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Dmukauskas M, Cioffi G, Waite KA, Sloan AE, Neff C, Price M, Ostrom QT, Barnholtz-Sloan JS. Sex differences in adverse events in Medicare individuals ≥ 66 years of age post glioblastoma treatment. J Neurooncol 2024; 168:111-123. [PMID: 38563855 PMCID: PMC11093825 DOI: 10.1007/s11060-024-04652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Glioblastoma (GB) is the most common primary malignant brain tumor with the highest incidence occurring in older adults with a median age at diagnosis of 64 years old. While treatment often improves survival it brings toxicities and adverse events (AE). Here we identify sex differences in treatment patterns and AE in individuals ≥ 66 years at diagnosis with GB. METHODS Using the SEER-Medicare dataset sex differences in adverse events were assessed using multivariable logistic regression performed to calculate the male/female odds ratio (M/F OR) and 95% confidence intervals [95% CI] of experiencing an AE adjusted for demographic variables and Elixhauser comorbidity score. RESULTS Males with GB were more likely to receive standard of care (SOC; Surgery with concurrent radio-chemotherapy) [20%] compared to females [17%], whereas females were more likely to receive no treatment [26%] compared to males [21%]. Females with GB receiving SOC were more likely to develop gastrointestinal disorders (M/F OR = 0.76; 95% CI,0.64-0.91, p = 0.002) or blood and lymphatic system disorders (M/F OR = 0.79; 95% CI,0.66-0.95, p = 0.012). Males with GB receiving SOC were more likely to develop cardiac disorders (M/F OR = 1.21; 95% CI,1.02-1.44, p = 0.029) and renal disorders (M/F OR = 1.65; 95% CI,1.37-2.01, p < 0.001). CONCLUSIONS Sex differences for individuals, 66 years and older, diagnosed with GB exist in treatment received and adverse events developed across different treatment modalities.
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Affiliation(s)
- Mantas Dmukauskas
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Andrew E Sloan
- Neuroscience Service Line and Piedmont Brain Tumor Center, Piedmont Health, Atlanta, GA, USA
| | - Corey Neff
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Mackenzie Price
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Quinn T Ostrom
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Shady Grove Campus 9609 Medical Center Dr, 20850, Rockville, MD, USA.
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2
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Rubsamen RM, Sloan AE. Editorial: Synthetic peptide vaccine platforms targeting tumor-specific antigens: advances and challenges. Front Pharmacol 2024; 15:1363282. [PMID: 38464714 PMCID: PMC10920325 DOI: 10.3389/fphar.2024.1363282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Reid M. Rubsamen
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- University Hospitals Cleveland Medical Center, Cleveland, OH, United States
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3
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Zhao L, Qiu Z, Yang Z, Xu L, Pearce TM, Wu Q, Yang K, Li F, Saulnier O, Fei F, Yu H, Gimple RC, Varadharajan V, Liu J, Hendrikse LD, Fong V, Wang W, Zhang J, Lv D, Lee D, Lehrich BM, Jin C, Ouyang L, Dixit D, Wu H, Wang X, Sloan AE, Wang X, Huan T, Mark Brown J, Goldman SA, Taylor MD, Zhou S, Rich JN. Lymphatic endothelial-like cells promote glioblastoma stem cell growth through cytokine-driven cholesterol metabolism. Nat Cancer 2024; 5:147-166. [PMID: 38172338 DOI: 10.1038/s43018-023-00658-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/26/2023] [Indexed: 01/05/2024]
Abstract
Glioblastoma is the most lethal primary brain tumor with glioblastoma stem cells (GSCs) atop a cellular hierarchy. GSCs often reside in a perivascular niche, where they receive maintenance cues from endothelial cells, but the role of heterogeneous endothelial cell populations remains unresolved. Here, we show that lymphatic endothelial-like cells (LECs), while previously unrecognized in brain parenchyma, are present in glioblastomas and promote growth of CCR7-positive GSCs through CCL21 secretion. Disruption of CCL21-CCR7 paracrine communication between LECs and GSCs inhibited GSC proliferation and growth. LEC-derived CCL21 induced KAT5-mediated acetylation of HMGCS1 on K273 in GSCs to enhance HMGCS1 protein stability. HMGCS1 promoted cholesterol synthesis in GSCs, favorable for tumor growth. Expression of the CCL21-CCR7 axis correlated with KAT5 expression and HMGCS1K273 acetylation in glioblastoma specimens, informing patient outcome. Collectively, glioblastomas contain previously unrecognized LECs that promote the molecular crosstalk between endothelial and tumor cells, offering potentially alternative therapeutic strategies.
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Affiliation(s)
- Linjie Zhao
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Zhixin Qiu
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Anesthesiology, Zhongshan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Zhengnan Yang
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University, and Collaborative Innovation Center, Chengdu, China
| | - Lian Xu
- Department of Pathology, West China Second Hospital, Sichuan University, Chengdu, China
| | - Thomas M Pearce
- Department of Pathology, Division of Neuropathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Qiulian Wu
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA
| | - Kailin Yang
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA
| | - FuLong Li
- Department of Pharmacology and Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Olivier Saulnier
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Fan Fei
- Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Huaxu Yu
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ryan C Gimple
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Venkateshwari Varadharajan
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute Cleveland Clinic, Cleveland, OH, USA
- Center for Microbiome and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Juxiu Liu
- Division of Obstetrics, Key Laboratory of Birth Defects and Related Disease of Women and Children of MOE, State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University, Chengdu, China
| | - Liam D Hendrikse
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Vernon Fong
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Wei Wang
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, China
| | - Jiao Zhang
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deguan Lv
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA
| | - Derrick Lee
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA
| | - Brandon M Lehrich
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA
| | - Chunyu Jin
- Howard Hughes Medical Institute, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Liang Ouyang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Deobrat Dixit
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Haoxing Wu
- Huaxi MR Research Center, Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wang
- Division of Obstetrics, Key Laboratory of Birth Defects and Related Disease of Women and Children of MOE, State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University, Chengdu, China
| | - Andrew E Sloan
- Department of Neurosurgery, Case Western Reserve University, Cleveland, OH, USA
| | - Xiuxing Wang
- School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Tao Huan
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - J Mark Brown
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute Cleveland Clinic, Cleveland, OH, USA
- Center for Microbiome and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Steven A Goldman
- University of Rochester Medical Center, Rochester, NY, USA
- University of Copenhagen, Copenhagen, Denmark
| | - Michael D Taylor
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Developmental & Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shengtao Zhou
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University, and Collaborative Innovation Center, Chengdu, China.
| | - Jeremy N Rich
- University of Pittsburgh Medical Center, Hillman Cancer Center, Pittsburgh, PA, USA.
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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4
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Lee MD, Patel SH, Mohan S, Akbari H, Bakas S, Nasrallah MP, Calabrese E, Rudie J, Villanueva-Meyer J, LaMontagne P, Marcus DS, Colen RR, Balana C, Choi YS, Badve C, Barnholtz-Sloan JS, Sloan AE, Booth TC, Palmer JD, Dicker AP, Flanders AE, Shi W, Griffith B, Poisson LM, Chakravarti A, Mahajan A, Chang S, Orringer D, Davatzikos C, Jain R. Association of partial T2-FLAIR mismatch sign and isocitrate dehydrogenase mutation in WHO grade 4 gliomas: results from the ReSPOND consortium. Neuroradiology 2023; 65:1343-1352. [PMID: 37468750 PMCID: PMC11058040 DOI: 10.1007/s00234-023-03196-9] [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: 04/14/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE While the T2-FLAIR mismatch sign is highly specific for isocitrate dehydrogenase (IDH)-mutant, 1p/19q-noncodeleted astrocytomas among lower-grade gliomas, its utility in WHO grade 4 gliomas is not well-studied. We derived the partial T2-FLAIR mismatch sign as an imaging biomarker for IDH mutation in WHO grade 4 gliomas. METHODS Preoperative MRI scans of adult WHO grade 4 glioma patients (n = 2165) from the multi-institutional ReSPOND (Radiomics Signatures for PrecisiON Diagnostics) consortium were analyzed. Diagnostic performance of the partial T2-FLAIR mismatch sign was evaluated. Subset analyses were performed to assess associations of imaging markers with overall survival (OS). RESULTS One hundred twenty-one (5.6%) of 2165 grade 4 gliomas were IDH-mutant. Partial T2-FLAIR mismatch was present in 40 (1.8%) cases, 32 of which were IDH-mutant, yielding 26.4% sensitivity, 99.6% specificity, 80.0% positive predictive value, and 95.8% negative predictive value. Multivariate logistic regression demonstrated IDH mutation was significantly associated with partial T2-FLAIR mismatch (odds ratio [OR] 5.715, 95% CI [1.896, 17.221], p = 0.002), younger age (OR 0.911 [0.895, 0.927], p < 0.001), tumor centered in frontal lobe (OR 3.842, [2.361, 6.251], p < 0.001), absence of multicentricity (OR 0.173, [0.049, 0.612], p = 0.007), and presence of cystic (OR 6.596, [3.023, 14.391], p < 0.001) or non-enhancing solid components (OR 6.069, [3.371, 10.928], p < 0.001). Multivariate Cox analysis demonstrated cystic components (p = 0.024) and non-enhancing solid components (p = 0.003) were associated with longer OS, while older age (p < 0.001), frontal lobe center (p = 0.008), multifocality (p < 0.001), and multicentricity (p < 0.001) were associated with shorter OS. CONCLUSION Partial T2-FLAIR mismatch sign is highly specific for IDH mutation in WHO grade 4 gliomas.
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Affiliation(s)
- Matthew D Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA.
| | - Sohil H Patel
- Department of Radiology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Suyash Mohan
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Hamed Akbari
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - MacLean P Nasrallah
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Glioblastoma Multiforme Translational Center of Excellence, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Evan Calabrese
- Department of Radiology, Division of Neuroradiology, Duke University, Durham, NC, USA
| | - Jeffrey Rudie
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Pamela LaMontagne
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel S Marcus
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rivka R Colen
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Carmen Balana
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Yoon Seong Choi
- Department of Radiology, Section of Neuroradiology, Yonsei University Health System, Seoul, South Korea
| | - Chaitra Badve
- Department of Radiology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA
| | - Jill S Barnholtz-Sloan
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, MD, USA
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Andrew E Sloan
- Department of Neurosurgery, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA
- Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Thomas C Booth
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, Ruskin WingLondon, UK
| | - Joshua D Palmer
- Department of Radiation Oncology and Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Wenyin Shi
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health, Detroit, MI, USA
| | - Laila M Poisson
- Department of Public Health Sciences, Center for Bioinformatics, Henry Ford Health, Detroit, MI, USA
| | - Arnab Chakravarti
- Department of Radiation Oncology and Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Susan Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Daniel Orringer
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Department of Pathology, NYU Grossman School of Medicine, New York, NY, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
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Soler DC, Ballesteros A, Sloan AE, McCormick TS, Stepanyan R. Multiple plasma membrane reporters discern LHFPL5 region that blocks trafficking to the plasma membrane. Sci Rep 2023; 13:2528. [PMID: 36781873 PMCID: PMC9925724 DOI: 10.1038/s41598-023-28045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/11/2023] [Indexed: 02/15/2023] Open
Abstract
The mechano-electrical transduction (MET) channel of the inner ear receptor cells, termed hair cells, is a protein complex that enables our senses of hearing and balance. Hair cell MET requires an elaborate interplay of multiple proteins that form the MET channel. One of the MET complex components is the transmembrane protein LHFPL5, which is required for hair cell MET and hearing. LHFPL5 is thought to form a multi-protein complex with other MET channel proteins, such as PCDH15, TMIE, and TMC1. Despite localizing to the plasma membrane of stereocilia, the mechanosensing organelles of hair cells, LHFPL5 requires its binding partner within the MET complex, PCDH15, to localize to the stereocilia tips in hair cells and to the plasma membrane in heterologous cells. Using the Aquaporin 3-tGFP reporter (AGR) for plasma membrane localization, we found that a region within extracellular loop 1, which interacts with PCDH15, precludes the trafficking of AGR reporter to the plasma membrane in heterologous cell lines. Our results suggest that the presence of protein partners may mask endoplasmic reticulum retention regions or enable the proper folding and trafficking of the MET complex components, to facilitate expression of the MET complex at the stereocilia membrane.
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Affiliation(s)
- David C Soler
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
- Brain Tumor and Neuro-Oncology Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
- University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Angela Ballesteros
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Andrew E Sloan
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Brain Tumor and Neuro-Oncology Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Thomas S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
- Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Ruben Stepanyan
- Department of Otolaryngology - HNS, Case Western Reserve University, Cleveland, OH, USA.
- Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA.
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Tippareddy C, Onyewadume L, Sloan AE, Wang GM, Patil NT, Hu S, Barnholtz-Sloan JS, Boyacıoğlu R, Gulani V, Sunshine J, Griswold M, Ma D, Badve C. Novel 3D magnetic resonance fingerprinting radiomics in adult brain tumors: a feasibility study. Eur Radiol 2023; 33:836-844. [PMID: 35999374 DOI: 10.1007/s00330-022-09067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/16/2022] [Accepted: 07/27/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To test the feasibility of using 3D MRF maps with radiomics analysis and machine learning in the characterization of adult brain intra-axial neoplasms. METHODS 3D MRF acquisition was performed on 78 patients with newly diagnosed brain tumors including 33 glioblastomas (grade IV), 6 grade III gliomas, 12 grade II gliomas, and 27 patients with brain metastases. Regions of enhancing tumor, non-enhancing tumor, and peritumoral edema were segmented and radiomics analysis with gray-level co-occurrence matrices and gray-level run-length matrices was performed. Statistical analysis was performed to identify features capable of differentiating tumors based on type, grade, and isocitrate dehydrogenase (IDH1) status. Receiver operating curve analysis was performed and the area under the curve (AUC) was calculated for tumor classification and grading. For gliomas, Kaplan-Meier analysis for overall survival was performed using MRF T1 features from enhancing tumor region. RESULTS Multiple MRF T1 and T2 features from enhancing tumor region were capable of differentiating glioblastomas from brain metastases. Although no differences were identified between grade 2 and grade 3 gliomas, differentiation between grade 2 and grade 4 gliomas as well as between grade 3 and grade 4 gliomas was achieved. MRF radiomics features were also able to differentiate IDH1 mutant from the wild-type gliomas. Radiomics T1 features for enhancing tumor region in gliomas correlated to overall survival (p < 0.05). CONCLUSION Radiomics analysis of 3D MRF maps allows differentiating glioblastomas from metastases and is capable of differentiating glioblastomas from metastases and characterizing gliomas based on grade, IDH1 status, and survival. KEY POINTS • 3D MRF data analysis using radiomics offers novel tissue characterization of brain tumors. • 3D MRF with radiomics offers glioma characterization based on grade, IDH1 status, and overall patient survival.
