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Coombes RC, Badman PD, Lozano-Kuehne JP, Liu X, Macpherson IR, Zubairi I, Baird RD, Rosenfeld N, Garcia-Corbacho J, Cresti N, Plummer R, Armstrong A, Allerton R, Landers D, Nicholas H, McLellan L, Lim A, Mouliere F, Pardo OE, Ferguson V, Seckl MJ. Author Correction: Results of the phase IIa RADICAL trial of the FGFR inhibitor AZD4547 in endocrine resistant breast cancer. Nat Commun 2023; 14:260. [PMID: 36650166 PMCID: PMC9845345 DOI: 10.1038/s41467-023-35969-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- R C Coombes
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - P D Badman
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - J P Lozano-Kuehne
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - X Liu
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - I R Macpherson
- Cancer Research UK Clinical Trials Unit, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - I Zubairi
- Cancer Research UK Clinical Trials Unit, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - R D Baird
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
| | - N Rosenfeld
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
| | - J Garcia-Corbacho
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
| | - N Cresti
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Newcastle, UK
| | - R Plummer
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Newcastle, UK
| | - A Armstrong
- Breast Research Office, The Christie NHS Foundation Trust, Christie Hospital, Manchester, UK
| | - R Allerton
- C8 Admin Offices, Russell's Hall Hospital, Russells Hall, UK
| | | | - H Nicholas
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - L McLellan
- ECMC Programme Office, Research and Innovation, Cancer Research UK, London, UK
| | - A Lim
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - F Mouliere
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pathology, Cancer Centre Amsterdam, Amsterdam, The Netherlands
| | - O E Pardo
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - V Ferguson
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - M J Seckl
- Department of Surgery and Cancer, Imperial College London, London, UK.
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Coombes RC, Badman PD, Lozano-Kuehne JP, Liu X, Macpherson IR, Zubairi I, Baird RD, Rosenfeld N, Garcia-Corbacho J, Cresti N, Plummer R, Armstrong A, Allerton R, Landers D, Nicholas H, McLellan L, Lim A, Mouliere F, Pardo OE, Ferguson V, Seckl MJ. Results of the phase IIa RADICAL trial of the FGFR inhibitor AZD4547 in endocrine resistant breast cancer. Nat Commun 2022; 13:3246. [PMID: 35688802 PMCID: PMC9187670 DOI: 10.1038/s41467-022-30666-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/12/2022] [Indexed: 01/21/2023] Open
Abstract
We conducted a phase IIa, multi-centre, open label, single arm study (RADICAL; NCT01791985) of AZD4547 (a potent and selective inhibitor of Fibroblast Growth Factor Receptor (FGFR)-1, 2 and 3 receptor tyrosine kinases) administered with anastrozole or letrozole in estrogen receptor positive metastatic breast cancer patients who had become resistant to aromatase inhibitors. After a safety run-in study to assess safety and tolerability, we recruited 52 patients. The primary endpoint was change in tumour size at 12 weeks, and secondary endpoints were to assess response at 6 weeks, 20 weeks and every 8 weeks thereafter and tolerability of the combined treatment. Two partial responses (PR) and 19 stable disease (SD) patients were observed at the 12-week time point. At 28 weeks, according to centrally reviewed Response Evaluation Criteria in Solid Tumours (RECIST) criteria, five PR and 8 SD patients were observed in 50 assessable cases. Overall, objective response rate (5 PR) was of 10%, meeting the pre-specified endpoint. Fourteen patients discontinued due to adverse events. Eleven patients had retinal pigment epithelial detachments which was asymptomatic and reversible in all but one patient. Exploratory ribonucleic acid sequencing (RNA-Seq) analysis was done on patients' samples: 6 differentially-expressed-genes could distinguish those who benefited from the addition of AZD4547.
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Affiliation(s)
- R C Coombes
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - P D Badman
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - J P Lozano-Kuehne
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - X Liu
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - I R Macpherson
- Cancer Research UK Clinical Trials Unit, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - I Zubairi
- Cancer Research UK Clinical Trials Unit, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - R D Baird
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
| | - N Rosenfeld
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
| | - J Garcia-Corbacho
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
| | - N Cresti
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Newcastle, UK
| | - R Plummer
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Freeman Hospital, Newcastle, UK
| | - A Armstrong
- Breast Research Office, The Christie NHS Foundation Trust, Christie Hospital, Manchester, UK
| | - R Allerton
- C8 Admin Offices, Russell's Hall Hospital, Russells Hall, UK
| | | | - H Nicholas
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - L McLellan
- ECMC Programme Office, Research and Innovation, Cancer Research UK, London, UK
| | - A Lim
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - F Mouliere
- Medical Oncology, Addenbrooke's Hospital, Breast Cancer Research Unit, Cancer Research UK Cambridge Centre, Cambridge, UK
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pathology, Cancer Centre Amsterdam, Amsterdam, The Netherlands
| | - O E Pardo
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - V Ferguson
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - M J Seckl
- Department of Surgery and Cancer, Imperial College London, London, UK.
