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Mohammed FY, Abdrabo AA, Ahmed SM, Abdulbadie A, Eltahir Z, Ismail AM. Effect of dexamethasone administration on gonadal-fertility functions in female albino rats. Pan Afr Med J 2023. [DOI: 10.11604/pamj.2023.44.160.36748] [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: 04/08/2023] Open
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M Abbas A, Shalabi MG, A Elsiddig S, Eltahir Z, M A Babker A, G Ahmed H. Evaluation of Angiogenesis by Using CD105 and CD34 in Sudanese Breast Cancer Patients. Pak J Biol Sci 2021; 24:1144-1151. [PMID: 34842386 DOI: 10.3923/pjbs.2021.1144.1151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
<b>Background and Objective:</b> Angiogenesis is a mechanism by which new blood vessels are developed in healing and tumour tissues, where it is necessary for regeneration growth, tumour cells survival and metastasis. This study aimed to assess the angiogenesis mechanism among Sudanese females with breast cancer using anti-CD34 and anti-CD105 markers. <b>Materials and Methods:</b> Three hundred female representative Formalin-Fixed Paraffin-Embedded (FFPE) breast tissue blocks were included in this study. Of the 300 representative tissue blocks, 200 were breast cancer patient's tissues (confirmed cases) and 100 were normal breast tissues (controls). Their ages mean±SD, 47.3±12.9 years. <b>Results:</b> The results showed the MVD of CD34 significantly increased in malignant lesions as compared to normal breast tissues. The mean of MVD CD34 and MVD CD105 showed statistical differences among different histologic types of breast cancer. Also, a strong positive correlation was detected between the manual and automated MVD counting methods. Also, the current study revealed no significant differences were observed in mean MVD counting for both markers and menopausal status or the age groups of the study population. <b>Conclusion:</b> The MVD is a good tool for assessing prognostic markers. The CD105 marker has a high specificity to the new evolving tumour vessels and is a useful predictor for angiogenesis and breast cancer metastasis.
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Khan K, Rata M, Cunningham D, Koh DM, Tunariu N, Hahne JC, Vlachogiannis G, Hedayat S, Marchetti S, Lampis A, Damavandi MD, Lote H, Rana I, Williams A, Eccles SA, Fontana E, Collins D, Eltahir Z, Rao S, Watkins D, Starling N, Thomas J, Kalaitzaki E, Fotiadis N, Begum R, Bali M, Rugge M, Temple E, Fassan M, Chau I, Braconi C, Valeri N. Functional imaging and circulating biomarkers of response to regorafenib in treatment-refractory metastatic colorectal cancer patients in a prospective phase II study. Gut 2018; 67:1484-1492. [PMID: 28790159 PMCID: PMC6204951 DOI: 10.1136/gutjnl-2017-314178] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/16/2017] [Accepted: 05/23/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Regorafenib demonstrated efficacy in patients with metastatic colorectal cancer (mCRC). Lack of predictive biomarkers, potential toxicities and cost-effectiveness concerns highlight the unmet need for better patient selection. DESIGN Patients with RAS mutant mCRC with biopsiable metastases were enrolled in this phase II trial. Dynamic contrast-enhanced (DCE) MRI was acquired pretreatment and at day 15 post-treatment. Median values of volume transfer constant (Ktrans), enhancing fraction (EF) and their product KEF (summarised median values of Ktrans× EF) were generated. Circulating tumour (ct) DNA was collected monthly until progressive disease and tested for clonal RAS mutations by digital-droplet PCR. Tumour vasculature (CD-31) was scored by immunohistochemistry on 70 sequential tissue biopsies. RESULTS Twenty-seven patients with paired DCE-MRI scans were analysed. Median KEF decrease was 58.2%. Of the 23 patients with outcome data, >70% drop in KEF (6/23) was associated with higher disease control rate (p=0.048) measured by RECIST V. 1.1 at 2 months, improved progression-free survival (PFS) (HR 0.16 (95% CI 0.04 to 0.72), p=0.02), 4-month PFS (66.7% vs 23.5%) and overall survival (OS) (HR 0.08 (95% CI 0.01 to 0.63), p=0.02). KEF drop correlated with CD-31 reduction in sequential tissue biopsies (p=0.04). RAS mutant clones decay in ctDNA after 8 weeks of treatment was associated with better PFS (HR 0.21 (95% CI 0.06 to 0.71), p=0.01) and OS (HR 0.28 (95% CI 0.07-1.04), p=0.06). CONCLUSIONS Combining DCE-MRI and ctDNA predicts duration of anti-angiogenic response to regorafenib and may improve patient management with potential health/economic implications.
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Affiliation(s)
- Khurum Khan
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | - Mihaela Rata
- Division of Radiotherapy and Imaging, Cancer Research UK Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - David Cunningham
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Dow-Mu Koh
- Division of Radiotherapy and Imaging, Cancer Research UK Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Nina Tunariu
- Division of Radiotherapy and Imaging, Cancer Research UK Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Jens C Hahne
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | - George Vlachogiannis
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | - Somaieh Hedayat
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | - Silvia Marchetti
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | - Andrea Lampis
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | | | - Hazel Lote
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
| | - Isma Rana
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Anja Williams
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Suzanne A Eccles
- Division of Cancer Therapeutics, The Institute of Cancer Research, London and Sutton, UK
| | - Elisa Fontana
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - David Collins
- Division of Radiotherapy and Imaging, Cancer Research UK Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Zakaria Eltahir
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Sheela Rao
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - David Watkins
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Naureen Starling
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Jan Thomas
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Eleftheria Kalaitzaki
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
- Department of Statistics, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Nicos Fotiadis
- Division of Radiotherapy and Imaging, Cancer Research UK Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Ruwaida Begum
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Maria Bali
- Division of Radiotherapy and Imaging, Cancer Research UK Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Massimo Rugge
- Department of Medicine (DIMED) and Surgical Pathology, University of Padua, Padua, Italy
| | - Eleanor Temple
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Matteo Fassan
- Department of Medicine (DIMED) and Surgical Pathology, University of Padua, Padua, Italy
| | - Ian Chau
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
| | - Chiara Braconi
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London and Sutton, UK
| | - Nicola Valeri
- Department of Medicine, The Royal Marsden NHS Trust, London and Sutton, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton, UK
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4
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Lampis A, Carotenuto P, Vlachogiannis G, Cascione L, Hedayat S, Burke R, Clarke P, Bosma E, Simbolo M, Scarpa A, Yu S, Cole R, Smyth E, Mateos JF, Begum R, Hezelova B, Eltahir Z, Wotherspoon A, Fotiadis N, Bali MA, Nepal C, Khan K, Stubbs M, Hahne JC, Gasparini P, Guzzardo V, Croce CM, Eccles S, Fassan M, Cunningham D, Andersen JB, Workman P, Valeri N, Braconi C. MIR21 Drives Resistance to Heat Shock Protein 90 Inhibition in Cholangiocarcinoma. Gastroenterology 2018; 154:1066-1079.e5. [PMID: 29113809 PMCID: PMC5863695 DOI: 10.1053/j.gastro.2017.10.043] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/12/2017] [Accepted: 10/27/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Cholangiocarcinomas (CCA) are resistant to chemotherapy, so new therapeutic agents are needed. We performed a screen to identify small-molecule compounds that are active against CCAs. Levels of microRNA 21 (MIR21 or miRNA21) are increased in CCAs. We investigated whether miRNA21 mediates resistance of CCA cells and organoids to HSP90 inhibitors. METHODS We performed a high-throughput screen of 484 small-molecule compounds to identify those that reduced viability of 6 human CCA cell lines. We tested the effects of HSP90 inhibitors on cells with disruption of the MIR21 gene, cells incubated with MIR21 inhibitors, and stable cell lines with inducible expression of MIR21. We obtained CCA biopsies from patients, cultured them as organoids (patient-derived organoids). We assessed their architecture, mutation and gene expression patterns, response to compounds in culture, and when grown as subcutaneous xenograft tumors in mice. RESULTS Cells with IDH1 and PBRM1 mutations had the highest level of sensitivity to histone deacetylase inhibitors. HSP90 inhibitors were effective in all cell lines, irrespective of mutations. Sensitivity of cells to HSP90 inhibitors correlated inversely with baseline level of MIR21. Disruption of MIR21 increased cell sensitivity to HSP90 inhibitors. CCA cells that expressed transgenic MIR21 were more resistant to HSP90 inhibitors than cells transfected with control vectors; inactivation of MIR21 in these cells restored sensitivity to these agents. MIR21 was shown to target the DnaJ heat shock protein family (Hsp40) member B5 (DNAJB5). Transgenic expression of DNAJB5 in CCA cells that overexpressed MIR21 re-sensitized them to HSP90 inhibitors. Sensitivity of patient-derived organoids to HSP90 inhibitors, in culture and when grown as xenograft tumors in mice, depended on expression of miRNA21. CONCLUSIONS miRNA21 appears to mediate resistance of CCA cells to HSP90 inhibitors by reducing levels of DNAJB5. HSP90 inhibitors might be developed for the treatment of CCA and miRNA21 might be a marker of sensitivity to these agents.