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Affiliation(s)
- Charit Tippareddy
- Department of Radiology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Seidman Cancer Center and Case Comprehensive Cancer Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Louisa Onyewadume
- Department of Neurosurgery, West Virginia University Health Sciences Center, Morgantown, WV, USA
| | - Andrew E Sloan
- Departments of Neurosurgery and Pathology, Seidman Cancer Center and Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Gi-Ming Wang
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Research and Education Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Nirav T Patil
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Siyuan Hu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Jill S Barnholtz-Sloan
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, MD, USA
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Rasim Boyacıoğlu
- Department of Radiology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Seidman Cancer Center and Case Comprehensive Cancer Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Vikas Gulani
- Department of Radiology, Michigan Institute of Imaging Technology and Translation, Michigan Medicine, Ann Arbor, MI, USA
| | - Jeffrey Sunshine
- Department of Radiology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Seidman Cancer Center and Case Comprehensive Cancer Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Mark Griswold
- Department of Radiology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Seidman Cancer Center and Case Comprehensive Cancer Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Dan Ma
- Department of Radiology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Seidman Cancer Center and Case Comprehensive Cancer Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Chaitra Badve
- Department of Radiology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Seidman Cancer Center and Case Comprehensive Cancer Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
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Pati S, Baid U, Edwards B, Sheller M, Wang SH, Reina GA, Foley P, Gruzdev A, Karkada D, Davatzikos C, Sako C, Ghodasara S, Bilello M, Mohan S, Vollmuth P, Brugnara G, Preetha CJ, Sahm F, Maier-Hein K, Zenk M, Bendszus M, Wick W, Calabrese E, Rudie J, Villanueva-Meyer J, Cha S, Ingalhalikar M, Jadhav M, Pandey U, Saini J, Garrett J, Larson M, Jeraj R, Currie S, Frood R, Fatania K, Huang RY, Chang K, Balaña C, Capellades J, Puig J, Trenkler J, Pichler J, Necker G, Haunschmidt A, Meckel S, Shukla G, Liem S, Alexander GS, Lombardo J, Palmer JD, Flanders AE, Dicker AP, Sair HI, Jones CK, Venkataraman A, Jiang M, So TY, Chen C, Heng PA, Dou Q, Kozubek M, Lux F, Michálek J, Matula P, Keřkovský M, Kopřivová T, Dostál M, Vybíhal V, Vogelbaum MA, Mitchell JR, Farinhas J, Maldjian JA, Yogananda CGB, Pinho MC, Reddy D, Holcomb J, Wagner BC, Ellingson BM, Cloughesy TF, Raymond C, Oughourlian T, Hagiwara A, Wang C, To MS, Bhardwaj S, Chong C, Agzarian M, Falcão AX, Martins SB, Teixeira BCA, Sprenger F, Menotti D, Lucio DR, LaMontagne P, Marcus D, Wiestler B, Kofler F, Ezhov I, Metz M, Jain R, Lee M, Lui YW, McKinley R, Slotboom J, Radojewski P, Meier R, Wiest R, Murcia D, Fu E, Haas R, Thompson J, Ormond DR, Badve C, Sloan AE, Vadmal V, Waite K, Colen RR, Pei L, Ak M, Srinivasan A, Bapuraj JR, Rao A, Wang N, Yoshiaki O, Moritani T, Turk S, Lee J, Prabhudesai S, Morón F, Mandel J, Kamnitsas K, Glocker B, Dixon LVM, Williams M, Zampakis P, Panagiotopoulos V, Tsiganos P, Alexiou S, Haliassos I, Zacharaki EI, Moustakas K, Kalogeropoulou C, Kardamakis DM, Choi YS, Lee SK, Chang JH, Ahn SS, Luo B, Poisson L, Wen N, Tiwari P, Verma R, Bareja R, Yadav I, Chen J, Kumar N, Smits M, van der Voort SR, Alafandi A, Incekara F, Wijnenga MMJ, Kapsas G, Gahrmann R, Schouten JW, Dubbink HJ, Vincent AJPE, van den Bent MJ, French PJ, Klein S, Yuan Y, Sharma S, Tseng TC, Adabi S, Niclou SP, Keunen O, Hau AC, Vallières M, Fortin D, Lepage M, Landman B, Ramadass K, Xu K, Chotai S, Chambless LB, Mistry A, Thompson RC, Gusev Y, Bhuvaneshwar K, Sayah A, Bencheqroun C, Belouali A, Madhavan S, Booth TC, Chelliah A, Modat M, Shuaib H, Dragos C, Abayazeed A, Kolodziej K, Hill M, Abbassy A, Gamal S, Mekhaimar M, Qayati M, Reyes M, Park JE, Yun J, Kim HS, Mahajan A, Muzi M, Benson S, Beets-Tan RGH, Teuwen J, Herrera-Trujillo A, Trujillo M, Escobar W, Abello A, Bernal J, Gómez J, Choi J, Baek S, Kim Y, Ismael H, Allen B, Buatti JM, Kotrotsou A, Li H, Weiss T, Weller M, Bink A, Pouymayou B, Shaykh HF, Saltz J, Prasanna P, Shrestha S, Mani KM, Payne D, Kurc T, Pelaez E, Franco-Maldonado H, Loayza F, Quevedo S, Guevara P, Torche E, Mendoza C, Vera F, Ríos E, López E, Velastin SA, Ogbole G, Soneye M, Oyekunle D, Odafe-Oyibotha O, Osobu B, Shu'aibu M, Dorcas A, Dako F, Simpson AL, Hamghalam M, Peoples JJ, Hu R, Tran A, Cutler D, Moraes FY, Boss MA, Gimpel J, Veettil DK, Schmidt K, Bialecki B, Marella S, Price C, Cimino L, Apgar C, Shah P, Menze B, Barnholtz-Sloan JS, Martin J, Bakas S. Author Correction: Federated learning enables big data for rare cancer boundary detection. Nat Commun 2023; 14:436. [PMID: 36702828 PMCID: PMC9879935 DOI: 10.1038/s41467-023-36188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Sarthak Pati
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Satyam Ghodasara
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suyash Mohan
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Zenk
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany
| | - Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey Rudie
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Manali Jadhav
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - John Garrett
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Matthew Larson
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert Jeraj
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Stuart Currie
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Russell Frood
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Kavi Fatania
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | | | - Josep Puig
- Department of Radiology (IDI), Girona Biomedical Research Institute (IdIBGi), Josep Trueta University Hospital, Girona, Spain
| | - Johannes Trenkler
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Josef Pichler
- Department of Neurooncology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Georg Necker
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Andreas Haunschmidt
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Stephan Meckel
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
- Institute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, Christiana Care Health System, Philadelphia, PA, USA
| | - Spencer Liem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gregory S Alexander
- Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA
| | - Joseph Lombardo
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Craig K Jones
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Archana Venkataraman
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meirui Jiang
- The Chinese University of Hong Kong, Hong Kong, China
| | - Tiffany Y So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Cheng Chen
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Qi Dou
- The Chinese University of Hong Kong, Hong Kong, China
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Filip Lux
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jan Michálek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Petr Matula
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
- Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, and University Hospital and Czech Republic, Brno, Czech Republic
| | - Michael A Vogelbaum
- Department of Neuro Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - J Ross Mitchell
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Joaquim Farinhas
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | - Marco C Pinho
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Divya Reddy
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Holcomb
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Minh-Son To
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sargam Bhardwaj
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Chee Chong
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Bernardo C A Teixeira
- Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - David Menotti
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Diego R Lucio
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Pamela LaMontagne
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
| | - Florian Kofler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Marie Metz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Matthew Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvonne W Lui
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Raphael Meier
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Derrick Murcia
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Eric Fu
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Rourke Haas
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - John Thompson
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - David Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vachan Vadmal
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristin Waite
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Rivka R Colen
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Linmin Pei
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat Ak
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashok Srinivasan
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - J Rajiv Bapuraj
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Arvind Rao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Ota Yoshiaki
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Toshio Moritani
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Sevcan Turk
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Joonsang Lee
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Prabhudesai
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Fanny Morón
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Jacob Mandel
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantinos Kamnitsas
- Department of Computing, Imperial College London, London, UK
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ben Glocker
- Department of Computing, Imperial College London, London, UK
| | - Luke V M Dixon
- Department of Radiology, Imperial College NHS Healthcare Trust, London, UK
| | - Matthew Williams
- Computational Oncology Group, Institute for Global Health Innovation, Imperial College London, London, UK
| | - Peter Zampakis
- Department of NeuroRadiology, University of Patras, Patras, Greece
| | | | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Sotiris Alexiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Ilias Haliassos
- Department of Neuro-Oncology, University of Patras, Patras, Greece
| | - Evangelia I Zacharaki
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | | | | | | | | | | | | | - Sung Soo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Bing Luo
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Laila Poisson
- Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | | | - Ruchika Verma
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
- Case Western Reserve University, Cleveland, OH, USA
| | - Rohan Bareja
- Case Western Reserve University, Cleveland, OH, USA
| | - Ipsa Yadav
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Neeraj Kumar
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Ahmed Alafandi
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Maarten M J Wijnenga
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Georgios Kapsas
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Joost W Schouten
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Yading Yuan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tzu-Chi Tseng
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saba Adabi
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olivier Keunen
- Translation Radiomics, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Ann-Christin Hau
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
- Luxembourg Center of Neuropathology, Laboratoire National De Santé, Luxembourg, Luxembourg
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - David Fortin
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Neurosurgery and Neuro-Oncology, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Centre, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bennett Landman
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Silky Chotai
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lola B Chambless
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akshitkumar Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reid C Thompson
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Krithika Bhuvaneshwar
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anousheh Sayah
- Division of Neuroradiology & Neurointerventional Radiology, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Camelia Bencheqroun
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anas Belouali
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Subha Madhavan
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK
| | - Alysha Chelliah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Haris Shuaib
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Carmen Dragos
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
| | | | | | | | | | - Shady Gamal
- University of Cairo School of Medicine, Giza, Egypt
| | | | | | | | - Ji Eun Park
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Jihye Yun
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place, Liverpool, UK
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Sean Benson
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht, Netherlands
| | - Jonas Teuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - William Escobar
- Clínica Imbanaco Grupo Quirón Salud, Cali, Colombia
- Universidad del Valle, Cali, Colombia
| | | | - Jose Bernal
- Universidad del Valle, Cali, Colombia
- The University of Edinburgh, Edinburgh, UK
| | | | - Joseph Choi
- Department of Industrial and Systems Engineering, University of Iowa, Iowa, USA
| | - Stephen Baek
- Department of Industrial and Systems Engineering, Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Heba Ismael
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Bryan Allen
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Hongwei Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bertrand Pouymayou
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Sampurna Shrestha
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Kartik M Mani
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Department of Radiation Oncology, Stony Brook University, Stony Brook, NY, USA
| | - David Payne
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Scientific Data Group, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Enrique Pelaez
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | - Francis Loayza
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | | | | | | | - Franco Vera
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Elvis Ríos
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Eduardo López
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Sergio A Velastin
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mayowa Soneye
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Dotun Oyekunle
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | | | - Babatunde Osobu
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mustapha Shu'aibu
- Department of Radiology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Adeleye Dorcas
- Department of Radiology, Obafemi Awolowo University Ile-Ife, Ile-Ife, Osun, Nigeria
| | - Farouk Dako
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Simpson
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Mohammad Hamghalam
- School of Computing, Queen's University, Kingston, ON, Canada
- Department of Electrical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Jacob J Peoples
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Ricky Hu
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Anh Tran
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Danielle Cutler
- The Faculty of Arts & Sciences, Queen's University, Kingston, ON, Canada
| | - Fabio Y Moraes
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - James Gimpel
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Deepak Kattil Veettil
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Kendall Schmidt
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Brian Bialecki
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Sailaja Marella
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Cynthia Price
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Lisa Cimino
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Charles Apgar
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | | | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Jill S Barnholtz-Sloan
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), National Institute of Health, Bethesda, MD, USA
| | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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8
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Johansen ML, Vincent J, Rose M, Sloan AE, Brady-Kalnay SM. Comparison of Near-Infrared Imaging Agents Targeting the PTPmu Tumor Biomarker. Mol Imaging Biol 2023:10.1007/s11307-023-01799-5. [PMID: 36695968 DOI: 10.1007/s11307-023-01799-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE Maximal, safe resection of solid tumors is considered a critical first step in successful cancer treatment. The advent of fluorescence image-guided surgery (FIGS) using non-specific agents has improved patient outcomes, particularly in the case of glioblastoma. Molecularly targeted agents that recognize specific tumor biomarkers have the potential to augment these gains. Identification of the optimal combination of targeting moiety and fluorophore is needed prior to initiating clinical trials. PROCEDURES A 20-amino acid peptide (SBK2) recognizing the receptor protein-tyrosine phosphatase mu (PTPmu)-derived tumor-specific biomarker, with or without a linker, was conjugated to three different near-infrared fluorophores: indocyanine green (ICG), IRDye® 800CW, and Tide Fluor™ 8WS. The in vivo specificity, time course, and biodistribution were evaluated for each using mice with heterotopic human glioma tumors that express the PTPmu biomarker to identify component combinations with optimal properties for FIGS. RESULTS SBK2 conjugated to ICG demonstrated excellent specificity for gliomas in heterotopic tumors. SBK2-ICG showed significantly higher in vivo tumor labeling compared to the Scram-ICG control from 10 min to 24 h, p < 0.01 at all timepoints, following injection, as well as a significantly higher ex vivo tumor signal at 24 h, p < 0.001. Inserting a six-amino acid linker between the targeting peptide and ICG increased the clearance rate and resulted in significantly higher in vivo tumor signal relative to its linker-containing Scrambled control from 10 min to 8 h, p < 0.05 at all timepoints, after dosing. Agents made with the more hydrophilic IRDye® 800CW and Tide Fluor™ 8WS showed no specific tumor labeling relative to the controls. The IRDye 800CW-conjugated agents cleared within 1 h, while the non-specific fluorescent tumor signal generated by the Tide Fluor 8WS-conjugated agents persists beyond 24 h. CONCLUSIONS The SBK2 PTPmu-targeting peptide conjugated to ICG specifically labels heterotopic human gliomas grown in mice between 10 min and 24 h following injection. Similar molecules constructed with more hydrophilic dyes demonstrated no specificity. These studies present a promising candidate for use in FIGS of PTPmu biomarker-expressing tumors.
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Affiliation(s)
- Mette L Johansen
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Jason Vincent
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Marissa Rose
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, Case Western Reserve University and University Hospitals, Cleveland, OH, 44106, USA
- The Case Comprehensive Cancer Center, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Susann M Brady-Kalnay
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA.
- The Case Comprehensive Cancer Center, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA.
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9
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Sloan AE, Nock CJ, Ye X, Buerki R, Chang S, Lesser G, Norden A, Cloughesy T, Olson J, Kerstetter-Fogle A, Rich J, Fisher J, Desideri S, Takebe N, Timmer W, Grossman S, Prados M. ABTC-0904: targeting glioma stem cells in GBM: a phase 0/II study of hedgehog pathway inhibitor GDC-0449. J Neurooncol 2023; 161:33-43. [PMID: 36581779 DOI: 10.1007/s11060-022-04193-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/04/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Gliomagenesis and resistance of glioblastoma (GBM) are believed to be mediated by glioma stem cells (GSC). Evidence suggests that SHH signaling promotes GSC proliferation and self-renewal. METHODS ABTC-0904 was a two-arm, multicenter phase 0/II study of GDC-0449, an oral inhibitor of Smoothened (SMO) in patients undergoing resection for recurrent GBM. All patients (Arms I and II) had surgery and received drug post-operatively. Only patients in Arm I received drug prior to surgery. The primary objective was to determine 6-month progression free survival (PFS-6). Secondary endpoints include median PFS (mPFS) and overall survival (mOS), response rate, and toxicity. Correlative studies included bioanalysis of GDC-0449, and inhibition of SHH signaling, GSC proliferation and self-renewal. RESULTS Forty-one patients were enrolled. Pharmacokinetics of GDC-0449 in plasma demonstrated levels within expected therapeutic range in 75% of patients. The proportion of tumorcells producing CD133+ neurospheres, neurosphere proliferation, self-renewal, and expression of the SHh downstream signaling was significantly decreased in Arm I following GDC-0449 treatment (p < 0.005; p < 0.001 respectively) compared to Arm II (no drug pre-op). Treatment was well tolerated. There were no objective responders in either arm. Overall PFS-6 was 2.4% (95% CI 0.9-11.1%). Median PFS was 2.3 months (95% CI 1.9-2.6) and mOS was 7.8 months (95% CI 5.4-10.1). CONCLUSIONS GDC-0449 was well tolerated, reached tumor, and inhibited CD133+ neurosphere formation, but had little clinical efficacy as a single agent in rGBM. This suggests growth and maintenance of rGBM is not solely dependent on the SHH pathway thus targeting SMO may require combined approaches.
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Affiliation(s)
- Andrew E Sloan
- Chief of Neuroscience, Piedmont Healthcare, Atlanta, USA.
| | - Charles J Nock
- Department of Medicine, UH-Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Xiaobu Ye
- Adult Brain Tumor Consortium, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Robert Buerki
- Department of Neurology, UH-Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Susan Chang
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
| | - Glenn Lesser
- Department of Radiation Oncology, Wake Forest University, Wake Forest, NC, USA
| | - Andrew Norden
- Department of Medicine, Dana Farber Cancer Institute, Boston, MA, USA
| | - Timothy Cloughesy
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jeffrey Olson
- Department of Neurosurgery, Emory University, Atlanta, GA, USA
| | | | - Jeremy Rich
- Department of Neurology and Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joy Fisher
- Adult Brain Tumor Consortium, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Serena Desideri
- Adult Brain Tumor Consortium, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Naoko Takebe
- National Cancer Institute, Clinical Investigations Branch, National Institutes of Health, Bethesda, MD, USA
| | - William Timmer
- National Cancer Institute, Clinical Investigations Branch, National Institutes of Health, Bethesda, MD, USA
| | - Stuart Grossman
- Adult Brain Tumor Consortium, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michael Prados
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA
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10
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Pati S, Baid U, Edwards B, Sheller M, Wang SH, Reina GA, Foley P, Gruzdev A, Karkada D, Davatzikos C, Sako C, Ghodasara S, Bilello M, Mohan S, Vollmuth P, Brugnara G, Preetha CJ, Sahm F, Maier-Hein K, Zenk M, Bendszus M, Wick W, Calabrese E, Rudie J, Villanueva-Meyer J, Cha S, Ingalhalikar M, Jadhav M, Pandey U, Saini J, Garrett J, Larson M, Jeraj R, Currie S, Frood R, Fatania K, Huang RY, Chang K, Balaña C, Capellades J, Puig J, Trenkler J, Pichler J, Necker G, Haunschmidt A, Meckel S, Shukla G, Liem S, Alexander GS, Lombardo J, Palmer JD, Flanders AE, Dicker AP, Sair HI, Jones CK, Venkataraman A, Jiang M, So TY, Chen C, Heng PA, Dou Q, Kozubek M, Lux F, Michálek J, Matula P, Keřkovský M, Kopřivová T, Dostál M, Vybíhal V, Vogelbaum MA, Mitchell JR, Farinhas J, Maldjian JA, Yogananda CGB, Pinho MC, Reddy D, Holcomb J, Wagner BC, Ellingson BM, Cloughesy TF, Raymond C, Oughourlian T, Hagiwara A, Wang C, To MS, Bhardwaj S, Chong C, Agzarian M, Falcão AX, Martins SB, Teixeira BCA, Sprenger F, Menotti D, Lucio DR, LaMontagne P, Marcus D, Wiestler B, Kofler F, Ezhov I, Metz M, Jain R, Lee M, Lui YW, McKinley R, Slotboom J, Radojewski P, Meier R, Wiest R, Murcia D, Fu E, Haas R, Thompson J, Ormond DR, Badve C, Sloan AE, Vadmal V, Waite K, Colen RR, Pei L, Ak M, Srinivasan A, Bapuraj JR, Rao A, Wang N, Yoshiaki O, Moritani T, Turk S, Lee J, Prabhudesai S, Morón F, Mandel J, Kamnitsas K, Glocker B, Dixon LVM, Williams M, Zampakis P, Panagiotopoulos V, Tsiganos P, Alexiou S, Haliassos I, Zacharaki EI, Moustakas K, Kalogeropoulou C, Kardamakis DM, Choi YS, Lee SK, Chang JH, Ahn SS, Luo B, Poisson L, Wen N, Tiwari P, Verma R, Bareja R, Yadav I, Chen J, Kumar N, Smits M, van der Voort SR, Alafandi A, Incekara F, Wijnenga MMJ, Kapsas G, Gahrmann R, Schouten JW, Dubbink HJ, Vincent AJPE, van den Bent MJ, French PJ, Klein S, Yuan Y, Sharma S, Tseng TC, Adabi S, Niclou SP, Keunen O, Hau AC, Vallières M, Fortin D, Lepage M, Landman B, Ramadass K, Xu K, Chotai S, Chambless LB, Mistry A, Thompson RC, Gusev Y, Bhuvaneshwar K, Sayah A, Bencheqroun C, Belouali A, Madhavan S, Booth TC, Chelliah A, Modat M, Shuaib H, Dragos C, Abayazeed A, Kolodziej K, Hill M, Abbassy A, Gamal S, Mekhaimar M, Qayati M, Reyes M, Park JE, Yun J, Kim HS, Mahajan A, Muzi M, Benson S, Beets-Tan RGH, Teuwen J, Herrera-Trujillo A, Trujillo M, Escobar W, Abello A, Bernal J, Gómez J, Choi J, Baek S, Kim Y, Ismael H, Allen B, Buatti JM, Kotrotsou A, Li H, Weiss T, Weller M, Bink A, Pouymayou B, Shaykh HF, Saltz J, Prasanna P, Shrestha S, Mani KM, Payne D, Kurc T, Pelaez E, Franco-Maldonado H, Loayza F, Quevedo S, Guevara P, Torche E, Mendoza C, Vera F, Ríos E, López E, Velastin SA, Ogbole G, Soneye M, Oyekunle D, Odafe-Oyibotha O, Osobu B, Shu'aibu M, Dorcas A, Dako F, Simpson AL, Hamghalam M, Peoples JJ, Hu R, Tran A, Cutler D, Moraes FY, Boss MA, Gimpel J, Veettil DK, Schmidt K, Bialecki B, Marella S, Price C, Cimino L, Apgar C, Shah P, Menze B, Barnholtz-Sloan JS, Martin J, Bakas S. Federated learning enables big data for rare cancer boundary detection. Nat Commun 2022; 13:7346. [PMID: 36470898 PMCID: PMC9722782 DOI: 10.1038/s41467-022-33407-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/16/2022] [Indexed: 12/12/2022] Open
Abstract
Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing.