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Gale D, Heider K, Ruiz-Valdepenas A, Hackinger S, Perry M, Marsico G, Rundell V, Wulff J, Sharma G, Knock H, Castedo J, Cooper W, Zhao H, Smith CG, Garg S, Anand S, Howarth K, Gilligan D, Harden SV, Rassl DM, Rintoul RC, Rosenfeld N. Residual ctDNA after treatment predicts early relapse in patients with early-stage non-small cell lung cancer. Ann Oncol 2022; 33:500-510. [PMID: 35306155 PMCID: PMC9067454 DOI: 10.1016/j.annonc.2022.02.007] [Citation(s) in RCA: 115] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Identification of residual disease in patients with localized non-small cell lung cancer (NSCLC) following treatment with curative intent holds promise to identify patients at risk of relapse. New methods can detect circulating tumour DNA (ctDNA) in plasma to fractional concentrations as low as a few parts per million, and clinical evidence is required to inform their use. PATIENTS AND METHODS We analyzed 363 serial plasma samples from 88 patients with early-stage NSCLC (48.9%/28.4%/22.7% at stage I/II/III), predominantly adenocarcinomas (62.5%), treated with curative intent by surgery (n = 61), surgery and adjuvant chemotherapy/radiotherapy (n = 8), or chemoradiotherapy (n = 19). Tumour exome sequencing identified somatic mutations and plasma was analyzed using patient-specific RaDaR™ assays with up to 48 amplicons targeting tumour-specific variants unique to each patient. RESULTS ctDNA was detected before treatment in 24%, 77% and 87% of patients with stage I, II and III disease, respectively, and in 26% of all longitudinal samples. The median tumour fraction detected was 0.042%, with 63% of samples <0.1% and 36% of samples <0.01%. ctDNA detection had clinical specificity >98.5% and preceded clinical detection of recurrence of the primary tumour by a median of 212.5 days. ctDNA was detected after treatment in 18/28 (64.3%) of patients who had clinical recurrence of their primary tumour. Detection within the landmark timepoint 2 weeks to 4 months after treatment end occurred in 17% of patients, and was associated with shorter recurrence-free survival [hazard ratio (HR): 14.8, P <0.00001] and overall survival (HR: 5.48, P <0.0003). ctDNA was detected 1-3 days after surgery in 25% of patients yet was not associated with disease recurrence. Detection before treatment was associated with shorter overall survival and recurrence-free survival (HR: 2.97 and 3.14, P values 0.01 and 0.003, respectively). CONCLUSIONS ctDNA detection after initial treatment of patients with early-stage NSCLC using sensitive patient-specific assays has potential to identify patients who may benefit from further therapeutic intervention.
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Affiliation(s)
- D Gale
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - K Heider
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - A Ruiz-Valdepenas
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - S Hackinger
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - M Perry
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - G Marsico
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - V Rundell
- Cambridge Clinical Trials Unit - Cancer Theme, Cambridge, UK
| | - J Wulff
- Cambridge Clinical Trials Unit - Cancer Theme, Cambridge, UK
| | - G Sharma
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - H Knock
- Cambridge Clinical Trials Unit - Cancer Theme, Cambridge, UK
| | - J Castedo
- Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - W Cooper
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - H Zhao
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - C G Smith
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - S Garg
- Cancer Molecular Diagnostics Laboratory, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - S Anand
- Cancer Molecular Diagnostics Laboratory, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - K Howarth
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - D Gilligan
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK; Addenbrooke's Hospital, Cambridge, UK
| | | | - D M Rassl
- Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - R C Rintoul
- Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK.
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4
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Succony L, Rosenfeld N, Rintoul RC. Multimodality Approaches to Screening for Lung Cancer. Clin Oncol (R Coll Radiol) 2019; 31:702-705. [PMID: 31444024 DOI: 10.1016/j.clon.2019.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/31/2019] [Indexed: 01/19/2023]
Affiliation(s)
- L Succony
- Department of Thoracic Oncology, Royal Papworth Hospital, Cambridge, UK
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - R C Rintoul
- Department of Oncology, University of Cambridge, Cambridge, UK.
