1
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Rescigno P, Porta N, Finneran L, Riisnaes R, Figueiredo I, Carreira S, Flohr P, Miranda S, Bertan C, Ferreira A, Crespo M, Rodrigues DN, Gurel B, Nobes J, Crabb S, Malik Z, Ralph C, McGovern U, Hoskin P, Jones RJ, Birtle A, Gale J, Sankey P, Jain S, McLaren D, Chadwick E, Espinasse A, Hall E, de Bono J. Capivasertib in combination with enzalutamide for metastatic castration resistant prostate cancer after docetaxel and abiraterone: Results from the randomized phase II RE-AKT trial. Eur J Cancer 2024; 205:114103. [PMID: 38729054 DOI: 10.1016/j.ejca.2024.114103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND PTEN loss and aberrations in PI3K/AKT signaling kinases associate with poorer response to abiraterone acetate (AA) in metastatic castration-resistant prostate cancer (mCRPC). In this study, we assessed antitumor activity of the AKT inhibitor capivasertib combined with enzalutamide in mCRPC with prior progression on AA and docetaxel. METHODS This double-blind, placebo-controlled, randomized phase 2 trial, recruited men ≥ 18 years with progressing mCRPC and performance status 0-2 from 15 UK centers. Randomized participants (1:1) received enzalutamide (160 mg orally, once daily) with capivasertib (400 mg)/ placebo orally, twice daily on an intermittent (4 days on, 3 days off) schedule. Primary endpoint was composite response rate (RR): RECIST 1.1 objective response, ≥ 50 % PSA decrease from baseline, or circulating tumor cell count conversion (from ≥ 5 at baseline to < 5 cells/7.5 mL). Subgroup analyses by PTENIHC status were pre-planned. RESULTS Overall, 100 participants were randomized (50:50); 95 were evaluable for primary endpoint (47:48); median follow-up was 43 months. RR were 9/47 (19.1 %) enzalutamide/capivasertib and 9/48 (18.8 %) enzalutamide/placebo (absolute difference 0.4 % 90 %CI -12.8 to 13.6, p = 0.58), with similar results in the PTENIHC loss subgroup. Irrespective of treatment, OS was significantly worse for PTENIHC loss (10.1 months [95 %CI: 4.6-13.9] vs 14.8 months [95 %CI: 10.8-18]; p = 0.02). Most common treatment-emergent grade ≥ 3 adverse events for the combination were diarrhea (13 % vs 2 %) and fatigue (10 % vs 6 %). CONCLUSIONS Combined capivasertib/enzalutamide was well tolerated but didn't significantly improve outcomes from abiraterone pre-treated mCRPC.
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Affiliation(s)
- Pasquale Rescigno
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK; Newcastle University, Newcastle upon Tyne, UK
| | - Nuria Porta
- The Institute of Cancer Research, London, UK
| | | | | | | | | | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | | | | | | | | | | | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | | | - Simon Crabb
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Zafar Malik
- The Clatterbridge Cancer Centre, Liverpool, UK
| | | | | | | | - Robert J Jones
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Alison Birtle
- Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK; University of Manchester, Manchester, UK; University of Central Lancashire, Preston, UK
| | | | | | | | | | | | | | - Emma Hall
- The Institute of Cancer Research, London, UK
| | - Johann de Bono
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
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2
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Challapalli A, Barwick TD, Dubash SR, Inglese M, Grech-Sollars M, Kozlowski K, Tam H, Patel NH, Winkler M, Flohr P, Saleem A, Bahl A, Falconer A, De Bono JS, Aboagye EO, Mangar S. Bench to Bedside Development of [ 18F]Fluoromethyl-(1,2- 2H 4)choline ([ 18F]D4-FCH). Molecules 2023; 28:8018. [PMID: 38138508 PMCID: PMC10745874 DOI: 10.3390/molecules28248018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Malignant transformation is characterised by aberrant phospholipid metabolism of cancers, associated with the upregulation of choline kinase alpha (CHKα). Due to the metabolic instability of choline radiotracers and the increasing use of late-imaging protocols, we developed a more stable choline radiotracer, [18F]fluoromethyl-[1,2-2H4]choline ([18F]D4-FCH). [18F]D4-FCH has improved protection against choline oxidase, the key choline catabolic enzyme, via a 1H/2D isotope effect, together with fluorine substitution. Due to the promising mechanistic and safety profiles of [18F]D4-FCH in vitro and preclinically, the radiotracer has transitioned to clinical development. [18F]D4-FCH is a safe positron emission tomography (PET) tracer, with a favourable radiation dosimetry profile for clinical imaging. [18F]D4-FCH PET/CT in lung and prostate cancers has shown highly heterogeneous intratumoral distribution and large lesion variability. Treatment with abiraterone or enzalutamide in metastatic castrate-resistant prostate cancer patients elicited mixed responses on PET at 12-16 weeks despite predominantly stable radiological appearances. The sum of the weighted tumour-to-background ratios (TBRs-wsum) was associated with the duration of survival.
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Affiliation(s)
- Amarnath Challapalli
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
- Department of Clinical Oncology, Bristol Haematology and Oncology Center, Horfield Road, Bristol BS2 8ED, UK;
| | - Tara D. Barwick
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
- Department of Radiology & Nuclear Medicine, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; (H.T.); (N.H.P.)
| | - Suraiya R. Dubash
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Marianna Inglese
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Matthew Grech-Sollars
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Kasia Kozlowski
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Henry Tam
- Department of Radiology & Nuclear Medicine, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; (H.T.); (N.H.P.)
| | - Neva H. Patel
- Department of Radiology & Nuclear Medicine, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; (H.T.); (N.H.P.)
| | - Mathias Winkler
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK; (M.W.); (A.F.)
