarify how genetic diversity amongst virus strains affects bioinformatics-driven
approaches for determining tropism. Although this strategy could be useful for
screening patients in developing countries, some limitations remain that restrict the
wider application of coreceptor usage tests in clinical practice.
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Affiliation(s)
- Liã Bárbara Arruda
- Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - Marilia Ladeira de Araújo
- Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology School of Medicine at University of São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - Maira Luccia Martinez
- Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology School of Medicine at University of São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - Claudio Roberto Gonsalez
- HIV Out-clinic, Ambulatory of Secondary Immunodeficiencies, ADEE3002, Department of Dermatology, Hospital of Clinics at School of Medicine, University of São Paulo
| | - Alberto José da Silva Duarte
- Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology School of Medicine at University of São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - Eoin Coakley
- Monogram Biosciences, Inc., South San Francisco, CA, USA
| | - Yolanda Lie
- Monogram Biosciences, Inc., South San Francisco, CA, USA
| | - Jorge Casseb
- Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, SP, Brazil
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16
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Landais E, Briney BS, Kosakovsky-Pond SL, MacLeod DT, Lie Y, Algate P, Burton DR, Wrin T, Chan-Hui PY, Poignard P. Development of a V1/V2-targeting Quaternary-specific Broadly Neutralizing Lineage. AIDS Res Hum Retroviruses 2014. [DOI: 10.1089/aid.2014.5054.abstract] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elise Landais
- The International AIDS Vaccine Initiative, Neutralizing Antibody Center, La Jolla, CA, United States
| | - Bryan S. Briney
- The Scripps Research Institute, Department of Immunology and Microbial Sciences, La Jolla, CA, United States
| | | | - Daniel T. MacLeod
- The International AIDS Vaccine Initiative, Neutralizing Antibody Center, La Jolla, CA, United States
| | - Yolanda Lie
- Monogram Biosciences Inc, San Francisco, CA, United States
| | - Paul Algate
- Theraclone Sciences Inc., Seattle, WA, United States
| | - Dennis R. Burton
- The Scripps Research Institute, Department of Immunology and Microbial Sciences, La Jolla, CA, United States
| | - Terri Wrin
- Monogram Biosciences Inc, San Francisco, CA, United States
| | | | - Pascal Poignard
- The International AIDS Vaccine Initiative, Neutralizing Antibody Center, La Jolla, CA, United States
- The Scripps Research Institute, Department of Immunology and Microbial Sciences, La Jolla, CA, United States
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17
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Lipton A, Goodman L, Leitzel K, Cook J, Sperinde J, Haddad M, Köstler WJ, Huang W, Weidler JM, Ali S, Newton A, Fuchs EM, Paquet A, Singer CF, Horvat R, Jin X, Banerjee J, Mukherjee A, Tan Y, Shi Y, Chenna A, Larson J, Lie Y, Sherwood T, Petropoulos CJ, Williams S, Winslow J, Parry G, Bates M. HER3, p95HER2, and HER2 protein expression levels define multiple subtypes of HER2-positive metastatic breast cancer. Breast Cancer Res Treat 2014; 141:43-53. [PMID: 23959396 PMCID: PMC3758835 DOI: 10.1007/s10549-013-2665-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/05/2013] [Indexed: 01/06/2023]
Abstract
Trastuzumab is effective in the treatment of HER2/neu over-expressing breast cancer, but not all patients benefit from it. In vitro data suggest a role for HER3 in the initiation of signaling activity involving the AKT–mTOR pathway leading to trastuzumab insensitivity. We sought to investigate the potential of HER3 alone and in the context of p95HER2 (p95), a trastuzumab resistance marker, as biomarkers of trastuzumab escape. Using the VeraTag® assay platform, we developed a dual antibody proximity-based assay for the precise quantitation of HER3 total protein (H3T) from formalin-fixed paraffin-embedded (FFPE) breast tumors. We then measured H3T in 89 patients with metastatic breast cancer treated with trastuzumab-based therapy, and correlated the results with progression-free survival and overall survival using Kaplan–Meier and decision tree analyses that also included HER2 total (H2T) and p95 expression levels. Within the sub-population of patients that over-expressed HER2, high levels of HER3 and/or p95 protein expression were significantly associated with poor clinical outcomes on trastuzumab-based therapy. Based on quantitative H3T, p95, and H2T measurements, multiple subtypes of HER2-positive breast cancer were identified that differ in their outcome following trastuzumab therapy. These data suggest that HER3 and p95 are informative biomarkers of clinical outcomes on trastuzumab therapy, and that multiple subtypes of HER2-positive breast cancer may be defined by quantitative measurements of H3T, p95, and H2T.
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Affiliation(s)
- Allan Lipton
- Breast Oncology Research, Division of Hematology/Oncology, Department of Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
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18
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Duchnowska R, Sperinde J, Chenna A, Haddad M, Paquet A, Lie Y, Weidler JM, Huang W, Winslow J, Jankowski T, Czartoryska-Arłukowicz B, Wysocki PJ, Foszczyńska-Kłoda M, Radecka B, Litwiniuk MM, Zok J, Wiśniewski M, Zuziak D, Biernat W, Jassem J. Quantitative measurements of tumoral p95HER2 protein expression in metastatic breast cancer patients treated with trastuzumab: independent validation of the p95HER2 clinical cutoff. Clin Cancer Res 2014; 20:2805-13. [PMID: 24668646 DOI: 10.1158/1078-0432.ccr-13-2782] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE P95HER2 (p95) is a truncated form of the HER2, which lacks the trastuzumab-binding site and contains a hyperactive kinase domain. Previously, an optimal clinical cutoff of p95 expression for progression-free survival (PFS) and overall survival (OS) was defined using a quantitative VeraTag assay (Monogram Biosciences) in a training set of trastuzumab-treated metastatic breast cancer (MBC) patients. EXPERIMENTAL DESIGN In the current study, the predictive value of the p95 VeraTag assay cutoff established in the training set was retrospectively validated for PFS and OS in an independent series of 240 trastuzumab-treated MBC patients from multiple institutions. RESULTS In the subset of 190 tumors assessed as HER2-total (H2T)-positive using the quantitative HERmark assay (Monogram Biosciences), p95 VeraTag values above the predefined cutoff correlated with shorter PFS (HR = 1.43; P = 0.039) and shorter OS (HR = 1.94; P = 0.0055) where both outcomes were stratified by hormone receptor status and tumor grade. High p95 expression correlated with shorter PFS (HR = 2.41; P = 0.0003) and OS (HR = 2.57; P = 0.0025) in the hormone receptor-positive subgroup of patients (N = 78), but not in the hormone receptor-negative group. In contrast with the quantitative p95 VeraTag measurements, p95 immunohistochemical expression using the same antibody was not significantly correlated with outcomes. CONCLUSIONS The consistency in the p95 VeraTag cutoff across different cohorts of patients with MBC treated with trastuzumab justifies additional studies using blinded analyses in larger series of patients.
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Affiliation(s)
- Renata Duchnowska
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jeff Sperinde
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Ahmed Chenna
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Mojgan Haddad
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Agnes Paquet
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Yolanda Lie
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jodi M Weidler
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Weidong Huang
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - John Winslow
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Tomasz Jankowski
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Bogumiła Czartoryska-Arłukowicz
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Piotr J Wysocki
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Małgorzata Foszczyńska-Kłoda
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Barbara Radecka
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Maria M Litwiniuk
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jolanta Zok
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Michał Wiśniewski
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Dorota Zuziak
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Wojciech Biernat
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
| | - Jacek Jassem
- Authors' Affiliations: Military Institute of Medicine, Warsaw; Lublin Oncology Center, Lublin; Białystok Oncology Center, Białystok; Greater Poland Cancer Center, Poznań; West Pomeranian Oncology Center, Szczecin; Opole Oncology Center, Opole; Warmia and Masuria Oncology Center, Olsztyn; Bydgoszcz Oncology Center, Bydgoszcz; Beskidy Oncology Center, Bielsko-Biała; Medical University of Gdańsk, Gdańsk, Poland; and Monogram Biosciences, Inc., South San Francisco, California
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19
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Ransy DG, Motorina A, Merindol N, Akouamba BS, Samson J, Lie Y, Napolitano LA, Lapointe N, Boucher M, Soudeyns H. Evolution of HIV-1 coreceptor usage and coreceptor switching during pregnancy. AIDS Res Hum Retroviruses 2014; 30:312-24. [PMID: 24090041 DOI: 10.1089/aid.2013.0155] [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: 11/13/2022] Open
Abstract
Coreceptor switch from CCR5 to CXCR4 is associated with HIV disease progression. To document the evolution of coreceptor tropism during pregnancy, a longitudinal study of envelope gene sequences was performed in a group of pregnant women infected with HIV-1 of clade B (n=10) or non-B (n=9). Polymerase chain reaction (PCR) amplification of the V1-V3 region was performed on plasma viral RNA, followed by cloning and sequencing. Using geno2pheno and PSSMX4R5, the presence of X4 variants was predicted in nine of 19 subjects (X4 subjects) independent of HIV-1 clade. Six of nine X4 subjects exhibited CD4(+) T cell counts <200 cells/mm(3), and the presence of X4-capable virus was confirmed using a recombinant phenotypic assay in four of seven cases where testing was successful. In five of nine X4 subjects, a statistically significant decline in the geno2pheno false-positive rate was observed during the course of pregnancy, invariably accompanied by progressive increases in the PSSMX4R5 score, the net charge of V3, and the relative representation of X4 sequences. Evolution toward X4 tropism was also echoed in the primary structure of V2, as an accumulation of substitutions associated with CXCR4 tropism was seen in X4 subjects. Results from these experiments provide the first evidence of the ongoing evolution of coreceptor utilization from CCR5 to CXCR4 during pregnancy in a significant fraction of HIV-infected women. These results inform changes in host-pathogen interactions that lead to a directional shaping of viral populations and viral tropism during pregnancy, and provide insights into the biology of HIV transmission from mother to child.
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Affiliation(s)
- Doris G. Ransy
- Unité d'immunopathologie virale, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Alena Motorina
- Unité d'immunopathologie virale, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Natacha Merindol
- Unité d'immunopathologie virale, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Bertine S. Akouamba
- Unité d'immunopathologie virale, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Johanne Samson
- Centre maternel et infantile sur le SIDA, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Yolanda Lie
- Monogram Biosciences Inc., South San Francisco, California
| | | | - Normand Lapointe
- Centre maternel et infantile sur le SIDA, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Marc Boucher
- Centre maternel et infantile sur le SIDA, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Hugo Soudeyns
- Unité d'immunopathologie virale, Centre de recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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20
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Duchnowska R, Sperinde J, Chenna A, Huang W, Weidler J, Winslow J, Haddad M, Paquet A, Lie Y, Trojanowski T, Mandat T, Kowalczyk A, Czartoryska-Arlukowicz B, Radecka B, Jarosz B, Staszkiewicz R, Kalinka-Warzocha E, Chudzik M, Biernat W, Jassem J. Abstract P6-11-07: Quantitative p95HER2 levels in primary breast cancers and in matched brain metastases. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-11-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Patients with HER2-positive breast cancer are at high risk for brain metastases. A large number of HER2-positive tumors also express p95HER2 (p95), a truncated form of HER2 that lacks the trastuzumab binding site but retains kinase activity. Although p95 expression in primary breast tumors is well studied, the prevalence and significance of p95 expression in brain metastases is unknown. In the current study we examined expression of p95 in brain metastases and in matched primary breast tumors.