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5
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Remon J, Jovelet C, Lacroix L, Planchard D, Mezquita L, Howarth K, Green E, Plagnol V, Morris C, Rosenfeld N, Caramella C, Lepéchoux C, Aboubakar Nana F, Botticella A, Adam J, Ferrara R, Gazzah A, Ngocamus M, Soria J, Besse B. P2.13-24 Prospective Efficacy of Osimertinib in Circulating Tumour DNA (ctDNA) T790M-Mutant NSCLC Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1419] [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: 11/29/2022]
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Moore E, Chandrananda D, Piskorz A, Mouliere F, Goranova T, Addley H, Crawford R, Parkinson C, Rosenfeld N, Brenton J. PO-483 Improved sensitivity for non-invasive diagnosis of high-grade serous ovarian cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.985] [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: 11/04/2022] Open
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Abstract
Molecular profiling has changed the treatment landscape in advanced non-small-cell lung cancer. Accurately identifying the tumours that harbour sensitizing EGFR mutations, the most common targetable molecular alteration, as well as those with acquired resistance mutations (e.g. T790M) on treatment is a high clinical priority. The current clinical gold standard is genotyping of tumour specimens. However, the practical utility of this approach is limited by the lack of available tissue and the potential complications associated with biopsies. With the advent of newer sequencing assays, it has become feasible to assess tumour genomics via a blood sample, termed a 'liquid biopsy'. In this review, we summarize the available techniques for liquid biopsies and their applicability for detecting sensitizing and resistance EGFR mutations and how these results may be used for making treatment decisions.
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Affiliation(s)
- J W Goldman
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
| | - Z S Noor
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
| | - J Remon
- Department of Oncology Medicine, Gustave Roussy, Villejuif
| | - B Besse
- Department of Oncology Medicine, Gustave Roussy, Villejuif
- University Paris-Sud, Orsay, France
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge
- Cancer Research UK Major Centre - Cambridge, Cambridge, UK
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8
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Fribbens C, Garcia Murillas I, Beaney M, Hrebien S, O'Leary B, Kilburn L, Howarth K, Epstein M, Green E, Rosenfeld N, Ring A, Johnston S, Turner N. Tracking evolution of aromatase inhibitor resistance with circulating tumour DNA analysis in metastatic breast cancer. Ann Oncol 2018; 29:145-153. [PMID: 29045530 PMCID: PMC6264798 DOI: 10.1093/annonc/mdx483] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background Selection of resistance mutations may play a major role in the development of endocrine resistance. ESR1 mutations are rare in primary breast cancer but have high prevalence in patients treated with aromatase inhibitors (AI) for advanced breast cancer. We investigated the evolution of genetic resistance to the first-line AI therapy using sequential ctDNA sampling in patients with advanced breast cancer. Patients and methods Eighty-three patients on the first-line AI therapy for metastatic breast cancer were enrolled in a prospective study. Plasma samples were collected every 3 months to disease progression and ctDNA analysed by digital droplet PCR and enhanced tagged-amplicon sequencing (eTAm-Seq). Mutations identified in progression samples by sequencing were tracked back through samples before progression to study the evolution of mutations on therapy. The frequency of novel mutations was validated in an independent cohort of available baseline plasma samples in the Study of Faslodex versus Exemestane with or without Arimidex (SoFEA) trial, which enrolled patients with prior sensitivity to AI. Results Of the 39 patients who progressed on the first-line AI, 56.4% (22/39) had ESR1 mutations detectable at progression, which were polyclonal in 40.9% (9/22) patients. In serial tracking, ESR1 mutations were detectable median 6.7 months (95% confidence interval 3.7-NA) before clinical progression. Utilising eTAm-Seq ctDNA sequencing of progression plasma, ESR1 mutations were demonstrated to be sub-clonal in 72.2% (13/18) patients. Mutations in RAS genes were identified in 15.4% (6/39) of progressing patients (4 KRAS, 1 HRAS, 1 NRAS). In SoFEA, KRAS mutations were detected in 21.2% (24/113) patients although there was no evidence that KRAS mutation status was prognostic for progression free or overall survival. Conclusions Cancers progressing on the first-line AI show high levels of genetic heterogeneity, with frequent sub-clonal mutations. Sub-clonal KRAS mutations are found at high frequency. The genetic diversity of AI resistant cancers may limit subsequent targeted therapy approaches.