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research and Royal Marsden Hospital, Cotswold Road, Sutton SM2 5NG, UK; (P.F.); (J.S.D.B.)
| | - Azeem Saleem
- Invicro, A Konica Minolta Company, Burlington Danes Building, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK;
- Hull York Medical School, University of Hull, Cottingham Road, Hull HU6 7RX, UK
| | - Amit Bahl
- Department of Clinical Oncology, Bristol Haematology and Oncology Center, Horfield Road, Bristol BS2 8ED, UK;
| | - Alison Falconer
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK; (M.W.); (A.F.)
| | - Johann S. De Bono
- Division of Clinical Studies, The Institute of Cancer Research and Royal Marsden Hospital, Cotswold Road, Sutton SM2 5NG, UK; (P.F.); (J.S.D.B.)
| | - Eric O. Aboagye
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Stephen Mangar
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK; (M.W.); (A.F.)
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3
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Guo C, Sharp A, Gurel B, Crespo M, Figueiredo I, Jain S, Vogl U, Rekowski J, Rouhifard M, Gallagher L, Yuan W, Carreira S, Chandran K, Paschalis A, Colombo I, Stathis A, Bertan C, Seed G, Goodall J, Raynaud F, Ruddle R, Swales KE, Malia J, Bogdan D, Tiu C, Caldwell R, Aversa C, Ferreira A, Neeb A, Tunariu N, Westaby D, Carmichael J, Fenor de la Maza MD, Yap C, Matthews R, Badham H, Prout T, Turner A, Parmar M, Tovey H, Riisnaes R, Flohr P, Gil J, Waugh D, Decordova S, Schlag A, Calì B, Alimonti A, de Bono JS. Targeting myeloid chemotaxis to reverse prostate cancer therapy resistance. Nature 2023; 623:1053-1061. [PMID: 37844613 PMCID: PMC10686834 DOI: 10.1038/s41586-023-06696-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
Inflammation is a hallmark of cancer1. In patients with cancer, peripheral blood myeloid expansion, indicated by a high neutrophil-to-lymphocyte ratio, associates with shorter survival and treatment resistance across malignancies and therapeutic modalities2-5. Whether myeloid inflammation drives progression of prostate cancer in humans remain unclear. Here we show that inhibition of myeloid chemotaxis can reduce tumour-elicited myeloid inflammation and reverse therapy resistance in a subset of patients with metastatic castration-resistant prostate cancer (CRPC). We show that a higher blood neutrophil-to-lymphocyte ratio reflects tumour myeloid infiltration and tumour expression of senescence-associated mRNA species, including those that encode myeloid-chemoattracting CXCR2 ligands. To determine whether myeloid cells fuel resistance to androgen receptor signalling inhibitors, and whether inhibiting CXCR2 to block myeloid chemotaxis reverses this, we conducted an investigator-initiated, proof-of-concept clinical trial of a CXCR2 inhibitor (AZD5069) plus enzalutamide in patients with metastatic CRPC that is resistant to androgen receptor signalling inhibitors. This combination was well tolerated without dose-limiting toxicity and it decreased circulating neutrophil levels, reduced intratumour CD11b+HLA-DRloCD15+CD14- myeloid cell infiltration and imparted durable clinical benefit with biochemical and radiological responses in a subset of patients with metastatic CRPC. This study provides clinical evidence that senescence-associated myeloid inflammation can fuel metastatic CRPC progression and resistance to androgen receptor blockade. Targeting myeloid chemotaxis merits broader evaluation in other cancers.
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Affiliation(s)
- Christina Guo
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Adam Sharp
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | | | | | - Suneil Jain
- Northern Ireland Cancer Centre, Belfast, UK
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Ursula Vogl
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | | | | | | | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | | | - Khobe Chandran
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Alec Paschalis
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Ilaria Colombo
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Anastasios Stathis
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | | | - George Seed
- The Institute of Cancer Research, London, UK
| | | | | | - Ruth Ruddle
- The Institute of Cancer Research, London, UK
| | | | - Jason Malia
- The Institute of Cancer Research, London, UK
| | | | - Crescens Tiu
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | - Antje Neeb
- The Institute of Cancer Research, London, UK
| | - Nina Tunariu
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Daniel Westaby
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Juliet Carmichael
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | | | - Toby Prout
- The Institute of Cancer Research, London, UK
| | | | - Mona Parmar
- The Institute of Cancer Research, London, UK
| | - Holly Tovey
- The Institute of Cancer Research, London, UK
| | | | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | - Jesus Gil
- MRC London Institute of Medical Sciences (LMS), London, UK
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK
| | - David Waugh
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
- Centre for Cancer Biology, University of South Australia, Adelaide, South Australia, Australia
| | | | - Anna Schlag
- The Institute of Cancer Research, London, UK
| | - Bianca Calì
- Institute of Oncology Research, Bellinzona, Switzerland
| | - Andrea Alimonti
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
- Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), Zurich, Switzerland
- Department of Medicine, Veneto Institute of Molecular Medicine, University of Padova, Padua, Italy
| | - Johann S de Bono
- The Institute of Cancer Research, London, UK.
- The Royal Marsden NHS Foundation Trust, London, UK.
