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Heeke S, Gay CM, Estecio MR, Tran H, Morris BB, Zhang B, Tang X, Raso MG, Rocha P, Lai S, Arriola E, Hofman P, Hofman V, Kopparapu P, Lovly CM, Concannon K, De Sousa LG, Lewis WE, Kondo K, Hu X, Tanimoto A, Vokes NI, Nilsson MB, Stewart A, Jansen M, Horváth I, Gaga M, Panagoulias V, Raviv Y, Frumkin D, Wasserstrom A, Shuali A, Schnabel CA, Xi Y, Diao L, Wang Q, Zhang J, Van Loo P, Wang J, Wistuba II, Byers LA, Heymach JV. Tumor- and circulating-free DNA methylation identifies clinically relevant small cell lung cancer subtypes. Cancer Cell 2024; 42:225-237.e5. [PMID: 38278149 PMCID: PMC10982990 DOI: 10.1016/j.ccell.2024.01.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/26/2023] [Accepted: 01/04/2024] [Indexed: 01/28/2024]
Abstract
Small cell lung cancer (SCLC) is an aggressive malignancy composed of distinct transcriptional subtypes, but implementing subtyping in the clinic has remained challenging, particularly due to limited tissue availability. Given the known epigenetic regulation of critical SCLC transcriptional programs, we hypothesized that subtype-specific patterns of DNA methylation could be detected in tumor or blood from SCLC patients. Using genomic-wide reduced-representation bisulfite sequencing (RRBS) in two cohorts totaling 179 SCLC patients and using machine learning approaches, we report a highly accurate DNA methylation-based classifier (SCLC-DMC) that can distinguish SCLC subtypes. We further adjust the classifier for circulating-free DNA (cfDNA) to subtype SCLC from plasma. Using the cfDNA classifier (cfDMC), we demonstrate that SCLC phenotypes can evolve during disease progression, highlighting the need for longitudinal tracking of SCLC during clinical treatment. These data establish that tumor and cfDNA methylation can be used to identify SCLC subtypes and might guide precision SCLC therapy.
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Affiliation(s)
- Simon Heeke
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carl M Gay
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marcos R Estecio
- Epigenetic and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hai Tran
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Benjamin B Morris
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bingnan Zhang
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ximing Tang
- Department of Translational Molecular Pathology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maria Gabriela Raso
- Department of Translational Molecular Pathology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pedro Rocha
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Siqi Lai
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center UTHealth Houston, Houston, TX, USA
| | - Edurne Arriola
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, IHU RespirERA, Nice Hospital, University Côte d'Azur, Nice, France
| | - Veronique Hofman
- Laboratory of Clinical and Experimental Pathology, IHU RespirERA, Nice Hospital, University Côte d'Azur, Nice, France
| | - Prasad Kopparapu
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christine M Lovly
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyle Concannon
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luana Guimaraes De Sousa
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Whitney Elisabeth Lewis
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kimie Kondo
- Epigenetic and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xin Hu
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Azusa Tanimoto
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Natalie I Vokes
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monique B Nilsson
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Allison Stewart
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maarten Jansen
- Pulmonary Department, Ziekenhuisgroep Twente, Hengelo, the Netherlands
| | - Ildikó Horváth
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Mina Gaga
- 7th Respiratory Medicine Department, Athens Chest Hospital, Athens, Greece
| | | | - Yael Raviv
- Department of Medicine, Pulmonology, Institute, Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | | | | | | | | | - Yuanxin Xi
- Department of Bioinformatics and Computational Biology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lixia Diao
- Department of Bioinformatics and Computational Biology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qi Wang
- Department of Bioinformatics and Computational Biology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jianjun Zhang
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peter Van Loo
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The Francis Crick Institute, London, UK
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren A Byers
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - John V Heymach
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Zhang B, Lewis W, Stewart CA, Morris BB, Solis LM, Serrano A, Xi Y, Wang Q, Lopez ER, Concannon K, Heeke S, Tang X, Raso G, Cardnell RJ, Vokes N, Blumenschein G, Elamin Y, Fosella F, Tsao A, Skoulidis F, Hume CB, Sasak K, Lewis J, Rinsurongkawong W, Rinsurongkawong V, Lee J, Tran H, Zhang J, Gibbons D, Vaporciyan A, Wang J, Park K, Heymach JV, Byers LA, Gay CM, Le X. Brief Report: Comprehensive Clinicogenomic Profiling of Small Cell Transformation From EGFR-Mutant NSCLC Informs Potential Therapeutic Targets. JTO Clin Res Rep 2024; 5:100623. [PMID: 38357092 PMCID: PMC10864847 DOI: 10.1016/j.jtocrr.2023.100623] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction NSCLC transformation to SCLC has been best characterized with EGFR-mutant NSCLC, with emerging case reports seen in ALK, RET, and KRAS-altered NSCLC. Previous reports revealed transformed SCLC from EGFR-mutant NSCLC portends very poor prognosis and lack effective treatment. Genomic analyses revealed TP53 and RB1 loss of function increase the risk of SCLC transformation. Little has been reported on the detailed clinicogenomic characteristics and potential therapeutic targets for this patient population. Methods In this study, we conducted a single-center retrospective analysis of clinical and genomic characteristics of patients with EGFR-mutant NSCLC transformed to SCLC. Demographic data, treatment course, and clinical molecular testing reports were extracted from electronic medical records. Kaplan-Meier analyses were used to estimate survival outcomes. Next generation sequencing-based assays was used to identify EGFR and co-occurring genetic alterations in tissue or plasma before and after SCLC transformation. Single-cell RNA sequencing (scRNA-seq) was performed on a patient-derived-xenograft model generated from a patient with EGFR-NSCLC transformed SCLC tumor. Results A total of 34 patients were identified in our study. Median age at initial diagnosis was 58, and median time to SCLC transformation was 24.2 months. 68% were female and 82% were never smokers. 79% of patients were diagnosed as stage IV disease, and over half had brain metastases at baseline. Median overall survival of the entire cohort was 38.3 months from initial diagnoses and 12.4 months from time of SCLC transformation. Most patients harbored EGFR exon19 deletions as opposed to exon21 L858R alteration. Continuing EGFR tyrosine kinase inhibitor post-transformation did not improve overall survival compared with those patients where tyrosine kinase inhibitor was stopped in our cohort. In the 20 paired pretransformed and post-transformed patient samples, statistically significant enrichment was seen with PIK3CA alterations (p = 0.04) post-transformation. Profiling of longitudinal liquid biopsy samples suggest emergence of SCLC genetic alterations before biopsy-proven SCLC, as shown by increasing variant allele frequency of TP53, RB1, PIK3CA alterations. ScRNA-seq revealed potential therapeutic targets including DLL3, CD276 (B7-H3) and PTK7 were widely expressed in transformed SCLC. Conclusions SCLC transformation is a potential treatment resistance mechanism in driver-mutant NSCLC. In our cohort of 34 EGFR-mutant NSCLC, poor prognosis was observed after SCLC transformation. Clinicogenomic analyses of paired and longitudinal samples identified genomic alterations emerging post-transformation and scRNA-seq reveal potential therapeutic targets in this population. Further studies are needed to rigorously validate biomarkers and therapeutic targets for this patient population.
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Affiliation(s)
- Bingnan Zhang
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Whitney Lewis
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - C. Allison Stewart
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Benjamin B. Morris
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Luisa M. Solis
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alejandra Serrano
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yuanxin Xi
- Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qi Wang
- Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elyse R. Lopez
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas
| | - Kyle Concannon
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Simon Heeke
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ximing Tang
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gabriela Raso
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Robert J. Cardnell
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Natalie Vokes
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - George Blumenschein
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yasir Elamin
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Frank Fosella
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anne Tsao
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ferdinandos Skoulidis
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Celyne Bueno Hume
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Koji Sasak
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeff Lewis
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Waree Rinsurongkawong
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vadeerat Rinsurongkawong
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack Lee
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hai Tran
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jianjun Zhang
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Don Gibbons
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ara Vaporciyan
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jing Wang
- Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Keunchil Park
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John V. Heymach
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lauren A. Byers
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carl M. Gay
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiuning Le
- Department of Thoracic Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Tran H, Feng Y, Chao D, Liu QS, Hogan QH, Pan B. Descending mechanism by which medial prefrontal cortex endocannabinoid signaling controls the development of neuropathic pain and neuronal activity of dorsal root ganglion. Pain 2024; 165:102-114. [PMID: 37463226 PMCID: PMC10787817 DOI: 10.1097/j.pain.0000000000002992] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/05/2023] [Indexed: 07/20/2023]
Abstract
ABSTRACT Although regulation of nociceptive processes in the dorsal horn by deep brain structures has long been established, the role of cortical networks in pain regulation is minimally explored. The medial prefrontal cortex (mPFC) is a key brain area in pain processing that receives ascending nociceptive input and exerts top-down control of pain sensation. We have shown critical changes in mPFC synaptic function during neuropathic pain, controlled by endocannabinoid (eCB) signaling. This study tests whether mPFC eCB signaling modulates neuropathic pain through descending control. Intra-mPFC injection of cannabinoid receptor type 1 (CB1R) agonist WIN-55,212-2 (WIN) in the chronic phase transiently alleviates the pain-like behaviors in spared nerve injury (SNI) rats. By contrast, intra-mPFC injection of CB1R antagonist AM4113 in the early phase of neuropathic pain reduces the development of pain-like behaviors in the chronic phase. Spared nerve injury reduced the mechanical threshold to induce action potential firing of dorsal horn wide-dynamic-range neurons, but this was reversed in rats by WIN in the chronic phase of SNI and by mPFC injection of AM4113 in the early phase of SNI. Elevated dorsal root ganglion neuronal activity after injury was also diminished in rats by mPFC injection of AM4113, potentially by reducing antidromic activity and subsequent neuronal inflammation. These findings suggest that depending on the phase of the pain condition, both blocking and activating CB1 receptors in the mPFC can regulate descending control of pain and affect both dorsal horn neurons and peripheral sensory neurons, contributing to changes in pain sensitivity.