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Affiliation(s)
- C Fribbens
- Breast Cancer Now Research Centre, Institute of Cancer Research, London, UK
- Breast Unit, Royal Marsden Hospital, London, UK
| | - I Garcia Murillas
- Breast Cancer Now Research Centre, Institute of Cancer Research, London, UK
| | - M Beaney
- Breast Cancer Now Research Centre, Institute of Cancer Research, London, UK
| | - S Hrebien
- Breast Cancer Now Research Centre, Institute of Cancer Research, London, UK
| | - B O'Leary
- Breast Cancer Now Research Centre, Institute of Cancer Research, London, UK
| | - L Kilburn
- Institute of Cancer Research Clinical Trials & Statistics Unit (ICR-CTSU), London, UK
| | - K Howarth
- Inivata Ltd., The Portway, Granta Park, Great Abington, UK
| | - M Epstein
- Inivata Ltd., The Portway, Granta Park, Great Abington, UK
| | - E Green
- Inivata Ltd., The Portway, Granta Park, Great Abington, UK
| | - N Rosenfeld
- Inivata Ltd., The Portway, Granta Park, Great Abington, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre, Robinson Way, Cambridge, UK
| | - A Ring
- Breast Unit, Royal Marsden Hospital, London, UK
| | - S Johnston
- Breast Unit, Royal Marsden Hospital, London, UK
| | - N Turner
- Breast Cancer Now Research Centre, Institute of Cancer Research, London, UK
- Breast Unit, Royal Marsden Hospital, London, UK
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9
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Ruiz-Valdepenas A, Heider K, Doughton G, Qian W, Massie C, Chandrananda D, Smith C, Gale D, Moseley E, Castedo C, Stone A, Thorbinson C, Eisen T, Rassl D, Harden S, Rintoul R, Rosenfeld N. MA 11.02 Circulating Tumor DNA in Early Stage NSCLC: High Sensitivity Analysis in Low Burden Disease. LUCID Study Update. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Patel KM, van der Vos KE, Smith CG, Mouliere F, Tsui D, Morris J, Chandrananda D, Marass F, van den Broek D, Neal DE, Gnanapragasam VJ, Forshew T, van Rhijn BW, Massie CE, Rosenfeld N, van der Heijden MS. Association Of Plasma And Urinary Mutant DNA With Clinical Outcomes In Muscle Invasive Bladder Cancer. Sci Rep 2017; 7:5554. [PMID: 28717136 PMCID: PMC5514073 DOI: 10.1038/s41598-017-05623-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/31/2017] [Indexed: 01/06/2023] Open
Abstract
Muscle Invasive Bladder Cancer (MIBC) has a poor prognosis. Whilst patients can achieve a 6% improvement in overall survival with Neo-Adjuvant Chemotherapy (NAC), many do not respond. Body fluid mutant DNA (mutDNA) may allow non-invasive identification of treatment failure. We collected 248 liquid biopsy samples including plasma, cell pellet (UCP) and supernatant (USN) from spun urine, from 17 patients undergoing NAC. We assessed single nucleotide variants and copy number alterations in mutDNA using Tagged-Amplicon- and shallow Whole Genome- Sequencing. MutDNA was detected in 35.3%, 47.1% and 52.9% of pre-NAC plasma, UCP and USN samples respectively, and urine samples contained higher levels of mutDNA (p = <0.001). Longitudinal mutDNA demonstrated tumour evolution under the selective pressure of NAC e.g. in one case, urine analysis tracked two distinct clones with contrasting treatment sensitivity. Of note, persistence of mutDNA detection during NAC predicted disease recurrence (p = 0.003), emphasising its potential as an early biomarker for chemotherapy response.
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Affiliation(s)
- K M Patel
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Academic Urology Group, Department of Surgery & Oncology, University of Cambridge, Box 279 (S4), Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - K E van der Vos
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - C G Smith
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - F Mouliere
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - D Tsui
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - J Morris
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - D Chandrananda
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - F Marass
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - D van den Broek
- Department of Clinical Chemistry, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - D E Neal
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Nuffield Department of Surgery, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK
| | - V J Gnanapragasam
- Academic Urology Group, Department of Surgery & Oncology, University of Cambridge, Box 279 (S4), Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - T Forshew
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- UCL cancer Institute, Huntley St, Camden Town, London, WC1E 6DD, UK
| | - B W van Rhijn
- Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - C E Massie
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK.
- Cancer Research UK Cambridge Cancer Centre, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, CB2 0RE, UK.
| | - M S van der Heijden
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
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11
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Remon J, Caramella C, Jovelet C, Lacroix L, Lawson A, Smalley S, Howarth K, Gale D, Green E, Plagnol V, Rosenfeld N, Planchard D, Bluthgen MV, Gazzah A, Pannet C, Nicotra C, Auclin E, Soria JC, Besse B. Osimertinib benefit in EGFR-mutant NSCLC patients with T790M-mutation detected by circulating tumour DNA. Ann Oncol 2017; 28:784-790. [PMID: 28104619 DOI: 10.1093/annonc/mdx017] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [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: 10/17/2016] [Indexed: 02/01/2023] Open
Abstract
Background Approximately 50% of epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitors (TKIs) will acquire resistance by the T790M mutation. Osimertinib is the standard of care in this situation. The present study assesses the efficacy of osimertinib when T790M status is determined in circulating cell-free tumour DNA (ctDNA) from blood samples in progressing advanced EGFR-mutant NSCLC patients. Material and methods ctDNA T790M mutational status was assessed by Inivata InVision™ (eTAm-Seq™) assay in 48 EGFR-mutant advanced NSCLC patients with acquired resistance to EGFR TKIs without a tissue biopsy between April 2015 and April 2016. Progressing T790M-positive NSCLC patients received osimertinib (80 mg daily). The objectives were to assess the response rate to osimertinib according to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1, the progression-free survival (PFS) on osimertinib, and the percentage of T790M positive in ctDNA. Results The ctDNA T790M mutation was detected in 50% of NSCLC patients. Among assessable patients, osimertinib gave a partial response rate of 62.5% and a stable disease rate of 37.5%. All responses were confirmed responses. After median follow up of 8 months, median PFS by RECIST criteria was not achieved (95% CI: 4-NA), with 6- and 12-months PFS of 66.7% and 52%, respectively. Conclusion(s) ctDNA from liquid biopsy can be used as a surrogate marker for T790M in tumour tissue.