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Affiliation(s)
| | | | | | - Luciano Cascione
- Bioinformatics Core Unit, Institute of Oncology Research, Bellinzona, Switzerland
| | | | | | - Paul Clarke
- The Institute of Cancer Research, London, UK
| | - Else Bosma
- The Institute of Cancer Research, London, UK
| | - Michele Simbolo
- ARC-Net Research Centre and Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Aldo Scarpa
- ARC-Net Research Centre and Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Sijia Yu
- The Institute of Cancer Research, London, UK
| | | | | | | | | | | | | | | | | | | | - Chirag Nepal
- Biotech Research and Innovation Centre, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Khurum Khan
- The Royal Marsden NHS Trust, London and Surrey, UK
| | - Mark Stubbs
- The Institute of Cancer Research, London, UK
| | | | | | | | | | | | - Matteo Fassan
- ARC-Net Research Centre and Department of Pathology and Diagnostics, University of Verona, Verona, Italy; Department of Medicine, University of Padua, Padua, Italy
| | | | - Jesper B Andersen
- Biotech Research and Innovation Centre, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Nicola Valeri
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London and Surrey, UK
| | - Chiara Braconi
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London and Surrey, UK.
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Vlachogiannis G, Hedayat S, Vatsiou A, Jamin Y, Fernández-Mateos J, Khan K, Lampis A, Eason K, Huntingford I, Burke R, Rata M, Koh DM, Tunariu N, Collins D, Hulkki-Wilson S, Ragulan C, Spiteri I, Moorcraft SY, Chau I, Rao S, Watkins D, Fotiadis N, Bali M, Darvish-Damavandi M, Lote H, Eltahir Z, Smyth EC, Begum R, Clarke PA, Hahne JC, Dowsett M, de Bono J, Workman P, Sadanandam A, Fassan M, Sansom OJ, Eccles S, Starling N, Braconi C, Sottoriva A, Robinson SP, Cunningham D, Valeri N. Patient-derived organoids model treatment response of metastatic gastrointestinal cancers. Science 2018; 359:920-926. [PMID: 29472484 PMCID: PMC6112415 DOI: 10.1126/science.aao2774] [Citation(s) in RCA: 1041] [Impact Index Per Article: 173.5] [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] [Received: 07/04/2017] [Revised: 10/26/2017] [Accepted: 01/11/2018] [Indexed: 12/20/2022]
Abstract
Patient-derived organoids (PDOs) have recently emerged as robust preclinical models; however, their potential to predict clinical outcomes in patients has remained unclear. We report on a living biobank of PDOs from metastatic, heavily pretreated colorectal and gastroesophageal cancer patients recruited in phase 1/2 clinical trials. Phenotypic and genotypic profiling of PDOs showed a high degree of similarity to the original patient tumors. Molecular profiling of tumor organoids was matched to drug-screening results, suggesting that PDOs could complement existing approaches in defining cancer vulnerabilities and improving treatment responses. We compared responses to anticancer agents ex vivo in organoids and PDO-based orthotopic mouse tumor xenograft models with the responses of the patients in clinical trials. Our data suggest that PDOs can recapitulate patient responses in the clinic and could be implemented in personalized medicine programs.
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Affiliation(s)
| | - Somaieh Hedayat
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Alexandra Vatsiou
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Yann Jamin
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Javier Fernández-Mateos
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Khurum Khan
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - Andrea Lampis
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Katherine Eason
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Ian Huntingford
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Rosemary Burke
- Cancer Research UK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Mihaela Rata
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Dow-Mu Koh
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - Nina Tunariu
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - David Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - Sanna Hulkki-Wilson
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Chanthirika Ragulan
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Inmaculada Spiteri
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | | | - Ian Chau
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - Sheela Rao
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - David Watkins
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - Nicos Fotiadis
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - Maria Bali
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | | | - Hazel Lote
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - Zakaria Eltahir
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | | | - Ruwaida Begum
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
| | - Paul A Clarke
- Cancer Research UK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Jens C Hahne
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Mitchell Dowsett
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden Hospital NHS Trust, London, UK
| | - Johann de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Paul Workman
- Cancer Research UK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Anguraj Sadanandam
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology and Cytopathology Unit, University of Padua, Padua, Italy
| | | | - Suzanne Eccles
- Cancer Research UK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | | | - Chiara Braconi
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
- Cancer Research UK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Andrea Sottoriva
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Simon P Robinson
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | | | - Nicola Valeri
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK.
- Department of Medicine, The Royal Marsden NHS Trust, London, UK
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6
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Sclafani F, Chau I, Cunningham D, Hahne JC, Vlachogiannis G, Eltahir Z, Lampis A, Braconi C, Kalaitzaki E, De Castro DG, Wotherspoon A, Capdevila J, Glimelius B, Tarazona N, Begum R, Lote H, Hulkki Wilson S, Mentrasti G, Brown G, Tait D, Oates J, Valeri N. KRAS and BRAF mutations in circulating tumour DNA from locally advanced rectal cancer. Sci Rep 2018; 8:1445. [PMID: 29362371 PMCID: PMC5780472 DOI: 10.1038/s41598-018-19212-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 06/06/2017] [Accepted: 12/27/2017] [Indexed: 12/12/2022] Open
Abstract
There are limited data on circulating, cell-free, tumour (ct)DNA analysis in locally advanced rectal cancer (LARC). Digital droplet (dd)PCR was used to investigate KRAS/BRAF mutations in ctDNA from baseline blood samples of 97 LARC patients who were treated with CAPOX followed by chemoradiotherapy, surgery and adjuvant CAPOX ± cetuximab in a randomised phase II trial. KRAS mutation in G12D, G12V or G13D was detected in the ctDNA of 43% and 35% of patients with tumours that were mutant and wild-type for these hotspot mutations, respectively, according to standard PCR-based analyses on tissue. The detection rate in the ctDNA of 10 patients with less common mutations was 50%. In 26 cases ctDNA analysis revealed KRAS mutations that were not previously found in tissue. Twenty-two of these (84.6%) were detected following repeat tissue testing by ddPCR. Overall, the ctDNA detection rate in the KRAS mutant population was 66%. Detection of KRAS mutation in ctDNA failed to predict prognosis or refine patient selection for cetuximab. While this study confirms the feasibility of ctDNA analysis in LARC and the high sensitivity of ddPCR, larger series are needed to better address the role of ctDNA as a prognostic or predictive tool in this setting.
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Affiliation(s)
- Francesco Sclafani
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - David Cunningham
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Jens C Hahne
- The Institute of Cancer Research, London and Surrey, United Kingdom
| | | | - Zakaria Eltahir
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Andrea Lampis
- The Institute of Cancer Research, London and Surrey, United Kingdom
| | - Chiara Braconi
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
- The Institute of Cancer Research, London and Surrey, United Kingdom
| | | | | | - Andrew Wotherspoon
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Jaume Capdevila
- Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Noelia Tarazona
- Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - Ruwaida Begum
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Hazel Lote
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
- The Institute of Cancer Research, London and Surrey, United Kingdom
| | | | - Giulia Mentrasti
- The Institute of Cancer Research, London and Surrey, United Kingdom
| | - Gina Brown
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Diana Tait
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Jacqueline Oates
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Nicola Valeri
- The Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom.