Methods: Seventy-five pairs of formalin-fixed paraffin-embedded samples from matched primary breast cancers and brain metastases were assayed for quantitative p95 protein expression using the p95 VeraTag® assay (Clin Cancer Res, 16:4226, 2010) specific for the M611 form of p95. Sufficient material to obtain p95 data in both primary and matched brain metastasis samples was available in 52 cases. In the remaining 23 cases, a p95 measurement was obtained in either the primary or brain metastasis sample. Estrogen (ER) and progesterone (PR) receptor status were scored using immunohistochemistry. Hormone receptor positivity was defined as either ER or PR positive. Quantitative HER2 protein expression was measured using the HERmark® assay. Both the p95 VeraTag assay and the HERmark assay measure tumor-averaged protein expression in units of relative fluorescence per mm2 tumor (RF/mm2). Measurements of p95 > 2.8 RF/mm2 and HER2 > 17.8 RF/mm2 were considered as positive results.
Results: There was a net increase in p95 expression in brain metastases relative to the matched primary tumor with a median increase of 1.5-fold (p = 0.001, range 0.2-fold to 35-fold). The increase in p95 expression was only weakly correlated with the increase in quantitative HER2 expression (R2 = 0.18; p = 0.0018). Cases with HERmark-positive tumors were more likely to have the largest (≥ 5-fold) increase in p95 expression compared to those with lower HER2 expression (odds ratio = 6.3; p = 0.018). Changes in p95 levels from primary to brain metastasis were unrelated to hormone receptor status (p = 0.59). P95 positivity in the primary tumor correlated with time from breast cancer diagnosis to first progression (HR = 2.2; p = 0.012) when stratified by hormone receptor status and tumor grade. Although there was a trend towards correlation of p95 positivity in the brain metastasis with time from diagnosis to brain metastasis (HR = 1.7; p = 0.058, stratified as above), p95 positivity did not correlate with overall survival from the time of brain metastasis diagnosis (HR = 1.3; p = 0.42, stratified as above).
Conclusions: This is the first study of quantitative p95 expression in matched primary tumors and brain metastases. Brain metastases of breast cancer show significant increases in p95 protein expression compared to matched primary tumors. These data provide a rationale for future correlative studies on p95 levels in brain metastases.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-11-07.
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Affiliation(s)
- R Duchnowska
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - J Sperinde
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - A Chenna
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - W Huang
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - J Weidler
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - J Winslow
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - M Haddad
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - A Paquet
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - Y Lie
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - T Trojanowski
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - T Mandat
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - A Kowalczyk
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - B Czartoryska-Arlukowicz
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - B Radecka
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - B Jarosz
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - R Staszkiewicz
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - E Kalinka-Warzocha
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - M Chudzik
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - W Biernat
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
| | - J Jassem
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences, Integrated Oncology, LabCorp, South San Francisco, CA; Medical University of Lublin, Lublin, Poland; Institute of Oncology, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Bialystok Oncology Center, Bialystok, Poland; Opole Oncology Center, Opole, Poland; Interior Affairs Hospital, Olsztyn, Poland; Regional Oncology Center, Lodz, Poland; Oncology Center, Warsaw, Poland
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21
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Pou C, Codoñer FM, Thielen A, Bellido R, Pérez-Álvarez S, Cabrera C, Dalmau J, Curriu M, Lie Y, Noguera-Julian M, Puig J, Martínez-Picado J, Blanco J, Coakley E, Däumer M, Clotet B, Paredes R. HIV-1 tropism testing in subjects achieving undetectable HIV-1 RNA: diagnostic accuracy, viral evolution and compartmentalization. PLoS One 2013; 8:e67085. [PMID: 23936293 PMCID: PMC3731261 DOI: 10.1371/journal.pone.0067085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 05/15/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Technically, HIV-1 tropism can be evaluated in plasma or peripheral blood mononuclear cells (PBMCs). However, only tropism testing of plasma HIV-1 has been validated as a tool to predict virological response to CCR5 antagonists in clinical trials. The preferable tropism testing strategy in subjects with undetectable HIV-1 viremia, in whom plasma tropism testing is not feasible, remains uncertain. METHODS & RESULTS We designed a proof-of-concept study including 30 chronically HIV-1-infected individuals who achieved HIV-1 RNA <50 copies/mL during at least 2 years after first-line ART initiation. First, we determined the diagnostic accuracy of 454 and population sequencing of gp120 V3-loops in plasma and PBMCs, as well as of MT-2 assays before ART initiation. The Enhanced Sensitivity Trofile Assay (ESTA) was used as the technical reference standard. 454 sequencing of plasma viruses provided the highest agreement with ESTA. The accuracy of 454 sequencing decreased in PBMCs due to reduced specificity. Population sequencing in plasma and PBMCs was slightly less accurate than plasma 454 sequencing, being less sensitive but more specific. MT-2 assays had low sensitivity but 100% specificity. Then, we used optimized 454 sequence data to investigate viral evolution in PBMCs during viremia suppression and only found evolution of R5 viruses in one subject. No de novo CXCR4-using HIV-1 production was observed over time. Finally, Slatkin-Maddison tests suggested that plasma and cell-associated V3 forms were sometimes compartmentalized. CONCLUSIONS The absence of tropism shifts during viremia suppression suggests that, when available, testing of stored plasma samples is generally safe and informative, provided that HIV-1 suppression is maintained. Tropism testing in PBMCs may not necessarily produce equivalent biological results to plasma, because the structure of viral populations and the diagnostic performance of tropism assays may sometimes vary between compartments. Thereby, proviral DNA tropism testing should be specifically validated in clinical trials before it can be applied to routine clinical decision-making.
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Affiliation(s)
- Christian Pou
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
- * E-mail: (CP); (RP)
| | - Francisco M. Codoñer
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | | | - Rocío Bellido
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Susana Pérez-Álvarez
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Cecilia Cabrera
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Judith Dalmau
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Marta Curriu
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Yolanda Lie
- Monogram Biosciences Inc., South San Francisco, California, United States of America
| | - Marc Noguera-Julian
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Jordi Puig
- HIV Unit-Fundació Lluita contra la SIDA, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Javier Martínez-Picado
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Julià Blanco
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Eoin Coakley
- Monogram Biosciences Inc., South San Francisco, California, United States of America
| | - Martin Däumer
- Institut für Immunologie und Genetik, Kaiserlautern, Germany
| | - Bonaventura Clotet
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
- HIV Unit-Fundació Lluita contra la SIDA, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Roger Paredes
- Institut de Recerca de la SIDA irsiCaixa – HIVACAT, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
- HIV Unit-Fundació Lluita contra la SIDA, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Catalonia, Spain
- * E-mail: (CP); (RP)
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Duchnowska R, Sperinde J, Haddad M, Chenna A, Paquet A, Lie Y, Weidler J, Huang W, Winslow JW, Jankowski T, Czartoryska-Arlukowicz B, Wysocki PJ, Foszczynska-Kloda M, Radecka B, Litwiniuk MM, Zok J, Wisniewski M, Zuziak D, Biernat W, Jassem J. Quantitative measurements of p95HER2 (p95) protein expression in tumors from patients with metastatic breast cancer (MBC) treated with trastuzumab: Independent confirmation of the p95 clinical cutoff. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.604] [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
604 Background: Expression of p95 in HER2-positive breast cancer is potentially a major determinant of trastuzumab resistance because p95 lacks the trastuzumab binding site while retaining kinase activity. Previously, an optimal clinical cutoff for a continuous measurement of p95 expression was defined in a training set of trastuzumab-treated MBC patients (Clin Cancer Res, 16:4226, 2010). Methods: Quantitative H2T (HERmark HER2-total) and p95 assays (VeraTag, Monogram Biosciences) were retrospectively performed on formalin-fixed, paraffin-embedded tumors from an independent series of 240 trastuzumab-treated MBC patients. The pre-specified cutoff for p95 was tested to determine whether p95 above the cutoff in the HER2-positive subset correlated with worse progression-free survival (PFS) and overall survival (OS), as was observed in the training set. P95 expression was also assessed by immunohistochemistry (IHC) using the same antibody as the p95 VeraTag assay. Results: In the subset of tumors assessed as H2T-positive (N=190), p95 VeraTag values above the pre-defined cutoff correlated with shorter PFS (HR=1.41; p=0.043) and shorter OS (HR=1.72; p=0.021) where both outcomes were stratified by hormone receptor status and tumor grade. The hormone receptor positive patients (N=78) primarily drove the shorter PFS (HR=2.08, p=0.0026) and OS (HR=2.28, p=0.0099) observed in the p95-high subset. In contrast to the quantitative p95 VeraTag measurements, p95 IHC was not significantly correlated with outcomes. Conclusions: A clinical p95 cutoff (VeraTag assay) predictive of clinical outcomes derived from a previous training dataset was confirmed in a second independent clinical series. In contrast, p95 IHC did not correlate with outcomes. The observed consistency in the p95 VeraTag cutoff across different cohorts of MBC patients treated with trastuzumab justifies additional studies employing blinded analyses in larger series of patients. Clinical relevance of p95 protein expression remains to be established in a controlled clinical trial.
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Affiliation(s)
| | | | | | - Ahmed Chenna
- Monogram Biosciences, Inc., South San Francisco, CA
| | - Agnes Paquet
- Monogram Biosciences, Inc., South San Francisco, CA
| | - Yolanda Lie
- Monogram Biosciences, Inc., South San Francisco, CA
| | - Jodi Weidler
- Monogram Biosciences, Inc., South San Francisco, CA
| | | | | | | | | | - Piotr Jan Wysocki
- Greater Poland Cancer Center, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | - Jolanta Zok
- Warmia and Masuria Oncology Center, Olsztyn, Poland
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Mulinge M, Lemaire M, Servais JY, Rybicki A, Struck D, da Silva ES, Verhofstede C, Lie Y, Seguin-Devaux C, Schmit JC, Bercoff DP. HIV-1 tropism determination using a phenotypic Env recombinant viral assay highlights overestimation of CXCR4-usage by genotypic prediction algorithms for CRF01_AE and CRF02_AG [corrected]. PLoS One 2013; 8:e60566. [PMID: 23667426 PMCID: PMC3648519 DOI: 10.1371/journal.pone.0060566] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/28/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Human Immunodeficiency virus type-1 (HIV) entry into target cells involves binding of the viral envelope (Env) to CD4 and a coreceptor, mainly CCR5 or CXCR4. The only currently licensed HIV entry inhibitor, maraviroc, targets CCR5, and the presence of CXCX4-using strains must be excluded prior to treatment. Co-receptor usage can be assessed by phenotypic assays or through genotypic prediction. Here we compared the performance of a phenotypic Env-Recombinant Viral Assay (RVA) to the two most widely used genotypic prediction algorithms, Geno2Pheno[coreceptor] and webPSSM. METHODS Co-receptor tropism of samples from 73 subtype B and 219 non-B infections was measured phenotypically using a luciferase-tagged, NL4-3-based, RVA targeting Env. In parallel, tropism was inferred genotypically from the corresponding V3-loop sequences using Geno2Pheno[coreceptor] (5-20% FPR) and webPSSM-R5X4. For discordant samples, phenotypic outcome was retested using co-receptor antagonists or the validated Trofile® Enhanced-Sensitivity-Tropism-Assay. RESULTS The lower detection limit of the RVA was 2.5% and 5% for X4 and R5 minority variants respectively. A phenotype/genotype result was obtained for 210 samples. Overall, concordance of phenotypic results with Geno2Pheno[coreceptor] was 85.2% and concordance with webPSSM was 79.5%. For subtype B, concordance with Geno2pheno[coreceptor] was 94.4% and concordance with webPSSM was 79.6%. High concordance of genotypic tools with phenotypic outcome was seen for subtype C (90% for both tools). Main discordances involved CRF01_AE and CRF02_AG for both algorithms (CRF01_AE: 35.9% discordances with Geno2Pheno[coreceptor] and 28.2% with webPSSM; CRF02_AG: 20.7% for both algorithms). Genotypic prediction overestimated CXCR4-usage for both CRFs. For webPSSM, 40% discordance was observed for subtype A. CONCLUSIONS Phenotypic assays remain the most accurate for most non-B subtypes and new subtype-specific rules should be developed for non-B subtypes, as research studies more and more draw conclusions from genotypically-inferred tropism, and to avoid unnecessarily precluding patients with limited treatment options from receiving maraviroc or other entry inhibitors.