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Affiliation(s)
- Hai Tran
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - Yin Feng
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - Dongman Chao
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - Qing-song Liu
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - Quinn H. Hogan
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
| | - Bin Pan
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226
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Bui TD, Tran DK, Vu VH, Tran H, Le MK, Truong QB, Thanh Hiep N, Minh Duc N. Beneficial effects of pulmonary embolism response team establishment in patients with pulmonary embolism in a developing country: a single-center experience. Clin Ter 2023; 174:518-524. [PMID: 38048115 DOI: 10.7417/ct.2023.5019] [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] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Objective The impact of establishing a pulmonary embolism response team (PERT) in patients with pulmonary embolism (PE) has been proven in many developed countries. However, the efficacy of a PERT largely depends on expertise and infrastructure. This study explored the benefit of establishing a PERT in developing countries with limited healthcare resources by comparing the outcomes of patients with acute PE before and after PERT establishment at University Medical Center Ho Chi Minh City in Vietnam. Methods We conducted a single-center observational study from January 1, 2019, to August 1, 2021. All patients with PE confirmed on computed tomography were included. Patients admitted before PERT establishment were treated by cardiologists alone, while those hospitalized after PERT establishment were managed by the PERT. Results A total of 130 patients were included (pre-PERT estab-lishment: 51 patients; post-PERT establishment: 79 patients). The demographic characteristics, severity of PE, and clinical and laboratory findings were similar between the two groups. The post-PERT establishment group had a lower incidence rate of major and clinically relevant nonmajor bleeding (11.3% vs. 31.4%, p = 0.005) and required more interventional therapies (16.5% vs. 3.9%, p = 0.046) than did the pre-PERT establishment group. The in-hospital mortality rate decreased in the post-PERT establishment group compared with that in the pre-PERT establishment group (8.9% vs. 21.6%, p = 0.041). Conclusions Involvement of the PERT in PE management was associated with improved outcomes of patients with PE, including reduced bleeding and mortality rates in a resource-constrained hospital.
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Affiliation(s)
- T D Bui
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - D K Tran
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - V H Vu
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - H Tran
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - M K Le
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Critical Care Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Q B Truong
- Cardiovascular Center, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N Thanh Hiep
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - N Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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Wischnewski M, Tran H, Zhao Z, Shirinpour S, Haigh Z, Rotteveel J, Perera N, Alekseichuk I, Zimmermann J, Opitz A. Induced neural phase precession through exogeneous electric fields. bioRxiv 2023:2023.03.31.535073. [PMID: 37034780 PMCID: PMC10081336 DOI: 10.1101/2023.03.31.535073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
The gradual shifting of preferred neural spiking relative to local field potentials (LFPs), known as phase precession, plays a prominent role in neural coding. Correlations between the phase precession and behavior have been observed throughout various brain regions. As such, phase precession is suggested to be a global neural mechanism that promotes local neuroplasticity. However, causal evidence and neuroplastic mechanisms of phase precession are lacking so far. Here we show a causal link between LFP dynamics and phase precession. In three experiments, we modulated LFPs in humans, a non-human primate, and computational models using alternating current stimulation. We show that continuous stimulation of motor cortex oscillations in humans lead to a gradual phase shift of maximal corticospinal excitability by ~90°. Further, exogenous alternating current stimulation induced phase precession in a subset of entrained neurons (~30%) in the non-human primate. Multiscale modeling of realistic neural circuits suggests that alternating current stimulation-induced phase precession is driven by NMDA-mediated synaptic plasticity. Altogether, the three experiments provide mechanistic and causal evidence for phase precession as a global neocortical process. Alternating current-induced phase precession and consequently synaptic plasticity is crucial for the development of novel therapeutic neuromodulation methods.
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Affiliation(s)
- M. Wischnewski
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - H. Tran
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Z. Zhao
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - S. Shirinpour
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Z.J. Haigh
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - J. Rotteveel
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - N.D. Perera
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - I. Alekseichuk
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - J. Zimmermann
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - A. Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
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Vo T, Tran T, Ho T, Le C, Pham H, Tran H, Ho N, Cao T, Vo B. Clinical evaluation of hysterectomy for the treatment of invasive mole in Southern Vietnam. Eur Rev Med Pharmacol Sci 2023; 27:7720-7727. [PMID: 37667950 DOI: 10.26355/eurrev_202308_33426] [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] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE This study aimed to determine the rate of salvage chemotherapy and review associated factors in invasive mole patients treated by primary or delayed hysterectomy. PATIENTS AND METHODS This study was carried out at the Tu Du Hospital, where a total of 189 patients were diagnosed with invasive mole based on histologic examination by hysterectomy between 01/2016 to 12/2020. We used the life table method to estimate the cumulative rate. We applied the Cox proportional hazard model to determine the factors associated with the need for salvage chemotherapy. RESULTS At 12-month follow-up, 47 patients had required salvage chemotherapy. The incidence was 24.87% (95% CI: 18.88-31.66). Applying the multivariate model, prophylactic chemotherapy (HR = 2.75, 95% Cl: 1.20-6.30) and two weeks postoperative hCG value greater than 1,900 mIU/mL (HR = 4.30, 95% Cl: 2.08-8.87) increased the risk of requiring salvage chemotherapy. Postoperative chemotherapy decreased the risk of requiring salvage chemotherapy (HR = 0.43, 95% Cl: 0.22-0.83). CONCLUSIONS Hysterectomy can be considered safe and effective in treating invasive mole patients. Although patients were treated by hysterectomy, 24.87% of patients needed salvage chemotherapy to achieve remission. This study affirms the malignant nature of invasive mole, a subtype of gestational trophoblastic neoplasia (GTN). It is not purely a local invasion of molar villi. Postoperative chemotherapy plays an essential role in reducing the risk of requiring salvage chemotherapy.
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Affiliation(s)
- T Vo
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Li R, Altan M, Reuben A, Lin R, Heymach JV, Tran H, Chen R, Little L, Hubert S, Zhang J, Li Z. A novel statistical method for decontaminating T-cell receptor sequencing data. Brief Bioinform 2023:bbad230. [PMID: 37337757 PMCID: PMC10359082 DOI: 10.1093/bib/bbad230] [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: 12/29/2022] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023] Open
Abstract
The T-cell receptor (TCR) repertoire is highly diverse among the population and plays an essential role in initiating multiple immune processes. TCR sequencing (TCR-seq) has been developed to profile the T cell repertoire. Similar to other high-throughput experiments, contamination can happen during several steps of TCR-seq, including sample collection, preparation and sequencing. Such contamination creates artifacts in the data, leading to inaccurate or even biased results. Most existing methods assume 'clean' TCR-seq data as the starting point with no ability to handle data contamination. Here, we develop a novel statistical model to systematically detect and remove contamination in TCR-seq data. We summarize the observed contamination into two sources, pairwise and cross-cohort. For both sources, we provide visualizations and summary statistics to help users assess the severity of the contamination. Incorporating prior information from 14 existing TCR-seq datasets with minimum contamination, we develop a straightforward Bayesian model to statistically identify contaminated samples. We further provide strategies for removing the impacted sequences to allow for downstream analysis, thus avoiding any need to repeat experiments. Our proposed model shows robustness in contamination detection compared with a few off-the-shelf detection methods in simulation studies. We illustrate the use of our proposed method on two TCR-seq datasets generated locally.
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Affiliation(s)
- Ruoxing Li
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, 77030, Texas, Houston, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Mehmet Altan
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Alexandre Reuben
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Ruitao Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - John V Heymach
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Hai Tran
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Runzhe Chen
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Latasha Little
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Shawna Hubert
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Jianjun Zhang
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
| | - Ziyi Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 77030, Texas, Houston, USA
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8
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Zhao Z, Shirinpour S, Tran H, Wischnewski M, Opitz A. Intensity- and frequency-specific effects of transcranial alternating current stimulation are explained by network dynamics. bioRxiv 2023:2023.05.19.541493. [PMID: 37293105 PMCID: PMC10245793 DOI: 10.1101/2023.05.19.541493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Transcranial alternating current stimulation (tACS) can be used to non-invasively entrain neural activity, and thereby cause changes in local neural oscillatory power. Despite an increased use in cognitive and clinical neuroscience, the fundamental mechanisms of tACS are still not fully understood. Here, we develop a computational neuronal network model of two-compartment pyramidal neurons and inhibitory interneurons which mimic the local cortical circuits. We model tACS with electric field strengths that are achievable in human applications. We then simulate intrinsic network activity and measure neural entrainment to investigate how tACS modulates ongoing endogenous oscillations. First, we show that intensity-specific effects of tACS are non-linear. At low intensities (<0.3 mV/mm), tACS desynchronizes neural firing relative to the endogenous oscillations. At higher intensities (>0.3 mV/mm), neurons are entrained to the exogenous electric field. We then further explore the stimulation parameter space and find that entrainment of ongoing cortical oscillations also depends on frequency by following an Arnold tongue. Moreover, neuronal networks can amplify the tACS induced entrainment via excitation-inhibition balance. Our model shows that pyramidal neurons are directly entrained by the exogenous electric field and drive the inhibitory neurons. Our findings can thus provide a mechanistic framework for understanding the intensity- and frequency- specific effects of oscillating electric fields on neuronal networks. This is crucial for rational parameters selection for tACS in cognitive studies and clinical applications.
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Affiliation(s)
- Z. Zhao
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - S. Shirinpour
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - H. Tran
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - M. Wischnewski
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - A. Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
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9
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Bui-Thi HD, Nguyen DK, To GK, Bui TD, Tran H, Nguyen MD, Le MK. Uncovering hypercoagulation status using rotational thromboelastometry in patients with sepsis presented with hypocoagulation based on conventional coagulation tests: an observational study. Eur Rev Med Pharmacol Sci 2023; 27:4492-4503. [PMID: 37259730 DOI: 10.26355/eurrev_202305_32455] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Conventional coagulation tests (CCTs) cannot identify hypercoagulation, despite being common in patients with sepsis. Moreover, CCTs overdiagnose hypocoagulation, which increases unnecessary blood transfusion. Therefore, we aimed to use rotational thromboelastometry (ROTEM) to classify the coagulation status of patients with sepsis with abnormal CCTs and to identify the main coagulation components that affect coagulation status. PATIENTS AND METHODS This study was part of an observational study to investigate ROTEM use in 161 patients with sepsis with the Sepsis-3 criteria. They underwent concurrent CCTs and ROTEM assessments within 24 hours of Intensive Care Unit admission at the University Medical Center, Ho Chi Minh City, from June 2020 to December 2021. This study only extracted data from patients with sepsis with abnormal CCTs, including activated partial thromboplastin time ratio, international normalized ratio (INR), platelet count, and fibrinogen concentration. RESULTS A total of 158 patients with sepsis with abnormal CCTs had a median age of 69, and 48.7% were women. Of 34 patients with INR ≥1.6, ROTEM identified 11.8% with hypercoagulation and 20.6% with normal coagulation. Of 29 patients with platelet counts <100 (103/mm3), ROTEM identified 3.5% with hypercoagulation and 24.1% with normal coagulation. In the ROTEM-based hypercoagulability group, an increase in maximum clot firmness was observed in 95.1% of cases; also, this group had significantly higher plasma fibrinogen concentrations than other groups (p<0.005). CONCLUSIONS ROTEM can reveal hypercoagulability in patients with sepsis with hypocoagulation based on CCTs. Hyperfibrinogenemia causes hypercoagulation in patients with sepsis.