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4
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Scott E, Hodgson K, Calle B, Turner H, Cheung K, Bermudez A, Marques FJG, Pye H, Yo EC, Islam K, Oo HZ, McClurg UL, Wilson L, Thomas H, Frame FM, Orozco-Moreno M, Bastian K, Arredondo HM, Roustan C, Gray MA, Kelly L, Tolson A, Mellor E, Hysenaj G, Goode EA, Garnham R, Duxfield A, Heavey S, Stopka-Farooqui U, Haider A, Freeman A, Singh S, Johnston EW, Punwani S, Knight B, McCullagh P, McGrath J, Crundwell M, Harries L, Bogdan D, Westaby D, Fowler G, Flohr P, Yuan W, Sharp A, de Bono J, Maitland NJ, Wisnovsky S, Bertozzi CR, Heer R, Guerrero RH, Daugaard M, Leivo J, Whitaker H, Pitteri S, Wang N, Elliott DJ, Schumann B, Munkley J. Upregulation of GALNT7 in prostate cancer modifies O-glycosylation and promotes tumour growth. Oncogene 2023; 42:926-937. [PMID: 36725887 PMCID: PMC10020086 DOI: 10.1038/s41388-023-02604-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 09/22/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
Prostate cancer is the most common cancer in men and it is estimated that over 350,000 men worldwide die of prostate cancer every year. There remains an unmet clinical need to improve how clinically significant prostate cancer is diagnosed and develop new treatments for advanced disease. Aberrant glycosylation is a hallmark of cancer implicated in tumour growth, metastasis, and immune evasion. One of the key drivers of aberrant glycosylation is the dysregulated expression of glycosylation enzymes within the cancer cell. Here, we demonstrate using multiple independent clinical cohorts that the glycosyltransferase enzyme GALNT7 is upregulated in prostate cancer tissue. We show GALNT7 can identify men with prostate cancer, using urine and blood samples, with improved diagnostic accuracy than serum PSA alone. We also show that GALNT7 levels remain high in progression to castrate-resistant disease, and using in vitro and in vivo models, reveal that GALNT7 promotes prostate tumour growth. Mechanistically, GALNT7 can modify O-glycosylation in prostate cancer cells and correlates with cell cycle and immune signalling pathways. Our study provides a new biomarker to aid the diagnosis of clinically significant disease and cements GALNT7-mediated O-glycosylation as an important driver of prostate cancer progression.
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Affiliation(s)
- Emma Scott
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Kirsty Hodgson
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Beatriz Calle
- The Chemical Glycobiology Laboratory, The Francis Crick Institute, NW1 1AT, London, UK
- Department of Chemistry, Imperial College London, W12 0BZ, London, UK
| | - Helen Turner
- Cellular Pathology, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Kathleen Cheung
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Abel Bermudez
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University, Palo Alto, CA, 94304, USA
| | - Fernando Jose Garcia Marques
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University, Palo Alto, CA, 94304, USA
| | - Hayley Pye
- Molecular Diagnostics and Therapeutics Group, Charles Bell House, Division of Surgery and Interventional Science, University College London, London, UK
| | - Edward Christopher Yo
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Khirul Islam
- Department of Life Technologies, Division of Biotechnology, University of Turku, Turku, Finland
| | - Htoo Zarni Oo
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada
- Vancouver Prostate Centre, Vancouver, BC, V6H 3Z6, Canada
| | - Urszula L McClurg
- Institute for Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Laura Wilson
- Newcastle University Centre for Cancer, Translational and Clinical Research Institute, Paul O'Gorman Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Huw Thomas
- Newcastle University Centre for Cancer, Translational and Clinical Research Institute, Paul O'Gorman Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Fiona M Frame
- Cancer Research Unit, Department of Biology, University of York, Heslington, North Yorkshire, YO10 5DD, UK
| | - Margarita Orozco-Moreno
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Kayla Bastian
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Hector M Arredondo
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Chloe Roustan
- Structural Biology Science Technology Platform, The Francis Crick Institute, NW1 1AT, London, UK
| | - Melissa Anne Gray
- Sarafan Chem-H and Departemnt of Chemistry, Stanford University, 424 Santa Teresa St, Stanford, CA, 94305, USA
| | - Lois Kelly
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Aaron Tolson
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Ellie Mellor
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Gerald Hysenaj
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Emily Archer Goode
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Rebecca Garnham
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Adam Duxfield
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Susan Heavey
- Molecular Diagnostics and Therapeutics Group, Charles Bell House, Division of Surgery and Interventional Science, University College London, London, UK
| | - Urszula Stopka-Farooqui
- Molecular Diagnostics and Therapeutics Group, Charles Bell House, Division of Surgery and Interventional Science, University College London, London, UK
| | - Aiman Haider
- Department of Pathology, UCLH NHS Foundation Trust, London, UK
| | - Alex Freeman
- Department of Pathology, UCLH NHS Foundation Trust, London, UK
| | - Saurabh Singh
- UCL Centre for Medical Imaging, Charles Bell House, University College London, London, UK
| | - Edward W Johnston
- UCL Centre for Medical Imaging, Charles Bell House, University College London, London, UK
| | - Shonit Punwani
- UCL Centre for Medical Imaging, Charles Bell House, University College London, London, UK
| | - Bridget Knight
- NIHR Exeter Clinical Research Facility, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Paul McCullagh