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Affiliation(s)
- Martin Mulinge
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
| | - Morgane Lemaire
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
| | - Jean-Yves Servais
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
| | - Arkadiusz Rybicki
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
| | - Daniel Struck
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
| | | | | | - Yolanda Lie
- Monogram Biosciences Inc., South San Francisco, California, United States of America
| | - Carole Seguin-Devaux
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
| | - Jean-Claude Schmit
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
- Service National des Maladies Infectieuses, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Danielle Perez Bercoff
- Laboratory of Retrovirology, Centre Recherche Public de la Santé, Luxembourg, Luxembourg
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Mesplède T, Quashie PK, Osman N, Han Y, Singhroy DN, Lie Y, Petropoulos CJ, Huang W, Wainberg MA. Viral fitness cost prevents HIV-1 from evading dolutegravir drug pressure. Retrovirology 2013; 10:22. [PMID: 23432922 PMCID: PMC3598531 DOI: 10.1186/1742-4690-10-22] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 02/20/2013] [Indexed: 12/14/2022] Open
Abstract
Background Clinical studies have shown that integrase strand transfer inhibitors can be used to treat HIV-1 infection. Although the first-generation integrase inhibitors are susceptible to the emergence of resistance mutations that impair their efficacy in therapy, such resistance has not been identified to date in drug-naïve patients who have been treated with the second-generation inhibitor dolutegravir. During previous in vitro selection study, we identified a R263K mutation as the most common substitution to arise in the presence of dolutegravir with H51Y arising as a secondary mutation. Additional experiments reported here provide a plausible explanation for the absence of reported dolutegravir resistance among integrase inhibitor-naïve patients to date. Results We now show that H51Y in combination with R263K increases resistance to dolutegravir but is accompanied by dramatic decreases in both enzymatic activity and viral replication. Conclusions Since H51Y and R263K may define a unique resistance pathway to dolutegravir, our results are consistent with the absence of resistance mutations in antiretroviral drug-naive patients treated with this drug.
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Affiliation(s)
- Thibault Mesplède
- McGill University AIDS Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
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25
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Duchnowska R, Sperinde J, Leitzel K, Szostakiewicz B, Paquet A, Ali SM, Jankowski T, Haddad M, Fuchs EM, Arlukowicz-Czartoryska B, Winslow J, Singer C, Wysocki PJ, Lie Y, Horvat R, Foszczynska-Kloda M, Petropoulos C, Radecka B, Litwiniuk M, Debska S, Weidler J, Huang W, Biernat W, Köstler WJ, Jassem J, Lipton A. Abstract P2-10-31: Correlation of quantitative p95HER2 and total HER2 levels with clinical outcomes in a combined analysis of two cohorts of trastuzumab-treated metastatic breast cancer patients. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-10-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Expression of p95HER2 (p95), a truncated form of HER2 also known as p110 or M611-CTF, is a possible trastuzumab resistance mechanism and has been associated with poor prognosis in trastuzumab-treated HER2-positive metastatic breast cancer (MBC). Previously we reported on optimal clinical cutoffs for quantitative p95 (Clin Cancer Res, 16:4226, 2010) and quantitative HER2 protein expression (H2T) by HERmark® (Cancer, 116:5168, 2010) that defined patient subsets with different progression-free survival (PFS). These cutoffs were confirmed in an independent trastuzumab-treated MBC cohort (ASCO 2011, #586). Here, using individual patient data, we performed an analysis on the combined data set of 243 cases from the discovery and validation cohorts to derive optimal cutoffs for quantitative p95 and H2T.
Methods: Both quantitative H2T (HERmark, Monogram Biosciences) and p95 assays employed the VeraTag® method to quantify protein expression in formalin-fixed, paraffin-embedded tumor samples from two cohorts of 101 and 142 cases of trastuzumab-treated MBC with 7.4 and 9.2 months median PFS, respectively. All analyses were stratified by hormone receptor status, tumor grade (3 vs. 1+2) and cohort. H2T measurements were compared to pre-specified cutoffs for HERmark negative (H2T<10.5 Relative Fluorescence/mm2 tumor [RF/mm2]) and HERmark positive (H2T>17.8 RF/mm2), derived from the <5th percentile of centrally determined HER2-positives and the >95th percentile of centrally determined HER2-negatives, respectively, within a reference database of 1,090 breast cancer patient samples.
Results: Patients classified as HERmark-positive had longer PFS than those classified as HERmark-negative (HR = 0.52; p = 0.0006; medians 10.0 and 5.9 months). The previously determined optimal H2T cutoff of 13.8 RF/mm2 in the center of the HERmark-equivocal zone, gave a similar result (HR = 0.54; p = 0.0005). This was close to the optimal cutoff of 12.75 RF/mm2 (HR = 0.48; p < 0.0001, unadjusted) for the combined data set. The PFS for the small group of patients in the HERmark-equivocal zone (n = 20) was more similar to the HERmark-negatives (equivocal vs. negative: HR=0.98; p = 0.9) than the HERmark-positives (positive vs. equivocal: HR=0.57; p = 0.057). The pre-specified p95 cutoff at 2.8 RF/mm2 separated the 174 HERmark-positive cases into two groups of longer (p95<2.8 RF/mm2) vs. shorter PFS (HR = 1.9; p = 0.0014; medians 13.1 and 7.4 months). Increasing continuous p95 also correlated with shorter PFS (HR = 1.9/log; p = 0.022) in the HERmark-positive subset. An optimal p95 cutoff was identified at 2.7 RF/mm2 (HR = 2.0; p = 0.0009, unadjusted), although a slightly higher local HR maximum was found at 1.55 RF/mm2 (HR = 2.3; p = 0.0004, unadjusted).
Conclusions: HERmark positive and negative categories, defined by analytical comparison with centrally determined HER2 status, were confirmed to have significantly different PFS in trastuzumab-treated MBC patients. The optimal H2T clinical cutoff for this combined analysis was centered in the HERmark analytical equivocal zone. An optimal p95 clinical cutoff of 2.7 RF/mm2 derived from this combined analysis was nearly identical to the previously established cutoff of 2.8 RF/mm2.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-31.
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Affiliation(s)
- R Duchnowska
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - J Sperinde
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - K Leitzel
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - B Szostakiewicz
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - A Paquet
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - SM Ali
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - T Jankowski
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - M Haddad
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - E-M Fuchs
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - B Arlukowicz-Czartoryska
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - J Winslow
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - C Singer
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - PJ Wysocki
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - Y Lie
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - R Horvat
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - M Foszczynska-Kloda
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - C Petropoulos
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - B Radecka
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - M Litwiniuk
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - S Debska
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - J Weidler
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - W Huang
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - W Biernat
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - WJ Köstler
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - J Jassem
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
| | - A Lipton
- Military Institute of Medicine, Warsaw, Poland; Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Penn State/Hershey Medical Center, Hershey, PA; Medical University of Gdansk, Poland; Lublin Oncology Center, Lublin, Poland; Medical University of Vienna, Austria; Bialystok Oncology Center, Bialystok, Poland; Greater Poland Cancer Center, Poznan, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Opole Oncology Center, Opole, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland
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Yardley DA, Kaufman PA, Adams JW, Krekow L, Savin M, Lawler WE, Zrada S, Starr A, Einhorn H, Schwartzberg LS, Huang W, Weidler J, Lie Y, Paquet A, Haddad M, Anderson S, Brigino M, Bosserman L. Abstract P2-05-06: Quantitative measurement of HER2 expression in breast cancers: comparison with “real world” HER2 testing in a multi-center Collaborative Biomarker Study (CBS) and correlation with clinicopathological features. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-05-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Accurate determination of HER2 status is critical in determining appropriate therapy for breast cancer patients. The HERmark® assay is a novel method to quantitatively measure HER2 total protein expression (H2T) in breast cancer. In this study, we compared HERmark H2T with central laboratory HER2 retesting and local (site reported) HER2 testing of formalin-fixed, paraffin-embedded (FFPE) breast cancer tissues. The quantitative total HER2 measurements (H2T) by HERmark and results of local HER2 tests were correlated with tumor pathohistological characteristics and overall survival of breast cancer patients.
Methods: 232 FFPE breast cancer tissues were provided by 11 CBS study sites for HER2 testing by the HERmark assay and central laboratory IHC re-testing performed in blinded fashion. Local HER2 immunohistochemistry and/or fluorescence in situ hybridization (FISH) results and valid HERmark H2T and central HER2 IHC results were obtained in 192 cases for analysis.
Results: H2T showed a significant correlation with central HER2 IHC staining intensity (P < 0.0001). The concordance rates of positive and negative HERmark status (excluding equivocal) with those of local HER2 status determined by the CBS sites, and with those of central HER2 IHC status were 84% (Kappa = 0.68) and 96% (Kappa = 0.91), respectively. Higher H2T levels significantly correlated with higher tumor grade (p = 0.007) and negative ER/PR status (p = 0.002). Twenty-six (14%) cases showed discordant (conversion of negative and positive) results between local HER2 status and HERmark status. Of the discordant cases, HERmark significantly agreed with H-score of central HER2 IHC retesting (p = 0.014), as compared with local HER2 status. The concordant negative group (local HER2 negative/H2T low) demonstrated better overall survival (OS) (HR = 0.198, p = 0.0001), compared to that of concordant positive group (local HER2 positive/H2T high). The concordant negative group also showed better OS than that of discordant local HER2 negative/H2T high group (HR = 0.065, p = 0.0003), but showed no significant difference in OS as compared to that of discordant local HER2 positive/H2T low group (HR = 1.774, p = 0.499).). In 24 cases (13%) considered to be “triple negative” by local HER2, ER and PR testing, HERmark re-classified 4 cases (17%) as HER2 positive.
Conclusions: H2T by HERmark yields a continuum of quantitative HER2 protein measurements that shows an excellent correlation with central HER2 IHC retesting and confirms the known correlations between HER2 expression with tumor grade and ER/PR status. OS results of concordant HER2 positive or negative groups (between local HER2 testing and HERmark H2T) confirmed that HER2 positive patients (excluding adjuvant trastuzumab therapy) have worse OS than patients with HER2 negative disease. However, in the HERmark and local HER2 discordant groups, OS appeared to track better with H2T by HERmark and not with the local HER2 status. Novel quantitative HER2 measurements may identify patients with false (+) and (−) HER2 status by local HER2 testing and may provide added clinical value to routine “real world” HER2 testing.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-05-06.
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Affiliation(s)
- DA Yardley
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - PA Kaufman
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - JW Adams
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - L Krekow
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - M Savin
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - WE Lawler
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - S Zrada
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - A Starr
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - H Einhorn
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - LS Schwartzberg
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - W Huang
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - J Weidler
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - Y Lie
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - A Paquet
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - M Haddad
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - S Anderson
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - M Brigino
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
| | - L Bosserman
- Sarah Cannon Research Institute, Nashville, TN; Tennessee Oncology PLLC, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Arlington Cancer Center, Arlington, TX; Texas Oncology Bedford, Bedford, TX; Texas Oncology at Medical City Dallas 2, Dallas, TX; St. Jude Heritage Medical Group, Fullerton, CA; The Center for Cancer and Hematologic Disease, Cherry Hill, NJ; Monroe Medical Associates, Harvey, IL; Swedish American Regional Cancer Center, Rockford, IL; The West Clinic, Memphis, TN; Monogram Biosciences, Inc., So. San Francisco, CA; Center for Molecular Biology and Pathology, Laboratory Corporation of America, Inc., Research Triangle Park, NC; Wilshire Oncology Medical Group, Rancho Cucamonga, CA
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Sperinde J, Lara J, Michaelson R, Sun X, Conte P, Guarneri V, Barbieri E, Ali S, Leitzel K, Weidler J, Lie Y, Cook J, Haddad M, Paquet A, Winslow J, Howitt J, Hurley L, Eisenberg M, Petropoulos C, Huang W, Lipton A. Abstract P2-10-16: Quantitative HER3 protein expression and PIK3CA mutation status in matched samples from primary and metastatic breast cancer tissues and correlation with time to recurrence. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-10-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER3 is thought to play a prominent role in resistance to HER2-directed breast cancer therapies. Recent data suggest that HER3 levels also influence HER2-normal breast tumor biology. HER3 and PI3K signaling are linked in that in HER3 signaling activates PI3K and inhibition of PI3K activity can upregulate HER3 expression. Here, we measured quantitative HER3 protein expression levels and PIK3CA mutation status in matched tissues from the primary tumor and site of metastasis to assess correlations with time to recurrence.