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Affiliation(s)
- H-D Bui-Thi
- Department of Intensive Care, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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10
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Concannon K, Heeke S, Sahu M, Tang X, Sasaki K, Patel S, Raso MG, Tran H, Gay C, Byers L. Abstract 1398: Clinical and transcriptomic analysis demonstrates improved survival and unique gene expression signatures among SCLC arising in patients with minimal tobacco use. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1398] [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: 04/07/2023]
Abstract
Abstract
Small-cell lung cancer (SCLC) represents 15% of all lung cancers with roughly 30,000 new cases in the U.S. annually. SCLC remains the deadliest histologic subtype with a median survival of only 12.3 months among those with extensive-stage (ES-SCLC) disease as demonstrated in the IMPower133 trial. Recent research by our group (Gay et al, 2021) has demonstrated that SCLC is defined by four transcriptionally defined subtypes, characterized by the predominant expression of the three transcription factors ASCL1 (SCLC-A), NEUROD1 (SCLC-N), POU2F3 (SCLC-P), and a fourth, inflamed subtype (SCLC-I). While SCLC is commonly associated with a history of heavy smoking, there is a paucity of information regarding tumors arising in patients with minimal tobacco use. This represents an unmet need given an increasing appreciation for low pack-year and never-smoker SCLC with some studies, like the CAPSTONE-1 trial, demonstrating an incidence of never-smoking SCLC >20%. To address this disparity, we profiled a cohort of 113 SCLC patients with ≤10 pack-year smoking history (~12.9% of patients with SCLC seen over that time period) treated at the University of Texas MD Anderson Cancer Center. Clinical outcomes were analyzed, as was transcriptomic analysis in a subset of patients. The overall survival of limited-stage (LS-SCLC) and ES-SCLC in the low-pack year cohort was 26.9 and 16.5 months respectively (P=0.029); superior to historic medians of roughly 17.0 and 12.3 months respectively. Interestingly, TP53 and RB1 mutations were significantly less common in the low-pack year cohort compared to patients with higher smoking burdens as determined by George et al. who evaluated 110 SCLC samples using whole-genome sequencing. Clinically obtained mutational analysis of our cohort (N=49) demonstrated a TP53 mutational incidence of 51.0% vs 98.2% from George et al. (P<0.001). Similarly, our RB1 mutational incidence was 26.5% vs 90.9% from George et al. (P<0.001). Samples lacking TP53-RB1 coexisting mutations frequently demonstrated abnormalities in alternative DNA repair genes including STK11, POLE, PALB2, MUTYH, MSH2, MSH6, MLH1, MDM2, BRCA2, and ARID1A. Given these findings, we performed whole-transcriptome profiling on our low pack-year SCLC samples to determine the SCLC-subtypes and identify unique gene signatures which may drive oncogenesis via mechanisms distinct from loss of RB1 and TP53. These data demonstrate that SCLC arising from patients with minimal smoking histories confers a more favorable prognosis and harbors unique RNA signatures with potential therapeutic implications. We anticipate these results will shift the current clinical practice toward routine evaluation of non-RB1 or TP53-mediated drivers of oncogenesis among low pack-year patients with SCLC and promote further work in identifying novel therapies for this population.
Citation Format: Kyle Concannon, Simon Heeke, Moushumi Sahu, Ximing Tang, Koji Sasaki, Sonia Patel, Maria Gabriela Raso, Hai Tran, Carl Gay, Lauren Byers. Clinical and transcriptomic analysis demonstrates improved survival and unique gene expression signatures among SCLC arising in patients with minimal tobacco use [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1398.
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Affiliation(s)
- Kyle Concannon
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Simon Heeke
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Moushumi Sahu
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ximing Tang
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Koji Sasaki
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sonia Patel
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Hai Tran
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carl Gay
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lauren Byers
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
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11
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Patel SA, Nilsson MB, Yang Y, Le X, Tran H, Elamin YY, Yu X, Zhang F, Poteete A, Ren X, Shen L, Wang J, Moghaddam SJ, Cascone T, Curran M, Gibbons DL, Heymach JV. IL6 Mediates Suppression of T- and NK-cell Function in EMT-associated TKI-resistant EGFR-mutant NSCLC. Clin Cancer Res 2023; 29:1292-1304. [PMID: 36595561 PMCID: PMC10290888 DOI: 10.1158/1078-0432.ccr-22-3379] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 11/02/2022] [Revised: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Patients with advanced non-small cell lung cancer (NSCLC) harboring activating EGFR mutations are initially responsive to tyrosine kinase inhibitors (TKI). However, therapeutic resistance eventually emerges, often via secondary EGFR mutations or EGFR-independent mechanisms such as epithelial-to-mesenchymal transition. Treatment options after EGFR-TKI resistance are limited as anti-PD-1/PD-L1 inhibitors typically display minimal benefit. Given that IL6 is associated with worse outcomes in patients with NSCLC, we investigate whether IL6 in part contributes to this immunosuppressed phenotype. EXPERIMENTAL DESIGN We utilized a syngeneic genetically engineered mouse model (GEMM) of EGFR-mutant NSCLC to investigate the effects of IL6 on the tumor microenvironment and the combined efficacy of IL6 inhibition and anti-PD-1 therapy. Corresponding in vitro studies used EGFR-mutant human cell lines and clinical specimens. RESULTS We identified that EGFR-mutant tumors which have oncogene-independent acquired resistance to EGFR-TKIs were more mesenchymal and had markedly enhanced IL6 secretion. In EGFR-mutant GEMMs, IL6 depletion enhanced activation of infiltrating natural killer (NK)- and T-cell subpopulations and decreased immunosuppressive regulatory T and Th17 cell populations. Inhibition of IL6 increased NK- and T cell-mediated killing of human osimertinib-resistant EGFR-mutant NSCLC tumor cells in cell culture. IL6 blockade sensitized EGFR-mutant GEMM tumors to PD-1 inhibitors through an increase in tumor-infiltrating IFNγ+ CD8+ T cells. CONCLUSIONS These data indicate that IL6 is upregulated in EGFR-mutant NSCLC tumors with acquired EGFR-TKI resistance and suppressed T- and NK-cell function. IL6 blockade enhanced antitumor immunity and efficacy of anti-PD-1 therapy warranting future clinical combinatorial investigations.
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Affiliation(s)
- Sonia A. Patel
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Monique B. Nilsson
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Yan Yang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Hai Tran
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Yasir Y. Elamin
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Xiaoxing Yu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Fahao Zhang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Alissa Poteete
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Xiaoyang Ren
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Li Shen
- Department of Bioinformatics and Computational Biology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Seyed Javad Moghaddam
- Department of Pulmonary Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Tina Cascone
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Michael Curran
- Department of Immunology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - Don L. Gibbons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
| | - John V. Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77130
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Enciso JS, Duran A, Tran H, Urey M, Adler E, White R, Kearns M, Pretorius V. Donor Characteristic Between Donor Circulatory Death and Donor Brain Death. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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13
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Barriola Rubarth R, Duran A, Sung K, Bui Q, McLenon M, Cruz Rodriguez J, Urey M, Adler E, Wettersten N, Kearns M, Pretorius V, Silva Enciso J, Tran H. Low Pulmonary Artery Pulsatility Index (PAPi) Early Post Heart Transplant is Associated with Short Term Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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14
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Pan B, Chao D, Feng Y, Tran H, Hogan Q. Monoacylglycerol Lipase Inhibitor Alleviates Pain Transiently Via Peripheral Mechanism And Pain-Induced Depression Long-Term Via Central Mechanism. The Journal of Pain 2023. [DOI: 10.1016/j.jpain.2023.02.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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15
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Duran A, Rubarth R, Agdashian D, Kumar A, Bui Q, McLenon M, Rodriguez JC, Urey M, Adler E, Wettersten N, Tran H, Kearns M, Pretorius V, Enciso JS. Early Graft Function by Hemodynamics is Similar Between Brain Death (DBD) and Circulatory Death Donors (DCD). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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16
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Lin A, Bui Q, Duran A, Gernhofer Y, White R, Sharaf K, Cookish D, Tran H, Hong K, Adler E, Wettersten N, Enciso JS, Urey M, Kearns M, Pretorius V. Impact of Dcd Donor Hearts on Transplant Outcomes: A Propensity-Matched Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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17
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Kearns M, Brann A, White R, Jackson B, Cookish D, Sharaf K, Huynh D, Gernhofer Y, Tran H, Urey M, Adler E, Pretorius V. A Single Center Comparison of DCD Heart Transplantation Using Two Procurement Strategies: Direct Procurement and Perfusion versus Normothermic Regional Perfusion. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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18
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Bui Q, Gernhofer Y, Duran A, Lin A, Ding J, Birs A, Ma G, White R, Sharaf K, Cookish D, Wettersten N, Rodriguez JC, Tran H, Hong K, Adler E, Enciso JS, Urey M, Kearns M, Pretorius V. One Year Cardiac Allograft Vasculopathy (cav) Outcomes in Donor after Circulatory Death (dcd) Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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19
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Bui TD, Pham ND, Phan-Nguyen TV, Vu-Thi LN, Tran VT, Nguyen VH, Nguyen MD, Tran H. Sinus arrest in familial hypokalemic periodic paralysis caused by SCN4A mutation: a case report. Eur Rev Med Pharmacol Sci 2023; 27:1767-1773. [PMID: 36930492 DOI: 10.26355/eurrev_202303_31538] [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] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Primary hypokalemic periodic paralysis (HypoPP), a rare skeletal muscle channelopathy resulting in episodic muscle weakness or paralysis under hypokalemic conditions, is caused by autosomal-dominant genetic mutations. HypoPP limits physical activity, and cardiac arrhythmias during paralytic attacks have been reported. We describe a rare familial HypoPP case complicated by sinus arrest and syncope requiring urgent temporary pacemaker implantation. CASE REPORT A 27-year-old Vietnamese man with a family history of periodic paralysis presented with his third attack of muscle weakness triggered by intense football training the previous day. Clinical and laboratory features justified a HypoPP diagnosis. During intravenous potassium replacement, the patient experienced syncopal sinus arrest requiring urgent temporary pacemaker implantation. The patient gradually improved, responding favorably to oral potassium supplements. Genetic testing revealed an Arg1132Gln mutation in the sodium ion channel (SCN4A, chromosome 17: 63947091). At discharge, the patient received expert consultation regarding nonpharmacological preventive strategies, including avoidance of vigorous exercise and carbohydrate-rich diet. CONCLUSIONS No evidence has established a relationship between hypokalemia and sinus arrest, and no specific treatment exists for familial HypoPP due to SCN4A mutation. Clinician awareness of this rare condition will promote appropriate diagnostic approaches and management strategies for acute paralytic attacks. Treatment should be tailored according to HypoPP phenotypes and genotypes.