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Affiliation(s)
- J Remon
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Caramella
- Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Jovelet
- Translational Research Laboratory, AMMICA, INSERM US23/CNRS UNS3655, Gustave Roussy, Villejuif, France
| | - L Lacroix
- Translational Research Laboratory, AMMICA, INSERM US23/CNRS UNS3655, Gustave Roussy, Villejuif, France
| | | | | | | | - D Gale
- Inivata Ltd, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | | | - N Rosenfeld
- Inivata Ltd, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cambridge Cancer Centre, Cambridge, UK
| | - D Planchard
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - M V Bluthgen
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - A Gazzah
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Pannet
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Nicotra
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - E Auclin
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - J C Soria
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- University Paris-Sud and Gustave Roussy Cancer Campus, Villejuif, France
| | - B Besse
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- University Paris-Sud and Gustave Roussy Cancer Campus, Villejuif, France
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12
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Swanton C, Soria JC, Bardelli A, Biankin A, Caldas C, Chandarlapaty S, de Koning L, Dive C, Feunteun J, Leung SY, Marais R, Mardis ER, McGranahan N, Middleton G, Quezada SA, Rodón J, Rosenfeld N, Sotiriou C, André F. Consensus on precision medicine for metastatic cancers: a report from the MAP conference. Ann Oncol 2016; 27:1443-8. [PMID: 27143638 DOI: 10.1093/annonc/mdw192] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/29/2016] [Indexed: 02/07/2023] Open
Abstract
Recent advances in biotechnologies have led to the development of multiplex genomic and proteomic analyses for clinical use. Nevertheless, guidelines are currently lacking to determine which molecular assays should be implemented in metastatic cancers. The first MAP conference was dedicated to exploring the use of genomics to better select therapies in the treatment of metastatic cancers. Sixteen consensus items were covered. There was a consensus that new technologies like next-generation sequencing of tumors and ddPCR on circulating free DNA have convincing analytical validity. Further work needs to be undertaken to establish the clinical utility of liquid biopsies and the added clinical value of expanding from individual gene tests into large gene panels. Experts agreed that standardized bioinformatics methods for biological interpretation of genomic data are needed and that precision medicine trials should be stratified based on the level of evidence available for the genomic alterations identified.
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Affiliation(s)
- C Swanton
- Translational Cancer Therapeutics Laboratory, The Francis Crick Institute, London UCL Hospitals and Cancer Institute, London, UK
| | - J-C Soria
- Drug Development Unit, Gustave Roussy, Villejuif Department of Medical Oncology, INSERM Unit U981, Faculté de medicine Paris-Sud XI, Kremlin-Bicêtre, Villejuif, France
| | - A Bardelli
- Department of Oncology, University of Torino, Candiolo, Torino Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Torino, Italy
| | - A Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Bearsden, Glasgow, UK South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales, Australia West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow
| | - C Caldas
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - S Chandarlapaty
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - L de Koning
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - C Dive
- Clinical and Experimental Pharmacology, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - J Feunteun
- Stabilité Génétique et Oncogenèse, Université Paris-Sud, Gustave-Roussy, Villejuif, France
| | - S-Y Leung
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - R Marais
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, UK
| | - E R Mardis
- McDonnell Genome Institute, Washington University School of Medicine, St Louis, USA
| | - N McGranahan
- Translational Cancer Therapeutics Laboratory, The Francis Crick Institute, London
| | - G Middleton
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham
| | - S A Quezada
- Cancer Immunology Unit, University College London Cancer Institute, University College London, London, UK
| | - J Rodón
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory-BCTL (ULB 290), Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - F André
- Department of Medical Oncology, INSERM Unit U981, Faculté de medicine Paris-Sud XI, Kremlin-Bicêtre, Villejuif, France
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13
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Murphy S, Wan J, Gale D, Morris J, Mouliere F, Bignell G, Alifrangis C, Parkinson C, Durrani A, McDermott U, Massie C, Corrie P, Rosenfeld N. Monitoring metastatic melanoma treatment resistance using circulating tumour DNA. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Jaron R, Rosenfeld N, Zahdeh F, Carmi S, Beni-Adani L, Doviner V, Picard E, Segel R, Zeligson S, Carmel L, Renbaum P, Levy-Lahad E. Expanding the phenotype of CRB2 mutations - A new ciliopathy syndrome? Clin Genet 2016; 90:540-544. [PMID: 26925547 DOI: 10.1111/cge.12764] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/09/2016] [Accepted: 02/22/2016] [Indexed: 12/21/2022]
Abstract