- The Institute of Cancer Research, London and Surrey, United Kingdom.
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7
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Eltahir Z. An update on precision medicine: Esophageal adenocarcinoma and molecular testing. Mol Biol 2018. [DOI: 10.4172/2168-9547-c1-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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8
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Moorcraft SY, Gonzalez de Castro D, Cunningham D, Jones T, Walker BA, Peckitt C, Yuan LC, Frampton M, Begum R, Eltahir Z, Wotherspoon A, Teixeira Mendes LS, Hulkki Wilson S, Gillbanks A, Baratelli C, Fotiadis N, Patel A, Braconi C, Valeri N, Gerlinger M, Rao S, Watkins D, Chau I, Starling N. Investigating the feasibility of tumour molecular profiling in gastrointestinal malignancies in routine clinical practice. Ann Oncol 2018; 29:230-236. [PMID: 29361134 DOI: 10.1093/annonc/mdx631] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Targeted capture sequencing can potentially facilitate precision medicine, but the feasibility of this approach in gastrointestinal (GI) malignancies is unknown. Patients and methods The FOrMAT (Feasibility of a Molecular Characterisation Approach to Treatment) study was a feasibility study enrolling patients with advanced GI malignancies from February 2014 to November 2015. Targeted capture sequencing (mainly using archival formalin-fixed paraffin-embedded diagnostic/resection samples) was carried out to detect mutations, copy number variations and translocations in up to 46 genes which had prognostic/predictive significance or were targets in current/upcoming clinical trials. Results Of the 222 patients recruited, 215 patients (96.8%) had available tissue samples, 125 patients (56.3%) had ≥16 genes successfully sequenced and 136 patients (61.2%) had ≥1 genes successfully sequenced. Sample characteristics influenced the proportion of successfully sequenced samples, e.g. tumour type (colorectal 70.9%, biliary 52.6%, oesophagogastric 50.7%, pancreas 27.3%, P = 0.002), tumour cellularity (high versus low: 78.3% versus 13.3%, P ≤ 0.001), tumour content (high versus low: 78.6% versus 27.3%, P = 0.001) and type of sample (resection versus biopsy: 82.4% versus 47.6%, P ≤ 0.001). Currently, actionable alterations were detected in 90 (40.5%) of the 222 patients recruited (66% of the 136 patients sequenced) and 2 patients subsequently received a targeted therapy. The most frequently detected currently actionable alterations were mutations in KRAS, BRAF, TP53 and PIK3CA. For the 205 patients with archival samples, the median time to obtain sequencing results was 18.9 weeks, including a median of 4.9 weeks for sample retrieval and 5.1 weeks for sequencing. Conclusions Targeted sequencing detected actionable alterations in formalin-fixed paraffin-embedded samples, but tissue characteristics are of critical importance in determining sequencing success. Routine molecular profiling of GI tumours outside of clinical trials is not an effective use of healthcare resources unless more targeted drugs become available. ClinicalTrials.gov identifier NCT02112357.
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Affiliation(s)
- S Y Moorcraft
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - D Gonzalez de Castro
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - D Cunningham
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - T Jones
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - B A Walker
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - C Peckitt
- Department of Statistics, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - L C Yuan
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - M Frampton
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R Begum
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - Z Eltahir
- Department of Pathology, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - A Wotherspoon
- Department of Pathology, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - L S Teixeira Mendes
- Department of Pathology, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - S Hulkki Wilson
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - A Gillbanks
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - C Baratelli
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - N Fotiadis
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - A Patel
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - C Braconi
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
- The Institute of Cancer Research, London and Sutton, UK
| | - N Valeri
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
- The Institute of Cancer Research, London and Sutton, UK
| | - M Gerlinger
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
- The Institute of Cancer Research, London and Sutton, UK
| | - S Rao
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - D Watkins
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - I Chau
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
| | - N Starling
- Gastrointestinal and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK
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9
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Smyth EC, Wotherspoon A, Peckitt C, Gonzalez D, Hulkki-Wilson S, Eltahir Z, Fassan M, Rugge M, Valeri N, Okines A, Hewish M, Allum W, Stenning S, Nankivell M, Langley R, Cunningham D. Mismatch Repair Deficiency, Microsatellite Instability, and Survival: An Exploratory Analysis of the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) Trial. JAMA Oncol 2017; 3:1197-1203. [PMID: 28241187 PMCID: PMC5824280 DOI: 10.1001/jamaoncol.2016.6762] [Citation(s) in RCA: 331] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/29/2016] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Mismatch repair (MMR) deficiency (MMRD) and microsatellite instability (MSI) are prognostic for survival in many cancers and for resistance to fluoropyrimidines in early colon cancer. However, the effect of MMRD and MSI in curatively resected gastric cancer treated with perioperative chemotherapy is unknown. OBJECTIVE To examine the association among MMRD, MSI, and survival in patients with resectable gastroesophageal cancer randomized to surgery alone or perioperative epirubicin, cisplatin, and fluorouracil chemotherapy in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial. DESIGN, SETTING, AND PARTICIPANTS This secondary post hoc analysis of the MAGIC trial included participants who were treated with surgery alone or perioperative chemotherapy plus surgery for operable gastroesophageal cancer from July 1, 1994, through April 30, 2002. Tumor sections were assessed for expression of the MMR proteins mutL homologue 1, mutS homologue 2, mutS homologue 6, and PMS1 homologue 2. The association among MSI, MMRD, and survival was assessed. MAIN OUTCOMES AND MEASURES Interaction between MMRD and MSI status and overall survival (OS). RESULTS Of the 503 study participants, MSI results were available for 303 patients (283 with microsatellite stability or low MSI [median age, 62 years; 219 males (77.4%)] and 20 with high MSI [median age, 66 years; 14 males (70.0%)]). A total of 254 patients had MSI and MMR results available. Patients treated with surgery alone who had high MSI or MMRD had a median OS that was not reached (95% CI, 11.5 months to not reached) compared with a median OS among those who had neither high MSI nor MMRD of 20.5 months (95% CI, 16.7-27.8 months; hazard ratio, 0.42; 95% CI, 0.15-1.15; P = .09). In contrast, patients treated with chemotherapy plus surgery who had either high MSI or MMRD had a median OS of 9.6 months (95% CI, 0.1-22.5 months) compared with a median OS among those who were neither high MSI nor MMRD of 19.5 months (95% CI, 15.4-35.2 months; hazard ratio, 2.18; 95% CI, 1.08-4.42; P = .03). CONCLUSIONS AND RELEVANCE In the MAGIC trial, MMRD and high MSI were associated with a positive prognostic effect in patients treated with surgery alone and a differentially negative prognostic effect in patients treated with chemotherapy. If independently validated, MSI or MMRD determined by preoperative biopsies could be used to select patients for perioperative chemotherapy.