- Department of Pathology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - John McGrath
- Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Malcolm Crundwell
- Exeter Surgical Health Services Research Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Lorna Harries
- Institute of Biomedical and Clinical Sciences, Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Denisa Bogdan
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Daniel Westaby
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group, The Royal Marsden Hospital, London, SM2 5PT, UK
| | - Gemma Fowler
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Wei Yuan
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Adam Sharp
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group, The Royal Marsden Hospital, London, SM2 5PT, UK
| | - Johann de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group, The Royal Marsden Hospital, London, SM2 5PT, UK
| | - Norman J Maitland
- Cancer Research Unit, Department of Biology, University of York, Heslington, North Yorkshire, YO10 5DD, UK
| | - Simon Wisnovsky
- University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, V6T 1Z3, Canada
| | - Carolyn R Bertozzi
- Howard Hughes Medical Institute, 424 Santa Teresa St, Stanford, CA, 94305, USA
| | - Rakesh Heer
- Newcastle University Centre for Cancer, Translational and Clinical Research Institute, Paul O'Gorman Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK
| | - Ramon Hurtado Guerrero
- University of Zaragoza, Mariano Esquillor s/n, Campus Rio Ebro, Edificio I+D, Zaragoza, Spain; Fundación ARAID, 50018, Zaragoza, Spain
- Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mads Daugaard
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada
- Vancouver Prostate Centre, Vancouver, BC, V6H 3Z6, Canada
| | - Janne Leivo
- Department of Life Technologies, Division of Biotechnology, University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Hayley Whitaker
- Molecular Diagnostics and Therapeutics Group, Charles Bell House, Division of Surgery and Interventional Science, University College London, London, UK
| | - Sharon Pitteri
- Canary Center at Stanford for Cancer Early Detection, Department of Radiology, Stanford University, Palo Alto, CA, 94304, USA
| | - Ning Wang
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - David J Elliott
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK
| | - Benjamin Schumann
- The Chemical Glycobiology Laboratory, The Francis Crick Institute, NW1 1AT, London, UK
- Department of Chemistry, Imperial College London, W12 0BZ, London, UK
| | - Jennifer Munkley
- Newcastle University Centre for Cancer, Newcastle University Institute of Biosciences, Newcastle, NE1 3BZ, UK.
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5
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Miranda S, Gil V, Riisnaes R, Gurel B, D’Ambrosio M, Vasciaveo A, Crespo M, Ferreira A, Brina D, Troiani M, Sharp A, Sheehan B, Christova R, Seed G, Figueiredo I, Lambros M, Dolling D, Rekowski J, Alajati A, Clarke M, Pereira R, Flohr P, Fowler G, Boysen G, Sumanasuriya S, Bianchini D, Rescigno P, Aversa C, Tunariu N, Guo C, Paschalis A, Bertan C, Buroni L, Ning J, Carreira S, Workman P, Swain A, Califano A, Shen MM, Alimonti A, Neeb A, Welti J, Yuan W, de Bono J. Abstract 2807: HER3 is an actionable target in advanced prostate cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2807] [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: ERBB signaling is implicated in castration resistant prostate cancer (CRPC), but so far clinical trials of ERBB targeting drugs failed to demonstrate antitumor activity. We elected to re-investigate ERBB receptors in endocrine treatment-resistant lethal PC, hypothesizing that targeting ERBB receptors merits further evaluation in metastatic CRPC (mCRPC).
Design: We analyzed matching, same-patient, formalin-fixed paraffin-embedded (FFPE) treatment-naïve, castration-sensitive PC (CSPC) samples (n=88), and mCRPC biopsies (n=51), from patients treated at The Royal Marsden Hospital, UK. Samples were stained for HER2 and HER3 protein, by immunohistochemistry (IHC), data was generated through digital image analysis and results were analyzed against clinical characteristics and outcome data. Moreover, we treated HER3 high (CP50) and low (CP142) expressing patient derived xenograft (PDX) models with anti-HER3 antibody-drug conjugate (HER3-ADC) U3-1402 (10mg/Kg), IgG-ADC (MAAA-9289, 10mg/Kg), anti-HER3 antibody Patritumab (U3-1287, 10mg/Kg) and 10mM acetate buffer-5% sorbitol-pH 5.5 as vehicle control, in vitro and in vivo. In vitro cell growth inhibitory activity was monitored for 7-days with endpoint assay luminescence. In vivo efficacy was evaluated comparing tumor volumes, measured every 2-3 days. Statistical significance was analyzed using ANOVA with Dunnett’s multiple comparisons correction test.
Results: Membranous HER2 (mHER2) and HER3 (mHER3) proteins were detectable in both CSPC and mCRPC biopsies, with HER3 being highly expressed in many tumors. The median optical density (OD) for mHER3 expression at diagnosis was 2958.0; PC with high mHER3 expression (> median OD; n=44) had a significantly shorter median time to CRPC (20.3 vs 14.2 months; p=0.016) and worse overall survival (OS) (79.0 vs 48.8 months; p=0.04) compared to CSPC with low mHER3 (≤ median; n=44). mHER2 staining did not associate with outcome. U3-1402 demonstrated in vivo potent and sustained antitumor activity in CP50, without inducing any body weight loss or apparent toxicity. Additionally, no tumor regrowth was observed up to 60-days following the end of dosing. This anti-HER3-ADC had minimal antitumor activity in CP142, highlighting the relevance of high HER3 expression as a functional therapeutic target.
Conclusion: HER3 is commonly expressed in advanced PC and has clinical relevance in this setting. Our data indicate that HER3 is a valid target for clinical trials for men suffering from high HER3 expressing advanced PC.