Recessive CRB2 mutations were recently reported to cause both steroid resistant nephrotic syndrome and prenatal onset ventriculomegaly with kidney disease. We report two Ashkenazi Jewish siblings clinically diagnosed with ciliopathy. Both presented with severe congenital hydrocephalus and mild urinary tract anomalies. One affected sibling also has lung hypoplasia and heart defects. Exome sequencing and further CRB2 analysis revealed that both siblings are compound heterozygotes for CRB2 mutations p.N800K and p.Gly1036Alafs*43, and heterozygous for a deleterious splice variant in the ciliopathy gene TTCB21. CRB2 is a polarity protein which plays a role in ciliogenesis and ciliary function. Biallelic CRB2 mutations in animal models result in phenotypes consistent with ciliopathy. This report expands the phenotype of CRB2 mutations to include lung hypoplasia and uretero-pelvic renal anomalies, and confirms cardiac malformation as a feature. We suggest that CRB2-associated disease is a new ciliopathy syndrome with possible digenic/triallelic inheritance, as observed in other ciliopathies. Clinically, CRB2 should be assessed when ciliopathy is suspected, especially in Ashkenazi Jews, where we found that p.N800K carrier frequency is 1 of 64. Patients harboring CRB2 mutations should be tested for the complete range of ciliopathy manifestations.
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Affiliation(s)
- R Jaron
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - N Rosenfeld
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem Medical School, Jerusalem, Israel
| | - F Zahdeh
- Department of Genetics, The Alexander Silberman Institute of Life Sciences, Faculty of Science Jerusalem, Edmond J. Safra Campus, Givat Ram, The Hebrew University of Jerusalem, Jerusalem, Israel.,Hereditary Research Lab, Life Sciences Department, Bethlehem University, Bethlehem, Israel
| | - S Carmi
- Braun School of Public Health, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - L Beni-Adani
- Pediatric Neurosurgery, Shaare Zedek Medical Center, Jerusalem, Israel.,Pediatric Neurology Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - V Doviner
- Department of Pathology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - E Picard
- Faculty of Medicine, The Hebrew University of Jerusalem Medical School, Jerusalem, Israel.,Pediatric Pulmonary Institute, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - R Segel
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem Medical School, Jerusalem, Israel
| | - S Zeligson
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - L Carmel
- Department of Genetics, The Alexander Silberman Institute of Life Sciences, Faculty of Science Jerusalem, Edmond J. Safra Campus, Givat Ram, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - P Renbaum
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - E Levy-Lahad
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem Medical School, Jerusalem, Israel
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15
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Tsui D, Wong A, Murtaza M, Forshew T, Soo R, Lim H, Goh B, Gale D, Chin T, Rosenfeld N. 58: Proffered Paper: Noninvasive monitoring of tumour mutations and dynamics in circulating DNA of non-small cell lung cancer patients treated with EGFR inhibitors. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50058-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Dawson S, Tsui D, Murtaza M, Biggs H, Chin S, Gale D, Forshew T, Wallis M, Rosenfeld N, Caldas C. Monitoring of Metastatic Breast Cancer Using Circulating Tumour DNA: A Comparison With Circulating Tumour Cells. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32772-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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17
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Dawson S, Tsui D, Murtaza M, Biggs H, Chin S, Gale D, Forshew T, Wallis M, Caldas C, Rosenfeld N. 876 Non-invasive Monitoring of Metastatic Breast Cancer by Circulating Tumour DNA – a Comparison With Circulating Tumour Cells. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Kozer E, Bar-Hamburger R, Rosenfeld N, Dalal I, Landu O, Fainmesser P, Ben-Yehuda Y, Berkovitch M. Strategy for increasing detection rates of drug and alcohol abuse in paediatric emergency departments. Acta Paediatr 2009; 98:1637-40. [PMID: 19555445 DOI: 10.1111/j.1651-2227.2009.01392.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To determine whether implementation of criteria for performing a toxicology screen and increasing staff awareness improve detection of substance abuse among adolescents presenting to the emergency department. METHODS Patients 12 to 18 years of age presenting to one of three emergency departments in Israel were included in a prospective cohort study. In the 'study' hospital, a set of criteria for urine toxicology screen and measurements of ethanol serum level were implemented. No specific interventions were implemented in the two other hospitals. The main outcome measure was the rate of substance abuse detection. RESULTS The number of adolescents seen in the participating centres was 3200 at the study hospital, and 3493 and 2792 at the two other hospitals. High blood ethanol concentrations were found in 49 patients at the study hospital compared with 30 and 19 patients at the two other hospitals (p < 0.001). Illicit drugs were detected in 13, 4 and 1 patients, respectively (p = 0.002). CONCLUSIONS Introducing structured guidelines for ordering toxicological screening increases the detection of alcohol and drug of abuse among adolescents presenting to paediatric emergency departments.