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Affiliation(s)
- Sarthak Pati
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Satyam Ghodasara
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suyash Mohan
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Zenk
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany
| | - Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey Rudie
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Manali Jadhav
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - John Garrett
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Matthew Larson
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert Jeraj
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Stuart Currie
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Russell Frood
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Kavi Fatania
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | | | - Josep Puig
- Department of Radiology (IDI), Girona Biomedical Research Institute (IdIBGi), Josep Trueta University Hospital, Girona, Spain
| | - Johannes Trenkler
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Josef Pichler
- Department of Neurooncology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Georg Necker
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Andreas Haunschmidt
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Stephan Meckel
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
- Institute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, Christiana Care Health System, Philadelphia, PA, USA
| | - Spencer Liem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gregory S Alexander
- Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA
| | - Joseph Lombardo
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Craig K Jones
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Archana Venkataraman
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meirui Jiang
- The Chinese University of Hong Kong, Hong Kong, China
| | - Tiffany Y So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Cheng Chen
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Qi Dou
- The Chinese University of Hong Kong, Hong Kong, China
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Filip Lux
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jan Michálek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Petr Matula
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
- Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, and University Hospital and Czech Republic, Brno, Czech Republic
| | - Michael A Vogelbaum
- Department of Neuro Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - J Ross Mitchell
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Joaquim Farinhas
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | - Marco C Pinho
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Divya Reddy
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Holcomb
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Minh-Son To
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sargam Bhardwaj
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Chee Chong
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Bernardo C A Teixeira
- Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - David Menotti
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Diego R Lucio
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Pamela LaMontagne
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
| | - Florian Kofler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Marie Metz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Matthew Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvonne W Lui
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Raphael Meier
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Derrick Murcia
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Eric Fu
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Rourke Haas
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - John Thompson
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - David Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vachan Vadmal
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristin Waite
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Rivka R Colen
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Linmin Pei
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat Ak
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashok Srinivasan
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - J Rajiv Bapuraj
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Arvind Rao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Ota Yoshiaki
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Toshio Moritani
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Sevcan Turk
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Joonsang Lee
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Prabhudesai
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Fanny Morón
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Jacob Mandel
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantinos Kamnitsas
- Department of Computing, Imperial College London, London, UK
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ben Glocker
- Department of Computing, Imperial College London, London, UK
| | - Luke V M Dixon
- Department of Radiology, Imperial College NHS Healthcare Trust, London, UK
| | - Matthew Williams
- Computational Oncology Group, Institute for Global Health Innovation, Imperial College London, London, UK
| | - Peter Zampakis
- Department of NeuroRadiology, University of Patras, Patras, Greece
| | | | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Sotiris Alexiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Ilias Haliassos
- Department of Neuro-Oncology, University of Patras, Patras, Greece
| | - Evangelia I Zacharaki
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | | | | | | | | | | | | | - Sung Soo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Bing Luo
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Laila Poisson
- Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | | | - Ruchika Verma
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
- Case Western Reserve University, Cleveland, OH, USA
| | - Rohan Bareja
- Case Western Reserve University, Cleveland, OH, USA
| | - Ipsa Yadav
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Neeraj Kumar
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Ahmed Alafandi
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Maarten M J Wijnenga
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Georgios Kapsas
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Joost W Schouten
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Yading Yuan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tzu-Chi Tseng
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saba Adabi
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olivier Keunen
- Translation Radiomics, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Ann-Christin Hau
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
- Luxembourg Center of Neuropathology, Laboratoire National De Santé, Luxembourg, Luxembourg
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - David Fortin
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Neurosurgery and Neuro-Oncology, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Centre, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bennett Landman
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Silky Chotai
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lola B Chambless
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akshitkumar Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reid C Thompson
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Krithika Bhuvaneshwar
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anousheh Sayah
- Division of Neuroradiology & Neurointerventional Radiology, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Camelia Bencheqroun
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anas Belouali
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Subha Madhavan
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK
| | - Alysha Chelliah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Haris Shuaib
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Carmen Dragos
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
| | | | | | | | | | - Shady Gamal
- University of Cairo School of Medicine, Giza, Egypt
| | | | | | | | - Ji Eun Park
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Jihye Yun
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place, Liverpool, UK
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Sean Benson
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht, Netherlands
| | - Jonas Teuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - William Escobar
- Clínica Imbanaco Grupo Quirón Salud, Cali, Colombia
- Universidad del Valle, Cali, Colombia
| | | | - Jose Bernal
- Universidad del Valle, Cali, Colombia
- The University of Edinburgh, Edinburgh, UK
| | | | - Joseph Choi
- Department of Industrial and Systems Engineering, University of Iowa, Iowa, USA
| | - Stephen Baek
- Department of Industrial and Systems Engineering, Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Heba Ismael
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Bryan Allen
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Hongwei Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bertrand Pouymayou
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Sampurna Shrestha
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Kartik M Mani
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Department of Radiation Oncology, Stony Brook University, Stony Brook, NY, USA
| | - David Payne
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Scientific Data Group, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Enrique Pelaez
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | - Francis Loayza
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | | | | | | | - Franco Vera
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Elvis Ríos
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Eduardo López
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Sergio A Velastin
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mayowa Soneye
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Dotun Oyekunle
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | | | - Babatunde Osobu
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mustapha Shu'aibu
- Department of Radiology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Adeleye Dorcas
- Department of Radiology, Obafemi Awolowo University Ile-Ife, Ile-Ife, Osun, Nigeria
| | - Farouk Dako
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Simpson
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Mohammad Hamghalam
- School of Computing, Queen's University, Kingston, ON, Canada
- Department of Electrical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Jacob J Peoples
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Ricky Hu
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Anh Tran
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Danielle Cutler
- The Faculty of Arts & Sciences, Queen's University, Kingston, ON, Canada
| | - Fabio Y Moraes
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - James Gimpel
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Deepak Kattil Veettil
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Kendall Schmidt
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Brian Bialecki
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Sailaja Marella
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Cynthia Price
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Lisa Cimino
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Charles Apgar
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | | | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Jill S Barnholtz-Sloan
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), National Institute of Health, Bethesda, MD, USA
| | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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11
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Sloan AR, Lee-Poturalski C, Hoffman HC, Harris PL, Elder TE, Richardson B, Kerstetter-Fogle A, Cioffi G, Schroer J, Desai A, Cameron M, Barnholtz-Sloan J, Rich J, Jankowsky E, Sen Gupta A, Sloan AE. Glioma stem cells activate platelets by plasma-independent thrombin production to promote glioblastoma tumorigenesis. Neurooncol Adv 2022; 4:vdac172. [PMID: 36452274 PMCID: PMC9700385 DOI: 10.1093/noajnl/vdac172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The interaction between platelets and cancer cells has been underexplored in solid tumor models that do not metastasize, for example, glioblastoma (GBM) where metastasis is rare. Histologically, it is known that glioma stem cells (GSCs) are found in perivascular and pseudsopalisading regions of GBM, which are also areas of platelet localization. High platelet counts have been associated with poor clinical outcomes in many cancers. While platelets are known to promote the progression of other tumors, mechanisms by which platelets influence GBM oncogenesis are unknown. Here, we aimed to understand how the bidirectional interaction between platelets and GSCs drives GBM oncogenesis. Methods Male and female NSG mice were transplanted with GSC lines and treated with antiplatelet and anti-thrombin inhibitors. Immunofluorescence, qPCR, and Western blots were used to determine expression of coagulation mechanism in GBM tissue and subsequent GSC lines. Results We show that GSCs activate platelets by endogenous production of all the factors of the intrinsic and extrinsic coagulation cascades in a plasma-independent manner. Therefore, GSCs produce thrombin resulting in platelet activation. We further demonstrate that the endogenous coagulation cascades of these cancer stem cells are tumorigenic: they activate platelets to promote stemness and proliferation in vitro and pharmacological inhibition delays tumor growth in vivo. Conclusions Our findings uncover a specific preferential relationship between platelets and GSCs that drive GBM malignancies and identify a therapeutically targetable novel interaction.
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Affiliation(s)
- Anthony R Sloan
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, Ohio, USA,Department of Neurosciences, Case Western Reserve University, Cleveland, Ohio, USA,Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Christine Lee-Poturalski
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA,Center for RNA Science and Therapeutics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Harry C Hoffman
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, Ohio, USA
| | - Peggy L Harris
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, Ohio, USA,Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Theresa E Elder
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, Ohio, USA,Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Brian Richardson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA,Department of Population and Quantitative Health Science, Case Western Reserve University, Cleveland, Ohio, USA
| | - Amber Kerstetter-Fogle
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, Ohio, USA,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Gino Cioffi
- Division of Cancer Epidemiology and Genetics, Trans-Divisional Research Program, National Cancer Institute, Bethesda, Maryland, USA
| | - Julia Schroer
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Ansh Desai
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, Ohio, USA
| | - Mark Cameron
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA,Department of Population and Quantitative Health Science, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jill Barnholtz-Sloan
- Division of Cancer Epidemiology and Genetics, Trans-Divisional Research Program, National Cancer Institute, Bethesda, Maryland, USA,Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland, USA
| | - Jeremy Rich
- Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eckhard Jankowsky
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA,Center for RNA Science and Therapeutics, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Andrew E Sloan
- Corresponding Author: Andrew E. Sloan MD, FACS, Department of Neurological Surgery and Pathology, University Hospital, Seidman Cancer Center, Case Western Reserve School of Medicine, and Case Comprehensive Cancer Center, 11100 Euclid Ave., HAN 524, Cleveland, OH 44106, USA () and Department of Neuroscience, Piedmont Health, 2001 Peachtree Rd., NE, Atlanta, GA, USA
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12
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Mahajan UV, Desai A, Shost MD, Cai Y, Anthony A, Labak CM, Herring EZ, Wijesekera O, Mukherjee D, Sloan AE, Hodges TR. Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis. Neurosurg Focus 2022; 53:E9. [DOI: 10.3171/2022.8.focus22369] [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] [Received: 06/30/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Stereotactic radiosurgery (SRS) has recently emerged as a minimally invasive alternative to resection for treating multiple brain metastases. Given the lack of consensus regarding the application of SRS versus resection for multiple brain metastases, the authors aimed to conduct a systematic literature review of all published work on the topic.
METHODS
The PubMed, OVID, Cochrane, Web of Science, and Scopus databases were used to identify studies that examined clinical outcomes after resection or SRS was performed in patients with multiple brain metastases. Radiological studies, case series with fewer than 3 patients, pediatric studies, or national database studies were excluded. Data extracted included patient demographics and mean overall survival (OS). Weighted t-tests and ANOVA were performed.
RESULTS
A total of 1300 abstracts were screened, 450 articles underwent full-text review, and 129 studies met inclusion criteria, encompassing 20,177 patients (18,852 treated with SRS and 1325 who underwent resection). The OS for the SRS group was 10.2 ± 6 months, and for the resection group it was 6.5 ± 3.8 months. A weighted ANOVA test comparing OS with covariates of age, sex, and publication year revealed that the treatment group (p = 0.045), age (p = 0.034), and publication year (0.0078) were all independently associated with OS (with SRS, younger age, and later publication year being associated with longer survival), whereas sex (p = 0.95) was not.
CONCLUSIONS
For patients with multiple brain metastases, SRS and resection are effective treatments to prolong OS, with published data suggesting that SRS may have a trend toward lengthened survival outcomes. The authors encourage additional work examining outcomes of treatments for multiple brain metastases.
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Affiliation(s)
- Uma V. Mahajan
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ansh Desai
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Michael D. Shost
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Yang Cai
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Austin Anthony
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Collin M. Labak
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and
| | - Eric Z. Herring
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and
| | - Olindi Wijesekera
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and
| | - Debraj Mukherjee
- Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Andrew E. Sloan
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and
| | - Tiffany R. Hodges
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; and
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13
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Labak CM, Rabah NM, Kipke JP, Mahajan UV, Labak KB, Ali SA, Fowler N, Sloan AE. Multidisciplinary approaches to gliosarcoma: A case report and review of the literature. Clin Case Rep 2022; 10:e5985. [PMID: 36017117 PMCID: PMC9396286 DOI: 10.1002/ccr3.5985] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/30/2022] Open
Abstract
A 58‐year‐old right‐handed man presented to our tertiary care center with gliosarcoma (GS) infiltration through the dura, skull, and soft tissue. Patient had a previous history of right temporal GS, with four intracranial surgeries prior to presentation. A multidisciplinary approach was used to treat the lesion and perform reconstruction.
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Affiliation(s)
- Collin M. Labak
- Department of Neurosurgery University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA
| | - Nicholas M. Rabah
- Department of Neurosurgery University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA
| | - Jasmine P. Kipke
- Department of Neurosurgery University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA
| | - Uma V. Mahajan
- Case Western Reserve University School of Medicine Cleveland Ohio USA
| | | | - S. Ahmed Ali
- Department of Otolaryngology University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA
| | - Nicole Fowler
- Department of Otolaryngology University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA
- Seidman Cancer Center and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Andrew E. Sloan
- Department of Neurosurgery University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland Ohio USA
- Seidman Cancer Center and Case Comprehensive Cancer Center Cleveland Ohio USA
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14
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Sloan AE. Commentary: A Novel 5-Aminolevulinic Acid-Enabled Surgical Loupe System—A Consecutive Brain Tumor Series of 11 Cases. Oper Neurosurg (Hagerstown) 2022; 22:e287-e288. [PMID: 35867099 PMCID: PMC9514739 DOI: 10.1227/ons.0000000000000192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Andrew E Sloan
- University Hospitals-Cleveland Medical Center & Seidman Cancer Center, Department of Neurosurgery, Cleveland, Ohio, USA; and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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15
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Herrgott GA, Asmaro KP, Wells M, Sabedot TS, Malta TM, Mosella MS, Nelson K, Scarpace L, Barnholtz-Sloan JS, Sloan AE, Selman WR, deCarvalho AC, Poisson LM, Mukherjee A, Robin AM, Lee IY, Snyder J, Walbert T, Rosenblum M, Mikkelsen T, Bhan A, Craig J, Kalkanis S, Rock J, Noushmehr H, Castro AV. Detection of Tumor-specific DNA Methylation Markers in the Blood of Patients with Pituitary Neuroendocrine Tumors. Neuro Oncol 2022; 24:1126-1139. [PMID: 35212383 PMCID: PMC9248407 DOI: 10.1093/neuonc/noac050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background DNA methylation abnormalities are pervasive in pituitary neuroendocrine tumors (PitNETs). The feasibility to detect methylome alterations in circulating cell-free DNA (cfDNA) has been reported for several central nervous system (CNS) tumors but not across PitNETs. The aim of the study was to use the liquid biopsy (LB) approach to detect PitNET-specific methylation signatures to differentiate these tumors from other sellar diseases. Methods We profiled the cfDNA methylome (EPIC array) of 59 serum and 41 plasma LB specimens from patients with PitNETs and other CNS diseases (sellar tumors and other pituitary non-neoplastic diseases, lower-grade gliomas, and skull-base meningiomas) or nontumor conditions, grouped as non-PitNET. Results Our results indicated that despite quantitative and qualitative differences between serum and plasma cfDNA composition, both sources of LB showed that patients with PitNETs presented a distinct methylome landscape compared to non-PitNETs. In addition, LB methylomes captured epigenetic features reported in PitNET tissue and provided information about cell-type composition. Using LB-derived PitNETs-specific signatures as input to develop machine-learning predictive models, we generated scores that distinguished PitNETs from non-PitNETs conditions, including sellar tumor and non-neoplastic pituitary diseases, with accuracies above ~93% in independent cohort sets. Conclusions Our results underpin the potential application of methylation-based LB profiling as a noninvasive approach to identify clinically relevant epigenetic markers to diagnose and potentially impact the prognostication and management of patients with PitNETs.
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Affiliation(s)
- Grayson A Herrgott
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Karam P Asmaro
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Michael Wells
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Thais S Sabedot
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Tathiane M Malta
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Maritza S Mosella
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Kevin Nelson
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Lisa Scarpace
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 2103 Cornell Rd, Cleveland, Ohio 44106 USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106 USA (EAS).,Case Comprehensive Cancer Center, 10900 Euclid Ave., Cleveland, OH 44106 USA (EAS)
| | - Warren R Selman
- Department of Neurological Surgery, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106 USA (EAS)
| | - Ana C deCarvalho
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Laila M Poisson
- Department of Biostatistics, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI, 48202 USA
| | - Abir Mukherjee
- Department of Pathology, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI, 48202 USA
| | - Adam M Robin
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Ian Y Lee
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - James Snyder
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Tobias Walbert
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Mark Rosenblum
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Tom Mikkelsen
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Arti Bhan
- Department of Endocrinology, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI, 48202 USA
| | - John Craig
- Department of Otolaryngology, Co-director of the Skull Base, Pituitary and Endoscopy Center
| | - Steven Kalkanis
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Jack Rock
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA
| | - Houtan Noushmehr
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
| | - Ana Valeria Castro
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 USA.,Department of Neurosurgery, Omics Laboratory, 2799 West Grand Boulevard, Henry Ford Health System, Detroit, MI 48202 USA
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16
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Soler DC, Kerstetter-Fogle A, Young AB, Rayman P, Finke JH, Debanne SM, Cooper KD, Barnholtz-Sloan J, Sloan AE, McCormick TS. Healthy myeloid-derived suppressor cells express the surface ectoenzyme Vanin-2 (VNN2). Mol Immunol 2022; 142:1-10. [PMID: 34953280 PMCID: PMC8800381 DOI: 10.1016/j.molimm.2021.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/18/2021] [Accepted: 12/09/2021] [Indexed: 02/03/2023]
Abstract
Study of human monocytic Myeloid-Derived Suppressor cells Mo-MDSC (CD14+ HLA-DRneg/low) has been hampered by the lack of positive cell-surface markers. In order to identify positive markers for Mo-MDSC, we performed microarray analysis comparing Mo-MDSC cells from healthy subjects versus CD14+ HLA-DRhigh monocytes. We have identified the surface ectoenzyme Vanin-2(VNN2) protein as a novel biomarker highly-enriched in healthy subjects Mo-MDSC. Indeed, healthy subjects Mo-MDSC cells expressed 68 % VNN2, whereas only 9% VNN2 expression was observed on CD14+ HLA-DRhigh cells (n = 4 p < 0.01). The top 10 percent positive VNN2 monocytes expressed CD33 and CD11b while being negative for HLA-DR, CD3, CD15, CD19 and CD56, consistent with a Mo-MDSC phenotype. CD14+VNN2high monocytes were able to inhibit CD8 T cell proliferation comparably to traditional Mo-MDSC at 51 % and 48 % respectively. However, VNN2 expression on CD14+ monocytes from glioma patients was inversely correlated to their grade. CD14+VNN2high monocytes thus appear to mark a monocytic population similar to Mo-MDSC only in healthy subjects, which may be useful for tumor diagnoses.
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Affiliation(s)
- David C. Soler
- The Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH 44195.,Brain Tumor and Neuro-Oncology Center, and the Center of Excellence for Translational Neuro-Oncology, Cleveland Clinic Foundation, Cleveland, OH 44195.,University Hospitals-Seidman Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Amber Kerstetter-Fogle
- The Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH 44195.,Brain Tumor and Neuro-Oncology Center, and the Center of Excellence for Translational Neuro-Oncology, Cleveland Clinic Foundation, Cleveland, OH 44195.,University Hospitals-Seidman Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Andrew B. Young
- Department of Dermatology, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA.,The Murdough Family Center for Psoriasis, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA
| | - Pat Rayman
- Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - James H. Finke
- Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Sarah M. Debanne
- Epidemiology and Biostatistics, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA
| | - Kevin D. Cooper
- Department of Dermatology, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA.,The Murdough Family Center for Psoriasis, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA
| | - Jill Barnholtz-Sloan
- The Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH 44195.,Brain Tumor and Neuro-Oncology Center, and the Center of Excellence for Translational Neuro-Oncology, Cleveland Clinic Foundation, Cleveland, OH 44195.,University Hospitals-Seidman Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195.,Epidemiology and Biostatistics, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA
| | - Andrew E. Sloan
- The Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH 44195.,Brain Tumor and Neuro-Oncology Center, and the Center of Excellence for Translational Neuro-Oncology, Cleveland Clinic Foundation, Cleveland, OH 44195.,University Hospitals-Seidman Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195
| | - Thomas S. McCormick
- Department of Dermatology, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA.,The Murdough Family Center for Psoriasis, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106 USA
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17
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Soler DC, Kowatz T, Sloan AE, McCormick TS, Cooper KD, Stepanyan R, Engel A, Vahedi-Faridi A. A region within the third extracellular loop of rat Aquaporin 6 precludes trafficking to plasma membrane in a heterologous cell line. Sci Rep 2021; 11:13673. [PMID: 34211055 PMCID: PMC8249660 DOI: 10.1038/s41598-021-93117-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/31/2021] [Indexed: 11/09/2022] Open
Abstract
The inability to over-express Aquaporin 6 (AQP6) in the plasma membrane of heterologous cells has hampered efforts to further characterize the function of this aquaglyceroporin membrane protein at atomic detail using crystallographic approaches. Using an Aquaporin 3-tGFP Reporter (AGR) system we have identified a region within loop C of AQP6 that is responsible for severely hampering plasma membrane expression. Serine substitution corroborated that amino acids present within AQP6194–213 of AQP6 loop C contribute to intracellular endoplasmic reticulum (ER) retention. This intracellular retention signal may preclude proper plasma membrane trafficking and severely curtail expression of AQP6 in heterologous expression systems.