Citation Format: Susana Miranda, Veronica Gil, Ruth Riisnaes, Bora Gurel, Mariantonietta D’Ambrosio, Alessandro Vasciaveo, Mateus Crespo, Ana Ferreira, Daniela Brina, Martina Troiani, Adam Sharp, Beshara Sheehan, Rossitza Christova, George Seed, Ines Figueiredo, Maryou Lambros, David Dolling, Jan Rekowski, Abdullah Alajati, Matthew Clarke, Rita Pereira, Penny Flohr, Gemma Fowler, Gunther Boysen, Semini Sumanasuriya, Diletta Bianchini, Pasquale Rescigno, Caterina Aversa, Nina Tunariu, Christina Guo, Alec Paschalis, Claudia Bertan, Lorenzo Buroni, Jian Ning, Suzanne Carreira, Paul Workman, Amanda Swain, Andrea Califano, Michael M. Shen, Andrea Alimonti, Antje Neeb, SU2C/PCF International Prostate Cancer Dream Team, Jonathan Welti, Wei Yuan, Johann de Bono. HER3 is an actionable target in advanced prostate cancer [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 2807.
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Affiliation(s)
- Susana Miranda
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Veronica Gil
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Ruth Riisnaes
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Bora Gurel
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | | | - Mateus Crespo
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Ana Ferreira
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Daniela Brina
- 2Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Martina Troiani
- 2Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Adam Sharp
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | | | - George Seed
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | - Maryou Lambros
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - David Dolling
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Jan Rekowski
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Abdullah Alajati
- 2Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Matthew Clarke
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Rita Pereira
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Penny Flohr
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Gemma Fowler
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Gunther Boysen
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | | | | | | | - Nina Tunariu
- 4The Royal Marsden Hospital, London, United Kingdom
| | - Christina Guo
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Alec Paschalis
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Claudia Bertan
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Lorenzo Buroni
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Jian Ning
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | - Paul Workman
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Amanda Swain
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Andrea Califano
- 3Columbia University College of Physicians and Surgeons, New York, NY
| | - Michael M. Shen
- 3Columbia University College of Physicians and Surgeons, New York, NY
| | - Andrea Alimonti
- 2Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Antje Neeb
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Jonathan Welti
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Wei Yuan
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Johann de Bono
- 1The Institute of Cancer Research, Sutton, United Kingdom
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Gil V, Miranda S, Riisnaes R, Gurel B, D'Ambrosio M, Vasciaveo A, Crespo M, Ferreira A, Brina D, Troiani M, Sharp A, Sheehan B, Christova R, Seed G, Figueiredo I, Lambros M, Dolling D, Rekowski J, Alajati A, Clarke M, Pereira R, Flohr P, Fowler G, Boysen G, Sumanasuriya S, Bianchini D, Rescigno P, Aversa C, Tunariu N, Guo C, Paschalis A, Bertan C, Buroni L, Ning J, Carreira S, Workman P, Swain A, Califano A, Shen MM, Alimonti A, Neeb A, Welti J, Yuan W, de Bono J. HER3 Is an Actionable Target in Advanced Prostate Cancer. Cancer Res 2021; 81:6207-6218. [PMID: 34753775 PMCID: PMC8932336 DOI: 10.1158/0008-5472.can-21-3360] [Citation(s) in RCA: 24] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
It has been recognized for decades that ERBB signaling is important in prostate cancer, but targeting ERBB receptors as a therapeutic strategy for prostate cancer has been ineffective clinically. However, we show here that membranous HER3 protein is commonly highly expressed in lethal prostate cancer, associating with reduced time to castration resistance (CR) and survival. Multiplex immunofluorescence indicated that the HER3 ligand NRG1 is detectable primarily in tumor-infiltrating myelomonocytic cells in human prostate cancer; this observation was confirmed using single-cell RNA sequencing of human prostate cancer biopsies and murine transgenic prostate cancer models. In castration-resistant prostate cancer (CRPC) patient-derived xenograft organoids with high HER3 expression as well as mouse prostate cancer organoids, recombinant NRG1 enhanced proliferation and survival. Supernatant from murine bone marrow-derived macrophages and myeloid-derived suppressor cells promoted murine prostate cancer organoid growth in vitro, which could be reversed by a neutralizing anti-NRG1 antibody and ERBB inhibition. Targeting HER3, especially with the HER3-directed antibody-drug conjugate U3-1402, exhibited antitumor activity against HER3-expressing prostate cancer. Overall, these data indicate that HER3 is commonly overexpressed in lethal prostate cancer and can be activated by NRG1 secreted by myelomonocytic cells in the tumor microenvironment, supporting HER3-targeted therapeutic strategies for treating HER3-expressing advanced CRPC. SIGNIFICANCE: HER3 is an actionable target in prostate cancer, especially with anti-HER3 immunoconjugates, and targeting HER3 warrants clinical evaluation in prospective trials.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Humanized/pharmacology
- Antineoplastic Agents, Immunological/pharmacology
- Apoptosis
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Camptothecin/analogs & derivatives
- Camptothecin/pharmacology
- Cell Proliferation
- Follow-Up Studies
- Humans
- Male
- Mice, Inbred NOD
- Mice, SCID
- Neuregulin-1/genetics
- Neuregulin-1/metabolism
- Organoids/drug effects
- Organoids/metabolism
- Organoids/pathology
- Prognosis
- Prospective Studies
- Prostatic Neoplasms/drug therapy
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/metabolism
- Prostatic Neoplasms/pathology
- Receptor, ErbB-3/antagonists & inhibitors
- Receptor, ErbB-3/genetics
- Receptor, ErbB-3/metabolism
- Survival Rate
- Tumor Cells, Cultured
- Tumor Microenvironment
- Xenograft Model Antitumor Assays
- Mice