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Affiliation(s)
- T-D Bui
- Department of Cardiology, University Medical Center HCMC, Ho Chi Minh City, Vietnam.
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20
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Nilsson MB, Yang Y, Heeke S, Patel SA, Poteete A, Udagawa H, Elamin YY, Moran CA, Kashima Y, Arumugam T, Yu X, Ren X, Diao L, Shen L, Wang Q, Zhang M, Robichaux JP, Shi C, Pfeil AN, Tran H, Gibbons DL, Bock J, Wang J, Minna JD, Kobayashi SS, Le X, Heymach JV. CD70 is a therapeutic target upregulated in EMT-associated EGFR tyrosine kinase inhibitor resistance. Cancer Cell 2023; 41:340-355.e6. [PMID: 36787696 PMCID: PMC10259078 DOI: 10.1016/j.ccell.2023.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/26/2022] [Accepted: 01/17/2023] [Indexed: 02/15/2023]
Abstract
Effective therapeutic strategies are needed for non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations that acquire resistance to EGFR tyrosine kinase inhibitors (TKIs) mediated by epithelial-to-mesenchymal transition (EMT). We investigate cell surface proteins that could be targeted by antibody-based or adoptive cell therapy approaches and identify CD70 as being highly upregulated in EMT-associated resistance. Moreover, CD70 upregulation is an early event in the evolution of resistance and occurs in drug-tolerant persister cells (DTPCs). CD70 promotes cell survival and invasiveness, and stimulation of CD70 triggers signal transduction pathways known to be re-activated with acquired TKI resistance. Anti-CD70 antibody drug conjugates (ADCs) and CD70-targeting chimeric antigen receptor (CAR) T cell and CAR NK cells show potent activity against EGFR TKI-resistant cells and DTPCs. These results identify CD70 as a therapeutic target for EGFR mutant tumors with acquired EGFR TKI resistance that merits clinical investigation.
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Affiliation(s)
- Monique B Nilsson
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yan Yang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Simon Heeke
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sonia A Patel
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Alissa Poteete
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hibiki Udagawa
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Division of Translational Genomics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Yasir Y Elamin
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Cesar A Moran
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yukie Kashima
- Division of Translational Genomics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Thiruvengadam Arumugam
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiaoxing Yu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiaoyang Ren
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lixia Diao
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Li Shen
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Qi Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Minying Zhang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jacqulyne P Robichaux
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Chunhua Shi
- Department of Biologics Development, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Allyson N Pfeil
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hai Tran
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Don L Gibbons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jason Bock
- Department of Oncology Research BIT, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - John D Minna
- Hamon Center for Therapeutic Oncology Research, Simmons Comprehensive Cancer Center, Department of Pharmacology, The University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Susumu S Kobayashi
- Division of Translational Genomics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - John V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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21
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Al-Falahi Z, Tran H, Middleton P, Basilakis J, Lo S, Dang V, Joseph V, Femia G, Nia A, Moore N, Houltham J, Silva R. Corrigendum to ‘Automation of Optical Coherence Tomography (OCT) Tissued Morphology and Vessel Sizing With Artificial Intelligence’ [Heart, Lung and Circulation volume 31 (2022) S321-S322]. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.11.005] [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: 12/24/2022]
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22
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Chao D, Tran H, Hogan QH, Pan B. Analgesic dorsal root ganglion field stimulation blocks both afferent and efferent spontaneous activity in sensory neurons of rats with monosodium iodoacetate-induced osteoarthritis. Osteoarthritis Cartilage 2022; 30:1468-1481. [PMID: 36030058 PMCID: PMC9588581 DOI: 10.1016/j.joca.2022.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/03/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Chronic joint pain is common in patients with osteoarthritis (OA). Non-steroidal anti-inflammatory drugs and opioids are used to relieve OA pain, but they are often inadequately effective. Dorsal root ganglion field stimulation (GFS) is a clinically used neuromodulation approach, although it is not commonly employed for patients with OA pain. GFS showed analgesic effectiveness in our previous study using the monosodium iodoacetate (MIA) - induced OA rat pain model. This study was to evaluate the mechanism of GFS analgesia in this model. METHODS After osteoarthritis was induced by intra-articular injection of MIA, pain behavioral tests were performed. Effects of GFS on the spontaneous activity (SA) were tested with in vivo single-unit recordings from teased fiber saphenous nerve, sural nerve, and dorsal root. RESULTS Two weeks after intra-articular MIA injection, rats developed pain-like behaviors. In vivo single unit recordings from bundles teased from the saphenous nerve and third lumbar (L3) dorsal root of MIA-OA rats showed a higher incidence of SA than those from saline-injected control rats. GFS at the L3 level blocked L3 dorsal root SA. MIA-OA reduced the punctate mechanical force threshold for inducing AP firing in bundles teased from the L4 dorsal root, which reversed to normal with GFS. After MIA-OA, there was increased retrograde SA (dorsal root reflex), which can be blocked by GFS. CONCLUSIONS These results indicate that GFS produces analgesia in MIA-OA rats at least in part by producing blockade of afferent inputs, possibly also by blocking efferent activity from the dorsal horn.
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Affiliation(s)
- D Chao
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - H Tran
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Q H Hogan
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - B Pan
- Department of Anesthesiology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA.
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Thai C, Tran V, Bui M, Nguyen D, Ninh H, Tran H. Real-time masked face classification and head pose estimation for RGB facial image via knowledge distillation. Inf Sci (N Y) 2022. [DOI: 10.1016/j.ins.2022.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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24
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Cannatà M, Russo R, Beghella Bartoli F, Palumbo I, Tran H, Votta C, Lupattelli M, Boldrini L, Dinapoli N, Camilli F, Balducci M, Gambacorta M, Valentini V, Aristei C, Sabatino G, Pignotti F, Gaudino S, Chiesa S. P02.11.B An hypothesis generating study of MRI-Derived Radiomics on tumor and microenvironment tissue heterogeneity to guide post-operative management of glioblastoma: toward personalized radiation treatment volume delineation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.104] [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: 11/14/2022] Open
Abstract
Abstract
Background
The glioblastoma’s bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification.The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigated the role of radiomic analysis in GBM management, to verify if radiomic features in the tissue around the resection cavity which may guide the radiation target volume delineation.
Material and Methods
We retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction.The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologist reviewed by a neuroradiologist, both with at least 10 years of experience. The Region of interest (ROI) considered for the analysis were: the surgical cavity +/- post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modelling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using the 226 features extracted from the Ring to perform a binary classification and predict the PFS at 6 months (statistical, morphological and textural features). A 3-fold cross-validation repeated five times was implemented for internal validation of the model.
Results
Two-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical test). The ROC curve of the model reported an AUC of 0.78 (95% CI: 0.68 - 0.88).
Conclusion
This is the first hypothesis-generating study who applies a radiomic analysis focusing on healthy tissue ring around the surgical cavity on post-operative MRI. This study provides a preliminary model for a decision support tool for a customization of the radiation target volume in GBM patients in order to achieve a margin reduction strategy.
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Affiliation(s)
- M Cannatà
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - R Russo
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - F Beghella Bartoli
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - I Palumbo
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - H Tran
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - C Votta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - M Lupattelli
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - L Boldrini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - N Dinapoli
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - F Camilli
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - M Balducci
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - M Gambacorta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - V Valentini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
| | - C Aristei
- Radiation Oncology Section, General Hospital , Perugia , Italy
| | - G Sabatino
- Radiation Oncology, Mater Olbia Hospital , 07026, Olbia , Italy
| | - F Pignotti
- Department of Neurosurgery, Mater Olbia Hospital , Olbia , Italy
| | - S Gaudino
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore , Roma , Italy
| | - S Chiesa
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Oncological Radiotherapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Roma , Italy
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Heeke S, Gay C, Estecio M, Stewart A, Tran H, Zhang B, Tang X, Raso M, Concannon K, De Sousa LG, Lewis W, Kondo K, Nilsson M, Xi Y, Diao L, Wang Q, Zhang J, Wang J, Wistuba I, Byers L, Heymach J. MA01.03 Exploiting DNA Methylation for Classification of SCLC Subtypes from Liquid Biopsies Using a Robust Machine Learning Approach. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kim S, Rebmann P, Tran H, Kellner E, Reisert M, Bamberg F, Kotter E, Russe M. Deep Learning zur Erkennung von Osteosynthesematerial, Hartverbänden und postoperativen Veränderungen am Beispiel des Sprunggelenks. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - P Rebmann
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg i. Br
| | - H Tran
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - E Kellner
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - M Reisert
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - F Bamberg
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - E Kotter
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
| | - M Russe
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg
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Elamin YY, Robichaux JP, Carter BW, Altan M, Tran H, Gibbons DL, Heeke S, Fossella FV, Lam VK, Le X, Negrao MV, Nilsson MB, Patel A, Vijayan RSK, Cross JB, Zhang J, Byers LA, Lu C, Cascone T, Feng L, Luthra R, San Lucas FA, Mantha G, Routbort M, Blumenschein G, Tsao AS, Heymach JV. Poziotinib for EGFR exon 20-mutant NSCLC: Clinical efficacy, resistance mechanisms, and impact of insertion location on drug sensitivity. Cancer Cell 2022; 40:754-767.e6. [PMID: 35820397 PMCID: PMC9667883 DOI: 10.1016/j.ccell.2022.06.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/14/2022] [Accepted: 06/14/2022] [Indexed: 02/06/2023]
Abstract
We report a phase II study of 50 advanced non-small cell lung cancer (NSCLC) patients with point mutations or insertions in EGFR exon 20 treated with poziotinib (NCT03066206). The study achieved its primary endpoint, with confirmed objective response rates (ORRs) of 32% and 31% by investigator and blinded independent review, respectively, with a median progression-free survival of 5.5 months. Using preclinical studies, in silico modeling, and molecular dynamics simulations, we found that poziotinib sensitivity was highly dependent on the insertion location, with near-loop insertions (amino acids A767 to P772) being more sensitive than far-loop insertions, an observation confirmed clinically with ORRs of 46% and 0% observed in near versus far-loop, respectively (p = 0.0015). Putative mechanisms of acquired resistance included EGFR T790M, MET amplifications, and epithelial-to-mesenchymal transition (EMT). Our data demonstrate that poziotinib is active in EGFR exon 20-mutant NSCLC, although this activity is influenced by insertion location.