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Affiliation(s)
- D C Soler
- The Department of Neurosurgery, Case Western Reserve University, Cleveland, USA.
| | - T Kowatz
- Department of Physiology and Biophysics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4965, USA
| | - A E Sloan
- The Department of Neurosurgery, Case Western Reserve University, Cleveland, USA.,Brain Tumor and Neuro-Oncology Center, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - T S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, USA.,Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, USA
| | - K D Cooper
- Department of Dermatology, Case Western Reserve University, Cleveland, USA.,Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, USA
| | - R Stepanyan
- Department of Otolaryngology-HNS, Case Western Reserve University, Cleveland, USA.,Department of Neurosciences, Case Western Reserve University, Cleveland, USA
| | - A Engel
- Biozentrum, University of Basel, Basel, Switzerland
| | - A Vahedi-Faridi
- Department of Physiology and Biophysics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4965, USA
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18
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Vellayappan BA, McGranahan T, Graber J, Taylor L, Venur V, Ellenbogen R, Sloan AE, Redmond KJ, Foote M, Chao ST, Suh JH, Chang EL, Sahgal A, Lo SS. Radiation Necrosis from Stereotactic Radiosurgery-How Do We Mitigate? Curr Treat Options Oncol 2021; 22:57. [PMID: 34097171 DOI: 10.1007/s11864-021-00854-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 12/12/2022]
Abstract
OPINION STATEMENT Intracranial stereotactic radiosurgery (SRS) is an effective and convenient treatment for many brain conditions. Data regarding safety come mostly from retrospective single institutional studies and a small number of prospective studies. Variations in target delineation, treatment delivery, imaging follow-up protocols and dose prescription limit the interpretation of this data. There has been much clinical focus on radiation necrosis (RN) in particular, as it is being increasingly recognized on follow-up imaging. Symptomatic RN may be treated with medical therapy (such as corticosteroids and bevacizumab) with surgical resection being reserved for refractory patients. Nevertheless, RN remains a challenging condition to manage, and therefore upfront patient selection for SRS remains critical to provide complication-free control. Mitigation strategies need to be considered in situations where the baseline risk of RN is expected to be high-such as large target volume or re-irradiation. These may involve reduction in the prescribed dose or hypofractionated stereotactic radiation therapy (HSRT). Recently published guidelines and international meta-analysis report the benefit of HSRT in larger lesions, without compromising control rates. However, careful attention to planning parameters and SRS techniques still need to be adhered, even with HSRT. In cases where the risk is deemed to be high despite mitigation, a combination approach of surgery with or without post-operative radiation should be considered.
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Affiliation(s)
- Balamurugan A Vellayappan
- Department of Radiation oncology, National University Cancer Institute, 1E Kent Ridge Road, Level 7 Tower block, Singapore, 119228, Singapore.
| | - Tresa McGranahan
- Department of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Jerome Graber
- Department of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Lynne Taylor
- Department of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Vyshak Venur
- Department of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Richard Ellenbogen
- Department of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, Seidman Cancer Center and University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA
| | - Kristin J Redmond
- Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University, Baltimore, MD, USA
| | - Matthew Foote
- Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Samuel T Chao
- Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - John H Suh
- Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Eric L Chang
- Department of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Arjun Sahgal
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Simon S Lo
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA
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19
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De Sa H, Dedousis D, Tirumani SH, Ardeshir-Larijani F, Nelson AA, Martin P, Mendiratta P, Sloan AE, Choi S, Mansur DB, Selfridge JE, Ramaiya NH, Hoimes CJ. Impact of BRAF mutations on outcomes in metastatic melanoma with central nervous system metastases treated with immune checkpoint inhibitors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21500] [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
e21500 Background: Half of patients (pts) with melanoma (mel) develop central nervous system (CNS) metastases (mets), leading to death in over 90% in the pre-immune checkpoint inhibitor (ICI) era. Overall survival (OS) has improved in the ICI era for those with CNS mets, yet the association of survival with ICI treatment for those with tumors harboring genomic variants (var) remains unclear. Methods: We retrospectively reviewed our electronic medical records to identify pts with mel and CNS mets who received ICI from 2010 to 2018. Treatment history, systemic and CNS responses, and genomic data were recorded. Genomic var were categorized as BRAFV600E (BRAF), NRAS, cKIT, other var, and no var. Concurrent RT (CRT) was defined as RT to CNS mets within 30 days of ICI. OS was calculated from date of first ICI or RT to date of death or last follow up, and comparison analyses made using Kaplan-Meier estimate. Fisher's exact or Chi-squared tests were used to compare categorical variables and Wilcoxon or Kruskal-Wallis tests to compare continuous variables. A two-sided p-value of < 0.05 was considered statistically significant. Results: A total of 49 pts were identified; 37 had var results available. BRAFV600E was the most common var identified (32%), followed by NRAS (19%), cKIT (5%), and other (5%); 38% had no var. BRAFV600K was not identified. Pts with BRAF had lower rates of CNS progression on ICI at 3 and 6 months than all other pts (17% vs 50%, p< 0.01 and 12.5% vs 40%, p< 0.01, respectively). Of 38 pts (10 BRAF) who had CNS mets at the start of ICI, 6-month OS was 50% in pts with BRAF, compared to 0% in pts with non-BRAF var ( p= 0.01) and 36% in pts with no var ( p= 0.7). 4 of the 10 pts with BRAF who had CNS mets at start of ICI received BRAF-targeted therapy after ICI. On ICI, only 30% of pts with BRAF developed new CNS mets, compared to 57% of all other pts ( p= 0.08). Pts who developed new CNS mets on ICI had worse OS than pts who did not (median OS (mOS) 314 days vs 662 days, p= 0.04). A majority of pts (55%) received anti-CTLA4 monotherapy as first ICI, and 39% received anti-CTLA4 plus anti-PD1. Pts with BRAF were just as likely to receive dual anti-CTLA4/PD-1 as pts without BRAF (33% vs 40%, p= 0.74). 40 pts underwent RT for CNS mets, of whom 22 received CRT. There was no difference in mOS between pts who received CRT and non-concurrent RT/no RT (468 days vs 314 days, p= 0.8). Rates of CRT between pts with BRAF and pts without BRAF were similar ( p> 0.9), and there was no difference in mOS between these groups (400 days vs 536 days, p= 0.9). Conclusions: Pts with BRAF-mutated mel with CNS mets receiving ICI had lower rates of progression in CNS and improved OS compared to other var. CRT was not associated with improved survival over non-concurrent RT. There has been significant improvement in OS of pts with mel CNS mets in the era of ICI and additional studies are warranted to understand the biology of BRAF var and the host immune system response in the CNS.
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Affiliation(s)
- Hong De Sa
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Demitrios Dedousis
- University Hospitals, Case Medical Center - Cleveland VA Hospital, Cleveland, OH
| | - Sree Harsha Tirumani
- University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | | | | | | | - Prateek Mendiratta
- University Hospitals of Seidman Cancer Center/Case Comprehensive Cancer Center, Cleveland, OH
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20
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Sloan AE, Buerki RA, Murphy C, Kelly AT, Ambady P, Brown M, Butowski NA, Cavaliere R, Curry WT, Desjardins A, Franklin L, Friedman HS, Gromeier M, Jackson L, Mixson L, Ong SS, Randazzo D, Wen PY, Nichols G. LUMINOS-101: Phase 2 study of PVSRIPO with pembrolizumab in recurrent glioblastoma. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps2065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS2065 Background: The prognosis for patients (pts) with recurrent (r) glioblastoma (GBM) is poor, with no highly effective approved therapies. Treatment failure may result from poor penetration of drugs through the blood-brain barrier and the immunosuppressive nature of the tumor microenvironment (TME). PVSRIPO, a recombinant poliovirus (PV):rhinovirus chimera, is a novel, non-neurovirulent, intratumoral immunotherapy. Trial results in rGBM pts show greater long-term survival with PVSRIPO monotherapy (21%, 36-60 months [mos]) vs criteria-matched external controls (4%, 36 mos; 2%, 60 mos; Desjardins 2018 NEJM). PVSRIPO targets CD155 (PV receptor), expressed on solid tumors and on APC. PVSRIPO infection results in inflammatory-mediated destruction of tumor cells but non-lethal lingering infection in TME APC. This leads to type I/III interferon-dominant inflammation and, ultimately, tumor antigen-specific T cell activation and recruitment (Brown 2017 Sci Transl Med), which is potentiated by immunologic recall to intratumoral replicating virus via prior vaccination. Induction of type 1 IFN dominant inflammation and compensatory activation of the PD-1:PD-L1 immune checkpoint (IC) pathway support investigation of PVSRIPO in combination with PD-1/L1 IC inhibitors. Immunologically cold mouse glioma models show PVSRIPO+anti-PD-1 therapy resulted in greater anti-tumor response than either agent. Methods: LUMINOS-101 is a phase 2, multicenter, open-label, single-arm study of intratumoral infusion of PVSRIPO (Day 1: 5x107 TCID50) followed by the anti-PD-1 monoclonal antibody pembrolizumab (200mg IV q3w) in adult pts with rGBM. The trial objective is to evaluate anti-tumor activity and safety and tolerability of the combination. Eligibility criteria include pts ≥18 years who had prior PV and boost IPOL® immunizations, histologically confirmed supratentorial rGBM, infusible 1 to ≤5.5cm enhancing disease, confirmed disease progression following prior therapies, and KPS ≥70. Key exclusion criteria include multifocal disease; discontinuation of prior anti-PD-1/L1 agent for toxicity; prior intratumoral therapy, immunotherapy, or radiotherapy within 12 weeks; high-dose systemic corticosteroids; chemotherapy, anti-VEGF, or TTF therapy ≤1-6 weeks depending on the therapy; serious cerebral herniation syndrome; extensive leptomeningeal, subependymal, or ≥1cm enhancing disease crossing the midline; and severe active comorbidities. Primary endpoints are objective response rate, duration of response, and safety. Secondary endpoints include overall and progression-free survival and disease control rate and duration. Exploratory endpoints include assessment of tumor and blood for biomarkers of response. The initially planned safety lead-in period is now fully enrolled. Recruitment is ongoing in the US, and results will inform the design of a randomized phase 3 trial. Clinical trial information: NCT04479241.
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Affiliation(s)
- Andrew E. Sloan
- University Hospitals Cleveland Medical Center & Seidman Cancer Center, Cleveland, OH
| | - Robin Arthur Buerki
- University Hospitals Cleveland Medical Center & Seidman Cancer Center, Cleveland, OH
| | - Christopher Murphy
- University Hospitals Cleveland Medical Center & Seidman Cancer Center, Cleveland, OH
| | | | | | - Michael Brown
- Duke University Medical Center, Preston Robert Tisch Brain Tumor Center, Durham, NC
| | | | | | | | - Annick Desjardins
- Duke University Medical Center, Preston Robert Tisch Brain Tumor Center, Durham, NC
| | | | - Henry S. Friedman
- Duke University Medical Center, Preston Robert Tisch Brain Tumor Center, Durham, NC
| | - Matthias Gromeier
- Duke University Medical Center, Preston Robert Tisch Brain Tumor Center, Durham, NC
| | | | | | - Shirley S. Ong
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - Dina Randazzo
- Duke University Medical Center, Preston Robert Tisch Brain Tumor Center, Durham, NC
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21
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Zhang A, Tao W, Zhai K, Fang X, Huang Z, Yu JS, Sloan AE, Rich JN, Zhou W, Bao S. Protein sumoylation with SUMO1 promoted by Pin1 in glioma stem cells augments glioblastoma malignancy. Neuro Oncol 2021; 22:1809-1821. [PMID: 32592588 DOI: 10.1093/neuonc/noaa150] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The tumorigenic potential of glioma stem cells (GSCs) is associated with multiple reversible molecular alternations, but the role of posttranslational protein sumoylation in GSCs has not been elucidated. The development of GSC-targeting drugs relies on the discovery of GSC-preferential molecular modifications and the relevant signaling pathways. In this work, we investigated the protein sumoylation status, the major sumoylated substrate, and the key regulatory enzyme in GSCs to explore the therapeutic potential of disrupting protein sumoylation for glioblastoma (GBM) treatment. METHODS Patient-derived GSCs, primary GBM sections, and intracranial GBM xenografts were used to determine protein sumoylation and the related molecular mechanisms by immunoblot, quantitative PCR, immunoprecipitation, immunofluorescence, and immunohistochemistry. Orthotopic GBM xenograft models were applied to investigate the inhibition of tumor growth by disrupting protein sumoylation with short hairpin (sh)RNAs or molecular inhibitors. RESULTS We show that high levels of small ubiquitin-related modifier 1 (SUMO1)-but not SUMO2/3-modified sumoylation are preferentially present in GSCs. The promyelocytic leukemia (PML) protein is a major SUMO1-sumoylated substrate in GSCs, whose sumoylation facilitates its interaction with c-Myc to stabilize c-Myc proteins. The prolyl-isomerase Pin1 is preferentially expressed in GSCs and functions as the key enzyme to promote SUMO1 sumoylation. Disruption of SUMO1 sumoylation by Pin1 silencing with shRNAs or inhibition with its inhibitor Juglone markedly abrogated GSC maintenance and mitigated GSC-driven tumor growth. CONCLUSIONS Our findings indicate that high SUMO1-modified protein sumoylation as a feature of GSCs is critical for GSC maintenance, suggesting that targeting SUMO1 sumoylation may effectively improve GBM treatment.
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Affiliation(s)
- Aili Zhang
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Weiwei Tao
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Kui Zhai
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Xiaoguang Fang
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Zhi Huang
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jennifer S Yu
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Brain Tumor and Neuro-Oncology Center, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jeremy N Rich
- Division of Regenerative Medicine, Department of Medicine, University of California at San Diego, San Diego, California, USA
| | - Wenchao Zhou
- Intelligent Pathology Institute, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Shideng Bao
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Brain Tumor and Neuro-Oncology Center, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.,Center for Cancer Stem Cell Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
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22
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Davatzikos C, Barnholtz-Sloan JS, Bakas S, Colen R, Mahajan A, Quintero CB, Capellades Font J, Puig J, Jain R, Sloan AE, Badve C, Marcus DS, Seong Choi Y, Lee SK, Chang JH, Poisson LM, Griffith B, Dicker AP, Flanders AE, Booth TC, Rathore S, Akbari H, Sako C, Bilello M, Shukla G, Fathi Kazerooni A, Brem S, Lustig R, Mohan S, Bagley S, Nasrallah M, O'Rourke DM. AI-based prognostic imaging biomarkers for precision neuro-oncology: the ReSPOND consortium. Neuro Oncol 2021; 22:886-888. [PMID: 32152622 DOI: 10.1093/neuonc/noaa045] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rivka Colen
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | - Josep Puig
- Department of Radiology, University of Manitoba Winnipeg, Manitoba, Canada
| | - Rajan Jain
- Department of Radiology, New York University
| | - Andrew E Sloan
- Department of Neurosurgery, Case Western Reserve University, Cleveland, Ohio, USA
| | - Chaitra Badve
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Daniel S Marcus
- Department of Radiology, Washington University, St. Louis, Missouri, USA
| | - Yoon Seong Choi
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.,Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College, Seoul, Korea
| | - Laila M Poisson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, Michigan, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adam E Flanders
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, England, UK
| | - Saima Rathore
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hamed Akbari
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anahita Fathi Kazerooni
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven Brem
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert Lustig
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suyash Mohan
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephen Bagley
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - MacLean Nasrallah
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Donald M O'Rourke
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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23
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Gittleman H, Sloan AE, Barnholtz-Sloan JS. An independently validated survival nomogram for lower-grade glioma. Neuro Oncol 2021; 22:665-674. [PMID: 31621885 DOI: 10.1093/neuonc/noz191] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [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: 10/09/2019] [Accepted: 10/09/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Gliomas are the most common primary malignant brain tumor. Diffuse low-grade and intermediate-grade gliomas, which together compose the lower-grade gliomas (LGGs; World Health Organization [WHO] grades II and III), present a therapeutic challenge to physicians due to the heterogeneity of their clinical behavior. Nomograms are useful tools for individualized estimation of survival. This study aimed to develop and independently validate a survival nomogram for patients with newly diagnosed LGG. METHODS Data were obtained for newly diagnosed LGG patients from The Cancer Genome Atlas (TCGA) and the Ohio Brain Tumor Study (OBTS) with the following variables: tumor grade (II or III), age at diagnosis, sex, Karnofsky performance status (KPS), and molecular subtype (IDH mutant with 1p/19q codeletion [IDHmut-codel], IDH mutant without 1p/19q codeletion, and IDH wild-type). Survival was assessed using Cox proportional hazards regression, random survival forests, and recursive partitioning analysis, with adjustment for known prognostic factors. The models were developed using TCGA data and independently validated using the OBTS data. Models were internally validated using 10-fold cross-validation and externally validated with calibration curves. RESULTS A final nomogram was validated for newly diagnosed LGG. Factors that increased the probability of survival included grade II tumor, younger age at diagnosis, having a high KPS, and the IDHmut-codel molecular subtype. CONCLUSIONS A nomogram that calculates individualized survival probabilities for patients with newly diagnosed LGG could be useful to health care providers for counseling patients regarding treatment decisions and optimizing therapeutic approaches. Free online software for implementing this nomogram is provided: https://hgittleman.shinyapps.io/LGG_Nomogram_H_Gittleman/. KEY POINTS 1. A survival nomogram for lower-grade glioma patients has been developed and externally validated.2. Free online software for implementing this nomogram is provided allowing for ease of use by practicing health care providers.
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Affiliation(s)
- Haley Gittleman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Neurological Surgery, University Hospitals of Cleveland and Case Western University School of Medicine, Cleveland, Ohio.,Seidman Cancer Center, University Hospitals of Cleveland, Cleveland, Ohio
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals Research Division, Cleveland, Ohio.,Cleveland Center for Health Outcomes Research, Case Western Reserve University School of Medicine, Cleveland, Ohio
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24
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Soler DC, Kerstetter-Fogle A, Elder T, Raghavan A, Barnholtz-Sloan JS, Cooper KD, McCormick TS, Sloan AE. A Liquid Biopsy to Assess Brain Tumor Recurrence: Presence of Circulating Mo-MDSC and CD14+ VNN2+ Myeloid Cells as Biomarkers That Distinguish Brain Metastasis From Radiation Necrosis Following Stereotactic Radiosurgery. Neurosurgery 2021; 88:E67-E72. [PMID: 32823285 DOI: 10.1093/neuros/nyaa334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/07/2020] [Accepted: 05/31/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Brain metastases (BM) are the most common type of brain tumor malignancy in the US. They are also the most common indication for stereotactic radiosurgery (SRS). However, the incidence of both local recurrence and radiation necrosis (RN) is increasing as treatments improve. MRI imagery often fails to differentiate BM from RN; thus, patients must often undergo surgical biopsy or resection to obtain a definitive diagnosis. OBJECTIVE To hypothesize that a marker of immunosuppression might serve as a surrogate marker to differentiate patients with active vs inactive cancer-including RN. METHODS We thus purified and quantified Monocytic Myeloid-Derived Suppressor Cells (Mo-MDSC) by flow cytometry in patients proven by biopsy to represent BM or RN. RESULTS We report the utility of the previously reported HLA-Dr-Vnn2 Index or DVI to discriminate recurrent BM from RN using peripheral blood. The presence of CD14+ HLA-DRneg/low Mo-MDSC is significantly increased in the peripheral blood of patients with brain metastasis recurrence compared to RN (Average 61.5% vs 7%, n = 10 and n = 12, respectively, P < .0001). In contrast, expression of VNN2 on circulating CD14+ monocytes is decreased in BM patients compared to patients with RN (5.5% vs 26.5%, n = 10 and n = 12, respectively, P = .0008). In patients with biopsy confirmed recurrence of brain metastasis, the average DVI was 11.65, whereas the average DVI for RN patients was consistently <1 (Avg. of 0.17). CONCLUSION These results suggest that DVI could be a useful diagnostic tool to differentiate recurrent BM from RN using a minimally invasive blood sample.