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Affiliation(s)
- Veronica Gil
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Bora Gurel
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Ana Ferreira
- The Institute of Cancer Research, London, United Kingdom
| | - Daniela Brina
- Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Martina Troiani
- Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Adam Sharp
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | | | | | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | | | - Maryou Lambros
- The Institute of Cancer Research, London, United Kingdom
| | - David Dolling
- The Institute of Cancer Research, London, United Kingdom
| | - Jan Rekowski
- The Institute of Cancer Research, London, United Kingdom
| | - Abdullah Alajati
- Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Matthew Clarke
- The Institute of Cancer Research, London, United Kingdom
| | - Rita Pereira
- The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- The Institute of Cancer Research, London, United Kingdom
| | - Gemma Fowler
- The Institute of Cancer Research, London, United Kingdom
| | - Gunther Boysen
- The Institute of Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Caterina Aversa
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Christina Guo
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Alec Paschalis
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Lorenzo Buroni
- The Institute of Cancer Research, London, United Kingdom
| | - Jian Ning
- The Institute of Cancer Research, London, United Kingdom
| | | | - Paul Workman
- The Institute of Cancer Research, London, United Kingdom
| | - Amanda Swain
- The Institute of Cancer Research, London, United Kingdom
| | - Andrea Califano
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Michael M Shen
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Andrea Alimonti
- Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | | | - Jonathan Welti
- The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - Johann de Bono
- The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden Hospital, London, United Kingdom
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7
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Pernigoni N, Zagato E, Calcinotto A, Troiani M, Mestre RP, Calì B, Attanasio G, Troisi J, Minini M, Mosole S, Revandkar A, Pasquini E, Elia AR, Bossi D, Rinaldi A, Rescigno P, Flohr P, Hunt J, Neeb A, Buroni L, Guo C, Welti J, Ferrari M, Grioni M, Gauthier J, Gharaibeh RZ, Palmisano A, Lucchini GM, D'Antonio E, Merler S, Bolis M, Grassi F, Esposito A, Bellone M, Briganti A, Rescigno M, Theurillat JP, Jobin C, Gillessen S, de Bono J, Alimonti A. Commensal bacteria promote endocrine resistance in prostate cancer through androgen biosynthesis. Science 2021; 374:216-224. [PMID: 34618582 DOI: 10.1126/science.abf8403] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Nicolò Pernigoni
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Elena Zagato
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Arianna Calcinotto
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Martina Troiani
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Ricardo Pereira Mestre
- Medical Oncology Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
| | - Bianca Calì
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Giuseppe Attanasio
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Jacopo Troisi
- Theoreo Srl, Montecorvino Pugliano, 84090 Salerno, Italy
| | - Mirko Minini
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Simone Mosole
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Ajinkya Revandkar
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Emiliano Pasquini
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Angela Rita Elia
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Daniela Bossi
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Andrea Rinaldi
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | | | - Penny Flohr
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Joanne Hunt
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Antje Neeb
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Lorenzo Buroni
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Christina Guo
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Jonathan Welti
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Matteo Ferrari
- Medical Oncology Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
| | - Matteo Grioni
- Cellular Immunology Unit, IRCCS Ospedale San Raffaele, 20100 Milan, Italy
| | - Josée Gauthier
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville, FL, USA
| | - Raad Z Gharaibeh
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville, FL, USA
| | - Anna Palmisano
- Experimental Imaging Center, San Raffaele Scientific Institute, 20100 Milan, Italy.,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | | | - Eugenia D'Antonio
- Medical Oncology Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
| | - Sara Merler
- Department of Medicine, Venetian Institute of Molecular Medicine, University of Padova, Padova, Italy.,Section of Oncology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Marco Bolis
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland.,Computational Oncology Unit, Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, 20156 Milano, Italy
| | - Fabio Grassi
- Institute for Research in Biomedicine, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6500 Bellinzona, Switzerland
| | - Antonio Esposito
- Experimental Imaging Center, San Raffaele Scientific Institute, 20100 Milan, Italy.,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Matteo Bellone
- Cellular Immunology Unit, IRCCS Ospedale San Raffaele, 20100 Milan, Italy
| | - Alberto Briganti
- Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Maria Rescigno
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy
| | - Jean-Philippe Theurillat
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland
| | - Christian Jobin
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville, FL, USA.,Department of Infectious Diseases and Immunology, University of Florida College of Medicine, Gainesville, FL, USA.,Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Silke Gillessen
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland.,Medical Oncology Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
| | - Johann de Bono
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Andrea Alimonti