Methods: 44 pairs (8 HER2+ by HERmark®) of matched tissues from the primary tumor and the site of metastasis were evaluated for HER3 protein expression using a sensitive, quantitative assay for HER3 protein expression in FFPE tissue sections (VeraTag®). Matched samples were also evaluated for quantitative HER2 expression (HERmark) and for PIK3CA mutations at exon 9 (E542K and E545K) and exon 20 (H1047R).
Results: HER3 protein expression at the metastatic site was largely independent of HER3 levels at the primary site (Spearman p = 0.50) in contrast to HER2 expression (Spearman p = 0.0004). HER3 expression in the primary tumor correlated with time to recurrence (TTR) (HR = 2.0 per 2-fold increase in HER3; p < 0.0001). Conversely, HER3 expression measured at the site of metastasis was not correlated with TTR (p = 0.55). Estrogen receptor negative tumors were less likely to have PIK3CA mutations (p = 0.023). In cases of primary tumors with PIK3CA mutations, no reversions to wild-type PIK3CA were observed in the metastatic sites. In metastatic tumors, mutations detected in the primary tumor as well as new mutations were observed. A gain of an exon 9 mutation at the metastatic site correlated with shorter TTR (HR = 2.5; p = 0.043). Excluding the 8 samples that were HER2+ by HERmark, longer TTR was observed for patients with PIK3CA mutations in the primary tumor (HR = 0.47; p = 0.042), which is consistent with previous reports. Interestingly, the longer TTR for those with PIK3CA mutations appeared to be dependent on quantitative HER3 protein level (interaction p = 0.065).
Conclusions: HER3 protein expression in matched primary and metastatic breast cancer tissues were unrelated. This may indicate that HER3 protein is influenced by the different tumor microenvironments of the primary and metastatic sites. PIK3CA mutations were either maintained or acquired at metastatic sites. Both low HER3 protein expression and the presence of PIK3CA mutations in the primary tumor but not the metastatic tumor were associated with longer TTR. These observations suggest that HER3 protein expression may be an important prognostic factor for breast cancer progression.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-16.
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Affiliation(s)
- J Sperinde
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - J Lara
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - R Michaelson
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - X Sun
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - P Conte
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - V Guarneri
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - E Barbieri
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - S Ali
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - K Leitzel
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - J Weidler
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - Y Lie
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - J Cook
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - M Haddad
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - A Paquet
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - J Winslow
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - J Howitt
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - L Hurley
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - M Eisenberg
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - C Petropoulos
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - W Huang
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
| | - A Lipton
- Monogram Biosciences/Integrated Oncology/LabCorp, South San Francisco, CA; Saint Barnabas Medical Center, Livingston, NJ; University of Modena, Modena, Italy; Penn State/Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Laboratory Corporation of America, Research Triangle Park, NC
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Villasboas JC, Hurley J, Weidler JM, Paquet A, Fernandez CG, Cioffi Lavina M, Sperinde J, Chenna A, Haddad M, Lie Y, Winslow JW, Huang W, Petropoulos CJ, Pegram MD. Correlation of quantitative p95HER2, HER2, and HER3 protein expression with pathologic complete response (pCR) in HER2-positive breast cancer patients (pts) treated with neoadjuvant chemotherapy and trastuzumab. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.27_suppl.137] [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
137 Background: Elevated p95HER2 [HER2-M611-CTF (carboxy-terminal-fragment) also known as p95] expression has been correlated with poor outcomes in HER2+ pts with metastatic breast cancer treated with trastuzumab (T); however, limited data is available on the correlation between p95 and pCR to T in the neoadjuvant (NEO) setting, where p95 was measured by immunohistochemistry. The current study aims to determine whether quantitative p95, HER3 and HER2 expression correlated with pCR in pts treated with T + chemotherapy in the NEO setting. Methods: pCR data and quantitative HER2 (H2T), p95, and HER3 (H3T) results by HERmark/VeraTag assays were available in 45 patient cases with pre-therapy, formalin-fixed, paraffin-embedded breast tumors. pCR was defined as the absence of invasive disease in the breast. Quantitative biomarker data were correlated with pCR according to previously published or presented biomarker cutoffs. Results: The overall pCR rate was 46.7% (ER+: 14.3% vs. ER-: 75%; p<0.0001) and was significantly associated with higher H2T levels (p=0.02) and lower H3T levels (p=0.04). In ER- subjects (N=24), no difference in H2T levels was observed between pCR vs non-pCR groups (median H2T=111.5 vs 150.5, respectively; p=0.721). However, within the ER+ group (N=21), H2T levels were significantly higher in the pCR group vs non-pCR group (median H2T=254 vs 37.3; p=0.024). Using multivariate logistic regression, increasing log(H2T) (p = 0.012), ER-negativity (p = 0.027) and low p95 (p = 0.074) were found to correlate or trend with pCR. Conclusions: pCR was significantly associated with high H2T, particularly in ER+ HER2+ breast cancer pts who received NEO therapy with T + chemotherapy. Lower H3T was also associated with pCR. A trend towards pCR was seen in tumors with low p95. These data suggest that quantitative H2T, H3T and p95 may provide additional information on response to T-based regimens in breast cancer stratified by ER status. Additional investigation into the relationship between quantitative H2T, p95 and H3T expression and T response in the NEO setting in larger cohorts is warranted.
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Affiliation(s)
| | - Judith Hurley
- University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | | | | | | | | | | | | | | | - Yolanda Lie
- Monogram Biosciences, South San Francisco, CA
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Han SW, Cha Y, Paquet A, Huang W, Weidler J, Lie Y, Sherwood T, Bates M, Haddad M, Park IH, Oh DY, Lee KS, Im SA, Bang YJ, Ro J, Kim TY. Correlation of HER2, p95HER2 and HER3 expression and treatment outcome of lapatinib plus capecitabine in her2-positive metastatic breast cancer. PLoS One 2012; 7:e39943. [PMID: 22848366 PMCID: PMC3407213 DOI: 10.1371/journal.pone.0039943] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 05/29/2012] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lapatinib plus capecitabine is an effective treatment option for trastuzumab-refractory HER2-positive metastatic breast cancer. We have investigated the correlation between quantitative measures of HER2, p95HER2, and HER3 and treatment outcomes using lapatinib and capecitabine. METHODS Total HER2 (H2T), p95HER2 (p95), and total HER3 (H3T) expression were quantified in formalin-fixed paraffin-embedded samples using the VeraTag assays. Patients received lapatinib and capecitabine treatment following trastuzumab failure according to the Lapatinib Expanded Access Program. The association between the protein expression levels and clinical outcomes was analyzed. RESULTS A total of 52 patients were evaluable. H2T level was significantly higher in responders (median 93.49 in partial response, 47.66 in stable disease, and 17.27 in progressive disease; p = 0.020). Longer time-to-progression (TTP) was observed in patients with high H2T [p = 0.018, median 5.2 months in high (>14.95) vs. 1.8 in low (<14.95)] and high H3T [p = 0.017, median 5.0 months in high (>0.605) vs. 2.2 in low (<0.605)]. Patients having both high H2T and high H3T had significantly longer TTP [adjusted hazard ratio (HR) 0.38 (95% CI 0.20-0.73), p = 0.004] and overall survival [adjusted HR 0.46 (95% CI 0.24-0.89), p = 0.020]. No significant association between p95 and response or survival was observed. CONCLUSIONS These data suggest a correlation between high HER2 and high HER3 expression and treatment outcome, while no significant difference was observed between clinical outcome and p95 expression level in this cohort of HER2-positive, trastuzumab-refractory metastatic breast cancer patients treated with lapatinib and capecitabine.
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Affiliation(s)
- Sae-Won Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yongjun Cha
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Agnes Paquet
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Weidong Huang
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Jodi Weidler
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Yolanda Lie
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Thomas Sherwood
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Michael Bates
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - Mojgan Haddad
- Monogram Biosciences, Inc., San Francisco, California, United States of America
| | - In Hae Park
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Do-Youn Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yung-Jue Bang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jungsil Ro
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
- * E-mail: (TYK); (JR)
| | - Tae-You Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Molecular Medicine & Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
- * E-mail: (TYK); (JR)
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Myers JE, Taylor BS, Rojas Fermín RA, Reyes EV, Vaughan C, José L, Javier C, Franco Estévez R, Donastorg Cabral Y, Batista A, Lie Y, Coakley E, Hammer SM, Brudney K. Transmitted drug resistance among antiretroviral-naive patients with established HIV type 1 infection in Santo Domingo, Dominican Republic and review of the Latin American and Caribbean literature. AIDS Res Hum Retroviruses 2012; 28:667-74. [PMID: 21851324 DOI: 10.1089/aid.2010.0355] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Emergence of HIV resistance is a concerning consequence of global scale-up of antiretroviral therapy (ART). To date, there is no published information about HIV resistance from the Dominican Republic. The study's aim was to determine the prevalence of transmitted drug resistance (TDR) to reverse transcriptase and protease inhibitors in a sample of chronically HIV-1-infected patients in one clinic in Santo Domingo. The data are presented in the context of a review of the TDR literature from Latin America and the Caribbean. Genotype testing was successfully performed on 103 treatment-naive adults planning to initiate antiretroviral therapy; the World Health Organization (WHO) list of surveillance drug resistance mutations (SDRM) was used to determine the presence of TDR mutations. WHO SDRM were identified in eight patients (7.8%); none had received sdNVP. There were no significant differences in epidemiologic or clinical variables between those with or without WHO SDRM. The prevalence of WHO SDRM was 1.0% and 6.8% for nucleoside reverse transcriptase inhibitors and nonnucleoside reverse transcriptase inhibitors, respectively. No WHO SDRMs for protease inhibitors were identified. Among 12 studies of TDR in the region with a sample size of at least 100 subjects, the reported prevalence of SDRM ranged from 2.8% to 8.1%. The most commonly identified SDRM was K103N. This information adds to our understanding of the epidemiology of TDR in the region and the possible role such mutations could play in undermining first-line treatment. Ongoing surveillance is clearly needed to better understand the TDR phenomenon in the Caribbean.
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Affiliation(s)
- Julie E Myers
- Division of Infectious Diseases, Columbia University Medical Center, New York, NY 10032, USA.