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Affiliation(s)
- Yasir Y Elamin
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Jacqulyne P Robichaux
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Brett W Carter
- Department of Thoracic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Mehmet Altan
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Hai Tran
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Don L Gibbons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Simon Heeke
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Frank V Fossella
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Vincent K Lam
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA; Department of Medicine, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, MD 21287, USA
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Marcelo V Negrao
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Monique B Nilsson
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Anisha Patel
- Department of Dermatology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - R S K Vijayan
- Institute for Applied Cancer Science, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Jason B Cross
- Institute for Applied Cancer Science, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Jianjun Zhang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Lauren A Byers
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Charles Lu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Tina Cascone
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Lei Feng
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Rajyalakshmi Luthra
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Francis A San Lucas
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Geeta Mantha
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Mark Routbort
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - George Blumenschein
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - Anne S Tsao
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA
| | - John V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 432, PO Box 301402, 1500 Holcombe Boulevard, Houston, TX 77030, USA.
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Scott A, Kim P, Tran H, Kligerman S, Adler E, Contijoch F. 465 Free Wall And Septal Wall Right Ventricular Strain With Ct For Postoperative Right Ventricular Failure Risk. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.076] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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29
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Heeke S, Gay CM, Estecio MR, Stewart A, Tran H, Zhang B, Tang X, Raso G, Concannon K, De Sousa LG, Lewis WE, Nilsson M, Xi Y, Diao L, Wang Q, Zhang J, Wang J, Wistuba II, Byers LA, Heymach JV. Abstract 3473: Use of DNA methylation from tumor and plasma to identify four major small cell lung cancer subtypes with distinct biology and therapeutic vulnerabilities. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Small cell lung cancer (SCLC) is a highly aggressive cancer with limited treatment options and generally poor prognosis. Treatment of SCLC has not considerably changed over the last decades with therapeutic options focusing on unselected populations. Although in the past SCLC was thought to be a relatively homogenous malignancy, recent reports from our group and others identified four major distinct subgroups of SCLC, each with different therapeutic vulnerabilities. Three of the subtypes are defined by the expression of a specific transcription factor, ASCL1 (SCLC-A), NEUROD1 (SCLC-N) and POU2F3 (SCLC-P) while the fourth subtype is defined by an inflamed phenotype (SCLC-I). While our initial subtyping of SCLC is based on a gene expression signature comprised of ~1300 genes, which makes routine implementation challenging, we hypothesized that DNA methylation as a proxy to gene expression might be a more suitable approach for biomarker development in SCLC. We assembled a cohort of 105 SCLC formalin-fixed paraffin embedded (FFPE) samples (82/105 Stage > IIIb) and performed matched RNA-Sequencing (RNAseq) and methylation profiling using reduced-representation bisulfite sequencing (RRBS). To validate our findings and expand our analysis across different sample types, we profiled a panel of 59 fully characterized SCLC cell lines as well as 68 patient-derived xenograft models. We found that methylation levels differ markedly between the four subtypes, with the SCLC-N presenting with a hypermethylated phenotype and the SCLC-P with a hypomethylated phenotype across the genome, highlighting the profound differences in the underlying epigenetic regulation among the SCLC subtypes and supporting DNA methylation analysis as a potential readout for identifying SCLC subtypes. Furthermore, in order to subtype the clinical SCLC samples, we developed a predictive model using an extreme gradient boost model using RNA expression and DNA methylation, respectively, to allow the classification with 94.5% accuracy in the tissue testing cohort. Using a cohort of matched plasma samples, we further demonstrated that the DNA methylation differences were indeed preserved in cell-free DNA (cfDNA) allowing subtype classification with an accuracy of 87.5%. These data indicate that DNA methylation can be used for reliable subtyping of SCLC in tissue and in liquid biopsy samples. In summary, using a large cohort of predominantly extensive stage SCLC clinical samples, we were able to identify profound differences in DNA methylation that can be exploited as a novel biomarker for the classification of SCLC into four distinct subtypes with both tissue biopsy and non-invasive using plasma. Considering the previously shown therapeutic vulnerabilities of the four subtypes, these findings will enable the rapid initiation of personalized clinical trials in SCLC.
Citation Format: Simon Heeke, Carl M. Gay, Marcos R. Estecio, Allison Stewart, Hai Tran, Bingnan Zhang, Ximing Tang, Gabriela Raso, Kyle Concannon, Luana Guimaraes De Sousa, Whitney E. Lewis, Monique Nilsson, Yuanxin Xi, Lixia Diao, Qi Wang, Jianjun Zhang, Jing Wang, Ignacio I. Wistuba, Lauren A. Byers, John V. Heymach. Use of DNA methylation from tumor and plasma to identify four major small cell lung cancer subtypes with distinct biology and therapeutic vulnerabilities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3473.
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Affiliation(s)
| | | | | | | | - Hai Tran
- 1MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | | | | | | - Qi Wang
- 1MD Anderson Cancer Center, Houston, TX
| | | | - Jing Wang
- 1MD Anderson Cancer Center, Houston, TX
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Nilsson MB, Yang Y, Patel S, Heeke S, Le X, Aruguman T, Robichaux J, Yu X, Poteete A, Ren X, Diao L, Shen L, Wang Q, Zhang F, Clemente LC, Soto LS, Shi C, Tran H, Bock J, Wang J, Wistuba II, Minna JD, Heymach JV. Abstract 1827: CD70 is a novel therapeutic target for EGFR mutant NSCLC with acquired, EMT-associated EGFR TKI resistance. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Approximately 15% of all patients with non-small cell lung cancer (NSCLC) and nearly 35% of Asian patients with NSCLC harbor activating mutations within the epidermal growth factor receptor (EGFR). Although these patients are initially highly sensitive to first or second generation EGFR tyrosine kinase inhibitors (TKIs) including erlotinib or third-generation inhibitors including osimertinib, EGFR TKI-refractory disease inevitably emerges. While therapeutic strategies to target resistant disease that emerges though secondary EGFR mutations or MET amplification have been developed, there remains a void of therapeutic options for patients where resistance occurs through EGFR-independent mechanism such as epithelial to mesenchymal transition (EMT) or transformation to small cell lung cancer (SCLC). To identify cell surface proteins that could be targeted by antibody-based or adoptive cell therapy approaches we interrogated RNAseq data from EGFR mutant NSCLC cell lines (HCC827 and HCC4006) and their associated EGFR TKI resistant variants previously shown to have developed resistance through EMT and filtered gene expression data to include only genes which transcribed proteins localized to the cell surface. We identified CD70 as a being highly upregulated in EGFR TKI resistant cells (p = 7.2e-42). Given that CD70 expression is highly restricted and only transiently expressed on immune cells, CD70 was selected as a top candidate cell surface protein for targeting studies. Western blotting and flow cytometry analysis confirmed CD70 protein levels to be highly upregulated in EGFR TKI resistant cells that had undergone EMT but not in cells harboring secondary EGFR mutations or MET amplifications. We also observed CD70 upregulation in osimertinib-treated drug tolerant persister cells, indicating that CD70 upregulation is an early event in the evolution of TKI resistance. Moreover, patient-derived models of acquired EGFR TKI resistance also exhibited CD70 positivity. Our data also indicated that in EGFR mutant NSCLC cells, CD70 could be upregulated through decreased CD70 promoter methylation as well as by the EMT regulators, transforming growth factor-β (TGF-β) and ZEB1, both of which were upregulated in TKI resistant cells. In EGFR TKI resistant cells, CD70 knockdown impaired cell viability and invasiveness, and stimulation of CD70 using the exogenous binding partner CD27 resulted in activation of AKT and MAPK, pathways known to be re-activated with acquired TKI resistance. CD70-targeting approaches including anti-CD70 antibody drug conjugates (ADCs) and CD70-targeting CAR T cell and CAR NK cells showed promising in vitro and in vivo activity against CD70 positive tumor cells and in osimertinib drug-tolerant persister cells. These results identify CD70 as a novel therapeutic target for EGFR mutant tumors with acquired EGFR TKI resistance that merits further investigation in the clinic.
Citation Format: Monique B. Nilsson, Yan Yang, Sonia Patel, Simon Heeke, Xiuning Le, Thiru Aruguman, Jacqulyne Robichaux, Xiaoxing Yu, Alissa Poteete, Xiaoyang Ren, Lixia Diao, Li Shen, Qi Wang, Fahao Zhang, Leticia Campos Clemente, Luisa Solis Soto, Chunhua Shi, Hai Tran, Jason Bock, Jing Wang, Ignacio I. Wistuba, John D. Minna, John V. Heymach. CD70 is a novel therapeutic target for EGFR mutant NSCLC with acquired, EMT-associated EGFR TKI resistance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1827.
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Affiliation(s)
| | - Yan Yang
- 1MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | | | | | | - Li Shen
- 1MD Anderson Cancer Center, Houston, TX
| | - Qi Wang
- 1MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Hai Tran
- 1MD Anderson Cancer Center, Houston, TX
| | | | - Jing Wang
- 1MD Anderson Cancer Center, Houston, TX
| | | | - John D. Minna
- 2The University of Texas Southwestern Medical Center, Dallas, TX
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Le X, Wang R, Vokes N, Elamin Y, Kalhor N, McGrail D, Xi Y, III ST, Hong L, Du R, Blumenschein G, Gay C, Negrao M, Altan M, Tran H, Hu L, Wang J, Heeke S, Nilsson M, Robichaux J, Dang M, Han G, Byers L, Tsao A, Sepesi B, Bernatchez C, Zhang J, Wang L, Heymach J. Abstract 3260: Enhanced lineage plasticity in RTK-independent TKI-resistant EGFR-mutant NSCLC. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Resistance to targeted tyrosine kinase inhibitors (TKI) inevitably develops in metastatic EGFR-mutant non-small cell lung cancer (NSCLC). Resistance mechanisms are diverse, and mechanisms beyond receptor tyrosine kinase (RTK) pathway mutations are poorly understood. We hypothesized that the use of osimertinib as first-line therapy is increasing the prevalence of RTK-independent resistance mechanisms, and that RTK-independent resistant tumors undergo enhanced tumor cell lineage plasticity as an escape mechanism to EGFR TKI therapy.
Methods: We identified patients who developed osimertinib resistance (OR) after first line (1L, n=54) and second line (2L, n=42) treatments and determined the resistance mechanisms based on clinical sequencing and histopathology. We also performed single-cell RNA-seq of 24 samples from 13 patients with EGFRm NSCLC at TKI treatment-naïve (TN, n=2), residual disease (RD, n=4), and progression disease (PD, n=7) stages.