- Institute of Oncology Research, Oncology Institute of Southern Switzerland, CH-6500 Bellinzona, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, CH-1011 Lugano, Switzerland.,Department of Medicine, Venetian Institute of Molecular Medicine, University of Padova, Padova, Italy.,Department of Health Sciences and Technology, Eidgenössische Technische Hochschule (ETH) Zürich, Zurich, Switzerland
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8
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Kolinsky MP, Rescigno P, Bianchini D, Zafeiriou Z, Mehra N, Mateo J, Michalarea V, Riisnaes R, Crespo M, Figueiredo I, Miranda S, Nava Rodrigues D, Flohr P, Tunariu N, Banerji U, Ruddle R, Sharp A, Welti J, Lambros M, Carreira S, Raynaud FI, Swales KE, Plymate S, Luo J, Tovey H, Porta N, Slade R, Leonard L, Hall E, de Bono JS. A phase I dose-escalation study of enzalutamide in combination with the AKT inhibitor AZD5363 (capivasertib) in patients with metastatic castration-resistant prostate cancer. Ann Oncol 2020; 31:619-625. [PMID: 32205016 PMCID: PMC7217345 DOI: 10.1016/j.annonc.2020.01.074] [Citation(s) in RCA: 28] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 01/16/2020] [Accepted: 01/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Activation of the PI3K/AKT/mTOR pathway through loss of phosphatase and tensin homolog (PTEN) occurs in approximately 50% of patients with metastatic castration-resistant prostate cancer (mCRPC). Recent evidence suggests that combined inhibition of the androgen receptor (AR) and AKT may be beneficial in mCRPC with PTEN loss. PATIENTS AND METHODS mCRPC patients who previously failed abiraterone and/or enzalutamide, received escalating doses of AZD5363 (capivasertib) starting at 320 mg twice daily (b.i.d.) given 4 days on and 3 days off, in combination with enzalutamide 160 mg daily. The co-primary endpoints were safety/tolerability and determining the maximum tolerated dose and recommended phase II dose; pharmacokinetics, antitumour activity, and exploratory biomarker analysis were also evaluated. RESULTS Sixteen patients were enrolled, 15 received study treatment and 13 were assessable for dose-limiting toxicities (DLTs). Patients were treated at 320, 400, and 480 mg b.i.d. dose levels of capivasertib. The recommended phase II dose identified for capivasertib was 400 mg b.i.d. with 1/6 patients experiencing a DLT (maculopapular rash) at this level. The most common grade ≥3 adverse events were hyperglycemia (26.7%) and rash (20%). Concomitant administration of enzalutamide significantly decreased plasma exposure of capivasertib, though this did not appear to impact pharmacodynamics. Three patients met the criteria for response (defined as prostate-specific antigen decline ≥50%, circulating tumour cell conversion, and/or radiological response). Responses were seen in patients with PTEN loss or activating mutations in AKT, low or absent AR-V7 expression, as well as those with an increase in phosphorylated extracellular signal-regulated kinase (pERK) in post-exposure samples. CONCLUSIONS The combination of capivasertib and enzalutamide is tolerable and has antitumour activity, with all responding patients harbouring aberrations in the PI3K/AKT/mTOR pathway. CLINICAL TRIAL NUMBER NCT02525068.
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Affiliation(s)
- M P Kolinsky
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; Cross Cancer Institute, Edmonton, Canada
| | - P Rescigno
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; Department of Clinical Medicine and Surgery, Department of Translational Medical Sciences, AOU Federico II, Naples, Italy
| | - D Bianchini
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - Z Zafeiriou
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - N Mehra
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - J Mateo
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - V Michalarea
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - R Riisnaes
- The Institute of Cancer Research, London, UK
| | - M Crespo
- The Institute of Cancer Research, London, UK
| | | | - S Miranda
- The Institute of Cancer Research, London, UK
| | | | - P Flohr
- The Institute of Cancer Research, London, UK
| | - N Tunariu
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - U Banerji
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - R Ruddle
- The Institute of Cancer Research, London, UK
| | - A Sharp
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - J Welti
- The Institute of Cancer Research, London, UK
| | - M Lambros
- The Institute of Cancer Research, London, UK
| | - S Carreira
- The Institute of Cancer Research, London, UK
| | - F I Raynaud
- The Institute of Cancer Research, London, UK
| | - K E Swales
- The Institute of Cancer Research, London, UK
| | - S Plymate
- University of Washington School of Medicine, Seattle, USA
| | - J Luo
- Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, USA
| | - H Tovey
- The Institute of Cancer Research, London, UK
| | - N Porta
- The Institute of Cancer Research, London, UK
| | - R Slade
- The Institute of Cancer Research, London, UK
| | - L Leonard
- The Institute of Cancer Research, London, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
| | - J S de Bono
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
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Mateo J, Porta N, Bianchini D, McGovern U, Elliott T, Jones R, Syndikus I, Ralph C, Jain S, Varughese M, Parikh O, Crabb S, Robinson A, McLaren D, Birtle A, Tanguay J, Miranda S, Figueiredo I, Seed G, Bertan C, Flohr P, Ebbs B, Rescigno P, Fowler G, Ferreira A, Riisnaes R, Pereira R, Curcean A, Chandler R, Clarke M, Gurel B, Crespo M, Nava Rodrigues D, Sandhu S, Espinasse A, Chatfield P, Tunariu N, Yuan W, Hall E, Carreira S, de Bono JS. Olaparib in patients with metastatic castration-resistant prostate cancer with DNA repair gene aberrations (TOPARP-B): a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol 2020; 21:162-174. [PMID: 31806540 PMCID: PMC6941219 DOI: 10.1016/s1470-2045(19)30684-9] [Citation(s) in RCA: 400] [Impact Index Per Article: 100.0] [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: 08/07/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Metastatic castration-resistant prostate cancer is enriched in DNA damage response (DDR) gene aberrations. The TOPARP-B trial aims to prospectively validate the association between DDR gene aberrations and response to olaparib in metastatic castration-resistant prostate cancer. METHODS In this open-label, investigator-initiated, randomised phase 2 trial following a selection (or pick-the-winner) design, we recruited participants from 17 UK hospitals. Men aged 18 years or older with progressing metastatic castration-resistant prostate cancer previously treated with one