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Villasboas JC, Hurley J, Weidler JM, Paquet A, Fernandez CG, Cioffi Lavina M, Sperinde J, Chenna A, Haddad M, Lie Y, Winslow JW, Huang W, Petropoulos CJ, Pegram MD. Correlation of quantitative p95HER2 and HER2 protein expression with pathologic complete response (pCR) in HER2-positive breast cancer patients (pts) treated with neoadjuvant (NEO) trastuzumab-containing therapy. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.608] [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
608 Background: Elevated p95 [HER2-M611-CTF (carboxy-terminal-fragment) also known as p110 or p95HER2] expression has been correlated with poor outcomes in HER2+ pts with metastatic breast cancer treated with trastuzumab (T); however, limited data have been presented on the correlation between p95 and pCR to T in the NEO setting, where p95 was measured by immunohistochemistry. In the current study, we sought to determine whether quantitative p95 and HER2 expression correlated with pCR in pts treated with T + chemotherapy in the NEO setting. Methods: HER2 expression (H2T) was quantified by HERmark in 47 breast tumors using formalin-fixed, paraffin-embedded sections. Tissue remained in 40 cases to measure p95 by VeraTag and compare to a previously published cutoff (Clin Cancer Res 16:4226, 2010). pCR data were available for 45 cases. pCR was defined as the absence of invasive disease in the breast. Results: The overall pCR rate was 46.7% (ER+: 14.3% vs. ER-: 75%; Wilcoxon rank p<0.0001) and was significantly associated with higher H2T levels (p=0.02). In ER- subjects (N=24), no difference in H2T levels was observed between pCR vs non-pCR groups [median H2T=111.5 (IQR 63.4-162.2) vs 150.5 (IQR 43 – 226.2), respectively; p=0.721]. However, within the ER+ group (N=21), H2T levels were significantly higher in the pCR group vs non-pCR group [median H2T=254 (IQR 181.5-584.5) vs 37.3 (IQR 16.4-89); p=0.024]. Using multivariate logistic regression, increasing log(H2T) (p = 0.011), ER-negativity (p = 0.027) and low p95 (p = 0.074) were found to correlate or trend with pCR. Conclusions: pCR was significantly associated with high H2T expression in ER+ HER2+ breast cancer pts who received NEO therapy with T + chemotherapy. A trend towards pCR was seen in tumors that had low p95. These data suggest that quantitative H2T and p95 may provide additional information on response to T-based regimens in breast cancer, particularly ER+ breast cancer. Additional investigation into the possible relationship between quantitative levels of HER2 and p95 expression and T response in the NEO setting in larger cohorts is warranted.
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Affiliation(s)
| | - Judith Hurley
- University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | | | | | | | | | | | | | | | - Yolanda Lie
- Monogram Biosciences, South San Francisco, CA
| | | | | | | | - Mark D. Pegram
- University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
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Biernat W, Duchnowska R, Trojanowski T, Mandat T, Kowalczyk A, Czartoryska-Arlukowicz B, Radecka B, Jarosz B, Staszkiewicz R, Kalinka-Warzocha E, Chudzik M, Sperinde J, Haddad M, Paquet A, Lie Y, Winslow JW, Weidler JM, Huang W, Petropoulos CJ, Jassem J. Quantitative HER2 levels and steroid receptor expression in primary breast cancers and in matched brain metastases. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.603] [Citation(s) in RCA: 2] [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
603 Background: Breast cancer patients with HER2-positive tumors are at high risk for brain metastases. In the current study we examined expression of ER, PR and HER2 in primary breast tumors and in matched brain metastases, as changes of their levels might reflect modes of escape from therapy. Methods: Fifty-three pairs of matched formalin-fixed paraffin-embedded samples from primary breast cancers and brain metastases were assayed for ER and PR status by immuno-histochemistry, whereas HER2 expression was quantified using the novel HERmark assay. Nuclear staining of ER and PR >10%, and relative fluorescence of HER2 >17.8/mm2 were considered as positive results. Results: HER2 levels in brain metastases were generally higher than in the primary tumors (p = 3e-6), with a median increase of 1.9-fold (range 0.08 to 199-fold). There were also substantial differences in ER and PR status between primary tumors and brain metastases. Loss of steroid receptor positivity in brain metastases was more frequent than its gain (ER: 46% vs. 26%; p = 0.16; PR: 57% vs. 23%; p = 0.044). These changes resulted in a net increase in the number of HER2-positive/ER-negative brain metastases, which more than doubled the proportion of primary breast tumors with this phenotype (26% vs. 11%, respectively; p = 0.08). Additionally, HER2 levels in the primary tumors significantly correlated with overall survival when stratified by ER status (p = 0.011). Conclusions: Brain metastases of breast cancer show significant changes in steroid receptor status and in quantitative HER2 levels compared to matched primary tumors. These data provide a rationale for future studies and may help in designing treatment strategies that target the most likely escape pathways of breast cancer.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Agnes Paquet
- Monogram Biosciences, Inc., South San Francisco, CA
| | - Yolanda Lie
- Monogram Biosciences, Inc., South San Francisco, CA
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Huang W, Lara JF, Michaelson R, Sun X, Conte P, Guarneri V, Barbieri E, Ali SM, Leitzel K, Weidler JM, Lie Y, Haddad M, Paquet A, Sperinde J, Howitt J, Eisenberg M, Hurley L, Petropoulos CJ, Lipton A. Quantitative HER2 measurement and PI3K mutation profile in matched primary and metastatic breast cancer tissues. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.614] [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
614 Background: HER2 status of primary breast cancer (PBC) is routinely used to determine systemic treatment for metastatic breast cancer (MBC) patients. Discordance rates of HER2 status between PBC and MBC range from 5.5% to 29% based on published meta-analyses. The clinical benefit of re-assessing HER2 in MBC tissues remains controversial. In this study, we measured quantitative HER2 expression in matched PBC and MBC tissues and correlated changes of HER2 with mutations in the catalytic domain of PI3 kinase(PIK3CA). Methods: Total HER2 protein expression (H2T) was quantified by the HERmark assay in 41 matched PBC and MBC formalin-fixed, paraffin-embedded specimens. PIK3CA mutation status in exons 9 (E545K and E542K) and 20 (H1047R) was determined using a validated pyrosequencing assay. Results: MBC samples included 5 lymph node, 13 viscera, 6 brain, and 17 soft tissue lesions (N=41). 27 (66%) cases showed higher H2T in MBC than in matched PBC; and 14 (34%) cases had higher H2T in PBC than in matched MBC, indicating an overall increase of H2T in matched MBC lesions (fold change 0.25-17.57; p=0.005, paired Wilcoxon rank sum test). HER2 positive conversion (HERmark negative/equivocal in PBC, but positive in matched MBC) was found in 6 (15%) cases, while HER2 negative conversion (HERmark positive in PBC, but negative/equivocal in matched MBC) was seen in 2 (5%) cases. HER2 status was unchanged in 33 (80%) cases. PIK3CA mutations were detected in 13 (32%) of PBC and 19 (46%) of MBC samples. Among the HER2 positive conversion cases, PIK3CA mutation was identified in 50% (3/6) PBC and 67% (4/6) MBC, compared to 0% (0/2, PBC or MBC) in the HER2 negative conversion cases. Among cases with unchanged HER2 status, PIK3CA mutation was observed in 30% (10/33) PBC and 42% (14/33) MBC. Conclusions: Quantitative HER2 assessment revealed a 20% discordance in HER2 status between matched PBC and MBC tissues, with more frequent conversion from low HER2 in PBC to high HER2 in MBC. PIK3CA mutation was observed more frequently in patients who converted from HER2 negative PBC to HER2 positive MBC. These results suggest that re-assessment of biomarkers in MBC tissues may better inform the selection of therapeutic options for patients with MBC.
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Affiliation(s)
| | | | | | - Xiu Sun
- Saint Barnabas Medical Center, Livingston, NJ
| | | | | | | | | | - Kim Leitzel
- Penn State Hershey Medical Center, Hershey, PA
| | | | - Yolanda Lie
- Monogram Biosciences, South San Francisco, CA
| | | | | | | | - John Howitt
- Laboratory Corporation of America, Research Triangle Park, NC
| | | | - Laura Hurley
- Laboratory Corporation of America, Research Triangle Park, NC
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Green TN, Archary M, Gordon ML, Padayachi N, Lie Y, Anton ED, Reeves JD, Grobler A, Bobat R, Coovadia H, Ndung'u T. Drug resistance and coreceptor usage in HIV type 1 subtype C-infected children initiating or failing highly active antiretroviral therapy in South Africa. AIDS Res Hum Retroviruses 2012; 28:324-32. [PMID: 21819257 DOI: 10.1089/aid.2011.0106] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
HIV-1 drug resistance monitoring in resource-poor settings is crucial due to limited drug alternatives. Recent reports of the increased prevalence of CXCR4 usage in subtype C infections may have implications for CCR5 antagonists in therapy. We investigated the prevalence of drug resistance mutations and CXCR4 coreceptor utilization of viruses from HIV-1 subtype C-infected children. Fifty-one children with virological failure during highly active antiretroviral therapy (HAART) and 43 HAART-naive children were recruited. Drug resistance genotyping and coreceptor utilization assessment by phenotypic and genotypic methods were performed. At least one significant drug resistance mutation was present in 85.4% of HAART-failing children. Thymidine analogue mutations (TAMs) were detected in 58.5% of HAART-failing children and 39.0% had ≥3 TAMs. CXCR4 (X4) or dual (R5X4)/mixed (R5, X4) (D/M)-tropic viruses were found in 54.3% of HAART-failing and 9.4% of HAART-naive children (p<0.0001); however, the HAART-failing children were significantly older (p<0.0001). In multivariate logistic regression, significant predictors of CXCR4 usage included antiretroviral treatment, older age, and lower percent CD4(+) T cell counts. The majority of genotypic prediction tools had low sensitivity (≤65.0%) and high specificity (≥87.5%) for predicting CXCR4 usage. Extensive drug resistance, including the high percentage of TAMs found, may compromise future drug choices for children, highlighting the need for improved treatment monitoring and adherence counseling. Additionally, the increased prevalence of X4/D/M viruses in HAART-failing children suggests limited use of CCR5 antagonists in salvage therapy. Enhanced genotypic prediction tools are needed as current tools are not sensitive enough for predicting CXCR4 usage.
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Affiliation(s)
- Taryn N. Green
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Mohendran Archary
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - Michelle L. Gordon
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Department of Virology, University of KwaZulu-Natal, Durban, South Africa
| | - Nagavelli Padayachi
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Department of Virology, University of KwaZulu-Natal, Durban, South Africa
| | - Yolanda Lie
- Monogram Biosciences, Inc., South San Francisco, California
| | | | | | - Anneke Grobler
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Raziya Bobat
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - Hoosen Coovadia
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - Thumbi Ndung'u
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Bedimo R, Kyriakides T, Brown S, Weidler J, Lie Y, Coakley E, Holodniy M. Predictive value of HIV-1 replication capacity and phenotypic susceptibility scores in antiretroviral treatment-experienced patients. HIV Med 2012; 13:345-51. [PMID: 22276745 DOI: 10.1111/j.1468-1293.2011.00981.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] [Accepted: 10/27/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the study was to determine the prognostic value of HIV replication capacity (RC) for subsequent antiretroviral (ARV) treatment response in ARV-experienced patients. METHODS RC and phenotypic resistance testing were performed at baseline and week 12 on plasma samples from patients randomized to undergo a 12-week ARV drug-free period (ARDFP) or initiate immediate salvage therapy (no-ARDFP group) in the Options in Management with Antiretrovirals (OPTIMA) trial. Dichotomous and incremental phenotypic susceptibility scores (dPSSs and iPSSs, respectively) were calculated. The predictive value of RC and PSS for ARV therapy response and/or ARDFP was evaluated using multivariate regression analysis and Pearson correlations. RESULTS In 146 no-ARDFP subjects, baseline RC (50.8%) did not change at week 12 and was not correlated with CD4 cell count or viral load changes at week 12 (P=0.33 and P=0.79, respectively) or at week 24 (P=0.96 and P=0.14, respectively). dPSS predicted virological but not CD4 cell count response to ARV therapy at weeks 12, 24 and 48 (P=0.002, P<0.001 and P=0.005, respectively). RC was significantly correlated with dPSS and iPSS at baseline, but did not increase their predictive value. In the 137 ARDFP patients, RC increased significantly (from 52.4 to 85.8%), but did not predict CD4 cell count and viral load changes during ARDFP (P=0.92 and P=0.26, respectively). RC after ARDFP did not predict subsequent CD4 cell count and viral load changes 12 weeks following ARV treatment reinitiation (P=0.90 and P=0.29, respectively). CONCLUSIONS We found no additional predictive value of replication capacity for virological or immunological responses (above what PSS provides) in patients undergoing salvage ARV treatment.