Results: Compared to 2L OR tumors, 1L OR tumors had increased RTK-independent mechanisms of resistance (76% vs. 46%, p=0.002), including 8% with small cell transformation (n=4), 2% with squamous transformation (n=1) and 66% with unknown mechanisms (n=34). To understand inter- and intra-tumor heterogeneity, we analyzed transcriptomic profiles of 76,266 single cells. Lung developmental lineages were assigned to 10,250 EpCAM+ cells, including 4,735 cells classified as malignant cells by inferCNV and RTK signaling analysis. In the two EGFRm TN tumors, the malignant cells demonstrated bronchoalveolar lineage and moderate EGFR expression. In the TKI resistant cases (PD, n=7), both RTK-dependent and RTK-independent resistance were observed. The RTK-dependent tumors (EGFR T790M n=1; ERBB2 amplification n=1) demonstrated preserved bronchoalveolar lineage identity. In the RTK-independent resistant tumors (n=5), one had complete lineage switch from epithelial to small cell neuroendocrine and very low expression level of EGFR. The remaining 4 PD tumors displayed varying expression of epithelial-to-mesenchymal transformation (EMT) features. One tumor had sarcomatoid histology and a high proportion of cells having positive VIM expression (84%) and 92% of cells having complete loss of NAPSA expression; 3 tumors had partial EMT demonstrated by heterogeneous proportion of cells having VIM expression (18-56%) and loss of NAPSA (26-67%). Interestingly, some of the cells with EMT and partial-EMT had moderate levels of EGFR expression, similar to the levels in the TN tumors.
Conclusion: With osimertinib use at 1L, the incidence of RTK-independent resistance has increased to become the dominant mechanism, whereas RTK-dependent resistance has decreased. Increased lineage plasticity (small cell neuroendocrine, squamous and EMT) potentially serves as an RTK-independent TKI-resistance mechanism in EGFRm NSCLC.
Citation Format: Xiuning Le, Ruiping Wang, Natalie Vokes, Yasir Elamin, Neda Kalhor, Daniel McGrail, Yuanxin Xi, Santiago Treviño III, Lingzhi Hong, Robyn Du, George Blumenschein, Carl Gay, Marcelo Negrao, Mehmet Altan, Hai Tran, Limei Hu, Jing Wang, Simon Heeke, Monique Nilsson, Jacqulyne Robichaux, Minghao Dang, Guangchun Han, Lauren Byers, Anne Tsao, Boris Sepesi, Chantale Bernatchez, Jianjun Zhang, Linghua Wang, John Heymach. Enhanced lineage plasticity in RTK-independent TKI-resistant EGFR-mutant NSCLC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3260.
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Affiliation(s)
- Xiuning Le
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | - Yuanxin Xi
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | - Robyn Du
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | - Carl Gay
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | - Hai Tran
- 1UT MD Anderson Cancer Center, Houston, TX
| | - Limei Hu
- 1UT MD Anderson Cancer Center, Houston, TX
| | - Jing Wang
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | - Anne Tsao
- 1UT MD Anderson Cancer Center, Houston, TX
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Xiao GY, Tan X, Rodriguez L, Liu X, Yu J, Vasquez M, Tran H, Russell W, Gibbons D, Kurie J. Abstract 673: The EMT activator ZEB1 initiates polarized secretion of pro-tumorigenic effector proteins to drive lung adenocarcinoma progression. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
There are few effective therapeutic options for metastatic lung adenocarcinomas (LUADs) that lack actionable mutations in receptor tyrosine kinases, and there is an urgent need to develop a better understanding of the biological basis of LUAD growth and metastasis. Our group has developed mouse models of LUAD metastasis and found that LUAD metastasis is epithelial-to-mesenchymal transition (EMT)-dependent. EMT causes cancer cells to switch their axis of polarity from apical-basal to front-rear, which orients organelles and actinbased cytoskeletal structures in ways that facilitate purposeful cancer cell motility and metastasis. The EMT-activating transcription factor ZEB1 silences microRNAs that target key inhibitors of the polarity axis switch. These data support the general belief that EMT-dependent metastasis is a cell-autonomous process. However, our new findings here show that ZEB1 coordinates the components of secretory trafficking machinery, Rab6A and Rab8A, via silencing miR-148a that target these effectors, to drive polarized secretory trafficking toward the leading edge of LUAD cells, to enhance surface exposure of MMP14 so that triggers ECM degradation, accelerates focal adhesion turnover and promotes cancer cell migration. Moreover, the ZEB1-driven secretory trafficking increases the secretions of cytokines and immunomodulation factors, to generate an immunosuppressive tumor microenvironment, and to promote LUAD metastasis. These findings advance a paradigm in which EMT drives LUAD metastasis through a cell non-autonomous mechanism. The novelty rests in our results that demonstrate a transcriptional governance of polarized vesicular transport, providing the potential to target ZEB1-driven secretory pathways for the purpose of blocking metastasis in LUAD.
Citation Format: Guan-Yu Xiao, Xiaochao Tan, Leticia Rodriguez, Xin Liu, Jiang Yu, Mayra Vasquez, Hai Tran, William Russell, Don Gibbons, Jonathan Kurie. The EMT activator ZEB1 initiates polarized secretion of pro-tumorigenic effector proteins to drive lung adenocarcinoma progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 673.
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Affiliation(s)
- Guan-Yu Xiao
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Xiaochao Tan
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Xin Liu
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jiang Yu
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mayra Vasquez
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hai Tran
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Don Gibbons
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jonathan Kurie
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
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Hong J, Tran H, Jeong J, Jang H, Yoon IY, Hong JK, Kim JW. 0348 Sleep Staging Using End-to-End Deep Learning Model Based on Nocturnal Sound for Smartphones. Sleep 2022. [DOI: 10.1093/sleep/zsac079.345] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Convenient sleep tracking with mobile devices such as smartphones is desirable for people who want to easily objectify their sleep. The objective of this study was to introduce a deep learning model for sound-based sleep staging using audio data recorded with smartphones during sleep.
Methods
Two different audio datasets were used. One (N = 1,154) was extracted from polysomnography (PSG) data and the other (N = 327) was recorded using a smartphone during PSG from independent subjects. The performance of sound-based sleep staging would always depend on the quality of the audio. In practical conditions (non-contact and smartphone microphones), breathing and body movement sounds during night are so weak that the energy of such signals is sometimes smaller than that of ambient noise. The audio was converted into Mel spectrogram to detect latent temporal frequency patterns of breathing and body movement sound from ambient noise. The proposed neural network model consisted of two sub-models. The first sub-model extracted features from each 30-second epoch Mel spectrogram and the second one classified sleep stages through inter-epoch analysis of extracted features.
Results
Our model achieved 70 % epoch-by-epoch agreement for 4-class (wake, light, deep, rapid eye movement) stage classification and robust performance across various signal-to-noise conditions. More precisely, the model was correct in 77% of wake, 73% of light, 46% of deep, and 66% of REM. The model performance was not considerably affected by existence of sleep apnea but degradation observed with severe periodic limb movement. External validation with smartphone dataset also showed 68 % epoch-by-epoch agreement. Compared with some commercially available sleep trackers such as Fitbit Alta HR (0.6325 in mean per-class sensitivity) and SleepScore Max (0.565 in mean per-class sensitivity), our model showed superior performance in both PSG audio (0.655 in mean per-class sensitivity) and smartphone audio (0.6525 in mean per-class sensitivity).
Conclusion
To the best of our knowledge, this is the first end (Mel spectrogram-based feature extraction)-to-end (sleep staging) deep learning model that can work with audio data in practical conditions. Our proposed deep learning model of sound-based sleep staging has potential to be integrated in smartphone application for reliable at-home sleep tracking.
Support (If Any)
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Brichko L, Van Breugel L, Underhill A, Tran H, Mitra B, Cameron P, Smit D, Giles ML, McCreary D, Paton A, O'Reilly G. The Impact of COVID-19 Vaccinations on Emergency Department Presentations. Emerg Med Australas 2022; 34:913-919. [PMID: 35475322 PMCID: PMC9111314 DOI: 10.1111/1742-6723.14012] [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: 12/06/2021] [Revised: 04/07/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022]
Abstract
Objective The aim of the present study was to describe the burden of patients presenting to the ED with symptoms occurring after receiving a COVID‐19 vaccination. Methods This was a retrospective cohort study performed over a 4‐month period across two EDs. Participants were eligible for inclusion if it was documented in the ED triage record that their ED attendance was associated with the receipt of a COVID‐19 vaccination. Data regarding the type of vaccine (Comirnaty or ChAdOx1) were subsequently extracted from their electronic medical record. Primary outcome was ED length of stay (LOS) and secondary outcomes included requests for imaging and ED disposition destination. Results During the study period of 22 February 2021 to 21 June 2021, 632 patients were identified for inclusion in the present study, of which 543 (85.9%) had received the ChAdOx1 vaccination. The highest proportion of COVID‐19 vaccine‐related attendances occurred in June 2021 and accounted for 21 (8%) of 262 total daily ED attendances. Patients who had an ED presentation related to ChAdOx1 had a longer median ED LOS (253 vs 180 min, P < 0.001) compared to Comirnaty and a higher proportion had haematology tests and imaging requested in the ED. Most patients (n = 588, 88.8%) were discharged home from the ED. Conclusion There was a notable proportion of ED attendances related to recent COVID‐19 vaccination administration, many of which were associated with lengthy ED stays and had multiple investigations. In the majority of cases, the patients were able to be discharged home from the ED.