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Affiliation(s)
- Elizabeth C. Smyth
- Department of Gastrointestinal Oncology and Lymphoma, Royal Marsden Hospital, London and Sutton, United Kingdom
| | - Andrew Wotherspoon
- Department of Pathology, Royal Marsden Hospital, London and Sutton, United Kingdom
| | - Clare Peckitt
- Department of Clinical Research and Development, Royal Marsden Hospital, London and Sutton, United Kingdom
| | - David Gonzalez
- Department of Molecular Pathology, The Institute of Cancer Research, London and Sutton, United Kingdom
| | - Sanna Hulkki-Wilson
- Department of Molecular Pathology, The Institute of Cancer Research, London and Sutton, United Kingdom
| | - Zakaria Eltahir
- Department of Pathology, Royal Marsden Hospital, London and Sutton, United Kingdom
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Massimo Rugge
- Department of Medicine, Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Nicola Valeri
- Department of Gastrointestinal Oncology and Lymphoma, Royal Marsden Hospital, London and Sutton, United Kingdom
- Department of Molecular Pathology, The Institute of Cancer Research, London and Sutton, United Kingdom
| | - Alicia Okines
- Department of Gastrointestinal Oncology and Lymphoma, Royal Marsden Hospital, London and Sutton, United Kingdom
| | - Madeleine Hewish
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Surrey, United Kingdom
| | - William Allum
- Department of Surgery, Royal Marsden Hospital, London and Sutton, United Kingdom
| | - Sally Stenning
- Medical Research Council Clinical Trials Unit, University College London, Institute of Clinical Trials and Methodology, London, United Kingdom
| | - Matthew Nankivell
- Medical Research Council Clinical Trials Unit, University College London, Institute of Clinical Trials and Methodology, London, United Kingdom
| | - Ruth Langley
- Medical Research Council Clinical Trials Unit, University College London, Institute of Clinical Trials and Methodology, London, United Kingdom
| | - David Cunningham
- Department of Gastrointestinal Oncology and Lymphoma, Royal Marsden Hospital, London and Sutton, United Kingdom
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10
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Davies MN, Barber LJ, Spain G, Lopes F, Loga KV, Griffiths B, Woolston A, Alpar D, Gomez M, Lipinski KA, Fenwick K, Eltahir Z, Lise S, Agoston EI, Harsanyi L, Marais R, Wotherspoon A, Szasz A, Springer C, Gerlinger M. Abstract 422: Lymph node metastasis evolution drives immune evasion and targeted therapy resistance in gastro-esophageal adenocarcinomas (GEAs). Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-422] [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
GEAs are aggressive tumors in which several targeted therapy trials have failed. We assessed intratumor heterogeneity (ITH) and its impact on progression and therapy failure by applying an 81-gene NGS panel and SNP array copy number aberration (CNA) analysis to multiple primary tumor (T) regions and lymph node (LN) metastases from 9 GEAs.
Analysis of 39 samples found ITH in all cases. 8 chromosomally instable (CIN) GEAs predominantly evolved through CNAs, with 17-76% of the genome affected by heterogeneous CNAs. A microsatellite instable GEA showed parallel evolution and diversified exclusively through point mutations (58% ITH). This demonstrates ongoing genomic instability rather than punctuated evolution and that specific instability mechanisms impact evolutionary trajectories.
LN metastases contributed more to ITH (p<0.01) than any anatomic location within T. Further, subclonal aberrations that activate the Mitogen Activated Protein Kinase-pathway (MAPK-pw), including ERBB3, ERK2, KRAS and NRAS amplifications (amp) and NRAS mutations, were detected in LN metastases from 4/8 CIN GEAs. Subclonal MAPK-activating amp were enriched in LN (p=0.019) compared to T regions that only exhibited a single subclonal MET amp. Convergent evolution of LN subclones across several GEAs suggests that selection pressures differ systematically between LN and T ecosystems.
To assess the phenotypes established by MAPK-activating amp evolution, we analyzed 135 published primary CIN subtype GEAs. Cytolytic activity (CYT), estimating tumor immune recognition from RNA expression data, correlated with the mutation load in GEAs with EGFR, ERBB2 or MET amp (p=0.04). In contrast, CYT did not correlate with mutation load in GEAs with KRAS or ERBB3 amp (p=0.22, NRAS/ERK2: insufficient data), indicating that these specific alterations, that also recurrently evolved in LN, may enable immune evasion. Downregulation of TAP and Class I MHC genes (p<0.05) in KRAS or ERBB3 amp GEAs suggested impaired antigen processing and presentation as the mechanisms driving T cell immune evasion.
Moreover, ITH of MAPK-activating amp is likely to confer resistance to upstream tyrosine kinase inhibition. We used GEA cell lines with various MAPK-activating amp (ERBB2, MET, NRAS) to investigate downstream MAPK-pw inhibition as a novel strategy to broadly target heterogeneous subclones. Growth control was incomplete with ERK- and MEK-inhibitors but the panRAF/SRC inhibitor CCT196969 was effective in all lines, suggesting that it can effectively intercept subclonal heterogeneity in GEAs.
In conclusion, we identified ITH with parallel and convergent evolution in 9/9 metastatic GEAs. Distinct selection pressures in LN foster the evolution of subclonal MAPK-activating amp that decrease immunogenicity and drive evolutionary pre-adaptation to future targeted drugs that can be intercepted by panRAF/SRC inhibitors.
Citation Format: Matthew N. Davies, Louise J. Barber, Georgia Spain, Filipa Lopes, Katharina von Loga, Beatrice Griffiths, Andrew Woolston, Donat Alpar, Marta Gomez, Kamil A. Lipinski, Kerry Fenwick, Zakaria Eltahir, Stefano Lise, Emese I. Agoston, Laszlo Harsanyi, Richard Marais, Andrew Wotherspoon, A Szasz, Caroline Springer, Marco Gerlinger. Lymph node metastasis evolution drives immune evasion and targeted therapy resistance in gastro-esophageal adenocarcinomas (GEAs) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 422. doi:10.1158/1538-7445.AM2017-422
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Affiliation(s)
| | | | - Georgia Spain
- 1The Institute of Cancer Research, London, United Kingdom
| | - Filipa Lopes
- 1The Institute of Cancer Research, London, United Kingdom
| | | | | | | | - Donat Alpar
- 1The Institute of Cancer Research, London, United Kingdom
| | - Marta Gomez
- 1The Institute of Cancer Research, London, United Kingdom
| | | | - Kerry Fenwick
- 1The Institute of Cancer Research, London, United Kingdom
| | | | - Stefano Lise
- 1The Institute of Cancer Research, London, United Kingdom
| | | | | | - Richard Marais
- 4Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | | | - A Szasz
- 3Semmelweis University, Budapest, Hungary
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11
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Lote H, Spiteri I, Ermini L, Vatsiou A, Roy A, McDonald A, Maka N, Balsitis M, Bose N, Simbolo M, Mafficini A, Lampis A, Hahne JC, Trevisani F, Eltahir Z, Mentrasti G, Findlay C, Kalkman EAJ, Punta M, Werner B, Lise S, Aktipis A, Maley C, Greaves M, Braconi C, White J, Fassan M, Scarpa A, Sottoriva A, Valeri N. Carbon dating cancer: defining the chronology of metastatic progression in colorectal cancer. Ann Oncol 2017; 28:1243-1249. [PMID: 28327965 PMCID: PMC5452067 DOI: 10.1093/annonc/mdx074] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Patients often ask oncologists how long a cancer has been present before causing symptoms or spreading to other organs. The evolutionary trajectory of cancers can be defined using phylogenetic approaches but lack of chronological references makes dating the exact onset of tumours very challenging. Patients and methods Here, we describe the case of a colorectal cancer (CRC) patient presenting with synchronous lung metastasis and metachronous thyroid, chest wall and urinary tract metastases over the course of 5 years. The chest wall metastasis was caused by needle tract seeding, implying a known time of onset. Using whole genome sequencing data from primary and metastatic sites we inferred the complete chronology of the cancer by exploiting the time of needle tract seeding as an in vivo 'stopwatch'. This approach allowed us to follow the progression of the disease back in time, dating each ancestral node of the phylogenetic tree in the past history of the tumour. We used a Bayesian phylogenomic approach, which accounts for possible dynamic changes in mutational rate, to reconstruct the phylogenetic tree and effectively 'carbon date' the malignant progression. Results The primary colon cancer emerged between 5 and 8 years before the clinical diagnosis. The primary tumour metastasized to the lung and the thyroid within a year from its onset. The thyroid lesion presented as a tumour-to-tumour deposit within a benign Hurthle adenoma. Despite rapid metastatic progression from the primary tumour, the patient showed an indolent disease course. Primary cancer and metastases were microsatellite stable and displayed low chromosomal instability. Neo-antigen analysis suggested minimal immunogenicity. Conclusion Our data provide the first in vivo experimental evidence documenting the timing of metastatic progression in CRC and suggest that genomic instability might be more important than the metastatic potential of the primary cancer in dictating CRC fate.