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Affiliation(s)
- R Bedimo
- Veterans Affairs North Texas Health Care System, Dallas, TX 75216, USA.
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Duchnowska R, Biernat W, Szostakiewicz B, Sperinde J, Piette F, Haddad M, Paquet A, Lie Y, Czartoryska-Arłukowicz B, Wysocki P, Jankowski T, Radecka B, Foszczynska-Kłoda M, Litwiniuk M, Debska S, Weidler J, Huang W, Buyse M, Bates M, Jassem J. Correlation between quantitative HER-2 protein expression and risk for brain metastases in HER-2+ advanced breast cancer patients receiving trastuzumab-containing therapy. Oncologist 2012; 17:26-35. [PMID: 22234627 DOI: 10.1634/theoncologist.2011-0212] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Patients with human epidermal growth factor receptor (HER)-2+ breast cancer are at particularly high risk for brain metastases; however, the biological basis is not fully understood. Using a novel HER-2 assay, we investigated the correlation between quantitative HER-2 expression in primary breast cancers and the time to brain metastasis (TTBM) in HER-2+ advanced breast cancer patients treated with trastuzumab. METHODS The study group included 142 consecutive patients who were administered trastuzumab-based therapy for HER-2+ metastatic breast cancer. HER-2/neu gene copy number was quantified as the HER-2/centromeric probe for chromosome 17 (CEP17) ratio by central laboratory fluorescence in situ hybridization (FISH). HER-2 protein was quantified as total HER-2 protein expression (H2T) by the HERmark® assay (Monogram Biosciences, Inc., South San Francisco, CA) in formalin-fixed, paraffin-embedded tumor samples. HER-2 variables were correlated with clinical features and TTBM was measured from the initiation of trastuzumab-containing therapy. RESULTS A higher H2T level (continuous variable) was correlated with shorter TTBM, whereas HER-2 amplification by FISH and a continuous HER-2/CEP17 ratio were not predictive (p = .013, .28, and .25, respectively). In the subset of patients that was centrally determined by FISH to be HER-2+, an above-the-median H2T level was significantly associated with a shorter TTBM (hazard ratio, [HR], 2.4; p = .005), whereas this was not true for the median HER-2/CEP17 ratio by FISH (p = .4). Correlation between a continuous H2T level and TTBM was confirmed on multivariate analysis (HR, 3.3; p = .024). CONCLUSIONS These data reveal a strong relationship between the quantitative HER-2 protein expression level and the risk for brain relapse in HER-2+ advanced breast cancer patients. Consequently, quantitative assessment of HER-2 protein expression may inform and facilitate refinements in therapeutic treatment strategies for selected subpopulations of patients in this group.
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Affiliation(s)
- Renata Duchnowska
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, ul. Dbinki 7, 80-211 Gdańsk, Poland.
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37
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Duchnowska R, Biernat W, Szostakiewicz B, Sperinde J, Piette F, Haddad M, Paquet A, Lie Y, Czartoryska-Arlukowicz B, Wysocki P, Jankowski T, Radecka B, Foszczynska-Kloda M, Litwiniuk M, Debska S, Weidler J, Huang W, Buyse M, Bates M, Jassem J. P2-12-05: Correlation between Quantitative HER2 Protein Expression and Risk of Brain Metastases in HER2−Positive Advanced Breast Cancer Patients Receiving Trastuzumab-Containing Therapy. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-12-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Patients with HER2−positive breast cancer are at particularly high risk for brain metastases; however, the biological basis is not fully understood. Within HER2−positive breast cancer tumors, it is possible to resolve a ∼1.5-log range of HER2 protein expression using a novel quantitative HER2 assay (HERmark®). We investigated the correlation between quantitative HER2 protein expression in primary breast cancers and the time to brain metastases (TTBM) in HER2−positive advanced breast cancer patients treated with trastuzumab.
Methods. The study group included 142 consecutive patients who were administered trastuzumab-based therapy for HER2−positive metastatic breast cancer, defined as 3+ categorical staining by immunohistochemistry (IHC). HER-2/neu gene copy number was subsequently quantified as HER2/CEP17 ratio by central laboratory fluorescence in situ hybridization (FISH). HER2 protein was quantified as total HER2 protein expression (H2T) by the HERmark assay in formalin-fixed, paraffin-embedded primary tumor samples. HER2 variables were correlated with clinical features and TTBM measured from the initiation of trastuzumab-containing therapy.
Results. H2T level (continuous variable) was correlated with shorter TTBM (HR=2.3; p=0.013), whereas HER2 gene amplification by FISH (p=0.28) and continuous HER2/CEP17 ratio (p=0.25) had no significant prognostic impact. The correlation between continuous H2T level and TTBM was confirmed in a multivariate analysis (HR=3.2; p=0.021). Controlling for the competing risk of death from causes other than brain metastases, continuous H2T remained a strong correlate of TTBM (HR=2.7; p=0.0009). In the subset of patients that was centrally-determined HER2 positive by FISH (117 patients), above-median H2T level was significantly associated with shorter TTBM (HR=2.4; p=0.005), whereas this was not true for median FISH/CEP17 ratio (p=0.4). In a multivariate analysis of this subset, continuous H2T (p=0.021) and a time dependent covariate capturing time to non-brain metastases (p=0.0044) were prognostic for TTBM, whereas FISH/CEP17, ER, PgR and grade were not.
Conclusions. These data reveal a strong relationship between quantitative HER2 protein expression levels and the risk of brain relapse in HER2−positive advanced breast cancer patients. Consequently, quantitative assessment of HER2 protein expression may inform and facilitate refinements in therapeutic treatment strategies for selected subpopulations of patients in this group.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-05.
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Affiliation(s)
- R Duchnowska
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - W Biernat
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - B Szostakiewicz
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - J Sperinde
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - F Piette
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Haddad
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - A Paquet
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - Y Lie
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - B Czartoryska-Arlukowicz
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - P Wysocki
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - T Jankowski
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - B Radecka
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Foszczynska-Kloda
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Litwiniuk
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - S Debska
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - J Weidler
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - W Huang
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Buyse
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Bates
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - J Jassem
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
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Huang W, Paquet A, Sivaraman S, Pesano R, Goodman L, Sherwood T, Lie Y, Hickey J, Walworth C, Haddad M, Anderson S, Bates M, Weidler J. P1-07-12: Assessment of Real World HER2 Status by Immunohistochemistry (IHC) and Fluorescence In Situ Hybridization (FISH) in Breast Cancers: Comparison with HERmark®, a Validated Quantitative Measure of HER2 Protein Expression. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-07-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Accurate assessment of the HER2 status is critical in determining appropriate therapy for patients with invasive breast cancer. ASCO/CAP HER2 testing guidelines caution that up to 20% of routine HER2 testing by IHC/FISH may be unreliable (Wolff et al. JCO 2007;25:118). The HERmark assay is a novel quantitative HER2 protein measurement for determining HER2 status in breast cancer. Central HER2 testing showed high concordance (96-98%) with HERmark for positive and negative categories when equivocal subsets were excluded (Huang et al. Am J Clin Pathol 2010;134:303; Joensuu et al, 2008 SABCS, abstract 2071). In this study, we examined concordance between HERmark and routine HER2 testing by IHC and FISH from “real world” formalin-fixed, paraffin-embedded (FFPE) breast cancers submitted commercially for HERmark testing.
Methods: 717 HERmark results on FFPE breast cancers tested from 2008 to 2010 and corresponding HER2 IHC/FISH results were reviewed. The IHC and FISH results, per pathology reports submitted at the time of HERmark testing, were compared to HERmark categorical (negative, equivocal, positive) results.
Results: 590 (419) samples had IHC (FISH) and HERmark results available. Of these cases, 92% (94%) were either negative or equivocal by IHC (FISH). The HERmark testing reported 33% HERmark negative, 33% HERmark equivocal and 34% HERmark positive. Comparisons of HER2 status by IHC and FISH vs. HERmark are detailed in Table 1.
19% of cases classified as IHC 0 or 1+ were positive by HERmark; 35% classified as FISH negative were HERmark positive. Of the 158 triple negative cases by IHC/FISH (ER, PR and HER2 negative, data not shown), 38 (24%) were reclassified as HER2 positive by HERmark.
Conclusions: Higher than expected discordance between HER2 IHC/FISH and the HERmark assay was observed in this study compared with central HER2 testing of prior study cohorts. Selection bias may have impacted these results as ≥ 92% of cases submitted for HERmark testing were either equivocal or negative by routine HER2 IHC/FISH.
Central HER2 FISH retesting of these samples will be performed and compared with HERmark results to further evaluate the discordance observed in this analysis.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-07-12.
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Affiliation(s)
- W Huang
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - A Paquet
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - S Sivaraman
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - R Pesano
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - L Goodman
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - T Sherwood
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - Y Lie
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - J Hickey
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - C Walworth
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - M Haddad
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - S Anderson
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - M Bates
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
| | - J Weidler
- 1Monogram Biosciences Inc., South San Francisco, CA; Incyte Corporation, Wilmington, DE; Quest Diagnostics Nichols Institute, San Juan Capistrano, CA; Affymetrix, Santa Clara, CA; Gilead Sciences, Inc, Foster City, CA; Cepheid, Sunnyvale, CA
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Huang W, Wirtz R, Weidler J, Lie Y, Sherwood T, Leinonen M, Bono P, Isola J, Kellokumpu-Lehtinen PL, Joensuu H. P1-07-01: Comparison of Four HER2 Testing Methods in the Detection of HER2−Positive Breast Cancer: Results from the FinHer Study Cohort. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-07-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Accurate assessment of the HER2 status is essential for identifying patients who may benefit from HER2 targeted therapy. The current methods, immunohistochemistry (IHC) and in situ hybridization (ISH), determine HER2 status semi-quantitatively as positive (+), equivocal (+/−) and negative (−) with predefined cutoff values. Recent studies have suggested that current HER2 cutoffs may not be optimal for all clinical settings of HER2 targeted therapy. In a small subset of adjuvant NCCTG N9831 patients confirmed as HER2−normal by round-robin review of HER2 testing, trastuzumab benefit was observed (Perez et al, SABCS 2010). Quantification of HER2 as continuous variable may enable a more accurate optimization of HER2 cutoffs for various HER2 targeted therapies. In this study, we measured continuous HER2 protein expression by the HERmark™ assay and continuous mRNA expression by quantitative real time polymerase chain reaction (qPCR), and compared these results with central IHC and central chromogenic in situ hybridization (CISH) results of FinHer.
Methods: Total HER2 protein expression (H2T) was quantified using the HERmark assay as previously described (Huang et al. Am J Clin Pathol 2010;134:303). HER2 mRNA expression (H2N) was measured by qPCR as previously published (Noske et al. Br Cancer Res Treat 2011;126:109). The results of H2T and H2N as continuous variables and as predefined categories were compared with central CISH results from FinHer (Joensuu et al, N Engl J Med 2006;354), and central IHC retesting.