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Affiliation(s)
- David C Soler
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Brain Tumor and Neuro-Oncology Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Amber Kerstetter-Fogle
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Brain Tumor and Neuro-Oncology Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Theresa Elder
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Brain Tumor and Neuro-Oncology Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Alankrita Raghavan
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Brain Tumor and Neuro-Oncology Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jill S Barnholtz-Sloan
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Brain Tumor and Neuro-Oncology Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Kevin D Cooper
- Department of Dermatology, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, Cleveland, Ohio.,The Murdough Family Center for Psoriasis, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, Cleveland, Ohio
| | - Thomas S McCormick
- Department of Dermatology, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, Cleveland, Ohio.,The Murdough Family Center for Psoriasis, University Hospitals-Cleveland Medical Center and the Case Western University School of Medicine, Cleveland, Ohio
| | - Andrew E Sloan
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Brain Tumor and Neuro-Oncology Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,University Hospitals-Cleveland Medical Center and the Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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25
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Hodges TR, Labak CM, Mahajan UV, Wright CH, Wright J, Cioffi G, Gittleman H, Herring EZ, Zhou X, Duncan K, Kruchko C, Sloan AE, Barnholtz-Sloan JS. Impact of race on care, readmissions, and survival for patients with glioblastoma: an analysis of the National Cancer Database. Neurooncol Adv 2021; 3:vdab040. [PMID: 33959715 PMCID: PMC8086235 DOI: 10.1093/noajnl/vdab040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background The objective of this study was to explore racial/ethnic factors that may be associated with survival in patients with glioblastoma by querying the National Cancer Database (NCDB). Methods The NCDB was queried for patients diagnosed with glioblastoma between 2004 and 2014. Patient demographic variables included age at diagnosis, sex, race, ethnicity, Charlson-Deyo score, insurance status, and rural/urban/metropolitan location of zip code. Treatment variables included surgical treatment, extent of resection, chemotherapy, radiation therapy, type of radiation, and treatment facility type. Outcomes included 30-day readmission, 30- and 90-day mortality, and overall survival. Multivariable Cox regression analyses were performed to evaluate variables associated with race and overall survival. Results A total of 103 652 glioblastoma patients were identified. There was a difference in the proportion of patients for whom surgery was performed, as well as the proportion receiving radiation, when stratified by race (P < .001). Black non-Hispanics had the highest rates of unplanned readmission (7.6%) within 30 days (odds ratio [OR]: 1.39 compared to White non-Hispanics, P < .001). Asian non-Hispanics had the lowest 30- (3.2%) and 90-day mortality (9.8%) when compared to other races (OR: 0.52 compared to White non-Hispanics, P = .031). Compared to White non-Hispanics, we found Black non-Hispanics (hazard ratio [HR]: 0.88, P < .001), Asian non-Hispanics (HR: 0.72, P < .001), and Hispanics (HR: 0.69, P < .001) had longer overall survival. Conclusions Differences in treatment and outcomes exist between races. Further studies are needed to elucidate the etiology of these race-related disparities and to improve outcomes for all patients.
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Affiliation(s)
- Tiffany R Hodges
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.,Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Collin M Labak
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Uma V Mahajan
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Christina Huang Wright
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - James Wright
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Gino Cioffi
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Haley Gittleman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Eric Z Herring
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Xiaofei Zhou
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Kelsey Duncan
- Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Andrew E Sloan
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.,Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
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26
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Rathore S, Mohan S, Bakas S, Sako C, Badve C, Pati S, Singh A, Bounias D, Ngo P, Akbari H, Gastounioti A, Bergman M, Bilello M, Shinohara RT, Yushkevich P, O'Rourke DM, Sloan AE, Kontos D, Nasrallah MP, Barnholtz-Sloan JS, Davatzikos C. Multi-institutional noninvasive in vivo characterization of IDH, 1p/19q, and EGFRvIII in glioma using neuro-Cancer Imaging Phenomics Toolkit (neuro-CaPTk). Neurooncol Adv 2021; 2:iv22-iv34. [PMID: 33521638 PMCID: PMC7829474 DOI: 10.1093/noajnl/vdaa128] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Gliomas represent a biologically heterogeneous group of primary brain tumors with uncontrolled cellular proliferation and diffuse infiltration that renders them almost incurable, thereby leading to a grim prognosis. Recent comprehensive genomic profiling has greatly elucidated the molecular hallmarks of gliomas, including the mutations in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2), loss of chromosomes 1p and 19q (1p/19q), and epidermal growth factor receptor variant III (EGFRvIII). Detection of these molecular alterations is based on ex vivo analysis of surgically resected tissue specimen that sometimes is not adequate for testing and/or does not capture the spatial tumor heterogeneity of the neoplasm. Methods We developed a method for noninvasive detection of radiogenomic markers of IDH both in lower-grade gliomas (WHO grade II and III tumors) and glioblastoma (WHO grade IV), 1p/19q in IDH-mutant lower-grade gliomas, and EGFRvIII in glioblastoma. Preoperative MRIs of 473 glioma patients from 3 of the studies participating in the ReSPOND consortium (collection I: Hospital of the University of Pennsylvania [HUP: n = 248], collection II: The Cancer Imaging Archive [TCIA; n = 192], and collection III: Ohio Brain Tumor Study [OBTS, n = 33]) were collected. Neuro-Cancer Imaging Phenomics Toolkit (neuro-CaPTk), a modular platform available for cancer imaging analytics and machine learning, was leveraged to extract histogram, shape, anatomical, and texture features from delineated tumor subregions and to integrate these features using support vector machine to generate models predictive of IDH, 1p/19q, and EGFRvIII. The models were validated using 3 configurations: (1) 70-30% training-testing splits or 10-fold cross-validation within individual collections, (2) 70-30% training-testing splits within merged collections, and (3) training on one collection and testing on another. Results These models achieved a classification accuracy of 86.74% (HUP), 85.45% (TCIA), and 75.15% (TCIA) in identifying EGFRvIII, IDH, and 1p/19q, respectively, in configuration I. The model, when applied on combined data in configuration II, yielded a classification success rate of 82.50% in predicting IDH mutation (HUP + TCIA + OBTS). The model when trained on TCIA dataset yielded classification accuracy of 84.88% in predicting IDH in HUP dataset. Conclusions Using machine learning algorithms, high accuracy was achieved in the prediction of IDH, 1p/19q, and EGFRvIII mutation. Neuro-CaPTk encompasses all the pipelines required to replicate these analyses in multi-institutional settings and could also be used for other radio(geno)mic analyses.
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Affiliation(s)
- Saima Rathore
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Sarthak Pati
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ashish Singh
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dimitrios Bounias
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Phuc Ngo
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hamed Akbari
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Aimilia Gastounioti
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark Bergman
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Russell T Shinohara
- Penn Statistics in Imaging and Visualization Center (PennSIVE), Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul Yushkevich
- Penn Image Computing and Science Lab (PICSL), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Donald M O'Rourke
- Glioblastoma Translational Center of Excellence, Abramson Cancer Center, Philadelphia, Pennsylvania, USA
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA.,Department of Neurological Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.,Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Despina Kontos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - MacLean P Nasrallah
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Peereboom DM, Ye X, Mikkelsen T, Lesser GJ, Lieberman FS, Robins HI, Ahluwalia MS, Sloan AE, Grossman SA. A Phase II and Pharmacodynamic Trial of RO4929097 for Patients With Recurrent/Progressive Glioblastoma. Neurosurgery 2021; 88:246-251. [PMID: 33027815 PMCID: PMC7919338 DOI: 10.1093/neuros/nyaa412] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 07/05/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cancer stem-like cells are a major cause of resistance to therapy in patients with glioblastoma (GBM) as well as other cancers. Tumor cells are maintained in a stem-like proliferative state in large part through the Notch signaling pathway. The function of this pathway in turn depends on gamma secretase activity. Inhibition of this enzyme therefore inhibits the Notch pathway and tumor growth as measured by a reduction in the formation of brain tumor neurospheres in murine models. RO4929097 is an oral gamma secretase inhibitor. OBJECTIVE To estimate the 6-mo progression-free survival rate (PFS6) in patients with progressive GBM and to inhibit by 50% the generation of neurospheres in fresh tissue resected from patients treated with RO4929097. METHODS In this phase II and pharmacodynamic study, patients with recurrent GBM received RO4929097 in a study of 2 groups. Group A patients had unresectable disease and received drug in a standard phase II design. Group B patients had resectable disease and received drug before and after surgical resection. Endpoints included PFS6 and the inhibition of neurosphere formation in the resected tumor samples. RESULTS A total of 47 patients received treatment, 7 of whom had tumor resection. The PFS6 was 4%, and the inhibition of neurosphere formation occurred in 1 of 7 patient samples. CONCLUSION RO4929097 was inactive in recurrent GBM patients and demonstrated minimal inhibition of neurosphere formation in fresh tissue samples.
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Affiliation(s)
| | - Xiaobu Ye
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - Tom Mikkelsen
- Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan
| | - Glenn J Lesser
- Hematology and Oncology, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, North Carolina
| | - Frank S Lieberman
- Department of Neurology, Hillman Cancer Center of University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - H Ian Robins
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | | | - Andrew E Sloan
- Department of Neurological Surgery, Seidman Cancer Center, University Hospitals & Case Comprehensive Cancer Center, Cleveland, Ohio
| | - Stuart A Grossman
- The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Molinaro AM, Hervey-Jumper S, Morshed RA, Young J, Han SJ, Chunduru P, Zhang Y, Phillips JJ, Shai A, Lafontaine M, Crane J, Chandra A, Flanigan P, Jahangiri A, Cioffi G, Ostrom Q, Anderson JE, Badve C, Barnholtz-Sloan J, Sloan AE, Erickson BJ, Decker PA, Kosel ML, LaChance D, Eckel-Passow J, Jenkins R, Villanueva-Meyer J, Rice T, Wrensch M, Wiencke JK, Oberheim Bush NA, Taylor J, Butowski N, Prados M, Clarke J, Chang S, Chang E, Aghi M, Theodosopoulos P, McDermott M, Berger MS. Association of Maximal Extent of Resection of Contrast-Enhanced and Non-Contrast-Enhanced Tumor With Survival Within Molecular Subgroups of Patients With Newly Diagnosed Glioblastoma. JAMA Oncol 2020; 6:495-503. [PMID: 32027343 DOI: 10.1001/jamaoncol.2019.6143] [Citation(s) in RCA: 278] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Per the World Health Organization 2016 integrative classification, newly diagnosed glioblastomas are separated into isocitrate dehydrogenase gene 1 or 2 (IDH)-wild-type and IDH-mutant subtypes, with median patient survival of 1.2 and 3.6 years, respectively. Although maximal resection of contrast-enhanced (CE) tumor is associated with longer survival, the prognostic importance of maximal resection within molecular subgroups and the potential importance of resection of non-contrast-enhanced (NCE) disease is poorly understood. Objective To assess the association of resection of CE and NCE tumors in conjunction with molecular and clinical information to develop a new road map for cytoreductive surgery. Design, Setting, and Participants This retrospective, multicenter cohort study included a development cohort from the University of California, San Francisco (761 patients diagnosed from January 1, 1997, through December 31, 2017, with 9.6 years of follow-up) and validation cohorts from the Mayo Clinic (107 patients diagnosed from January 1, 2004, through December 31, 2014, with 5.7 years of follow-up) and the Ohio Brain Tumor Study (99 patients with data collected from January 1, 2008, through December 31, 2011, with a median follow-up of 10.9 months). Image accessors were blinded to patient groupings. Eligible patients underwent surgical resection for newly diagnosed glioblastoma and had available survival, molecular, and clinical data and preoperative and postoperative magnetic resonance images. Data were analyzed from November 15, 2018, to March 15, 2019. Main Outcomes and Measures Overall survival. Results Among the 761 patients included in the development cohort (468 [61.5%] men; median age, 60 [interquartile range, 51.6-67.7] years), younger patients with IDH-wild-type tumors and aggressive resection of CE and NCE tumors had survival similar to that of patients with IDH-mutant tumors (median overall survival [OS], 37.3 [95% CI, 31.6-70.7] months). Younger patients with IDH-wild-type tumors and reduction of CE tumor but residual NCE tumors fared worse (median OS, 16.5 [95% CI, 14.7-18.3] months). Older patients with IDH-wild-type tumors benefited from reduction of CE tumor (median OS, 12.4 [95% CI, 11.4-14.0] months). The results were validated in the 2 external cohorts. The association between aggressive CE and NCE in patients with IDH-wild-type tumors was not attenuated by the methylation status of the promoter region of the DNA repair enzyme O6-methylguanine-DNA methyltransferase. Conclusions and Relevance This study confirms an association between maximal resection of CE tumor and OS in patients with glioblastoma across all subgroups. In addition, maximal resection of NCE tumor was associated with longer OS in younger patients, regardless of IDH status, and among patients with IDH-wild-type glioblastoma regardless of the methylation status of the promoter region of the DNA repair enzyme O6-methylguanine-DNA methyltransferase. These conclusions may help reassess surgical strategies for individual patients with newly diagnosed glioblastoma.
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Affiliation(s)
- Annette M Molinaro
- Department of Neurological Surgery, University of California, San Francisco
| | | | - Ramin A Morshed
- Department of Neurological Surgery, University of California, San Francisco
| | - Jacob Young
- Department of Neurological Surgery, University of California, San Francisco
| | - Seunggu J Han
- Department of Neurological Surgery, Oregon Health Sciences University, Portland
| | - Pranathi Chunduru
- Department of Neurological Surgery, University of California, San Francisco
| | - Yalan Zhang
- Department of Neurological Surgery, University of California, San Francisco
| | - Joanna J Phillips
- Department of Neurological Surgery, University of California, San Francisco.,Department of Pathology, University of California, San Francisco
| | - Anny Shai
- Department of Neurological Surgery, University of California, San Francisco
| | - Marisa Lafontaine
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Jason Crane
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Ankush Chandra
- Department of Neurological Surgery, University of California, San Francisco
| | - Patrick Flanigan
- Department of Neurological Surgery, University of California, San Francisco
| | - Arman Jahangiri
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Gino Cioffi
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Quinn Ostrom
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - John E Anderson
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Radiology, University Hospitals of Cleveland, Cleveland, Ohio
| | - Chaitra Badve
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Radiology, University Hospitals of Cleveland, Cleveland, Ohio
| | - Jill Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Research Division, University Hospitals of Cleveland, Cleveland, Ohio
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Seidman Cancer Center, University Hospitals of Cleveland, Cleveland, Ohio
| | | | | | | | | | | | | | | | - Terri Rice
- Department of Neurological Surgery, University of California, San Francisco
| | - Margaret Wrensch
- Department of Neurological Surgery, University of California, San Francisco
| | - John K Wiencke
- Department of Neurological Surgery, University of California, San Francisco
| | - Nancy Ann Oberheim Bush
- Department of Neurological Surgery, University of California, San Francisco.,Department of Neurology, University of California, San Francisco
| | - Jennie Taylor
- Department of Neurological Surgery, University of California, San Francisco.,Department of Neurology, University of California, San Francisco
| | - Nicholas Butowski
- Department of Neurological Surgery, University of California, San Francisco
| | - Michael Prados
- Department of Neurological Surgery, University of California, San Francisco
| | - Jennifer Clarke
- Department of Neurological Surgery, University of California, San Francisco.,Department of Neurology, University of California, San Francisco
| | - Susan Chang
- Department of Neurological Surgery, University of California, San Francisco
| | - Edward Chang
- Department of Neurological Surgery, University of California, San Francisco
| | - Manish Aghi
- Department of Neurological Surgery, University of California, San Francisco
| | | | - Michael McDermott
- Department of Neurological Surgery, University of California, San Francisco
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco
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29
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Tao W, Zhang A, Zhai K, Huang Z, Huang H, Zhou W, Huang Q, Fang X, Prager BC, Wang X, Wu Q, Sloan AE, Ahluwalia MS, Lathia JD, Yu JS, Rich JN, Bao S. SATB2 drives glioblastoma growth by recruiting CBP to promote FOXM1 expression in glioma stem cells. EMBO Mol Med 2020; 12:e12291. [PMID: 33124191 PMCID: PMC7721366 DOI: 10.15252/emmm.202012291] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022] Open
Abstract
Nuclear matrix-associated proteins (NMPs) play critical roles in regulating chromatin organization and gene transcription by binding to the matrix attachment regions (MARs) of DNA. However, the functional significance of NMPs in glioblastoma (GBM) progression remains unclear. Here, we show that the Special AT-rich Binding Protein-2 (SATB2), one of crucial NMPs, recruits histone acetyltransferase CBP to promote the FOXM1-mediated cell proliferation and tumor growth of GBM. SATB2 is preferentially expressed by glioma stem cells (GSCs) in GBM. Disrupting SATB2 markedly inhibited GSC proliferation and GBM malignant growth by down-regulating expression of key genes involved in cell proliferation program. SATB2 activates FOXM1 expression to promote GSC proliferation through binding to the MAR sequence of FOXM1 gene locus and recruiting CBP to the MAR. Importantly, pharmacological inhibition of SATB2/CBP transcriptional activity by the CBP inhibitor C646 suppressed GSC proliferation in vitro and GBM growth in vivo. Our study uncovers a crucial role of the SATB2/CBP-mediated transcriptional regulation in GBM growth, indicating that targeting SATB2/CBP may effectively improve GBM treatment.