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Affiliation(s)
- H. Lote
- Division of Molecular Pathology, The Institute of Cancer Research, Sutton
- Gastrointestinal Cancers and Lymphoma Unit, The Royal Marsden NHS Trust, Sutton
| | - I. Spiteri
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - L. Ermini
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - A. Vatsiou
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - A. Roy
- Department of Oncology, Crosshouse Hospital, Crosshouse, Kilmarnock
| | - A. McDonald
- Beatson West of Scotland Cancer Centre, Glasgow
| | - N. Maka
- Department of Pathology, Southern General Hospital, Glasgow
| | - M. Balsitis
- Department of Pathology, Crosshouse Hospital, Crosshouse, Kilmarnock, UK
| | - N. Bose
- Department of Oncology, Crosshouse Hospital, Crosshouse, Kilmarnock
| | - M. Simbolo
- Department of Pathology and Diagnostics, ARC-NET Research Centre University of Verona, Verona, Italy
| | - A. Mafficini
- Department of Pathology and Diagnostics, ARC-NET Research Centre University of Verona, Verona, Italy
| | - A. Lampis
- Division of Molecular Pathology, The Institute of Cancer Research, Sutton
| | - J. C. Hahne
- Division of Molecular Pathology, The Institute of Cancer Research, Sutton
| | - F. Trevisani
- Division of Molecular Pathology, The Institute of Cancer Research, Sutton
| | - Z. Eltahir
- Gastrointestinal Cancers and Lymphoma Unit, The Royal Marsden NHS Trust, Sutton
| | - G. Mentrasti
- Division of Molecular Pathology, The Institute of Cancer Research, Sutton
| | - C. Findlay
- Beatson West of Scotland Cancer Centre, Glasgow
| | | | - M. Punta
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - B. Werner
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - S. Lise
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - A. Aktipis
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
- Center for Evolution and Cancer, University of California San Francisco, San Francisco
- Department of Psychology
| | - C. Maley
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
- Center for Evolution and Cancer, University of California San Francisco, San Francisco
- Biodesign Institute, Arizona State University, Tempe, USA
| | - M. Greaves
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - C. Braconi
- Gastrointestinal Cancers and Lymphoma Unit, The Royal Marsden NHS Trust, Sutton
- Division of Cancer Therapeutics, The Institute of Cancer Research, Sutton, UK
| | - J. White
- Beatson West of Scotland Cancer Centre, Glasgow
| | - M. Fassan
- Department of Pathology and Diagnostics, ARC-NET Research Centre University of Verona, Verona, Italy
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - A. Scarpa
- Department of Pathology and Diagnostics, ARC-NET Research Centre University of Verona, Verona, Italy
| | - A. Sottoriva
- Centre for Evolution and Cancer, The Institute of Cancer Research, London
| | - N. Valeri
- Division of Molecular Pathology, The Institute of Cancer Research, Sutton
- Gastrointestinal Cancers and Lymphoma Unit, The Royal Marsden NHS Trust, Sutton
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12
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Moorcraft SY, Jones T, Walker BA, Ladas G, Kalaitzaki E, Yuan L, Begum R, Eltahir Z, Wotherspoon A, Montero-Fernandez A, Teixeira Mendes LS, Gonzalez de Castro D, Wilson SH, Proszek P, To YM, Hawkes E, Roy A, Cunningham D, Rao S, Watkins D, Starling N, Bowcock AM, Chau I. Molecular profiling of colorectal pulmonary metastases and primary tumours: implications for targeted treatment. Oncotarget 2017; 8:64999-65008. [PMID: 29029407 PMCID: PMC5630307 DOI: 10.18632/oncotarget.17048] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/29/2017] [Indexed: 12/29/2022] Open
Abstract
This study aimed to molecularly characterise colorectal pulmonary metastases (PM) and investigate whether their molecular profiles were concordant with those of the primary tumour. Clinical data and archival formalin fixed paraffin embedded tissue samples were retrospectively collected from patients who underwent ≥ 1 pulmonary metastasectomies for colorectal cancer between 1997–2012. Primary tumour and metastatic samples were analysed using a targeted capture sequencing panel of 46 cancer-associated genes. The 5-year progression-free and overall survival rates for the 81 patients in this study were 32% (95% CI 22–42%) and 77% (95% CI 66–85%) respectively. Fifty-four patients had samples available from ≥ 1 PM, and sequencing data were successfully obtained from 33 PM from 24 patients. The most frequently mutated genes were APC (71%), KRAS (58%) and TP53 (46%). Seventy-three percent of the 15 patients with matched primary and PM samples and 6 of the 7 patients (86%) with data from ≥ 2 PM had concordant molecular profiles. The concordance for KRAS and NRAS was 100%. At our institutions, patients with resectable colorectal PM had a favourable prognosis. RAS mutations were commonly detected in PM and the molecular profiles of colorectal PM were highly concordant with the primary tumour.
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Affiliation(s)
- Sing Y Moorcraft
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Thomas Jones
- The Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Brian A Walker
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - George Ladas
- The Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | | | - Lina Yuan
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Ruwaida Begum
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Zakaria Eltahir
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Andrew Wotherspoon
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | | | | | | | | | - Paula Proszek
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Ye M To
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Eliza Hawkes
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Amitesh Roy
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - David Cunningham
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Sheela Rao
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - David Watkins
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Naureen Starling
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Anne M Bowcock
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
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13
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Sclafani F, Chau I, Cunningham D, Vlachogiannis G, Eltahir Z, Lampis A, Braconi C, Kalaitzaki E, De Castro DG, Wotherspoon A, Capdevila J, Glimelius B, Cervantes A, Begum R, Lote H, Mentrasti G, Hahne J, Tait D, Brown G, Valeri N. KRAS mutations in circulating tumour DNA (ctDNA) in MRI-defined, high-risk, locally-advanced rectal cancer (LARC) patients (pts) from the EXPERT-C trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Moorcraft S, Gonzalez De Castro D, Cunningham D, Walker B, Jones T, Peckitt C, Wilson SH, Wotherspoon A, Te Mendes LS, Begum R, Eltahir Z, Yuan L, Gillbanks A, Baratelli C, Valeri N, Gerlinger M, Braconi C, Chau I, Watkins D, Starling N. Investigating the feasibility of precision medicine in gastrointestinal cancers. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Sclafani F, Chau I, Cunningham D, Lampis A, Hahne JC, Ghidini M, Lote H, Zito D, Tabernero J, Glimelius B, Cervantes A, Begum R, De Castro DG, Wilson SH, Peckitt C, Eltahir Z, Wotherspoon A, Tait D, Brown G, Oates J, Braconi C, Valeri N. Sequence variation in mature microRNA-608 and benefit from neo-adjuvant treatment in locally advanced rectal cancer patients. Carcinogenesis 2016; 37:852-7. [PMID: 27381831 PMCID: PMC5008250 DOI: 10.1093/carcin/bgw073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/21/2016] [Accepted: 06/28/2016] [Indexed: 12/12/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in microRNA genes have been associated with colorectal cancer (CRC) risk, survival and response to treatment. Conflicting results are available on the association between rs4919510, a SNP in mature miR-608 and clinical outcome in CRC. Here, we analyzed the association between rs4919510 and benefit from perioperative treatment in a randomised phase II trial of neoadjuvant Capecitabine and Oxaliplatin (CAPOX) followed by chemo-radiotherapy, surgery and adjuvant CAPOX ± Cetuximab in high-risk locally advanced rectal cancer (LARC). A total of 155/164 (94.5%) patients were assessable. 95 (61.3%) were homozygous for CC, 55 (35.5%) heterozygous (CG) and 5 (3.2%) homozygous for GG. Median follow-up was 64.9 months. In the CAPOX arm the 5-year progression-free survival (PFS) and overall survival (OS) rates were 54.6% and 60.7% for CC and 82.0% and 82.1% for CG/GG, respectively (HR PFS 0.13, 95% CI: 0.12-0.83, P = 0.02; HR OS 0.38, 95% CI: 0.14-1.01, P = 0.05). In the CAPOX-C arm PFS and OS were 73.2 and 82.2%, respectively for CC carriers and 64.6 and 73.1% for CG/GG carriers (HR PFS 1.38, 95% CI: 0.61-3.13, P = 0.44; HR OS 1.34, 95% CI: 0.52-3.48, P = 0.55). An interaction was found between study treatment and rs4919510 genotype for both PFS (P = 0.02) and OS (P = 0.07). This is the first study investigating rs4919510 in LARC. The CC genotype appeared to be associated with worse prognosis compared to the CG/GG genotype in patients treated with chemotherapy and chemo-radiotherapy alone. Addition of Cetuximab to chemotherapy and chemo-radiotherapy in CC carriers appeared to improve clinical outcome.