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Affiliation(s)
- E Kozer
- Pediatric Emergency Department and the Toxicology Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
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19
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Lebanony D, Benjamin H, Gilad S, Ashkenazi K, Nonaka D, Feinmesser M, Rosenfeld N, Chajut A, Cohen D, Aharonov R. MicroRNA-based assay for differential diagnosis of squamous from non-squamous non-small cell lung carcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.11069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11069 Background: Recent advances in biologically directed therapies for non-small cell lung carcinoma (NSCLC) emphasize the need for more accurate sub-classification of NSCLC, as treatment may be dictated by histologic subtype. In particular, squamous histology can be a counter-indication for treatment by VEGF inhibitors. MicroRNAs are highly tissue-specific biomarkers with potential clinical applicability for defining cancer type and origin. MicroRNAs are well preserved in formalin fixed tissue, making them ideal candidates for molecular markers for use in routinely processed material. Here we report on the development and performance of a microRNA-based assay for the differential diagnosis of squamous from non-squamous NSCLC. Methods: We developed protocols for extraction of high-quality RNA that retain the microRNA fraction from FFPE archival tissue samples. MicroRNA microarrays were used to profile more than a hundred NSCLC samples. Specific microRNA qRT-PCR was used to validate results, and to develop a diagnostic assay. Results: We identified a microRNA biomarker that is strongly overexpressed in squamous cell NSCLC. A diagnostic assay (miRview squamous) was developed, that utilizes qRT-PCR measurement of this microRNA, normalized by an additional microRNA and a small nuclear RNA. This assay was validated on a blinded test set of 64 tumor samples, and had sensitivity of 97% and specificity of 91%. More than ¾ of the samples were classified with high confidence, and these classifications were accurate in 96% of the cases. Conclusions: MicroRNAs are becoming an important tool for classification of cancers. A diagnostic assay based on the specificity of a single microRNA accurately identifies squamous from non-squamous NSCLC. This assay provides an important new tool for the classification of NSCLC. [Table: see text]
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Affiliation(s)
- D. Lebanony
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - H. Benjamin
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - S. Gilad
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - K. Ashkenazi
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - D. Nonaka
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - M. Feinmesser
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - N. Rosenfeld
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - A. Chajut
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - D. Cohen
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
| | - R. Aharonov
- Rosetta Genomics, Rehovot, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center,Beilinson Campus, Petah Tikva, Israel
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20
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Rosenwald S, Gibori H, Gilad S, Cohen L, Leizerman I, Barshack I, Nonaka D, Tobar A, Aharonov R, Rosenfeld N. Identification of tumor tissue origin by a microRNA-based molecular assay. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.11036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11036 Background: Hundreds of thousands of patients are diagnosed each year with metastatic cancer. For ∼10% of these, the tumor primary site is never identified, and they are defined as Cancer of Unknown Primary (CUP). Identification of tumor tissue-of- origin has significant therapeutic implications and presents a major diagnostic challenge. In previous work we showed that by combining expression profiles of tissue-specific microRNAs with a biologically-motivated classification scheme, tumor tissue-of-origin can be identified with high accuracy. Here we describe the development of this approach into a practical diagnostic assay. Methods: We developed protocols for extraction of high-quality RNA that retain the microRNA fraction from FFPE archival tissue samples. Proprietary, highly specific qRT-PCR was used to profile microRNA expression levels in hundreds of samples. Results: A training set of nearly 400 primary and metastatic tumors samples with known primary sites, representing 25 different tumor types, was used to define a standardized diagnostics assay (miRview mets). The assay uses a qRT-PCR protocol to measure a panel of 48 microRNA biomarkers. The assay was validated on a test set of nearly 200 primary and metastatic tumors whose primary sites were blinded. The classification protocol identifies either a single, high-confidence origin or two possible low-confidence predictions. Overall, correct primary site was identified for 83% of the tumors. For 70% of the cases a single high-confidence prediction was made; these cases had a higher accuracy: 90% of the primary sites predicted with high confidence were accurately identified. Conclusions: Previous studies highlighted the tissue-specificity of microRNA expression. We developed this potential into a diagnostic assay that identifies tumor origins with high accuracy. This assay provides an important new tool for diagnosing tumor tissue origin. [Table: see text]
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Affiliation(s)
- S. Rosenwald
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - H. Gibori
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - S. Gilad
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - L. Cohen
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - I. Leizerman
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - I. Barshack
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - D. Nonaka
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - A. Tobar
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - R. Aharonov
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - N. Rosenfeld