Results: H2T in 899 evaluable samples described a continuum of 0.4 to 721.2 (relative HERmark unit); while H2N in 915 evaluable samples showed a continuum of 31.4 to 42.8 (delta-Ct). Significant correlation between H2T and H2N as continuous variable was found (R2= 0.56, P< .0001). Paired method comparison was performed for samples with valid results in any two of the four testing methods. Overall concordance of H2T and H2N with predefined categories (+, +/−, -) was 81%, and concordance of (+) and (−) subsets was 95% when (+/−) cases (H2T 11%; H2N 6%) were excluded. Overall concordance of central IHC and H2T categories (+, +/−, -) was 75%, and concordance of (+) and (−) subsets was 96% when (+/−) cases (IHC 16%; H2T 11%) were excluded. Overall concordance of IHC and H2N categories (+, +/−, -) was 84%, and concordance of (+) and (−) subsets was 99% when (+/−) cases (IHC 16%; H2N 6%) were excluded. Concordance of central CISH (+, -) with H2T and H2N categories (+, -) was 89% and 91%, respectively, when (+/−) cases were excluded from H2T (13%) and H2N (8%), respectively.
Conclusions: All four methods identified HER2−positive breast cancers. The discordance rate between the methods tested was approximately 10 to 20% despite careful delineation of cancerous tissue in the sample and analysis of adjacent tumor sections. No combination of assays could be identified with concordance rate >95% when the equivocal subsets were included in comparisons. Exclusion of the equivocal subsets (about 10% of samples) yielded high concordance rates of approximately 95% or higher. H2T and H2N showed comparable continuous distribution patterns and significant concordance with standard HER2 status by central IHC and CISH.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-07-01.
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Affiliation(s)
- W Huang
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - R Wirtz
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - J Weidler
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - Y Lie
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - T Sherwood
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - M Leinonen
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - P Bono
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - J Isola
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - P-L Kellokumpu-Lehtinen
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
| | - H Joensuu
- 1Monogram Biosciences Inc., So. San Francisco, CA; STRATIFYER Molecular Pathology GmbH, Cologne, Germany; Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland; Tampere University Hospital, Tampere, Finland
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Joensuu H, Sperinde J, Leinonen M, Huang W, Weidler J, Bono P, Kataja V, Kokko R, Turpeenniemi-Hujanen T, Jyrkkiö S, Isola J, Kellokumpu-Lehtinen PL, Paquet A, Lie Y, Bates M. Very high quantitative tumor HER2 content and outcome in early breast cancer. Ann Oncol 2011; 22:2007-2013. [DOI: 10.1093/annonc/mdq710] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Biernat W, Duchnowska R, Szostakiewicz B, Sperinde J, Haddad M, Paquet A, Lie Y, Weidler J, Huang W, Winslow J, Jankowski T, Arlukowicz-Czartoryska B, Wysocki PJ, Foszczynska-Kloda M, Radecka B, Litwiniuk MM, Debska S, Bates M, Jassem J. Quantitative measurements of p95HER2 (p95) and total HER2 (H2T) protein expression in patients with trastuzumab-treated, metastatic breast cancer (MBC): Independent confirmation of clinical cutoffs. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.586] [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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Bates M, Sperinde J, Köstler WJ, Ali SM, Leitzel K, Fuchs EM, Paquet A, Lie Y, Sherwood T, Horvat R, Singer CF, Winslow J, Weidler JM, Huang W, Lipton A. Identification of a subpopulation of metastatic breast cancer patients with very high HER2 expression levels and possible resistance to trastuzumab. Ann Oncol 2011; 22:2014-2020. [PMID: 21289364 DOI: 10.1093/annonc/mdq706] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with metastatic breast cancer (MBC) overexpressing HER2 (human epidermal growth factor receptor 2) are currently selected for treatment with trastuzumab, but not all patients respond. PATIENTS AND METHODS Using a novel assay, HER2 protein expression (H2T) was measured in formalin-fixed, paraffin-embedded primary breast tumors from 98 women treated with trastuzumab-based therapy for MBC. Using subpopulation treatment effect pattern plots, the population was divided into H2T low (H2T < 13.8), H2T high (H2T ≥ 68.5), and H2T intermediate (13.8 ≤ H2T < 68.5) subgroups. Kaplan-Meier (KM) analyses were carried out comparing the groups for time to progression (TTP) and overall survival (OS). Cox multivariate analyses were carried out to identify correlates of clinical outcome. Bootstrapping analyses were carried out to test the robustness of the results. RESULTS TTP improved with increasing H2T until, at the highest levels of H2T, an abrupt decrease in the TTP was observed. KM analyses demonstrated that patients with H2T low tumors [median TTP 4.2 months, hazard ratio (HR) = 3.7, P < 0.0001] or H2T high tumors (median TTP 4.6 months, HR = 2.7, P = 0.008) had significantly shorter TTP than patients whose tumors were H2T intermediate (median TTP 12 months). OS analyses yielded similar results. CONCLUSIONS MBC patients with very high levels of H2T may represent a subgroup with de novo resistance to trastuzumab. These results are preliminary and require confirmation in larger controlled clinical cohorts.
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Affiliation(s)
- M Bates
- Division of Clinical Research.
| | - J Sperinde
- Division of Research and Development, Monogram Biosciences, South San Francisco, USA
| | - W J Köstler
- Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - S M Ali
- Department of Medicine, Lebanon Veterans Affairs Medical Center, Lebanon
| | - K Leitzel
- Department of Medicine, Division of Hematology/Medical Oncology, Penn State Hershey Medical Center, Hershey
| | - E M Fuchs
- Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - A Paquet
- Department of Translational Medicine and Biomarker Development, Division of Biostatics and Bioinformatics, Monogram Biosciences, South San Francisco, USA
| | - Y Lie
- Division of Clinical Research
| | | | - R Horvat
- Departments of Clinical Pathology
| | - C F Singer
- Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - J Winslow
- Division of Research and Development, Monogram Biosciences, South San Francisco, USA
| | | | - W Huang
- Division of Clinical Research
| | - A Lipton
- Department of Medicine, Division of Hematology/Medical Oncology, Penn State Hershey Medical Center, Hershey
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Hessol NA, Napolitano LA, Smith D, Lie Y, Levine A, Young M, Cohen M, Minkoff H, Anastos K, D'Souza G, Greenblatt RM, Goedert JJ. HIV tropism and decreased risk of breast cancer. PLoS One 2010; 5:e14349. [PMID: 21179547 PMCID: PMC3002931 DOI: 10.1371/journal.pone.0014349] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 11/19/2010] [Indexed: 11/21/2022] Open
Abstract
Background During the first two decades of the U.S. AIDS epidemic, and unlike some malignancies, breast cancer risk was significantly lower for women with human immunodeficiency virus (HIV) infection compared to the general population. This deficit in HIV-associated breast cancer could not be attributed to differences in survival, immune deficiency, childbearing or other breast cancer risk factors. HIV infects mononuclear immune cells by binding to the CD4 molecule and to CCR5 or CXCR4 chemokine coreceptors. Neoplastic breast cells commonly express CXCR4 but not CCR5. In vitro, binding HIV envelope protein to CXCR4 has been shown to induce apoptosis of neoplastic breast cells. Based on these observations, we hypothesized that breast cancer risk would be lower among women with CXCR4-tropic HIV infection. Methods and Findings We conducted a breast cancer nested case-control study among women who participated in the WIHS and HERS HIV cohort studies with longitudinally collected risk factor data and plasma. Cases were HIV-infected women (mean age 46 years) who had stored plasma collected within 24 months of breast cancer diagnosis and an HIV viral load ≥500 copies/mL. Three HIV-infected control women, without breast cancer, were matched to each case based on age and plasma collection date. CXCR4-tropism was determined by a phenotypic tropism assay. Odds ratios (OR) and 95% confidence intervals (CI) for breast cancer were estimated by exact conditional logistic regression. Two (9%) of 23 breast cancer cases had CXCR4-tropic HIV, compared to 19 (28%) of 69 matched controls. Breast cancer risk was significantly and independently reduced with CXCR4 tropism (adjusted odds ratio, 0.10, 95% CI 0.002–0.84) and with menopause (adjusted odds ratio, 0.08, 95% CI 0.001–0.83). Adjustment for CD4+ cell count, HIV viral load, and use of antiretroviral therapy did not attenuate the association between infection with CXCR4-tropic HIV and breast cancer. Conclusions Low breast cancer risk with HIV is specifically linked to CXCR4-using variants of HIV. These variants are thought to exclusively bind to and signal through a receptor that is commonly expressed on hyperplastic and neoplastic breast duct cells. Additional studies are needed to confirm these observations and to understand how CXCR4 might reduce breast cancer risk.
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Affiliation(s)
- Nancy A. Hessol
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America
| | - Laura A. Napolitano
- Monogram Biosciences, South San Francisco, California, United States of America
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Dawn Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Yolanda Lie
- Monogram Biosciences, South San Francisco, California, United States of America
| | - Alexandra Levine
- City of Hope National Medical Center, Duarte, California, United States of America
- Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Mary Young
- Georgetown University School of Medicine, Washington D.C., United States of America
| | - Mardge Cohen
- Departments of Medicine, Stroger Hospital and Rush University, Chicago, Illinois, United States of America
| | - Howard Minkoff
- Maimonides Medical Center and State University of New York, Health Sciences Center at Brooklyn, Brooklyn, New York, United States of America
| | - Kathryn Anastos
- Montefiore Medical Center, Bronx, New York, United States of America
| | - Gypsyamber D'Souza
- Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Ruth M. Greenblatt
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America
| | - James J. Goedert
- Infections & Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
- * E-mail:
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Hurley J, Welsh C, Fort AC, Weidler J, Paquet A, Huang W, Lie Y, Gupta S, Bates MP, Pegram MD. Correlation between quantitative HER2 protein level and pathologic complete response (pCR) in HER2-positive (+) breast cancer patients (pts) treated with neoadjuvant (NEO) dose-dense (dd) chemotherapy plus trastuzumab. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.586] [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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Leitzel K, Conte P, Guarneri V, Barbieri E, Huang W, Ali S, Ali S, Haddad M, Sperinde J, Lie Y, Weidler J, Bates M, Lipton A. Discordant HER2 Total and HER2 Homodimer Levels by HERmark Analysis in Matched Primary and Metastatic Breast Cancer FFPE Specimens. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-2131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER-2/neu is over-expressed in approximately 25% of primary invasive breast cancers and selection of patients for consideration of trastuzumab is a critical step in defining the treatment plan. We have previously reported that quantitative measurements of HER2 protein expression (H2T) and HER2 homodimers (H2D) using the HERmark assay identifies sub-populations of “HER2-positive” patients (by IHC and/or FISH) that have different clinical outcomes on trastuzumab (Leitzel, ASCO 2008; Lipton, SABCS 2008). Previous studies report up to a 20 % discordance in HER2 status using conventional IHC or FISH analysis between the primary and metastatic breast tumors. Here we correlate HER2 total and homodimer levels in matched primary and metastatic tissue from the same patient.Methods: 27 patients had matched primary and metastatic FFPE (formalin-fixed, paraffin-embedded) specimens tested in the HERmark assay to quantitate and compare their H2T and H2D expression levels.Results: FFPE tissue was available from 27 primary breast cancers and metachronous metastatic sites. Metastatic lesions included 7 skin, 5 lymph node, 3 bone, 3 pleura, 2 brain, 2 chest wall, and 5 other soft tissue lesions. The median elapsed time between matched primary and metastatic sites was 71 mo. (range 9-137 mo). During the time period between the primary specimen harvest and the metastatic biopsy, 6 patients were treated with chemotherapy alone, 10 received hormonal therapy without trastuzumab, 3 patients received trastuzumab, and 3 received no treatment. Treatment was not known for 5 patients. For the whole population, there was a weak to moderate positive correlation between primary and metastatic cancers with H2T (r2=0.36, p<0.001) and for H2D (r2=0.27, p<0.006). Using the optimized time to progression (TTP) positional scanning cutpoints for H2T and H2D defined in our previous reports, 4/20 patients (20%) converted from low to high, and 1/7 (14%) converted from high to low H2T. Using the H2D cutpoint, 7/15 patients (47%) converted from low to high, and 3/12 (25%) converted from high to low H2D. Overall discordance between primary and metastatic sites was 19% for H2T, and 37% for H2D.Conclusions: HERmark analysis of matching primary and metastatic breast cancers revealed 19% discordance for H2T, and 37% for H2D. The most frequent conversion was from low HER2 in the primary tissue to high HER2 in the metastatic site.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2131.