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Affiliation(s)
- Francesco Sclafani
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Ian Chau
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - David Cunningham
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Andrea Lampis
- Department of Molecular Pathology, The Institute of Cancer Research, Surrey SM2 5NG, UK
| | - Jens Claus Hahne
- Department of Molecular Pathology, The Institute of Cancer Research, Surrey SM2 5NG, UK
| | - Michele Ghidini
- Department of Molecular Pathology, The Institute of Cancer Research, Surrey SM2 5NG, UK
| | - Hazel Lote
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK, Department of Molecular Pathology, The Institute of Cancer Research, Surrey SM2 5NG, UK
| | - Domenico Zito
- Department of Molecular Pathology, The Institute of Cancer Research, Surrey SM2 5NG, UK
| | - Josep Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona 08035, Spain
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, University of Uppsala, Uppsala 78751 85, Sweden
| | - Andres Cervantes
- Department of Haematology and Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia 46010, Spain and
| | - Ruwaida Begum
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | | | - Sanna Hulkki Wilson
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Clare Peckitt
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Zakaria Eltahir
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Andrew Wotherspoon
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Diana Tait
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Gina Brown
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Jacqueline Oates
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK
| | - Chiara Braconi
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK, Department of Cancer Therapeutics, The Institute of Cancer Research, Surrey SM2 5NG, UK
| | - Nicola Valeri
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Surrey SM2 5PT, UK, Department of Molecular Pathology, The Institute of Cancer Research, Surrey SM2 5NG, UK,
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16
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Smyth EC, Wotherspoon A, Peckitt C, Nankivell MG, Eltahir Z, Hulkki Wilson S, Gonzalez de Castro D, Okines AFC, Langley RE, Cunningham D. Correlation between mismatch repair deficiency (MMRd), microsatellite instability (MSI) and survival in MAGIC. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
| | | | - Clare Peckitt
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Matthew Guy Nankivell
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - Zakaria Eltahir
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | | | | | | | - Ruth E Langley
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - David Cunningham
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
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17
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Moorcraft SY, Jones T, Walker B, Ladas G, Kalaitzaki E, Yuan L, Begum R, Eltahir Z, Wotherspoon A, Montero Fernandez A, Teixeira Mendes LS, Gonzalez de Castro D, Hulkki Wilson S, To YM, Bowcock A, Chau I. Comparison of the genetic profiles of primary colorectal cancers and their subsequent pulmonary metastases: Implications for targeted treatment. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15027] [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)
- Sing Yu Moorcraft
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Thomas Jones
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Brian Walker
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - George Ladas
- Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | | | - Lina Yuan
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Ruwaida Begum
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Zakaria Eltahir
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | | | | | | | | | | | - Ye Mong To
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Anne Bowcock
- National Heart and Lung Institute, London, United Kingdom
| | - Ian Chau
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
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Sclafani F, Chau I, Cunningham D, Peckitt C, Lampis A, Hahne JC, Braconi C, Tabernero J, Glimelius B, Cervantes A, Begum R, Gonzalez De Castro D, Hulkki Wilson S, Eltahir Z, Wotherspoon A, Tait D, Brown G, Oates J, Valeri N. Prognostic role of the LCS6 KRAS variant in locally advanced rectal cancer: results of the EXPERT-C trial. Ann Oncol 2015; 26:1936-1941. [PMID: 26162609 PMCID: PMC4551162 DOI: 10.1093/annonc/mdv285] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 05/29/2015] [Accepted: 06/26/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Lethal-7 (let-7) is a tumour suppressor miRNA which acts by down-regulating several oncogenes including KRAS. A single-nucleotide polymorphism (rs61764370, T > G base substitution) in the let-7 complementary site 6 (LCS-6) of KRAS mRNA has been shown to predict prognosis in early-stage colorectal cancer (CRC) and benefit from anti-epidermal growth factor receptor monoclonal antibodies in metastatic CRC. PATIENTS AND METHODS We analysed rs61764370 in EXPERT-C, a randomised phase II trial of neoadjuvant CAPOX followed by chemoradiotherapy, surgery and adjuvant CAPOX plus or minus cetuximab in locally advanced rectal cancer. DNA was isolated from formalin-fixed paraffin-embedded tumour tissue and genotyped using a PCR-based commercially available assay. Kaplan-Meier method and Cox regression analysis were used to calculate survival estimates and compare treatment arms. RESULTS A total of 155/164 (94.5%) patients were successfully analysed, of whom 123 (79.4%) and 32 (20.6%) had the LCS-6 TT and LCS-6 TG genotype, respectively. Carriers of the G allele were found to have a statistically significantly higher rate of complete response (CR) after neoadjuvant therapy (28.1% versus 10.6%; P = 0.020) and a trend for better 5-year progression-free survival (PFS) [77.4% versus 64.5%: hazard ratio (HR) 0.56; P = 0.152] and overall survival (OS) rates (80.3% versus 71.9%: HR 0.59; P = 0.234). Both CR and survival outcomes were independent of the use of cetuximab. The negative prognostic effect associated with KRAS mutation appeared to be stronger in patients with the LCS-6 TT genotype (HR PFS 1.70, P = 0.078; HR OS 1.79, P = 0.082) compared with those with the LCS-6 TG genotype (HR PFS 1.33, P = 0.713; HR OS 1.01, P = 0.995). CONCLUSION This analysis suggests that rs61764370 may be a biomarker of response to neoadjuvant treatment and an indicator of favourable outcome in locally advanced rectal cancer possibly by mitigating the poor prognosis of KRAS mutation. In this setting, however, this polymorphism does not appear to predict cetuximab benefit.
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Affiliation(s)
- F Sclafani
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - I Chau
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - D Cunningham
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - C Peckitt
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - A Lampis
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton
| | - J C Hahne
- Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton
| | - C Braconi
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey; Division of Cancer Therapeutics, The Institute of Cancer Research, London and Sutton, UK
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B Glimelius
- Department of Immunology, Genetics and Pathology, University of Uppsala, Uppsala, Sweden
| | - A Cervantes
- Department of Hematology and Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - R Begum
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - D Gonzalez De Castro
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - S Hulkki Wilson
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - Z Eltahir
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - A Wotherspoon
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - D Tait
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - G Brown
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - J Oates
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey
| | - N Valeri
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London and Surrey; Division of Molecular Pathology, The Institute of Cancer Research, London and Sutton.