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Affiliation(s)
- Weiwei Tao
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Aili Zhang
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Kui Zhai
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Zhi Huang
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Haidong Huang
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Wenchao Zhou
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Qian Huang
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Xiaoguang Fang
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
| | - Briana C Prager
- Division of Regenerative MedicineDepartment of MedicineUniversity of California, San DiegoSan DiegoCAUSA
- Department of PathologyCase Western Reserve University School of MedicineClevelandOHUSA
| | - Xiuxing Wang
- Division of Regenerative MedicineDepartment of MedicineUniversity of California, San DiegoSan DiegoCAUSA
| | - Qiulian Wu
- Division of Regenerative MedicineDepartment of MedicineUniversity of California, San DiegoSan DiegoCAUSA
| | - Andrew E Sloan
- Brain Tumor and Neuro‐Oncology Center & Center of Excellence for Translational Neuro‐OncologyUniversity Hospitals Seidman Cancer CenterCase Western Reserve UniversityClevelandOHUSA
- Case Comprehensive Cancer CenterCase Western Reserve University School of MedicineClevelandOHUSA
| | - Manmeet S Ahluwalia
- Brain Tumor and Neuro‐Oncology CenterTaussig Cancer InstituteCleveland ClinicClevelandOHUSA
| | - Justin D Lathia
- Case Comprehensive Cancer CenterCase Western Reserve University School of MedicineClevelandOHUSA
- Brain Tumor and Neuro‐Oncology CenterTaussig Cancer InstituteCleveland ClinicClevelandOHUSA
- Department of Cardiovascular and Metabolic SciencesCleveland ClinicClevelandOHUSA
| | - Jennifer S Yu
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
- Case Comprehensive Cancer CenterCase Western Reserve University School of MedicineClevelandOHUSA
- Center for Cancer Stem Cell ResearchLerner Research InstituteCleveland ClinicClevelandOHUSA
- Department of Radiation OncologyTaussig Cancer InstituteCleveland ClinicClevelandOHUSA
| | - Jeremy N Rich
- Division of Regenerative MedicineDepartment of MedicineUniversity of California, San DiegoSan DiegoCAUSA
| | - Shideng Bao
- Department of Cancer BiologyLerner Research InstituteCleveland ClinicClevelandOHUSA
- Case Comprehensive Cancer CenterCase Western Reserve University School of MedicineClevelandOHUSA
- Center for Cancer Stem Cell ResearchLerner Research InstituteCleveland ClinicClevelandOHUSA
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30
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Sloan A, Lee-Poturalski C, Elder T, Harris P, Kerstetter-Fogle A, Cioffi G, Raghavan A, Willis J, Rich J, Barnholtz-Sloan JS, Jankowsky E, Sloan AE. STEM-08. PLATELETS DRIVES GLIOBLASTOMA ONCOGENESIS BY ENHANCING THE GLIOMA STEM CELL PHENOTYPE. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.825] [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: 11/13/2022] Open
Abstract
Abstract
Glioblastoma (GBM) is recognized as one of the deadliest forms of cancer, despite aggressive therapy consisting of maximal surgical resection followed by concurrent radiation and chemotherapy, the median survival remains ~15 months. Glioma stem cells (GSCs) possess potent tumor-initiating properties and comprise a cellular hierarchy that is responsible for treatment resistance and progression. Specifically targeting GSCs has been considered a promising therapeutic approach, however no clear method has been identified. Histologically, it is known that GSCs are found in perivascular and pseudsopalisading regions of GBM. Similarly, platelet aggregates are often found in pseudsopalisading necrotic regions, suggesting a potential interaction between platelets and GSCs due to their spatial locations. High platelet counts have been associated with poor clinical outcome in many cancers including ovarian and endometrial cancer. While platelets are known to affect progression of other tumors, mechanisms by which platelets influence GBM oncogenesis are unknown. Our work aimed to understand the crosstalk between GSCs and platelets within GBM solid tumors that work to enhance disease progression and treatment resistance. Our clinical studies suggest elevated platelet counts positively correlate with tumor growth and negatively correlate to overall patient survival. We found platelets and GSC co-localization in GBM solid tissue; platelet exposure to GSCs results in increased proliferation of GSCs specifically, by increasing the self-renewing capacity of GSCs in a dose dependent manner, and resulted in an increased “Stem-like” transcriptional pattern. Consequently, inhibiting the GSC-platelet interaction results in a decrease in GSC renewal and stemness. These results introduce a novel interaction between GSCs and platelets and elucidate a novel therapeutic approach specifically targeting GSCs by disrupting the GSC-platelet interaction.
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Affiliation(s)
- Anthony Sloan
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Theresa Elder
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Peggy Harris
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Gino Cioffi
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - John Willis
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jeremy Rich
- University of California, San Diego, San Diego, CA, USA
| | | | - Eckhard Jankowsky
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Andrew E Sloan
- University Hospitals-Seidman Cancer Center & Case Comprehensive Cancer Center, Cleveland, OH, USA
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Damico N, Elder T, Kharouta M, Sloan A, Kerstetter-Fogle A, Harris P, Kumar A, Mansur D, Machtay M, Bhatt A, Buerki R, Sloan AE, Choi S. NCOG-33. HEMATOLOGIC PREDICTORS OF OUTCOMES IN GLIOBLASTOMA TREATED WITH SURGERY AND CHEMORADIATION. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.571] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
There are conflicting reports regarding the prognostic value of platelet and other blood counts in glioblastoma. However, few series have looked at all hematologic parameters simultaneously.
METHODS
We performed a retrospective chart review of patients diagnosed with supratentorial glioblastoma from 2014-2019 who started conventional chemoradiation following initial surgical biopsy and/or resection. Hematologic parameters were collected at baseline, in the preoperative and postoperative periods and at the initiation and completion of chemoradiation. This included platelet counts, hemoglobin levels, white blood cell counts (WBC), neutrophil and lymphocyte counts with neutrophil:lymphocyte (NLR) and platelet:lymphocyte ratios (PLR) calculated at each time point. Cox regression was performed to assess the association between each hematologic parameter and both overall survival (OS) and progression free survival (PFS). A multivariate Cox proportional hazards model adjusted for all hematologic parameters, age, sex, race and KPS was generated for each time point. All hematologic parameters were modeled as continuous variables.
RESULTS
A total of 58 patients met inclusion criteria. 18 were female and 40 male. The median age was 59.5 (range 43-82). Median follow up for all patients was 15.3 months. A total of 52 patients completed radiation therapy and 18 completed 6 cycles of adjuvant chemotherapy. Hemoglobin and neutrophil counts at the conclusion of chemoradiation were associated with OS and PFS on univariate and multivariate analyses. The HR for OS were 0.74 (95% CI 0.5807-0.9313) and 1.28 (1.143-1.441) respectively. The HR for PFS were 0.70 (0.5531-0.8881) and 1.16 (1.05-1.271) respectively. Postoperative lymphocyte and platelet counts at initiation of chemoradiation were both associated with OS with unadjusted HR of 3.2 (1.037-9.960) and HR of 0.99 (0.9898-0.9999) respectively, which remained significant on multivariate analysis. However, neither were associated with PFS.
CONCLUSION
Several hematologic parameters are associated with glioblastoma outcomes in these initial analyses. Further analyses with additional patients are ongoing.
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Affiliation(s)
- Nicholas Damico
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Theresa Elder
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Michael Kharouta
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Anthony Sloan
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Peggy Harris
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Aryavarta Kumar
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - David Mansur
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Mitchell Machtay
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Aashish Bhatt
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Robin Buerki
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Andrew E Sloan
- University Hospitals-Seidman Cancer Center & Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Serah Choi
- University Hospitals-Seidman Cancer Center & Case Comprehensive Cancer Center, Cleveland, OH, USA
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Sloan AE, Fung H, Reese J, Rgers L, Murphy C, Lazarus H, Dropulic B, Gerson S. CTNI-49. PHASE I STUDY OF MGMT-P140K TRANSFECTED HEMATOPOETIC PROGENITOR CELLS COMBINED WITH TMZ/O6BG DOSE ESCALATION FOR NEWLY DIAGNOSED, UNMETHYLATED GLIOBLASTOMA: TOLERANCE AND EVIDENCE OF SURVIVAL BENEFIT. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.215] [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: 11/13/2022] Open
Abstract
Abstract
INTRODUCTION
GBM has median survival of 12 months despite current SOC therapy. The most important mechanism of TMZ resistance is the O6-methylguanine-DNA methyltransferase (MGMT) gene. The MGMT inhibitor O6-benzylguanine (BG) demonstrated efficacy in depleting MGMT but approach led to unacceptable bone marrow toxicity and has thus been abandoned. We hypothesized that chemoprotection of hematopoietic HPC with an MGMT mutant (MGMT-P140K) characterized by normal methyltransferase activity, coupled with low affinity for BG would maximize anti-tumor response while enabling patients to tolerate TMZ & BG dose escalation with minimal toxicity. A phase I trial was performed to test this hypothesis.
METHODS
10 adults with newly diagnosed MGMT unmethylated, IDH-1 WT, GBM underwent standard surgery and radiation, followed by transplantation with autologous CD34+ HPC transfected with MGMT-P140K using a lentiviral vector. We tested tolerance and efficacy of three different paradigms for conditioning bone marrow and re-infusion of HPC.
RESULTS
Treatment was moderately toxic with 3/10 patients suffering grade 3–4 hematologic toxicity; no high grade non-hematologic toxicity was observed. Viral transduction rates ranged from 3–75% and were clearly improved in Arm III utilizing BCNU conditioning and intra-patient dose escalation of TMZ/O6GB. In patients tolerating 3 cycles or more, P140K-MGMT gene markings in peripheral blood and bone marrow cells increased 3-26-fold with only mild (Grade 2–3) myelosuppression consistent with chemo-protection as hypothesized. Median PFS and OS was 24 and 33 months respectfully, and three patients in Arm III were progression free at 36 months with one progression free at 48 months. OS exceeded RPA & Nomogram predicted survival by 3.6-fold, suggesting clinical benefit. Viral insertion site analysis demonstrate no clonal dominance.
CONCLUSIONS
P140K-MGMT transfected HPC enables TMZ/ BG dose escalation with acceptable toxicity and increased survival in a small cohort of selected patients. A U-01 funded phase II study is ongoing at UH and NIH.
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Affiliation(s)
- Andrew E Sloan
- University Hospitals-Seidman Cancer Center & Case Comprehensive Cancer Center, Cleveland, OH, USA
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Sloan A, Lee-Poturalski C, Elder T, Harris P, Cioffi G, Raghavan A, Willis J, Rich J, Kerstetter-Fogle A, Barnholtz-Sloan JS, Jankowsky E, Sloan AE. STEM-04. PLATELETS DRIVE GLIOBLASTOMA ONCOGENESIS BY ENHANCING THE GLIOMA STEM CELL PHENOTYPE. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.821] [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: 11/13/2022] Open
Abstract
Abstract
Glioblastoma (GBM) is recognized as one of the deadliest forms of cancer, despite aggressive therapy consisting of maximal surgical resection followed by concurrent radiation and chemotherapy, the median survival remains ~12 months. Glioma stem cells (GSCs) possess potent tumor-initiating properties and comprise a cellular hierarchy that is responsible for treatment resistance and progression. Specifically targeting GSCs has been considered a promising therapeutic approach, however no clear method has been identified. Histologically, it is known that GSCs are found in perivascular and pseudsopalisading regions of GBM. Similarly, platelet aggregates are often found in pseudsopalisading necrotic regions, suggesting a potential interaction between platelets and GSCs due to their spatial locations. High platelet counts have been associated with poor clinical outcome in many cancers including ovarian and endometrial cancer. While platelets are known to affect progression of other tumors, mechanisms by which platelets influence GBM oncogenesis are unknown. Our work aimed to understand the crosstalk between GSCs and platelets within GBM solid tumors that work to enhance disease progression and treatment resistance. Our clinical studies suggest elevated platelet counts positively correlate with tumor growth and negatively correlate to overall patient survival. We found platelets and GSC co-localization in GBM solid tissue; platelet exposure to GSCs results in increased proliferation of GSCs specifically, by increasing the self-renewing capacity of GSCs in a dose dependent manner, and resulted in an increased “Stem-like” transcriptional pattern. Inhibiting the GSC-platelet interaction results in a decrease in GSC renewal and stemness. These results introduce a novel interaction between GSCs and platelets and elucidate a novel therapeutic approach specifically targeting GSCs by disrupting the GSC-platelet interaction.
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Affiliation(s)
- Anthony Sloan
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Theresa Elder
- University Hospitals of Cleveland, Cleveland, OH, USA
| | - Peggy Harris
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Gino Cioffi
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - John Willis
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | | | | | - Eckhard Jankowsky
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Andrew E Sloan
- University Hospitals-Seidman Cancer Center & Case Comprehensive Cancer Center, Cleveland, OH, USA
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Fathi Kazerooni A, Akbari H, Shukla G, Badve C, Rudie JD, Sako C, Rathore S, Bakas S, Pati S, Singh A, Bergman M, Ha SM, Kontos D, Nasrallah M, Bagley SJ, Lustig RA, O'Rourke DM, Sloan AE, Barnholtz-Sloan JS, Mohan S, Bilello M, Davatzikos C. Cancer Imaging Phenomics via CaPTk: Multi-Institutional Prediction of Progression-Free Survival and Pattern of Recurrence in Glioblastoma. JCO Clin Cancer Inform 2020; 4:234-244. [PMID: 32191542 PMCID: PMC7113126 DOI: 10.1200/cci.19.00121] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To construct a multi-institutional radiomic model that supports upfront prediction of progression-free survival (PFS) and recurrence pattern (RP) in patients diagnosed with glioblastoma multiforme (GBM) at the time of initial diagnosis. PATIENTS AND METHODS We retrospectively identified data for patients with newly diagnosed GBM from two institutions (institution 1, n = 65; institution 2, n = 15) who underwent gross total resection followed by standard adjuvant chemoradiation therapy, with pathologically confirmed recurrence, sufficient follow-up magnetic resonance imaging (MRI) scans to reliably determine PFS, and available presurgical multiparametric MRI (MP-MRI). The advanced software suite Cancer Imaging Phenomics Toolkit (CaPTk) was leveraged to analyze standard clinical brain MP-MRI scans. A rich set of imaging features was extracted from the MP-MRI scans acquired before the initial resection and was integrated into two distinct imaging signatures for predicting mean shorter or longer PFS and near or distant RP. The predictive signatures for PFS and RP were evaluated on the basis of different classification schemes: single-institutional analysis, multi-institutional analysis with random partitioning of the data into discovery and replication cohorts, and multi-institutional assessment with data from institution 1 as the discovery cohort and data from institution 2 as the replication cohort. RESULTS These predictors achieved cross-validated classification performance (ie, area under the receiver operating characteristic curve) of 0.88 (single-institution analysis) and 0.82 to 0.83 (multi-institution analysis) for prediction of PFS and 0.88 (single-institution analysis) and 0.56 to 0.71 (multi-institution analysis) for prediction of RP. CONCLUSION Imaging signatures of presurgical MP-MRI scans reveal relatively high predictability of time and location of GBM recurrence, subject to the patients receiving standard first-line chemoradiation therapy. Through its graphical user interface, CaPTk offers easy accessibility to advanced computational algorithms for deriving imaging signatures predictive of clinical outcome and could similarly be used for a variety of radiomic and radiogenomic analyses.
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Affiliation(s)
- Anahita Fathi Kazerooni
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Hamed Akbari
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiation Oncology, Christiana Care Helen F. Graham Cancer Center and Research Institute, Newark, DE.,Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Chaitra Badve
- Department of Radiology, University Hospitals-Seidman Cancer Center, Cleveland, OH.,Case Comprehensive Cancer Center, Cleveland, OH
| | - Jeffrey D Rudie
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Saima Rathore
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sarthak Pati
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ashish Singh
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mark Bergman
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sung Min Ha
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Despina Kontos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - MacLean Nasrallah
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Stephen J Bagley
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Robert A Lustig
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Donald M O'Rourke
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Glioblastoma Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Andrew E Sloan
- Case Western Reserve University School of Medicine, Cleveland, OH.,Case Comprehensive Cancer Center, Cleveland, OH.,Department of Neurologic Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH
| | - Jill S Barnholtz-Sloan
- Case Western Reserve University School of Medicine, Cleveland, OH.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Rennert RC, Khan U, Bartek J, Tatter SB, Field M, Toyota B, Fecci PE, Judy K, Mohammadi AM, Landazuri P, Sloan AE, Kim AH, Leuthardt EC, Chen CC. Laser Ablation of Abnormal Neurological Tissue Using Robotic Neuroblate System (LAANTERN): Procedural Safety and Hospitalization. Neurosurgery 2020; 86:538-547. [PMID: 31076762 DOI: 10.1093/neuros/nyz141] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/25/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Stereotactic laser ablation (SLA) has demonstrated potential utility for a spectrum of difficult to treat neurosurgical pathologies in multiple small and/or retrospective single-institutional series. Here, we present the safety profile of SLA of intracranial lesions from the Laser Ablation of Abnormal Neurological Tissue using Robotic NeuroBlate System (LAANTERN; Monteris Medical) multi-institutional, international prospective observational registry. OBJECTIVE To determine the procedural safety of SLA for intracranial lesions. METHODS Prospective procedural safety and hospitalization data from the first 100 treated LAANTERN patients was collected and analyzed. RESULTS Mean age and baseline Karnofsky Performance Status (KPS) were 51(± 17) yr and 83(± 15), respectively. In total, 81.2% of patients had undergone prior surgical or radiation treatment. Most patients had a single lesion (79%) ablated through 1 burr hole (1.2 ± 0.7 per patient), immediately following a lesion biopsy. In total, >90% of the lesion was ablated in 72% of treated lesions. Average total procedural time was 188.2 ± 69.6 min, and average blood loss was 17.7 ± 55.6 ccs. The average length of intensive care unit (ICU) and hospital stays before discharge were 38.1 ± 62.7 h and 61.1 ± 87.2 h, respectively. There were 5 adverse events (AEs) attributable to SLA (5/100; 5%). After the procedure, 84.8% of patients were discharged home. There was 1 mortality within 30 d of the procedure (1/100; 1%), which was not attributable to SLA. CONCLUSION SLA is a safe, minimally invasive procedure with favorable postprocedural ICU and hospital utilization profiles.
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Affiliation(s)
- Robert C Rennert
- Department of Neurosurgery, University of California San Diego, San Diego, California
| | - Usman Khan
- Department of Neurosurgery, University of California San Diego, San Diego, California
| | - Jiri Bartek
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Denmark.,Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stephen B Tatter
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Brian Toyota
- Division of Neurosurgery, University of British Columbia, Vancouver, Canada
| | - Peter E Fecci
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Kevin Judy
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Alireza M Mohammadi
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Patrick Landazuri
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Albert H Kim
- Department of Neurosurgery, Washington University, St. Louis, Missouri
| | - Eric C Leuthardt
- Department of Neurosurgery, Washington University, St. Louis, Missouri
| | - Clark C Chen
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
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Rogers LR, Ostrom QT, Schroer J, Vengoechea J, Li L, Gerson S, Nock CJ, Machtay M, Selman W, Lo S, Sloan AE, Barnholtz-Sloan JS. Association of metabolic syndrome with glioblastoma: a retrospective cohort study and review. Neurooncol Pract 2020; 7:541-548. [PMID: 33014395 DOI: 10.1093/nop/npaa011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/31/2022] Open
Abstract
Background Metabolic syndrome is identified as a risk factor for the development of several systemic cancers, but its frequency among patients with glioblastoma and its association with clinical outcomes have yet to be determined. The aim of this study was to investigate metabolic syndrome as a risk factor for and affecting survival in glioblastoma patients. Methods A retrospective cohort study, consisting of patients with diagnoses at a single institution between 2007 and 2013, was conducted. Clinical records were reviewed, and clinical and laboratory data pertaining to 5 metabolic criteria were extrapolated. Overall survival was determined by time from initial surgical diagnosis to date of death or last follow-up. Results The frequency of metabolic syndrome among patients diagnosed with glioblastoma was slightly greater than the frequency of metabolic syndrome among the general population. Within a subset of patients (n = 91) receiving the full schedule of concurrent radiation and temozolomide and adjuvant temozolomide, median overall survival was significantly shorter for patients with metabolic syndrome compared with those without. In addition, the presence of all 5 elements of the metabolic syndrome resulted in significantly decreased median survival in these patients. Conclusions We identified the metabolic syndrome at a slightly higher frequency in patients with diagnosed glioblastoma compared with the general population. In addition, metabolic syndrome with each of its individual components is associated with an overall worse prognosis in patients receiving the standard schedule of radiation and temozolomide after adjustment for age.