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Affiliation(s)
- K. Leitzel
- 1Penn State / Hershey Medical Center, PA,
| | | | | | | | | | - S. Ali
- 1Penn State / Hershey Medical Center, PA,
| | - S. Ali
- 4Lebanon VA Medical Center, PA,
| | | | | | - Y. Lie
- 3Monogram Biosciences Inc., CA,
| | | | | | - A. Lipton
- 1Penn State / Hershey Medical Center, PA,
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Huang W, Weidler J, Lie Y, Whitcomb J, Leinonen M, Bono P, Isola J, Kellokumpu-Lehtinen P, Bates M, Joensuu H. Correlation of quantitative total HER2 expression and HER2 homodimers with histopathologic characteristics of breast cancers in the FinHer study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.11061] [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
11061 Background: We recently reported that the HERmark assay (Monogram Biosciences) accurately measures continua of total HER2 expression (H2T) and HER2 homodimers (H2D) over a wide (∼3 logs) dynamic range, and that a higher concordance was observed between H2T and HER2 status with more stringent central tests as compared with IHC tests performed locally (Joensuu et al, 2008 SABCS,abstract 2071). H2D/H2T ratio was reported as a marker of activated HER2 and a prognosticator of disease progression in HER2+ patients not treated with trastuzumab in the adjuvant setting (Bates et al, 2008 SABCS,abstract 1074). In this follow-up analysis, H2T, H2D, and H2D/H2T ratio were correlated with histopathologic characteristics of breast cancers in the FinHer study. Methods: The HERmark assay was used to measure H2T and H2D in 899 formalin-fixed, paraffin-embedded FinHer specimens. The results were correlated with histopathologic characteristics of breast cancers in the FinHer study (Joensuu et al, N Engl J Med2006;354), including estrogen receptor/progesterone receptor (ER/PR), tumor grade, tumor size, lymph node metastasis, and stage. Results: Higher H2T and H2D levels correlated with ER/PR negativity and high tumor grade (P<0.0001). 42% (102/244) of ER- and 37% (137/374) of PR- cases were HERmark Positive; while 17% (110/655) of ER+ and 14% (75/524) of PR+ cases were HERmark Positive. 10% (13/136) of grade 1, 18% (65/353) of grade 2, and 35% (131/375) of grade 3 tumors were HERmark Positive. No significant association was found between H2T or H2D and tumor size, lymph node metastasis or stage. ER/PR negative and poorly differentiated cancers had higher H2D/H2T ratios (P=0.013), and H2D/H2T ratios >0.6 were associated with smaller primary tumor diameters at the time of cancer detection (P=0.009). Conclusions: The quantitative H2T measurement confirms the known correlations between HER2 expression and histopathologic characteristics of breast cancer. The novel H2D measurement and H2D/H2T ratio may provide further insights into HER2 activation and better diagnostic tests for targeted HER2 therapy. [Table: see text]
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Affiliation(s)
- W. Huang
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - J. Weidler
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - Y. Lie
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - J. Whitcomb
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - M. Leinonen
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - P. Bono
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - J. Isola
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - P. Kellokumpu-Lehtinen
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - M. Bates
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
| | - H. Joensuu
- Monogram Biosciences Inc, South San Francisco, CA; 4Pharma, Turku, Finland; Helsinki University Central Hospital, Helsinki, Finland; Tampere University Hospital, Tampere, Finland
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Andrews DT, Williams DL, Alexander KD, Lie Y. Randomised comparison of the Classic Laryngeal Mask Airway with the Cobra Perilaryngeal Airway during anaesthesia in spontaneously breathing adult patients. Anaesth Intensive Care 2009; 37:85-92. [PMID: 19157352 DOI: 10.1177/0310057x0903700107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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
We tested the hypothesis that the Cobra Perilaryngeal Airway (PLA) with its high volume low-pressure cuff would provide superior airway leakage pressure compared with the Classic Laryngeal Mask Airway (LMA) in spontaneously breathing adult patients. Ninety consecutive adult patients were randomly allocated to receive one of these two supralaryngeal devices. The airway leakage pressure was higher for the PLA compared with the LMA (22 +/- 9 cmH2O vs. 18 +/- 6 cmH2O; P < 0.05). The mean airway device intracuff pressure was lower for the PLA compared to the LMA (36.1 +/- 15.2 mmHg vs. 86.3 +/- 25.3 mmHg P < 0.0001). The time required to achieve successful insertion was greater for the PLA compared with the LMA (39 +/- 21 seconds vs. 27 +/- 10 seconds; P < 0.005). The number of attempts required to achieve successful insertion and the incidence of postoperative complications were similar in both groups. The findings suggest that the PLA provides a superior airway seal at a lower intracuff pressure compared to the LMA. However the time for successful insertion may be increased.
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Affiliation(s)
- D T Andrews
- Department ofAnaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Joensuu H, Weidler J, Lie Y, Sherwood T, Whitcomb J, Leinonen M, Bono P, Isola J, Kellokumpu-Lehtinen P, Bates M, Huang W. Quantitative measurements of HER2 expression and HER2 homodimer using a novel proximity based assay: comparison with HER2 status by immunohistochemistry and chromogenic in situ hybridization in the FinHer study. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #2071
Background: The accuracy and reliability of current methods, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), to assess HER2 status has recently been a subject of debate. The best method to assess HER2 status remains controversial. We developed a novel assay (HERmark, Monogram Biosciences) that provides precise quantification of HER2 expression (H2T) and HER2 homodimer (H2D) in formalin-fixed paraffin-embedded (FFPE) tissues. We compared H2T and H2D to local IHC, central chromogenic in situ hybridization (CISH) and central IHC retesting of breast cancers from the FinHer study.
 Methods: H2T and H2D were detected through light-dependent release of fluorescent tags (VeraTag reporters) conjugated to a HER2 antibody, requiring proximity to a second HER2 “scissors” antibody. The VeraTag signal was quantified by capillary electrophoresis and normalized to tumor area. Assay comparisons correlated H2T and H2D with HER2 testing by local IHC and central CISH from FinHer (Joensuu et al, N Engl J Med 2006;354), as well as central HER2 status reassessment by combination of externally performed central IHC retesting (PhenoPath labs, Seattle, WA) and central CISH (FinHer) according to ASCO/CAP guideline for HER2 testing in breast cancer (Wolff et al, Arch Pathol Lab Med 2007;131).
 Results: H2T and H2D in 899 evaluable FinHer samples described a continuum over a wide dynamic range (∼ 3 logs), in contrast with conventional IHC categories (0-3+). The correlation between H2T and IHC categories was significant (P < .0001). Overlap of H2T among the IHC categories was observed. H2D showed a similar correlation with IHC and a general correlation with H2T (P < .0001). A H2T cutoff value, based on its ability to distinguish high and low responders in a cohort of metastatic breast cancer patients treated with trastuzumab-based regimens (log10 H2T= 1.14, Leitzel et al, 2008 ASCO, abstract 1002), was used to define HERmark negative (-) and positive (+), which were then compared with IHC and CISH results. The concordances between HERmark (-) and local IHC (-), central CISH (-), and central HER2 reassessment (-) were 89%, 84%, and 91%, respectively. The concordances between HERmark (+) and local IHC (+), central CISH (+), and central HER2 reassessment (+) were 71%, 89%, and 92%, respectively. The HERmark test showed greater overall concordance with central HER2 reassessment (91%) than with local IHC (84%) and central CISH (87%)
 Conclusions: HERmark reliably measures H2T and H2D in FFPE tissues. H2T showed excellent concordance with central HER2 status according to ASCO/CAP guideline for HER2 testing. The precise quantification of H2T and H2D may provide novel, quantifiable, predictive tests for targeted HER2 therapy.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2071.
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Affiliation(s)
- H Joensuu
- 3 Helsinki University Central Hospital, Helsinki, Finland
| | - J Weidler
- 1 Monogram Biosciences, Inc., So. San Francisco
| | - Y Lie
- 1 Monogram Biosciences, Inc., So. San Francisco
| | - T Sherwood
- 1 Monogram Biosciences, Inc., So. San Francisco
| | - J Whitcomb
- 1 Monogram Biosciences, Inc., So. San Francisco
| | | | - P Bono
- 3 Helsinki University Central Hospital, Helsinki, Finland
| | - J Isola
- 4 Tampere University Hospital, Tampere, Finland
| | | | - M Bates
- 1 Monogram Biosciences, Inc., So. San Francisco
| | - W Huang
- 1 Monogram Biosciences, Inc., So. San Francisco
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De Luca A, Weidler J, Di Giambenedetto S, Coakley E, Cingolani A, Bates M, Lie Y, Pesano R, Cauda R, Schapiro J. Association of HIV-1 Replication Capacity With Treatment Outcomes in Patients With Virologic Treatment Failure. J Acquir Immune Defic Syndr 2007; 45:411-7. [PMID: 17554216 DOI: 10.1097/qai.0b013e318074f008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The extent to which HIV-1 replication capacity (RC) influences the response to therapy remains to be established. METHODS Phenotypic susceptibility and RC of baseline isolates (n = 139) from patients enrolled in the ARGENTA trial were measured and correlated to treatment outcomes over 36 months. RESULTS RC in baseline isolates correlated with the number of phenotypically active drugs (R = 0.34, P < 0.001). Crude viral RC did not predict treatment outcomes. When viral RC was adjusted by baseline CD4 cell counts, HIV-1 RNA levels, and phenotypic susceptibility to the rescue regimen, it showed significant association with the immunologic outcome (per log10 RC higher, mean difference in 36 months' time-averaged change from baseline CD4 count = -68 cells/microL; P = 0.020). In the subgroup of patients with 3 or more phenotypically active drugs in the salvage regimen (n = 35, median RC = 65%), subjects carrying isolates with RC < or =65% as compared to those with RC >65% had better time-averaged HIV-1 RNA responses (mean: -1.04 vs. -0.32 log10 copies/mL; P = 0.012) and CD4 cell responses (mean: 132 vs. -7 cells/microL; P = 0.006). Among patients with HIV-1 RNA levels persistently >500 copies/mL (n = 61), RC, on a log10 basis, was inversely associated with time-averaged 36-month CD4 cell responses (beta = -0.26; P = 0.046). CONCLUSION After normalizing for viral susceptibility to the employed regimen or in patient subsets with suboptimal virologic response, higher viral RC may predict worse subsequent treatment outcomes.
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Affiliation(s)
- Andrea De Luca
- Institute of Clinical Infectious Diseases, Policlinoco Universitario Agostino Gemelli, Catholic University of the Sacred Heart, Largo F. Vito 1, 00168 Rome, Italy.
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Masquelier B, Capdepont S, Neau D, Peuchant O, Taupin JL, Coakley E, Lie Y, Carpentier W, Dabis F, Fleury HJA. Virological characterization of an infection with a dual-tropic, multidrug-resistant HIV-1 and further evolution on antiretroviral therapy. AIDS 2007; 21:103-6. [PMID: 17148975 DOI: 10.1097/qad.0b013e3280117053] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We studied a case of recent infection with multidrug-resistant (MDR) HIV-1. Over 16 months off-therapy, the CD4 cell count decreased from 419 to 184 cells/mul. Antiretroviral therapy (ART) then led to an incomplete virological response but to an immunological benefit, concurrently with a shift to CCR5-only tropism and a reduction in replication capacity. ART, even if suboptimal, can be of interest in the case of MDR virus infection.
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Affiliation(s)
- Bernard Masquelier
- Department of Virologie et Immunologie Biologique, CHU de Bordeaux, Bordeaux, France
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