- Rosetta Genomics, Rehovot, Israel; Sheba Medical Center, Tel Hashomer, Israel; NYU School of Medicine, New York, NY; Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
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21
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Benjamin H, Lebanony D, Cohen L, Elyakim E, Rosenfeld N, Chajut A, Cohen D. Differential diagnosis of mesothelioma using a microRNA assay. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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22
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Nass D, Rosenwald S, Sitbon E, Lithwick G, Elyakim E, Cholakh H, Spector Y, Rosenfeld N, Aharonov R, Barshack I, Bentwich Z. MicroRNAs as specific biomarkers for distinguishing between primary and metastatic brain tumors. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Rosenwald S, Meiri E, Gilad S, Ezagouri M, Spector Y, Ben Ari A, Levy A, Aharonov R, Rosenfeld N, Barshack I. MicroRNA signature identifies tissue origin of primary and metastatic tumors. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Barshack I, Rosenwald S, Bronfeld M, Aviel-Ronen S, Meiri E, Zepeniuk M, Shabes N, Tabak S, Cohen D, Rosenfeld N. MicroRNA expression profile identifies origin of tumors in the liver. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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25
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Rosenfeld N. Facility profile. Radiology revamp suits facility. Mount Sinai Hospital, Radiology 2000, New York, N.Y. Health Facil Manage 2000; 13:14-5. [PMID: 11183990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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26
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Rosenfeld N, Yeche S, Reynaud D, Abiad L, Dubois A. [Acute disseminated lupus erythematosus. Responsibility of Corenitec: apropos of a case]. Therapie 2000; 54:493-4. [PMID: 10667119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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27
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Rosenfeld N, Dubois A, Maubon A, Francois F, de Seguin C, Ferru JM, Yeche S, Reynaud D, Rosenfeld N. Une cause rare d'ictère: la fibröse périaortique. Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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28
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Rosenfeld N. Intake/discharge unit ups clinic's efficiency as well as its comfort. New York Eye and Ear Infirmary. Health Facil Manage 1994; 7:18-9. [PMID: 10171803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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29
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Berg ER, Rosenfeld N. Phased renovation and expansion make clinic a sight for sore eyes. Health Facil Manage 1992; 5:20-1. [PMID: 10120050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- E R Berg
- New York (City) Eye and Ear Infirmary
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Rosenfeld N. Lenox Hill streamlines functions in combined admit/discharge unit. Health Facil Manage 1989; 2:17-8. [PMID: 10292987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Rosenfeld N, Wyatt A. Urban nursing home rescued and renovated. Hospitals 1984; 58:109-10. [PMID: 6693097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
A case of a thirteen-year-old black female with Dupuytren's contracture is presented. This patient is one of the youngest black female patients with Dupuytren's contracture.
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33
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Rosenfeld N, Kaiserman CB. Workshop series cuts planning time and costs. Hospitals 1981; 55:149-151. [PMID: 7250918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The planning process involves a number of people with divergent needs whose conflicts frequently inhibit quick and sensible solutions. Although there are many approaches to developing a major complex building program, the workshop format proved to be a successful model for organizing and focusing planning efforts. Because participants were presented with graphic materials (plans, diagrams, charts), workshop leaders were able to rapidly define and expand concepts related to hospital design. Information-sharing meetings resulted in flexible solutions that met immediate needs and opened avenues for future growth. By structuring normally sequential tasks into a simultaneous process, hospitals can encourage participation in a building improvement project while reducing planning time and cost.
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Abstract
A case of chondroma of the soft tissues of the right middle finger is presented. The possible origins and treatment are discussed.
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Abstract
Gonococcal infection of tendon synovial sheath is discussed. A case of acute gonococcal flexor tenosynovitis without joint involvement is presented.
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Rosenfeld N, Dolich BH. Use of the articular branch of the ulnar nerve to the wrist for a local nerve graft. Case report. Plast Reconstr Surg 1977; 60:466-7. [PMID: 897008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The use of articular branch of the dorsal sensory ulnar nerve as a nerve graft is discussed. A case of traumatic neuroma of the dorsal ulnar nerve which was treated by this method is presented.
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Rosenfeld N, Harel M, Herman S. Familial neuropathy as a cause for distal thumb amputation. Case report. Plast Reconstr Surg 1977; 59:588-90. [PMID: 191862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Rosenfeld N, Babar A. Hidradenitis suppurativa of the perineal and gluteal regions, treated by excision and skin grafting. Case report. Plast Reconstr Surg 1976; 58:98-9. [PMID: 778874 DOI: 10.1097/00006534-197607000-00019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Rosenfeld N. Indirect lighting improves outlook for everyone. Mod Hosp 1971; 117:78 passim. [PMID: 5568918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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