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Davies MN, Alpar D, Griffiths B, Barber LJ, Lipinski KA, Eltahir Z, Agoston E, Harsanyi L, Wotherspoon A, Szasz AM, Gerlinger M. Intratumor heterogeneity of DNA copy number aberrations in gastric and oesophageal adenocarcinomas. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.78] [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
78 Background: DNA copy number aberrations (CNAs) are common in oesophageal and gastric adenocarcinomas (OGCs) and display extensive inter-tumour heterogeneity. CNA patterns define gastric cancer molecular subtypes and ERBB2 amplifications, present in a small fraction of patients with OGC, are predictive for ERBB2-targeted drug sensitivity. Together, this suggests a critical role of CNAs determining OGC tumour biology and clinical outcomes. Despite this, predictive and prognostic CNA biomarkers have not been identified for the majority of OGCs, precluding the development of effective personalized therapy approaches for these aggressive tumours. Intra-tumour heterogeneity, characterized by the presence of multiple subclones with distinct genetic profiles within an individual cancer, can hinder the accurate molecular analysis and classification of tumours. The aim of this pilot study was to assess whether chemotherapy-naïve localized OGCs display intra-tumour macroheterogeneity of CNA profiles. Methods: Tissue specimens from four tumour regions representing the macroscopic spatial extent of each of five OGCs were systematically collected after surgical resection. DNA extracted from these FFPE specimens was analysed by molecular inversion probe SNP arrays for high resolution CNA detection. Results: Comparison of genome wide copy number and B-allele frequency profiles suggested highly concordant CNA profiles across the regions from individual primary tumours. Eight driver CNAs leading to amplification of the MET, KRAS, ERBB2, PIK3CA or FGFR2 oncogenes were identified in 4/5 tumours. Only one out of these eight driver CNA’s, harbouring the KRAS oncogene, was heterogeneous within a tumour. Conclusions: Although chromosomal instability is thought to be common in this tumour type, this pilot study suggests that macroheterogeneity is limited and that CNA profiles assessed from a single tumour biopsy are likely to be representative of the dominant CNA profile of localized OGCs. Thus, clinical correlative CNA analyses may be possible from single biopsies of localized OGCs. Mutational heterogeneity and microheterogeneity in microdissected and single cells are currently being investigated.
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Affiliation(s)
- Matthew N Davies
- Translational Oncogenomics Lab, The Institute of Cancer Research, London, United Kingdom
| | - Donat Alpar
- Translational Oncogenomics Lab, The Institute of Cancer Research, London, United Kingdom
| | - Beatrice Griffiths
- Translational Oncogenomics Lab, The Institute of Cancer Research, London, United Kingdom
| | - Louise J Barber
- Translational Oncogenomics Lab, The Institute of Cancer Research, London, United Kingdom
| | - Kamil A Lipinski
- Translational Oncogenomics Lab, The Institute of Cancer Research, London, United Kingdom
| | - Zakaria Eltahir
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Emese Agoston
- First Department of Surgery, Semmelweis University, Budapest, Hungary
| | - Laszlo Harsanyi
- First Department of Surgery, Semmelweis University, Budapest, Hungary
| | | | - A Marcell Szasz
- Second Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Marco Gerlinger
- Translational Oncogenomics Lab, The Institute of Cancer Research, London, United Kingdom
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20
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Sclafani F, Chau I, Cunningham D, Lampis A, Hahne J, Braconi C, Peckitt C, Gonzalez D, Hullki Wilson S, Capdevila J, Glimelius B, Cervantes A, Begum R, Brown G, Tait DM, Wotherspoon A, Eltahir Z, Yusuf-Adam S, Oates JR, Valeri N. Prognostic effect of a single nucleotide polymorphism (SNP) in MIR608 in patients with high-risk locally advanced rectal cancer (LARC): Results of the EXPERT-C trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
581 Background: An association between rs4919510, a SNP of mir-608, and prognosis of patients with colorectal cancer has been reported. However, no studies have analysed the role of this SNP in LARC. We conducted a pharmacogenomic analysis of rs4919510 in EXPERT-C, a randomised phase II trial of neoadjuvant CAPOX followed by chemoradiotherapy, surgery and adjuvant CAPOX ± cetuximab in high-risk LARC. Methods: SNP analysis was performed on DNA extracted from tumour tissue. Kaplan-Meier method and Cox regression analysis were used to calculate survival estimates and compare treatment arms. Results: A total of 155/164 (94.5%) patients had tumours assessable for rs4919510 genotyping. 95 (61.3%) were homozygous for CC, 55 (35.5%) heterozygous (CG) and 5 (3.2%) homozygous for GG with no deviation from the Hardy-Weinberg equilibrium (p=0.379). Genotypes were evenly distributed in the two treatment groups and no association with baseline clinico-pathological characteristics or tumour molecular status (including RAS) was observed. Complete response did not differ according to the tumour genotype in the entire population (14.7% for CC, 13.3% for CG/GG) and was not influenced by treatment (12.0% for CC and 14.3% for CG/GG in CAPOX, 17.8% for CC and 12.5% for CG/GG in CAPOX-C) (all p values>0.05). Median follow-up was 64.9 months. In the CAPOX arm the 5-yr PFS and OS rates were 54.6% and 60.7% for CC and 82.0% and 82.1% for CG/GG, respectively (HR PFS 0.13, 95% CI: 0.12-0.83, p=0.02, HR OS 0.38, 95% CI: 0.14-1.01, p=0.05). In the CAPOX-C arm the same survival figures were 73.2% and 82.2% for CC and 64.6% and 73.1% for CG/GG (HR PFS 1.38, 95% CI: 0.61-3.13, p=0.44, HR OS 1.34, 95% CI: 0.52-3.48, p=0.55). An interaction was found between study treatment and rs4919510 genotype for both PFS (p=0.02) and OS (p=0.07). Conclusions: This is the first study investigating rs4919510 in LARC. We found that the CC genotype was associated with worse prognosis compared to the CG/GG genotype in patients treated with chemotherapy alone but not in those treated with cetuximab. The addition of cetuximab to chemotherapy may mitigate the unfavourable prognostic associated with the CC genotype.
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Affiliation(s)
| | - Ian Chau
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - David Cunningham
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Andrea Lampis
- Institute of Cancer Research, London, United Kingdom
| | - Jens Hahne
- Institute of Cancer Research, London, United Kingdom
| | | | - Clare Peckitt
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - David Gonzalez
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | | | | | | | - Andres Cervantes
- Department of Hematology and Medical Oncology, INCLIVA, University of Valencia, Valencia, Spain
| | - Ruwaida Begum
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Gina Brown
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Diana M. Tait
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | | | - Zakaria Eltahir
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Sandra Yusuf-Adam
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | | | - Nicola Valeri
- Institute of Cancer Research, London, United Kingdom
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21
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Thompson V, Frentzas S, Vermeulen P, Foo S, Eltahir Z, Brown G, Cunningham D, Reynolds A. 32: Proffered Paper: Vessel co-option in colorectal cancer liver metastases mediates resistance to conventional anti-angiogenic therapy. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50032-9] [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: 11/16/2022]
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22
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Sclafani F, Roy A, Cunningham D, Wotherspoon A, Peckitt C, Gonzalez de Castro D, Tabernero J, Glimelius B, Cervantes A, Eltahir Z, Oates J, Chau I. HER2 in high-risk rectal cancer patients treated in EXPERT-C, a randomized phase II trial of neoadjuvant capecitabine and oxaliplatin (CAPOX) and chemoradiotherapy (CRT) with or without cetuximab. Ann Oncol 2013; 24:3123-8. [PMID: 24146218 DOI: 10.1093/annonc/mdt408] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND HER2 is an established therapeutic target in breast and gastric cancers. The role of HER2 in rectal cancer is unclear, as conflicting data on the prevalence of HER2 expression in this disease have been reported. We evaluated the prevalence of HER2 and its impact on the outcome of high-risk rectal cancer patients treated with neoadjuvant CAPOX and CRT±cetuximab in the EXPERT-C trial. PATIENTS AND METHODS Eligible patients with available tumour tissue for HER2 analysis were included. HER2 expression was determined by immunohistochemistry (IHC) in pre-treatment biopsies and/or surgical specimens (score 0-3+). Immunostaining was scored according to the consensus panel recommendations on HER2 scoring for gastric cancer. Tumours with equivocal IHC result (2+) were tested for HER2 amplification by D-ISH. Tumours with IHC 3+ or D-ISH ratio ≥2.0 were classified as HER2+. The impact of HER2 on primary and secondary end points of the study was analysed. RESULTS Of 164 eligible study patients, 104 (63%) biopsy and 114 (69%) surgical specimens were available for analysis. Only 3 of 104 (2.9%) and 3 of 114 (2.6%) were HER2+, respectively. In 77 patients with paired specimens, concordance for HER2 status was found in 74 (96%). Overall, 141 patients were assessable for HER2 and 6 out of 141 (4.3%) had HER2 overexpression and/or amplification. The median follow-up was 58.6 months. HER2 was not associated with a difference in the outcome for any of the study end points, including in the subset of 90 KRAS/BRAF wild-type patients treated±cetuximab. CONCLUSIONS Based on the low prevalence of expression as recorded in the EXPERT-C trial, HER2 does not appear to represent a useful therapeutic target in high-risk rectal cancer. However, the role of HER2 as a potential predictive biomarker of resistance to anti-EGFR-based treatments and a therapeutic target in anti-EGFR refractory metastatic colorectal cancer (CRC) warrants further investigation. TRIAL REGISTRATION ISRCTN Register: 99828560.