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Affiliation(s)
- L Brichko
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,Emergency Department, Cabrini Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - L Van Breugel
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia
| | - A Underhill
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia
| | - H Tran
- Haematology Department, Alfred Hospital, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - B Mitra
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,National Trauma Research Institute, Melbourne, Australia
| | - P Cameron
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - D Smit
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,National Trauma Research Institute, Melbourne, Australia
| | - M L Giles
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.,Department of Infectious Diseases, Alfred Hospital, Melbourne, Australia
| | - D McCreary
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - A Paton
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,Adult Retrieval Victoria, Melbourne, Australia
| | - G O'Reilly
- The Alfred Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,National Trauma Research Institute, Melbourne, Australia
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Mohan SC, Siegel E, Tran H, Ozcan L, Alban R, Shariff S, Mirocha J, Chung A, Giuliano A, Dang C, Anand K, Shane R, Amersi F. Effects of paravertebral blocks versus liposomal bupivacaine on hospital utilization after mastectomy with reconstruction. Am J Surg 2022; 224:938-942. [DOI: 10.1016/j.amjsurg.2022.04.021] [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] [Received: 09/30/2021] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022]
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Lipinski J, Dharmavaram G, Cruz Rodriguez J, Urey M, Pretorius V, Adler E, Tran H. Normal Geriatric Nutritional Risk Index is Associated with Rehospitalization After Orthotopic Heart Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Brown M, Cruz Rodgriguez J, Duran J, Tran H, Urey M, Silva J, Winnike K, Topik A, Anguiano H, Kearns M, Pretorius V, Adler E. Outcomes in Cardiac Transplantation in Patients with a History of Methamphetamine Use: A Single Center Experience. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1668] [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: 10/18/2022] Open
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Frankul L, Ramirez-Sanchez C, Sigler R, Kozuch J, Law N, Tran H, Aslam S. Risk Factors for Invasive Fungal Infections in Heart Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1584] [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: 10/18/2022] Open
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Dharmavaram G, Lin A, Hannsun G, Nguyen V, Mendenhall M, Sirignano M, Adler E, Pretorius V, Tran H. Association of Fried's Frailty Score and Sarcopenia with Outcomes After Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1394] [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: 10/18/2022] Open
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Hoang S, Nguyen K, Huynh TM, Huynh K, Nguyen P, Tran H. Chest X-ray Severity Score as a Putative Predictor of Clinical Outcome in Hospitalized Patients: An Experience From a Vietnamese COVID-19 Field Hospital. Cureus 2022; 14:e23323. [PMID: 35464539 PMCID: PMC9015876 DOI: 10.7759/cureus.23323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 12/26/2022] Open
Abstract
Background Through the coronavirus disease 2019 (COVID-19) pandemic, portable radiography was particularly useful for assessing and monitoring the COVID-19 disease in Vietnamese field hospitals. It provides a convenient and precise picture of the progression of the disease. The purpose of this study was to evaluate the predictive value of chest radiograph reporting systems (Brixia and total severity score (TSS)) and the National Early Warning Score (NEWS) clinical score in a group of hospitalized patients with COVID-19. Methods This retrospective cohort study used routinely collected clinical data from polymerase chain reaction (PCR)-positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients admitted to Field Hospital District 8, Ho Chi Minh City, Vietnam, from August 2021 to September 2021. The initial chest radiographs were scored based on the TSS and Brixia scoring systems to quantify the extent of lung involvement. After the chest radiograph score was reported, two residents calculated the rate of all-cause in-hospital mortality with the consultation of expert radiologists. In this study, NEWS2 scores on hospital admission were calculated. The gradient boosting machines (GBMs) and Shapley additive exPlanations (SHAP) were applied to access the important variable and improve the accuracy of mortality prediction. The adjusted odds ratio for predictor was presented by univariate analysis and multivariate analysis. Results The chest X-rays (CXRs) at the admission of 273 patients (mean age 59 years +/-16, 42.1% were male) were scored. In the univariate analysis, age, vaccination status, previous disease, NEWS2, a saturation of peripheral oxygen (Sp02), the Brixia and TSS scores were significant predictors of mortality (p-value < 0.05). In multivariate analysis, there were statistically significant differences in mortality between age, Sp02, Brixia score, and patients with previous diseases were independent predictors of mortality and hospitalization. A gradient boosting machine was performed in the train data set, which showed that the best hyperparameters for predicting the mortality of patients are the Brixia score (exclude TSS score). In the top five predictors, an increase in Brixia, age, and BMI increased the logarithmic number of probability clarifying as death status. Although the TSS and Brixia scores evaluated chest imaging, the TSS score was not essential as the Brixia score (rank 6/11). It was clear that the BMI and NEWS2 score was positively correlated with the Brixia score, and age did not affect this correlation. Meanwhile, we did not find any trend between the TSS score versus BMI and NEWS2. Conclusion When integrated with the BMI and NEWS2 clinical classification systems, the severity score of COVID-19 chest radiographs, particularly the Brixia score, was an excellent predictor of all-cause in-hospital mortality.
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Abstract
Continuous ganglion block is increasingly being used to help manage ventricular tachyarrhythmias. We present the cases of 2 patients in whom we used continuous left thoracic paravertebral block to achieve sympathetic denervation and improvement in drug-refractory ventricular tachyarrhythmias. Whether as destination therapy or bridging therapy, we conclude that the block is safe, improves patients' comfort, and is superior in several ways to stellate ganglion block and other single-injection techniques.
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Affiliation(s)
- Daryl I Smith
- Acute Pain Service, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Sarah A Kralovic
- Acute Pain Service, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Rafeek A Hegazy
- Acute Pain Service, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Hai Tran
- Pediatric Anesthesiology Division, Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
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Al-Falahi Z, Tran H, Middleton P, Basilakis J, Lo S, Dang V, Joseph V, Fema G, Nia A, Moore N, Houltham J, Silva R. Automation of Optical Coherence Tomography (OCT) Tissued Morphology and Vessel Sizing With Artificial Intelligence. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.561] [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: 10/16/2022]
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Doan B, Nguyen C, Bui T, Tran T, Huynh H, Nguyen QT, Cu S, Nguyen LT, Tran C, Mai P, Tran H, Nguyen H. Synthesis of Conjugated Molecules Based on Dithienopyrrole Derivatives and Pyrene as Chemosensor for Mesotrione Detection. J BRAZIL CHEM SOC 2022. [DOI: 10.21577/0103-5053.20220031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The conjugated molecules based on pyrene and dithienopyrrole derivatives including 4-(2-ethylhexyl)-2-(pyren-1-yl)-4H-dithieno[3,2-b:2’,3’-d]pyrrole (EP4HP) and 4-(2-ethylhexyl)- 2,6-di(pyren-1-yl)-4H-dithieno[3,2-b:2’,3’-d]pyrrole (EDP4HP) have been successfully synthesized via C–H direct arylation reaction. The structures of these conjugated molecules were determined via nuclear magnetic resonance and Fourier-transform infrared spectroscopy (FTIR). The optical properties of conjugated molecules were evaluated via ultraviolet visible (UV-Vis) and fluorescence spectroscopies. The conjugated molecules exhibited the efficient fluorescence quenching toward herbicide mesotrione as nitroaromatic pesticides that could be promising candidates as the chemosensor for tracing of nitroaromatic pesticides.
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Tsuei M, Tran H, Roh S, Ober CK, Abbott NL. Using Liquid Crystals to Probe the Organization of Helical Polypeptide Brushes Induced by Solvent Pretreatment. Macromolecules 2021. [DOI: 10.1021/acs.macromol.1c01125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Tsuei
- Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Hai Tran
- Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Sangchul Roh
- Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Christopher K. Ober
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Nicholas L. Abbott
- Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853, United States
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Fahrmann JF, Katayama H, Irajizad E, Chakraborty A, Kato T, Mao X, Park S, Murage E, Rusling L, Yu CY, Cai Y, Hsiao FC, Dennison JB, Tran H, Ostrin E, Wilson DO, Yuan JM, Vykoukal J, Hanash S. Plasma Based Protein Signatures Associated with Small Cell Lung Cancer. Cancers (Basel) 2021; 13:cancers13163972. [PMID: 34439128 PMCID: PMC8391533 DOI: 10.3390/cancers13163972] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 02/04/2023] Open
Abstract
Small-cell-lung cancer (SCLC) is associated with overexpression of oncogenes including Myc family genes and YAP1 and inactivation of tumor suppressor genes. We performed in-depth proteomic profiling of plasmas collected from 15 individuals with newly diagnosed early stage SCLC and from 15 individuals before the diagnosis of SCLC and compared findings with plasma proteomic profiles of 30 matched controls to determine the occurrence of signatures that reflect disease pathogenesis. A total of 272 proteins were elevated (area under the receiver operating characteristic curve (AUC) ≥ 0.60) among newly diagnosed cases compared to matched controls of which 31 proteins were also elevated (AUC ≥ 0.60) in case plasmas collected within one year prior to diagnosis. Ingenuity Pathway analyses of SCLC-associated proteins revealed enrichment of signatures of oncogenic MYC and YAP1. Intersection of proteins elevated in case plasmas with proteomic profiles of conditioned medium from 17 SCLC cell lines yielded 52 overlapping proteins characterized by YAP1-associated signatures of cytoskeletal re-arrangement and epithelial-to-mesenchymal transition. Among samples collected more than one year prior to diagnosis there was a predominance of inflammatory markers. Our integrated analyses identified novel circulating protein features in early stage SCLC associated with oncogenic drivers.
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Affiliation(s)
- Johannes F. Fahrmann
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Hiroyuki Katayama
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Ehsan Irajizad
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Ashish Chakraborty
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Taketo Kato
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Xiangying Mao
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Soyoung Park
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Eunice Murage
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Leona Rusling
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Chuan-Yih Yu
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Yinging Cai
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Fu Chung Hsiao
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Jennifer B. Dennison
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Hai Tran
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA;
| | - Edwin Ostrin
- Department of Pulmonary Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA;
| | - David O. Wilson
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA 15232, USA;
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Jody Vykoukal
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
| | - Samir Hanash
- Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA; (J.F.F.); (H.K.); (E.I.); (A.C.); (T.K.); (X.M.); (S.P.); (E.M.); (L.R.); (C.-Y.Y.); (Y.C.); (F.C.H.); (J.B.D.); (J.V.)
- Correspondence:
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Patel SA, Herynk MH, Cascone T, Saigal B, Nilsson MB, Tran H, Ramachandran S, Diao L, Wang J, Le X, Minna J, Wistuba II, Heymach JV. Estrogen Promotes Resistance to Bevacizumab in Murine Models of NSCLC. J Thorac Oncol 2021; 16:2051-2064. [PMID: 34311109 DOI: 10.1016/j.jtho.2021.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Subgroup analyses from clinical studies have suggested that among patients with metastatic NSCLC receiving chemotherapy, females may derive less benefit from the addition of the vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (BV) than males. This has raised the question of whether estrogen may affect the response to antiangiogenic therapy. METHODS To address this, we investigated the effects of estrogen on tumor growth, angiogenesis, and the response to BV in human xenograft models of NSCLC. RESULTS We observed that estrogen induced marked resistance to BV, which was accompanied by a 2.3-fold increase in tumor vascular pericyte coverage (p = 0.01) and an up-regulation of proangiogenic factors, VEGF and platelet-derived growth factor-BB. We also investigated the role of infiltrating myeloid cells, a population that has been associated with resistance to anti-VEGF therapies. We observed that estrogen induced a greater than twofold increase (p = 0.001) in the recruitment of tumor-infiltrating myeloid cells and concomitant increases in the myeloid recruitment factors, G-CSF and CXCL1. Blockade of the estrogen receptor pathway using fulvestrant resensitized tumors to VEGF targeting as evidenced by reduced tumor vasculature and an increase in overall survival in our NSCLC xenograft models. CONCLUSIONS Collectively, these data provide evidence that estrogen may promote resistance to VEGF-targeted therapies, potentially by enhancing pericyte coverage and myeloid recruitment, and suggest that estrogen receptor blockade merits further investigation as an approach to enhance the effects of antiangiogenic therapy.