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Affiliation(s)
- Lisa R Rogers
- Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Quinn T Ostrom
- Department of Medicine, Section of Epidemiology and Population Health, Baylor College of Medicine, Houston, Texas
| | - Julia Schroer
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jaime Vengoechea
- Division of Medical Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Li Li
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Stanton Gerson
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Charles J Nock
- Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Hematology and Oncology, University Hospitals, Cleveland, Ohio
| | - Mitchell Machtay
- Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Radiation Oncology, University Hospitals, Cleveland, Ohio
| | - Warren Selman
- Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Simon Lo
- Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington
| | - Andrew E Sloan
- Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jill S Barnholtz-Sloan
- Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
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Bestic JM, Wessell DE, Beaman FD, Cassidy RC, Czuczman GJ, Demertzis JL, Lenchik L, Motamedi K, Pierce JL, Sharma A, Sloan AE, Than K, Walker EA, Ying-Kou Yung E, Kransdorf MJ. ACR Appropriateness Criteria® Primary Bone Tumors. J Am Coll Radiol 2020; 17:S226-S238. [PMID: 32370967 DOI: 10.1016/j.jacr.2020.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/25/2020] [Indexed: 12/28/2022]
Abstract
Although primary bone tumors are relatively uncommon, appropriate imaging evaluation is essential when they are suspected or incidentally detected. In almost all cases, radiographs are the most appropriate initial imaging study for screening and characterization of primary bone tumors. Radiographs often provide sufficient information for diagnosis and to guide the treating clinician. However, when conventional radiographs alone are inadequate, they still often guide the selection of the most appropriate next step for advanced imaging. MRI and CT are typically the most appropriate next step. MRI provides excellent soft-tissue contrast allowing for evaluation of the tissue composition (such as fat, hemorrhage, fluid levels) and anatomic extent of bone tumors. CT provides complementary information, with its ability to detect subtle matrix mineralization or periosteal reaction that may not be seen on radiographs or MRI. This publication focuses on six common variants to guide diagnosis and management of primary bone tumors. In addition to conventional radiographs, appropriate use of MRI, CT, PET/CT, bone scan, and ultrasound are discussed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | | | - R Carter Cassidy
- UK Healthcare Spine and Total Joint Service, Lexington, Kentucky; American Academy of Orthopaedic Surgeons
| | | | | | - Leon Lenchik
- Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Kambiz Motamedi
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | | | | | - Andrew E Sloan
- University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio; Neurosurgery expert
| | - Khoi Than
- Oregon Health & Science University, Portland, Oregon; Neurosurgery expert
| | - Eric A Walker
- Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania and Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Wright JM, Ascha M, Wright CH, Smith G, Lagman C, Patel M, Elder TA, Kruchko C, Barnholtz-Sloan JS, Sloan AE. Geographic and temporal variations in the utilization of stereotactic radiosurgery for treatment of non-small cell lung cancer brain metastases from 2010 to 2015: An analysis of the national cancer database. Interdisciplinary Neurosurgery 2020. [DOI: 10.1016/j.inat.2019.100580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Ascha MS, Funk K, Sloan AE, Kruchko C, Barnholtz-Sloan JS. Disparities in the use of stereotactic radiosurgery for the treatment of lung cancer brain metastases: a SEER-Medicare study. Clin Exp Metastasis 2020; 37:85-93. [PMID: 31705229 DOI: 10.1007/s10585-019-10005-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 11/03/2019] [Indexed: 12/21/2022]
Abstract
Stereotactic radiosurgery (SRS) is a costly procedure used to irradiate disease tissue while sparing healthy tissue, ideally limiting the side effects of treatment. SRS is frequently used in the setting of lung cancer, which is associated with greater rates of BM, though its cost may lead to potentially inequitable use across patient populations. This study investigates potential disparities in the use of SRS to treat Medicare patients. Surveillance, Epidemiology, and End-Results cancer registry data for patients diagnosed between the years 2010 and 2012 were examined to identify lung cancer patients diagnosed with BM at the same time as their primary cancer (SBM). Medicare claims for SRS were identified; the odds of having SRS claims and hazards of mortality associated with those odds were examined with respect to various clinical and demographic characteristics. Of 74,142 Medicare-enrolled patients diagnosed with lung cancer, 9192 were diagnosed with SBM and 3259 of those patients received SRS. Adjusting for clinical and demographic characteristics, males with SBM had 0.85 times the odds of SRS compared to females with SBM. Black patients and those of other race had significantly lower odds of evidence of SRS compared to WNH patients. SRS may not be delivered equitably among Medicare patients. Males and minority patients may have decreased odds of SRS and worse survival compared to female and WNH patients, respectively.
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Affiliation(s)
- Mustafa S Ascha
- Department of Population and Quantitative Health Sciences, Center for Clinical Investigation, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kaitlyn Funk
- Case Western Reserve University, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Comprehensive Cancer Center, Institute for Computational Biology, Case Western Reserve University School of Medicine, 2-526 Wolstein Research Bldg, 2103 Cornell Rd, Cleveland, OH, 44106-7295, USA.
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Wright CH, Wright J, Cioffi G, Hdeib A, Kasliwal MK, Kruchko C, Barnholtz-Sloan JS, Sloan AE. Association of cancer center type with treatment patterns and overall survival for patients with sacral and spinal chordomas: an analysis of the National Cancer Database from 2004 to 2015. J Neurosurg Spine 2020; 32:311-320. [DOI: 10.3171/2019.7.spine19566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/19/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVEChordomas of the spine and sacrum are a rare but debilitating cancer and require complex multidisciplinary care. Studies of other such rare cancers have demonstrated an association of high-volume and/or multidisciplinary centers with improved outcomes and survival. Such an association has been proposed for chordomas, but evidence to support this claim is lacking. The authors performed a study to investigate if treatment facility type is associated with patterns of care and survival for patients with spinal and sacral chordomas by assessing records from a US-based cancer database.METHODSIn this observational retrospective cohort study, the authors identified 1266 patients from the National Cancer Database with vertebral column or sacral chordomas diagnosed between 2004 and 2015. The primary study outcome was overall survival, and secondary outcomes included odds of receiving treatment and time to treatment, defined as radiation therapy, surgery, and/or any treatment, including surgery, radiation therapy, chemotherapy, or participation in clinical trials. The results were adjusted for age, sex, race/ethnicity, level of education, income, and Charlson/Deyo score.RESULTSOf the 1266 patients identified, the mean age at diagnosis was 59.70 years (SD 16.2 years), and the patients were predominantly male (n = 791 [62.50%]). Patients treated at community cancer programs demonstrated an increased risk of death (HR 1.98, 95% CI 1.13–3.47, p = 0.018) when compared to patients treated at academic/research programs (ARPs). The median survival was longest for those treated at ARPs (131.45 months) compared to community cancer programs (79.34 months, 95% CI 48.99–123.17) and comprehensive community cancer programs (CCCPs) (109.34 months, 95% CI 84.76–131.45); 5-year survival rates were 76.08%, 52.71%, and 61.57%, respectively. Patients treated at community cancer programs and CCCPs were less likely to receive any treatment compared to those treated at ARPs (OR 6.05, 95% CI 2.62–13.95, p < 0.0001; OR 3.74, 95% CI 2.23–6.28, p < 0.0001, respectively). Patients treated at CCCPs and community cancer programs were less likely to receive surgery than those treated at ARPs (OR 2.69, 95% CI 1.82–3.97, p = 0.010; OR = 2.64, 95% CI 1.22–5.71, p = 0.014, respectively). Patients were more likely to receive any treatment (OR 0.59, 95% CI 0.40–0.87, p = 0.007) and surgery (OR 0.58, 95% CI 0.38–0.88, p < 0.0001) within 30 days at a CCCP compared to an ARP. There were no differences in odds of receiving radiation therapy or time to radiation by facility type.CONCLUSIONSClinical care at an ARP is associated with increased odds of receiving treatment that is associated with improved overall survival for patients with spinal and sacral chordomas, suggesting that ARPs provide the most comprehensive specialized care for patients with this rare and devastating oncological disease.
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Affiliation(s)
- Christina Huang Wright
- 1Department of Neurological Surgery, University Hospitals Cleveland Medical Center
- 2Department of Neurosurgery, Case Western Reserve University
| | - James Wright
- 1Department of Neurological Surgery, University Hospitals Cleveland Medical Center
- 2Department of Neurosurgery, Case Western Reserve University
| | - Gino Cioffi
- 4Case Comprehensive Cancer Center and Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio; and
- 5Central Brain Tumor Registry of the United States, Hinsdale, Illinois
| | - Alia Hdeib
- 1Department of Neurological Surgery, University Hospitals Cleveland Medical Center
- 2Department of Neurosurgery, Case Western Reserve University
- 3Seidman Cancer Center and Case Comprehensive Cancer Center
| | - Manish K. Kasliwal
- 1Department of Neurological Surgery, University Hospitals Cleveland Medical Center
- 2Department of Neurosurgery, Case Western Reserve University
| | - Carol Kruchko
- 5Central Brain Tumor Registry of the United States, Hinsdale, Illinois
| | - Jill S. Barnholtz-Sloan
- 4Case Comprehensive Cancer Center and Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio; and
- 5Central Brain Tumor Registry of the United States, Hinsdale, Illinois
| | - Andrew E. Sloan
- 1Department of Neurological Surgery, University Hospitals Cleveland Medical Center
- 2Department of Neurosurgery, Case Western Reserve University
- 3Seidman Cancer Center and Case Comprehensive Cancer Center
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Raghavan A, Smith G, Onyewadume L, Peck MR, Herring E, Pace J, Rogers M, Momotaz H, Hoffer SA, Hu Y, Liu H, Tatsuoka C, Sajatovic M, Sloan AE. Morbidity and Mortality After Burr Hole Craniostomy Versus Craniotomy for Chronic Subdural Hematoma Evacuation: A Single-Center Experience. World Neurosurg 2020; 134:e196-e203. [DOI: 10.1016/j.wneu.2019.10.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 12/21/2022]
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Stetson LC, Ostrom QT, Schlatzer D, Liao P, Devine K, Waite K, Couce ME, Harris PLR, Kerstetter-Fogle A, Berens ME, Sloan AE, Islam MM, Rajaratnam V, Mirza SP, Chance MR, Barnholtz-Sloan JS. Proteins inform survival-based differences in patients with glioblastoma. Neurooncol Adv 2020; 2:vdaa039. [PMID: 32642694 PMCID: PMC7212893 DOI: 10.1093/noajnl/vdaa039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Improving the care of patients with glioblastoma (GB) requires accurate and reliable predictors of patient prognosis. Unfortunately, while protein markers are an effective readout of cellular function, proteomics has been underutilized in GB prognostic marker discovery. METHODS For this study, GB patients were prospectively recruited and proteomics discovery using liquid chromatography-mass spectrometry analysis (LC-MS/MS) was performed for 27 patients including 13 short-term survivors (STS) (≤10 months) and 14 long-term survivors (LTS) (≥18 months). RESULTS Proteomics discovery identified 11 941 peptides in 2495 unique proteins, with 469 proteins exhibiting significant dysregulation when comparing STS to LTS. We verified the differential abundance of 67 out of these 469 proteins in a small previously published independent dataset. Proteins involved in axon guidance were upregulated in STS compared to LTS, while those involved in p53 signaling were upregulated in LTS. We also assessed the correlation between LS MS/MS data with RNAseq data from the same discovery patients and found a low correlation between protein abundance and mRNA expression. Finally, using LC-MS/MS on a set of 18 samples from 6 patients, we quantified the intratumoral heterogeneity of more than 2256 proteins in the multisample dataset. CONCLUSIONS These proteomic datasets and noted protein variations present a beneficial resource for better predicting patient outcome and investigating potential therapeutic targets.
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Affiliation(s)
- L C Stetson
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Quinn T Ostrom
- Department of Medicine and Division of Hematology-Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Daniela Schlatzer
- Center for Proteomics and Bioinformatics and Department of Nutrition, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Peter Liao
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Karen Devine
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Kristin Waite
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences and Cleveland Center for Health Outcomes Research (CCHOR), Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Marta E Couce
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Peggy L R Harris
- Brain Tumor and Neuro-Oncology Center & Center of Excellence, Translational Neuro-Oncology, Department of Neurosurgery, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Amber Kerstetter-Fogle
- Brain Tumor and Neuro-Oncology Center & Center of Excellence, Translational Neuro-Oncology, Department of Neurosurgery, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Michael E Berens
- Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Brain Tumor and Neuro-Oncology Center & Center of Excellence, Translational Neuro-Oncology, Department of Neurosurgery, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Mohammad M Islam
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Vilashini Rajaratnam
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Shama P Mirza
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Mark R Chance
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Center for Proteomics and Bioinformatics and Department of Nutrition, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences and Cleveland Center for Health Outcomes Research (CCHOR), Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Berens ME, Sood A, Barnholtz-Sloan JS, Graf JF, Cho S, Kim S, Kiefer J, Byron SA, Halperin RF, Nasser S, Adkins J, Cuyugan L, Devine K, Ostrom Q, Couce M, Wolansky L, McDonough E, Schyberg S, Dinn S, Sloan AE, Prados M, Phillips JJ, Nelson SJ, Liang WS, Al-Kofahi Y, Rusu M, Zavodszky MI, Ginty F. Multiscale, multimodal analysis of tumor heterogeneity in IDH1 mutant vs wild-type diffuse gliomas. PLoS One 2019; 14:e0219724. [PMID: 31881020 PMCID: PMC6934292 DOI: 10.1371/journal.pone.0219724] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 06/27/2019] [Accepted: 11/12/2019] [Indexed: 12/31/2022] Open
Abstract
Glioma is recognized to be a highly heterogeneous CNS malignancy, whose diverse cellular composition and cellular interactions have not been well characterized. To gain new clinical- and biological-insights into the genetically-bifurcated IDH1 mutant (mt) vs wildtype (wt) forms of glioma, we integrated data from protein, genomic and MR imaging from 20 treatment-naïve glioma cases and 16 recurrent GBM cases. Multiplexed immunofluorescence (MxIF) was used to generate single cell data for 43 protein markers representing all cancer hallmarks, Genomic sequencing (exome and RNA (normal and tumor) and magnetic resonance imaging (MRI) quantitative features (protocols were T1-post, FLAIR and ADC) from whole tumor, peritumoral edema and enhancing core vs equivalent normal region were also collected from patients. Based on MxIF analysis, 85,767 cells (glioma cases) and 56,304 cells (GBM cases) were used to generate cell-level data for 24 biomarkers. K-means clustering was used to generate 7 distinct groups of cells with divergent biomarker profiles and deconvolution was used to assign RNA data into three classes. Spatial and molecular heterogeneity metrics were generated for the cell data. All features were compared between IDH mt and IDHwt patients and were finally combined to provide a holistic/integrated comparison. Protein expression by hallmark was generally lower in the IDHmt vs wt patients. Molecular and spatial heterogeneity scores for angiogenesis and cell invasion also differed between IDHmt and wt gliomas irrespective of prior treatment and tumor grade; these differences also persisted in the MR imaging features of peritumoral edema and contrast enhancement volumes. A coherent picture of enhanced angiogenesis in IDHwt tumors was derived from multiple platforms (genomic, proteomic and imaging) and scales from individual proteins to cell clusters and heterogeneity, as well as bulk tumor RNA and imaging features. Longer overall survival for IDH1mt glioma patients may reflect mutation-driven alterations in cellular, molecular, and spatial heterogeneity which manifest in discernable radiological manifestations.
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Affiliation(s)
- Michael E. Berens
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
- * E-mail: (MEB); (AS); (FG)
| | - Anup Sood
- GE Research Center, Niskayuna, NY, United States of America
- * E-mail: (MEB); (AS); (FG)
| | - Jill S. Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences and Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - John F. Graf
- GE Research Center, Niskayuna, NY, United States of America
| | - Sanghee Cho
- GE Research Center, Niskayuna, NY, United States of America
| | - Seungchan Kim
- Department of Electrical and Computer Engineering, Roy G. Perry College of Engineering, Prairie View A&M University, Prairie View, TX, United States of America
| | - Jeffrey Kiefer
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | - Sara A. Byron
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | - Rebecca F. Halperin
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | - Sara Nasser
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | - Jonathan Adkins
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | - Lori Cuyugan
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | - Karen Devine
- Department of Population and Quantitative Health Sciences and Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Quinn Ostrom
- Department of Population and Quantitative Health Sciences and Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Marta Couce
- Department of Population and Quantitative Health Sciences and Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Leo Wolansky
- Department of Population and Quantitative Health Sciences and Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | | | | | - Sean Dinn
- GE Research Center, Niskayuna, NY, United States of America
| | - Andrew E. Sloan
- Department of Neurosurgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, United States of America
| | - Michael Prados
- Department of Neurological Surgery, Helen Diller Cancer Center, University of California San Francisco, San Francisco, CA, United States of America
| | - Joanna J. Phillips
- Department of Neurological Surgery, Helen Diller Cancer Center, University of California San Francisco, San Francisco, CA, United States of America
| | - Sarah J. Nelson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States of America
| | - Winnie S. Liang
- Translational Genomics Research Institute, Phoenix, AZ, United States of America
| | | | - Mirabela Rusu
- GE Research Center, Niskayuna, NY, United States of America
| | | | - Fiona Ginty
- GE Research Center, Niskayuna, NY, United States of America
- * E-mail: (MEB); (AS); (FG)
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Barthel FP, Johnson KC, Varn FS, Moskalik AD, Tanner G, Kocakavuk E, Anderson KJ, Abiola O, Aldape K, Alfaro KD, Alpar D, Amin SB, Ashley DM, Bandopadhayay P, Barnholtz-Sloan JS, Beroukhim R, Bock C, Brastianos PK, Brat DJ, Brodbelt AR, Bruns AF, Bulsara KR, Chakrabarty A, Chakravarti A, Chuang JH, Claus EB, Cochran EJ, Connelly J, Costello JF, Finocchiaro G, Fletcher MN, French PJ, Gan HK, Gilbert MR, Gould PV, Grimmer MR, Iavarone A, Ismail A, Jenkinson MD, Khasraw M, Kim H, Kouwenhoven MCM, LaViolette PS, Li M, Lichter P, Ligon KL, Lowman AK, Malta TM, Mazor T, McDonald KL, Molinaro AM, Nam DH, Nayyar N, Ng HK, Ngan CY, Niclou SP, Niers JM, Noushmehr H, Noorbakhsh J, Ormond DR, Park CK, Poisson LM, Rabadan R, Radlwimmer B, Rao G, Reifenberger G, Sa JK, Schuster M, Shaw BL, Short SC, Smitt PAS, Sloan AE, Smits M, Suzuki H, Tabatabai G, Van Meir EG, Watts C, Weller M, Wesseling P, Westerman BA, Widhalm G, Woehrer A, Yung WKA, Zadeh G, Huse JT, De Groot JF, Stead LF, Verhaak RGW. Longitudinal molecular trajectories of diffuse glioma in adults. Nature 2019; 576:112-120. [PMID: 31748746 PMCID: PMC6897368 DOI: 10.1038/s41586-019-1775-1] [Citation(s) in RCA: 280] [Impact Index Per Article: 56.0] [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: 02/08/2019] [Accepted: 10/01/2019] [Indexed: 12/15/2022]
Abstract
The evolutionary processes that drive universal therapeutic resistance in adult patients with diffuse glioma remain unclear1,2. Here we analysed temporally separated DNA-sequencing data and matched clinical annotation from 222 adult patients with glioma. By analysing mutations and copy numbers across the three major subtypes of diffuse glioma, we found that driver genes detected at the initial stage of disease were retained at recurrence, whereas there was little evidence of recurrence-specific gene alterations. Treatment with alkylating agents resulted in a hypermutator phenotype at different rates across the glioma subtypes, and hypermutation was not associated with differences in overall survival. Acquired aneuploidy was frequently detected in recurrent gliomas and was characterized by IDH mutation but without co-deletion of chromosome arms 1p/19q, and further converged with acquired alterations in the cell cycle and poor outcomes. The clonal architecture of each tumour remained similar over time, but the presence of subclonal selection was associated with decreased survival. Finally, there were no differences in the levels of immunoediting between initial and recurrent gliomas. Collectively, our results suggest that the strongest selective pressures occur during early glioma development and that current therapies shape this evolution in a largely stochastic manner.