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Affiliation(s)
- F Sclafani
- The Royal Marsden NHS Foundation Trust, London & Surrey, UK
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23
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Chong IY, Cunningham D, Barber LJ, Campbell J, Chen L, Kozarewa I, Fenwick K, Assiotis I, Guettler S, Garcia-Murillas I, Awan S, Lambros M, Starling N, Wotherspoon A, Stamp G, Gonzalez-de-Castro D, Benson M, Chau I, Hulkki S, Nohadani M, Eltahir Z, Lemnrau A, Orr N, Rao S, Lord CJ, Ashworth A. The genomic landscape of oesophagogastric junctional adenocarcinoma. J Pathol 2013; 231:301-10. [DOI: 10.1002/path.4247] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Irene Y Chong
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Cancer Research UK Gene Function Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - David Cunningham
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Louise J Barber
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Cancer Research UK Gene Function Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - James Campbell
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Cancer Research UK Gene Function Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Tumour Profiling Unit; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Lina Chen
- Tumour Profiling Unit; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Iwanka Kozarewa
- Tumour Profiling Unit; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Kerry Fenwick
- Tumour Profiling Unit; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Ioannis Assiotis
- Tumour Profiling Unit; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Sebastian Guettler
- Structural Biology of Cell Signalling Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Isaac Garcia-Murillas
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Saima Awan
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Maryou Lambros
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Cancer Research UK Gene Function Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Tumour Profiling Unit; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Naureen Starling
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Andrew Wotherspoon
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Gordon Stamp
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | | | - Martin Benson
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Ian Chau
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Sanna Hulkki
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Mahrokh Nohadani
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Zakaria Eltahir
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Alina Lemnrau
- Complex Trait Genetics Laboratory; The Institute of Cancer Research; London SW3 6JB UK
| | - Nicholas Orr
- Complex Trait Genetics Laboratory; The Institute of Cancer Research; London SW3 6JB UK
| | - Sheela Rao
- Royal Marsden Hospital NHS Foundation Trust; Downs Road Sutton SM2 5PT UK
| | - Christopher J Lord
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Cancer Research UK Gene Function Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
| | - Alan Ashworth
- The Breakthrough Breast Cancer Research Centre; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
- Cancer Research UK Gene Function Laboratory; The Institute of Cancer Research; 237 Fulham Road, London SW3 6JB UK
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24
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Okines A, Thompson L, Cunningham D, Wotherspoon A, Reis-Filho J, Langley R, Waddell T, Noor D, Eltahir Z, Wong R, Stenning S. Effect of HER2 on prognosis and benefit from peri-operative chemotherapy in early oesophago-gastric adenocarcinoma in the MAGIC trial. Ann Oncol 2013; 24:1253-61. [DOI: 10.1093/annonc/mds622] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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25
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McAdam E, Haboubi HN, Forrester G, Eltahir Z, Spencer-Harty S, Davies C, Griffiths AP, Baxter JN, Jenkins GJS. Inducible nitric oxide synthase (iNOS) and nitric oxide (NO) are important mediators of reflux-induced cell signalling in esophageal cells. Carcinogenesis 2012; 33:2035-43. [PMID: 22826608 DOI: 10.1093/carcin/bgs241] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Nitric oxide (NO) produced by inducible nitric oxide synthase (iNOS) has been implicated in both DNA damage induction and aberrant cell signalling in various tissue and cell backgrounds. We investigated here the role of iNOS and NO in DNA damage induction and nuclear factor-kappa B (NF-κB) signalling in esophageal cells in vitro. As esophageal adenocarcinoma develops in a background of Barrett's esophagus secondary to reflux disease, it is possible that inflammatory mediators like NO may be important in esophageal cancer development. We show that reflux components like stomach acid and bile acids [deoxycholic acid (DCA)] can induce iNOS gene and protein expression and produce NO generation in esophageal cells, using real-time PCR, western blotting and NO sensitive fluorescent probes, respectively. This up-regulation of iNOS expression was not dependent on NF-κB activity. DCA-induced DNA damage was independent of NF-κB and only partially dependent on iNOS and NO, as measured by the micronucleus assay. These same reflux constituents also activated the oncogenic transcription factor NF-κB, as measured by transcription factor enzyme-linked immunosorbent assay and gene expression studies with NF-κB linked genes (e.g. interleukin-8). Importantly, we show here for the first time that basal levels of NF-κB activity (and possibly acid and DCA-induced NF-κB) are dependent on iNOS/NO and this may lead to a positive feedback loop whereby induced iNOS is upstream of NF-κB, hence prolonging and potentially amplifying this signalling, presumably through NO activation of NF-κB. Furthermore, we confirm increased protein levels of iNOS in esophageal adenocarcinoma and, therefore, in neoplastic development in the esophagus.
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Affiliation(s)
- E McAdam
- Institute of Life Science, School of Medicine, Swansea University Swansea, SA28PP, UK
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26
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Jenkins GJS, Cronin J, Alhamdani A, Rawat N, D'Souza F, Thomas T, Eltahir Z, Griffiths AP, Baxter JN. The bile acid deoxycholic acid has a non-linear dose response for DNA damage and possibly NF-kappaB activation in oesophageal cells, with a mechanism of action involving ROS. Mutagenesis 2008; 23:399-405. [PMID: 18515815 DOI: 10.1093/mutage/gen029] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Deoxycholic acid (DCA) is a secondary bile acid implicated in various cancers of the gastrointestinal (GI) tract. In oesophageal adenocarcinoma, DCA is believed to contribute to carcinogenesis during reflux where stomach contents enter the lower oesophagus. It is imperative that we understand the mechanisms whereby oesophageal carcinogens function in order that therapeutic options may be developed. We have previously shown that DCA can damage chromosomes and does so through its generation of reactive oxygen species (ROS). We show here, after detailed experiments, that DCA appears to have a non-linear dose response for DNA damage. DCA induces DNA damage (as measured by the micronucleus assay) at doses of 100 microM and higher in oesophageal OE33 cells, but fails to induce such DNA damage below this cut-off dose. We also show that in terms of NF-kappaB activation (as measured by up-regulation of two NF-kappaB target genes) by DCA, a similar dose response is observed. This dose-response data may be important clinically as DCA exposure to the oesophagus may be used as a way to identify the 10% of Barrett's oesophagus patients currently progressing to cancer from the 90% of patients who do not progress. Only quantitative studies measuring DCA concentrations in refluxates correlated with histological progression will answer this question. We further show here that ROS are behind DCAs ability to activate NF-kappaB as antioxidants (epigallocatechin gallate, resveratrol and vitamin C) abrogate DCAs ability to up-regulate NF-kappaB-controlled genes. In conclusion, low doses of DCA appear to be less biologically significant in vitro. If this were to be confirmed in vivo, it might suggest that reflux patients with low DCA concentrations may be at a lower risk of cancer progression compared to patients with high levels of DCA in their refluxate. Either way, antioxidant supplementation may possibly help prevent the deleterious effects of DCA in the whole GI tract.
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Affiliation(s)
- G J S Jenkins
- Institute of Life Science, Swansea School of Medicine, Swansea University, Swansea SA2 8PP, UK.
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