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Affiliation(s)
- Sonia A Patel
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matthew H Herynk
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tina Cascone
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Babita Saigal
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Monique B Nilsson
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hai Tran
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sumankalai Ramachandran
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lixia Diao
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John Minna
- Hamon Center for Therapeutic Oncology Research, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas; Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Lee Y, McGrail D, Tran H, Vasquez ME, Ramos C, Reuben A, Vaporciyan AA, Weissferdt A, Bernatchez C, Cascone T, Wistuba II, Zhang J, Heymach J, Negrao MV, Gibbons DL, Sepesi B, Haymaker CL. Abstract 1670: Circulating biomarkers are associated with recurrence following complete resection of non-small cell lung cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We have previously demonstrated that the presence of a proinflammatory peripheral cytokine milieu correlates with high levels of circulating neutrophils at the time of surgery and reduced overall survival and recurrence-free survival. In this study, we hypothesized that functional immune features or states in circulation may indicate early tumor recurrence when assessed longitudinally. We also investigated whether potential deficiencies in peripheral immune functionality at the time of lung cancer resection could identify correlates with subsequent outcome.
Methods: We performed flow cytometry and luminex profiling of blood samples collected from patients with stage I-IIIA resected NSCLC (n=150) and enrolled on the Immunogenomic profiling of NSCLC (ICON) prospective protocol. Patient characteristics include 75 adenocarcinomas, 30 squamous and 12 mixed or other histologies. Only patients who underwent primary cancer resection without neoadjuvant therapy were included. At a median follow up of 18.2 months, 37 patients had disease recurrence. Blood was collected at the time of primary lung cancer resection, at 4 weeks, and 4 months thereafter with PBMCs utilized for flow cytometry and plasma for cytokine assessment. Changes in cytokines were assessed by normalizing to baseline levels.
Results: Larger tumors as well as advanced clinical and pathological stages were associated with higher frequencies of proliferating Ki67+CD4+ and Ki67+CD8+ T cells in circulation at time of resection, suggesting an activated circulating immune response. We identified novel strong correlations in the plasma between soluble BTLA and Tim3 (r= 0.87, p=1.74e-140), PD1 and CD80 (r=0.72, p=6.41e-74) and moderate correlations between soluble PD1 and PDL1 (r=0.39, p=8.41e-18). Efforts are ongoing to determine the association of specific circulating immune states with the presence of these soluble receptors. CD8+Tim3+ T cells (FC=5.2%, p=0.028) and CTLA4+NK cells (FC=47.7%, p=0.002) as well as CTLA4+Tregs (FC=25.2%, p=0.05) were found to be increased in circulation at pre-recurrence time points (either 4 weeks or 4 months) relative to resection. This suggests the emergence of a suppressive cell type as well as induction of specific checkpoint receptors on effector cells that correlate with tumor recurrence. Finally, we identified a cytokine signature associated with recurrence by testing three sets within the ICON cohort with a training set AUC = 0.76 and the test set AUC=0.72, which was validated in a third set of patients yielding an AUC = 0.76.
Conclusions: We identified circulating immune features associated with initial tumor size and overall stage as well as unique associations among soluble proteins. Increased presence of potentially inhibited or suppressed CD8+ T cells and NK cells as well as Tregs are suggestive of mechanisms of immune suppression relative to tumor recurrence.
Citation Format: Younghee Lee, Daniel McGrail, Hai Tran, Mayra E. Vasquez, Carlos Ramos, Alexandre Reuben, Ara A. Vaporciyan, Annikka Weissferdt, Chantale Bernatchez, Tina Cascone, Ignacio I. Wistuba, Jianjun Zhang, John Heymach, Marcelo V. Negrao, Don L. Gibbons, Boris Sepesi, Cara L. Haymaker. Circulating biomarkers are associated with recurrence following complete resection of non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1670.
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Affiliation(s)
- Younghee Lee
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Daniel McGrail
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hai Tran
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Carlos Ramos
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Tina Cascone
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jianjun Zhang
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - John Heymach
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Don L. Gibbons
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Boris Sepesi
- University of Texas MD Anderson Cancer Center, Houston, TX
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Nilsson MB, Sun H, Robichaux J, Pfeifer M, McDermott U, Travers J, Diao L, Xi Y, Tong P, Shen L, Hofstad M, Kawakami M, Le X, Liu X, Fan Y, Poteete A, Hu L, Negrao MV, Tran H, Dmitrovsky E, Peng D, Gibbons DL, Wang J, Heymach JV. A YAP/FOXM1 axis mediates EMT-associated EGFR inhibitor resistance and increased expression of spindle assembly checkpoint components. Sci Transl Med 2021; 12:12/559/eaaz4589. [PMID: 32878980 DOI: 10.1126/scitranslmed.aaz4589] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 05/05/2020] [Accepted: 07/17/2020] [Indexed: 12/12/2022]
Abstract
Acquired resistance to tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) remains a clinical challenge. Especially challenging are cases in which resistance emerges through EGFR-independent mechanisms, such as through pathways that promote epithelial-to-mesenchymal transition (EMT). Through an integrated transcriptomic, proteomic, and drug screening approach, we identified activation of the yes-associated protein (YAP) and forkhead box protein M1 (FOXM1) axis as a driver of EMT-associated EGFR TKI resistance. EGFR inhibitor resistance was associated with broad multidrug resistance that extended across multiple chemotherapeutic and targeted agents, consistent with the difficulty of effectively treating resistant disease. EGFR TKI-resistant cells displayed increased abundance of spindle assembly checkpoint (SAC) proteins, including polo-like kinase 1 (PLK1), Aurora kinases, survivin, and kinesin spindle protein (KSP). Moreover, EGFR TKI-resistant cells exhibited vulnerability to SAC inhibitors. Increased activation of the YAP/FOXM1 axis mediated an increase in the abundance of SAC components in resistant cells. The clinical relevance of these finding was indicated by evaluation of specimens from patients with EGFR mutant lung cancer, which showed that high FOXM1 expression correlated with expression of genes encoding SAC proteins and was associated with a worse clinical outcome. These data revealed the YAP/FOXM1 axis as a central regulator of EMT-associated EGFR TKI resistance and that this pathway, along with SAC components, are therapeutic vulnerabilities for targeting this multidrug-resistant phenotype.
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Affiliation(s)
- Monique B Nilsson
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Huiying Sun
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jacqulyne Robichaux
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | - Jon Travers
- Oncology R&D, AstraZeneca, Cambridge, CB2 0RE, UK
| | - Lixia Diao
- Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yuanxin Xi
- Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Pan Tong
- Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Li Shen
- Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mia Hofstad
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Masanori Kawakami
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiuning Le
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xi Liu
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Youhong Fan
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Alissa Poteete
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Limei Hu
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Marcelo V Negrao
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hai Tran
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ethan Dmitrovsky
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - David Peng
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Don L Gibbons
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jing Wang
- Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - John V Heymach
- Departments of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Huang Y, Tran H, Ober CK. High-Resolution Nanopatterning of Free-Standing, Self-Supported Helical Polypeptide Rod Brushes via Electron Beam Lithography. ACS Macro Lett 2021; 10:755-759. [PMID: 35549094 DOI: 10.1021/acsmacrolett.1c00187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In this study of nanopatterned helical poly(benzyl-l-glutamate) (PBLG) brushes, rod-type brush arrays were fabricated via an integrated process of high-resolution lithography and surface-initiated vapor deposition polymerization (SI-VDP). "Nanospikes" of polymer brushes with spacings of less than 100 nm were produced. The topology and areal behavior of the resulting patterned rod-like brushes were analyzed and compared with patterned coil-type brushes. A geometric study of these self-assembled "nanospikes" was carried out, and their cross sections were investigated via focused ion beam (FIB) and scanning electron microscopy (SEM). Furthermore, the presence of poly(N-isopropylacrylamide) (PNIPAM) brushes in unpatterned regions was shown to inhibit undesired "inter-spike" bridging of the PBLG brushes, resulting in more well-defined nanostructures. It was shown that rod-like polypeptide brushes are capable of self-segregation and become arranged vertically without any external support from their surroundings, to form a rod bundle end-point functional topography that could provide possible pathways for studies of model biological surfaces, directed assembly of nanoparticles, or binary mixed brush surfaces with dual properties.
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Yu G, Segel I, Tran H, Park HJ, Ross E, Hogan QH, Pan B. Analgesic Effects of Tonic and Burst Dorsal Root Ganglion Stimulation in Rats With Painful Tibial Nerve Injury. Neuromodulation 2021; 25:970-979. [PMID: 34096146 DOI: 10.1111/ner.13472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Dorsal root ganglion (DRG) stimulation is effective in treating chronic pain. While burst stimulation has been proven to enhance the therapeutic efficacy in spinal cord stimulation, currently only a tonic stimulation waveform is clinically used in DRG stimulation. We hypothesized that burst DRG stimulation might also produce analgesic effect in a preclinical neuropathic pain model. We evaluated both the therapeutic effects of burst DRG stimulation and the possible effects of DRG stimulation upon inflammation within the DRG in a preclinical neuropathic pain model. MATERIALS AND METHODS Rats received either a painful tibial nerve injury or sham surgery. Analgesic effects of DRG stimulation were evaluated by testing a battery of evoked pain-related behaviors as well as measuring the positive affective state associated with relief of spontaneous pain using conditioned place preference. Histological evidence for neuronal trauma or neuroinflammation was evaluated. RESULTS All of the waveforms tested (20 Hz-tonic, 20 Hz-burst, and 40 Hz-burst) have similar analgesic effects in sensory tests and conditioned place preference. Long-term DRG stimulation for two weeks does not change DRG expression of markers for nerve injury and neuroinflammation. CONCLUSIONS DRG stimulation using burst waveform might be also suitable for treating neuropathic pain.
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Affiliation(s)
- Guoliang Yu
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Ian Segel
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Hai Tran
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | | | - Erika Ross
- Abbott Neuromodulation, Plano, TX, 75024, USA
| | - Quinn H Hogan
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Bin Pan
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
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