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Affiliation(s)
- Floris P Barthel
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- Department of Pathology, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kevin C Johnson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Frederick S Varn
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | - Georgette Tanner
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Emre Kocakavuk
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- DKFZ Division of Translational Neurooncology at the West German Cancer Center, German Cancer Consortium Partner Site, University Hospital Essen, Essen, Germany
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - Kevin J Anderson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Olajide Abiola
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Kenneth Aldape
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Kristin D Alfaro
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Donat Alpar
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | | | - David M Ashley
- Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, USA
| | - Pratiti Bandopadhayay
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rameen Beroukhim
- Broad Institute, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Daniel J Brat
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrew R Brodbelt
- Department of Neurosurgery, University of Liverpool & Walton Centre NHS Trust, Liverpool, UK
| | - Alexander F Bruns
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Ketan R Bulsara
- Division of Neurosurgery, The University of Connecticut Health Center, Farmington, CT, USA
| | - Aruna Chakrabarty
- Department of Cellular and Molecular Pathology, Leeds Teaching Hospital NHS Trust, St James's University Hospital, Leeds, UK
| | - Arnab Chakravarti
- Department of Radiation Oncology, The Ohio State Comprehensive Cancer Center-Arthur G. James Cancer Hospital, Columbus, OH, USA
| | - Jeffrey H Chuang
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- Department of Genetics and Genome Sciences, UConn Health, Farmington, CT, USA
| | - Elizabeth B Claus
- Yale University School of Public Health, New Haven, CT, USA
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Elizabeth J Cochran
- Department of Pathology & Laboratory Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer Connelly
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph F Costello
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | | | - Michael N Fletcher
- Division of Molecular Genetics, Heidelberg Center for Personalized Oncology, German Cancer Research Consortium, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pim J French
- Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hui K Gan
- Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Victoria, Australia
- La Trobe University School of Cancer Medicine, Heidelberg, Victoria, Australia
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Institutes of Health, Bethesda, MD, USA
| | - Peter V Gould
- Anatomic Pathology Service, Hôpital de l'Enfant-Jésus, CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Matthew R Grimmer
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Antonio Iavarone
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
- Institute for Cancer Genetics, Columbia University Medical Center, New York, NY, USA
| | - Azzam Ismail
- Department of Cellular and Molecular Pathology, Leeds Teaching Hospital NHS Trust, St James's University Hospital, Leeds, UK
| | - Michael D Jenkinson
- Department of Neurosurgery, University of Liverpool & Walton Centre NHS Trust, Liverpool, UK
| | - Mustafa Khasraw
- Cooperative Trials Group for Neuro-Oncology (COGNO) NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Hoon Kim
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter S LaViolette
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Meihong Li
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Peter Lichter
- Division of Molecular Genetics, Heidelberg Center for Personalized Oncology, German Cancer Research Consortium, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Keith L Ligon
- Broad Institute, Cambridge, MA, USA
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Allison K Lowman
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Tathiane M Malta
- Department of Neurosurgery, Henry Ford Health System, Henry Ford Cancer Institute, Detroit, MI, USA
| | - Tali Mazor
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Kerrie L McDonald
- Cure Brain Cancer Biomarkers and Translational Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Annette M Molinaro
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA
| | - Do-Hyun Nam
- Department of Neurosurgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
- Institute for Refractory Cancer Research, Samsung Medical Center, Seoul, South Korea
| | - Naema Nayyar
- Division of Neuro-Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Ho Keung Ng
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Chew Yee Ngan
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Simone P Niclou
- Department of Oncology, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Johanna M Niers
- Department of Neurology, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Houtan Noushmehr
- Department of Neurosurgery, Henry Ford Health System, Henry Ford Cancer Institute, Detroit, MI, USA
| | - Javad Noorbakhsh
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - D Ryan Ormond
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Laila M Poisson
- Department of Public Health Sciences, Henry Ford Health System, Henry Ford Cancer Institute, Detroit, MI, USA
| | - Raul Rabadan
- Department of Biomedical Informatics, Columbia University Medical Center, New York, NY, USA
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Bernhard Radlwimmer
- Division of Molecular Genetics, Heidelberg Center for Personalized Oncology, German Cancer Research Consortium, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ganesh Rao
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Jason K Sa
- Institute for Refractory Cancer Research, Samsung Medical Center, Seoul, South Korea
| | - Michael Schuster
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Brian L Shaw
- Division of Neuro-Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Susan C Short
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Peter A Sillevis Smitt
- Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Ghazaleh Tabatabai
- Interdiscplinary Division of Neuro-Oncology, Hertie Institute for Clinical Brain Research, DKTK Partner Site Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Erwin G Van Meir
- Department of Neurosurgery, School of Medicine and Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Colin Watts
- Institute of Cancer Genome Sciences, Department of Neurosurgery, University of Birmingham, Birmingham, UK
| | - Michael Weller
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Pieter Wesseling
- Department of Pathology, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Bart A Westerman
- Department of Neurosurgery, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Adelheid Woehrer
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - W K Alfred Yung
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University Health Network, Toronto, Ontario, Canada
| | - Jason T Huse
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John F De Groot
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lucy F Stead
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Roel G W Verhaak
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA.
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Ascha MS, Wang JF, Kumthekar P, Sloan AE, Kruchko C, Barnholtz-Sloan JS. Bevacizumab for the treatment of non-small cell lung cancer patients with synchronous brain metastases. Sci Rep 2019; 9:17792. [PMID: 31780762 PMCID: PMC6882803 DOI: 10.1038/s41598-019-54513-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 07/23/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
Bevacizumab is FDA-approved in the treatment of primary brain tumors, but its efficacy in patients with brain metastases could be better-studied. This study examines a population of non-small cell lung cancer (NSCLC) patients with synchronous brain metastases to identify predictors of the decision to use bevacizumab and survival following bevacizumab treatment. Primary cancer registry data were used to determine which NSCLC patients diagnosed in the years 2010 through 2012 had synchronous brain metastases at the time of diagnosis, and Medicare claims used to identify a population of patients treated with bevacizumab. Record of bevacizumab treatment was found for 81 and 666 patients with and without brain metastases, respectively. After adjusting for clinical and demographic characteristics, bevacizumab was associated with 0.88 times the hazard of mortality in the elderly NSCLC population (95% CI: 0.81–0.96, p: 0.003) and a corresponding hazard ratio of 0.75 in the population of elderly NSCLC patients with synchronous brain metastases (95% CI: 0.59–0.96, p: 0.020). Bevacizumab may benefit NSCLC patients with synchronous brain metastases more than it does patients without intracranial disease, possibly as a result of its multiple potential mechanisms of action simultaneously inhibiting angiogenesis and minimizing vasogenic edema.
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Affiliation(s)
- Mustafa S Ascha
- Center for Clinical Investigation, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Priya Kumthekar
- Northwestern University Feinberg School of Medicine, Department of Neurology, Evanston, Illinois, USA
| | - Andrew E Sloan
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Seidman Cancer Center, and the Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Jill S Barnholtz-Sloan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. .,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
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46
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Soler DC, Manikandan M, Gopal SR, Sloan AE, McCormick TS, Stepanyan R. An uncharacterized region within the N-terminus of mouse TMC1 precludes trafficking to plasma membrane in a heterologous cell line. Sci Rep 2019; 9:15263. [PMID: 31649296 PMCID: PMC6813322 DOI: 10.1038/s41598-019-51336-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 09/24/2019] [Indexed: 12/21/2022] Open
Abstract
Mechanotransduction by hair cell stereocilia lies at the heart of sound detection in vertebrates. Considerable effort has been put forth to identify proteins that comprise the hair cell mechanotransduction apparatus. TMC1, a member of the transmembrane channel-like (TMC) family, was identified as a core protein of the mechanotransduction complex in hair cells. However, the inability of TMC1 to traffic through the endoplasmic reticulum in heterologous cellular systems has hindered efforts to characterize its function and fully identify its role in mechanotransduction. We developed a novel approach that allowed for the detection of uncharacterized protein regions, which preclude trafficking to the plasma membrane (PM) in heterologous cells. Tagging N-terminal fragments of TMC1 with Aquaporin 3 (AQP3) and GFP fusion reporter, which intrinsically label PM in HEK293 cells, indicated that residues at the edges of amino acid sequence 138–168 invoke intracellular localization and/or degradation. This signal is able to preclude surface localization of PM protein AQP3 in HEK293 cells. Substitutions of the residues by alanine or serine corroborated that the information determining the intracellular retention is present within amino acid sequence 138–168 of TMC1 N-terminus. This novel signal may preclude the proper trafficking of TMC1 to the PM in heterologous cells.
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Affiliation(s)
- D C Soler
- The Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Brain Tumor and Neuro-Oncology Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
| | - M Manikandan
- Department of Otolaryngology - HNS, Case Western Reserve University, Cleveland, OH, USA
| | - S R Gopal
- Department of Otolaryngology - HNS, Case Western Reserve University, Cleveland, OH, USA
| | - A E Sloan
- The Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Brain Tumor and Neuro-Oncology Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - T S McCormick
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA.,Murdough Family Center for Psoriasis, Case Western Reserve University, Cleveland, OH, USA
| | - R Stepanyan
- Department of Otolaryngology - HNS, Case Western Reserve University, Cleveland, OH, USA. .,Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA.
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Gimple RC, Kidwell RL, Kim LJY, Sun T, Gromovsky AD, Wu Q, Wolf M, Lv D, Bhargava S, Jiang L, Prager BC, Wang X, Ye Q, Zhu Z, Zhang G, Dong Z, Zhao L, Lee D, Bi J, Sloan AE, Mischel PS, Brown JM, Cang H, Huan T, Mack SC, Xie Q, Rich JN. Glioma Stem Cell-Specific Superenhancer Promotes Polyunsaturated Fatty-Acid Synthesis to Support EGFR Signaling. Cancer Discov 2019; 9:1248-1267. [PMID: 31201181 DOI: 10.1158/2159-8290.cd-19-0061] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/03/2019] [Accepted: 06/11/2019] [Indexed: 01/02/2023]
Abstract
Glioblastoma ranks among the most aggressive and lethal of all human cancers. Functionally defined glioma stem cells (GSC) contribute to this poor prognosis by driving therapeutic resistance and maintaining cellular heterogeneity. To understand the molecular processes essential for GSC maintenance and tumorigenicity, we interrogated the superenhancer landscapes of primary glioblastoma specimens and in vitro GSCs. GSCs epigenetically upregulated ELOVL2, a key polyunsaturated fatty-acid synthesis enzyme. Targeting ELOVL2 inhibited glioblastoma cell growth and tumor initiation. ELOVL2 depletion altered cellular membrane phospholipid composition, disrupted membrane structural properties, and diminished EGFR signaling through control of fatty-acid elongation. In support of the translational potential of these findings, dual targeting of polyunsaturated fatty-acid synthesis and EGFR signaling had a combinatorial cytotoxic effect on GSCs. SIGNIFICANCE: Glioblastoma remains a devastating disease despite extensive characterization. We profiled epigenomic landscapes of glioblastoma to pinpoint cell state-specific dependencies and therapeutic vulnerabilities. GSCs utilize polyunsaturated fatty-acid synthesis to support membrane architecture, inhibition of which impairs EGFR signaling and GSC proliferation. Combinatorial targeting of these networks represents a promising therapeutic strategy.See related commentary by Affronti and Wellen, p. 1161.This article is highlighted in the In This Issue feature, p. 1143.
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Affiliation(s)
- Ryan C Gimple
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California.,Department of Pathology, Case Western University, Cleveland, Ohio
| | - Reilly L Kidwell
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Leo J Y Kim
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California.,Department of Pathology, Case Western University, Cleveland, Ohio
| | - Tengqian Sun
- Salk Institute for Biological Studies, La Jolla, California
| | - Anthony D Gromovsky
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Qiulian Wu
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Megan Wolf
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Deguan Lv
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Shruti Bhargava
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Li Jiang
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Briana C Prager
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California.,Department of Pathology, Case Western University, Cleveland, Ohio.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Xiuxing Wang
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Qing Ye
- Salk Institute for Biological Studies, La Jolla, California
| | - Zhe Zhu
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Guoxin Zhang
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Zhen Dong
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Linjie Zhao
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Derrick Lee
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California
| | - Junfeng Bi
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland Ohio.,Department of Neurological Surgery, University Hospitals-Cleveland Medical Center, Cleveland, Ohio
| | - Paul S Mischel
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California.,Department of Pathology, UCSD School of Medicine, La Jolla, California.,Moores Cancer Center, UCSD School of Medicine, La Jolla, California
| | - J Mark Brown
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Hu Cang
- Salk Institute for Biological Studies, La Jolla, California
| | - Tao Huan
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephen C Mack
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Dan L. Duncan Cancer Center, Houston, Texas
| | - Qi Xie
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California. .,Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, China
| | - Jeremy N Rich
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, San Diego, California. .,Moores Cancer Center, UCSD School of Medicine, La Jolla, California.,Department of Neurosciences, UCSD School of Medicine, La Jolla, California
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Gittleman H, Cioffi G, Chunduru P, Molinaro AM, Berger MS, Sloan AE, Barnholtz-Sloan JS. An independently validated nomogram for isocitrate dehydrogenase-wild-type glioblastoma patient survival. Neurooncol Adv 2019; 1:vdz007. [PMID: 31608326 PMCID: PMC6777501 DOI: 10.1093/noajnl/vdz007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In 2016, the World Health Organization reclassified the definition of glioblastoma (GBM), dividing these tumors into isocitrate dehydrogenase (IDH)-wild-type and IDH-mutant GBM, where the vast majority of GBMs are IDH-wild-type. Nomograms are useful tools for individualized estimation of survival. This study aimed to develop and independently validate a nomogram for IDH-wild-type patients with newly diagnosed GBM. Methods Data were obtained from newly diagnosed GBM patients from the Ohio Brain Tumor Study (OBTS) and the University of California San Francisco (UCSF) for diagnosis years 2007-2017 with the following variables: age at diagnosis, sex, extent of resection, concurrent radiation/temozolomide (TMZ) status, Karnofsky Performance Status (KPS), O6-methylguanine-DNA methyltransferase (MGMT) methylation status, and IDH mutation status. Survival was assessed using Cox proportional hazards regression, random survival forests, and recursive partitioning analysis, with adjustment for known prognostic factors. The models were developed using the OBTS data and independently validated using the UCSF data. Models were internally validated using 10-fold cross-validation and externally validated by plotting calibration curves. Results A final nomogram was validated for IDH-wild-type newly diagnosed GBM. Factors that increased the probability of survival included younger age at diagnosis, female sex, having gross total resection, having concurrent radiation/TMZ, having a high KPS, and having MGMT methylation. Conclusions A nomogram that calculates individualized survival probabilities for IDH-wild-type patients with newly diagnosed GBM could be useful to physicians for counseling patients regarding treatment decisions and optimizing therapeutic approaches. Free software for implementing this nomogram is provided: https://gcioffi.shinyapps.io/Nomogram_For_IDH_Wildtype_GBM_H_Gittleman/.
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Affiliation(s)
- Haley Gittleman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Gino Cioffi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Pranathi Chunduru
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Annette M Molinaro
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Andrew E Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Neurological Surgery, University Hospitals of Cleveland and Case Western University School of Medicine, Cleveland, Ohio.,Seidman Cancer Center, University Hospitals of Cleveland, Cleveland, Ohio
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Sloan AE, Roger L, Murphy C, Reese J, Lazarus HM, Dropulic B, Gerson SL. A phase I study of MGMT-P140K transfected hematopoetic progenitor cells (HPC) combined with TMZ/O6BG dose escalation for newly diagnosed, MGMT unmethylated glioblastoma: Tolerance and evidence of survival benefit. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2062 Background: GBM is the most common malignant brain tumor with a median survival of 15 months despite surgery and radio-chemotherapy. The most important mechanism of TMZ resistance is the O6-methylguanine-DNA methyltransferase (MGMT) gene which repairs temozolamide-induced DNA methylation. The MGMT inhibitor O6-benzylguanine (BG) demonstrated efficacy in depleting MGMT and maximizing tumor response in early phase clinical trials. However, MGMT expression is also low in hematopoietic cells, so this approach led to unacceptable bone marrow toxicity and thus has been abandoned. We hypothesized that chemoprotection of hematopoietic HPC with an MGMT mutant (MGMT-P140K) characterized by normal methyltransferase activity, coupled with low affinity for BG would maximize anti-tumor response while enabling patients to tolerate TMZ & BG dose escalation with minimal toxicity. A phase I trial was performed to test this hypothesis. Methods: 10 adults with newly diagnosed MGMT unmethylated, IDH-1 WT, GBM underwent standard surgery and radiation, followed by transplantation with autologous CD34+ HPC engineered to express MGMT-P140K using a lentiviral vector. We tested tolerance and efficacy of three different paradigms for conditioning bone marrow and re-infusion of HPC. To assess chemo-protection, patients’ blood counts and transgene marking were monitored during and after treatment, as was toxicity, response, and progression-free and overall survival. Results: Treatment was moderately toxic with 3/10 patients suffering grade 3-4 hematologic toxicity; no high grade non-hematologic toxicity was observed . Viral transduction rates ranged from 3-75% and were clearly improved in Arm III utilizing BCNU conditioning and intra-patient dose escalation of TMZ/O6GB. In patients tolerating 3 cycles or more, P140K-MGMT gene markings in peripheral blood and bone marrow cells increased 3-26-fold with only mild (Grade 2-3) mylosuppression consistent with chemo-protection as hypothesized. Median PFS and OS was 22 and 31 months respectfully, and three patients in Arm III are healthy and progression free at 36-39 months. OS exceeded RPA predicted survival by 3.3-fold suggesting clinical benefit. Viral insertion site analysis demonstrate lack of clonal dominance. Conclusions: P140K-MGMT transfected HPC enables TMZ/ BG dose escalation with acceptable toxicity and increased survival in a small cohort of selected patients. A phase II study is ongoing. Clinical trial information: NCT01269424.
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Affiliation(s)
| | | | | | - Jane Reese
- Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Boro Dropulic
- Lentigen Technology Inc., A Miltenyi Biotec Company, Gaithersburg, MD
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
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50
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Sloan AE, Shukla G, Rathore S, Akbari H, Gondi V, Davatzikos C. Radiomics-based identification of peritumoral infiltration in de novo glioblastoma imaging presents targets amenable for potential targeted extended resection: A neurosurgical survey. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13573 Background: Radiomics-based machine learning tools have been developed to analyze preoperative multiparametric MR images of patients with glioblastoma (GBM) to predict various outcomes of clinical interest, such as survival, molecular mutation status, and subclinical peritumoral infiltration, all before initial surgical resection. Preoperative identification of regions containing the highest probability of subclinical tumor infiltration presents an opportunity for targeted extended resection in the setting of a clinical trial, but the willingness of neurosurgeons to perform such a procedure is not known. Methods: We selected five neurosurgeons from high volume centers ( > 20 GBM surgeries per year) and performed an in silico study of anonymized preoperative images of patients with GBM, with radiomics-based infiltration maps depicting high probabilities of peritumoral infiltration. With regards to these regions beyond the enhancing tumor, we surveyed them on their willingness to attempt biopsy, and asked them to rate whether they felt such a region could be resected. Results: Preoperative maps of 20 patients with GBM, containing 26 regions of interest depicting high-risk peritumoral infiltration regions (distributed among frontal, temporal, occipital, parietal, cerebellar, and deep loci) were presented to five expert neurosurgeons from different institutions. Of the 20 patients, a median of 90% were deemed to be safe to biopsy; a median of 55% were felt to be definitely resectable, and median 35% to be possibly resectable. 85% of the 20 subjects were felt to be good candidates for participation in a clinical trial assessing the feasibility, safety, and efficacy of targeted extended resection. Conclusions: In selected patients, experienced neurosurgeons are willing to attempt targeted extended resection using radiomics-based maps of peritumoral infiltration in the context of a clinical trial. Proceeding with development of such a trial is warranted.
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Affiliation(s)
| | | | - Saima Rathore
- Center for Biomedical Image Computing and Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Hamed Akbari
- Center for Biomedical Image Computing and Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Vinai Gondi
- Northwestern Medicine Cancer Center Warrenville and Northwestern Medicine Proton Center, Warrenville, IL
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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