or two taxane chemotherapy regimens and with an Eastern Cooperative Oncology Group performance status of 2 or less had tumour biopsies tested with targeted sequencing. Patients with DDR gene aberrations were randomly assigned (1:1) by a computer-generated minimisation method, with balancing for circulating tumour cell count at screening, to receive 400 mg or 300 mg olaparib twice daily, given continuously in 4-week cycles until disease progression or unacceptable toxicity. Neither participants nor investigators were masked to dose allocation. The primary endpoint of confirmed response was defined as a composite of all patients presenting with any of the following outcomes: radiological objective response (as assessed by Response Evaluation Criteria in Solid Tumors 1.1), a decrease in prostate-specific antigen (PSA) of 50% or more (PSA50) from baseline, or conversion of circulating tumour cell count (from ≥5 cells per 7·5 mL blood at baseline to <5 cells per 7·5 mL blood). A confirmed response in a consecutive assessment after at least 4 weeks was required for each component. The primary analysis was done in the evaluable population. If at least 19 (43%) of 44 evaluable patients in a dose cohort responded, then the dose cohort would be considered successful. Safety was assessed in all patients who received at least one dose of olaparib. This trial is registered at ClinicalTrials.gov, NCT01682772. Recruitment for the trial has completed and follow-up is ongoing. FINDINGS 711 patients consented for targeted screening between April 1, 2015, and Aug 30, 2018. 161 patients had DDR gene aberrations, 98 of whom were randomly assigned and treated (49 patients for each olaparib dose), with 92 evaluable for the primary endpoint (46 patients for each olaparib dose). Median follow-up was 24·8 months (IQR 16·7-35·9). Confirmed composite response was achieved in 25 (54·3%; 95% CI 39·0-69·1) of 46 evaluable patients in the 400 mg cohort, and 18 (39·1%; 25·1-54·6) of 46 evaluable patients in the 300 mg cohort. Radiological response was achieved in eight (24·2%; 11·1-42·3) of 33 evaluable patients in the 400 mg cohort and six (16·2%; 6·2-32·0) of 37 in the 300 mg cohort; PSA50 response was achieved in 17 (37·0%; 23·2-52·5) of 46 and 13 (30·2%; 17·2-46·1) of 43; and circulating tumour cell count conversion was achieved in 15 (53·6%; 33·9-72·5) of 28 and 13 (48·1%; 28·7-68·1) of 27. The most common grade 3-4 adverse event in both cohorts was anaemia (15 [31%] of 49 patients in the 300 mg cohort and 18 [37%] of 49 in the 400 mg cohort). 19 serious adverse reactions were reported in 13 patients. One death possibly related to treatment (myocardial infarction) occurred after 11 days of treatment in the 300 mg cohort. INTERPRETATION Olaparib has antitumour activity against metastatic castration-resistant prostate cancer with DDR gene aberrations, supporting the implementation of genomic stratification of metastatic castration-resistant prostate cancer in clinical practice. FUNDING Cancer Research UK, AstraZeneca, Prostate Cancer UK, the Prostate Cancer Foundation, the Experimental Cancer Medicine Centres Network, and the National Institute for Health Research Biomedical Research Centres.
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Affiliation(s)
- Joaquin Mateo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Porta
- The Institute of Cancer Research, London, UK
| | - Diletta Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Ursula McGovern
- University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tony Elliott
- The Christie NHS Foundation Trust, Manchester, UK
| | - Robert Jones
- University of Glasgow and Beatson West of Scotland Cancer Centre, Glasgow, UK
| | | | - Christy Ralph
- St James's Institute of Oncology, University of Leeds, Leeds, UK
| | | | | | | | | | | | | | | | | | | | | | - George Seed
- The Institute of Cancer Research, London, UK
| | | | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | - Berni Ebbs
- The Institute of Cancer Research, London, UK
| | - Pasquale Rescigno
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | | | - Andra Curcean
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Robert Chandler
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | | | | | | | | | | | - Nina Tunariu
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | - Emma Hall
- The Institute of Cancer Research, London, UK
| | | | - Johann S de Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK.
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10
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Lorente D, Olmos D, Mateo J, Dolling D, Bianchini D, Seed G, Flohr P, Crespo M, Figueiredo I, Miranda S, Scher HI, Terstappen LWMM, de Bono JS. Circulating tumour cell increase as a biomarker of disease progression in metastatic castration-resistant prostate cancer patients with low baseline CTC counts. Ann Oncol 2019; 29:1554-1560. [PMID: 29741566 DOI: 10.1093/annonc/mdy172] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background The development of treatment response and surrogate biomarkers for advanced prostate cancer care is an unmet clinical need. Patients with baseline circulating tumour cell (BLCTCs) counts <5/7.5 mL represent a good prognosis subgroup but are non-evaluable for response assessment (decrease in CTCs). The aim of the study is to determine the value of any increase in CTCs (CTC progression) as an indicator of progression in prostate cancer patients with low pre-treatment CTCs (<5). Patients and methods We carried out a post hoc analysis of patients with BLCTCs < 5 treated in the COU-AA-301 (abiraterone or placebo + prednisone) and IMMC-38 (chemotherapy) trials. The association of CTC progression (increase in CTCs at 4, 8 or 12 weeks) with overall survival (OS) was evaluated in multi-variable Cox regression models. Performance of survival models with and without CTC progression was evaluated by calculating ROC curve area under the curves (AUCs) and weighted c-indices. Results Overall, 511 patients with CTCs < 5 (421 in COU-AA-301 and 90 in IMMC-38) were selected; 212 (41.7%) had CTC progression at 4, 8 or 12 weeks after treatment initiation. CTC progression was associated with significantly worse OS [27.1 versus 15.1 m; hazard ratio (HR) 3.4 (95% confidence interval [CI] 2.5-4.5; P < 0.001)], independent of baseline CTCs and established clinical variables. Adding CTC progression to the OS model significantly improved ROC AUC (0.77 versus 0.66; P < 0.001). Models including CTC progression had superior ROC AUC (0.77 versus 0.69; P < 0.001) and weighted c-index [0.750 versus 0.705; delta c-index: 0.045 (95% CI 0.019-0.071)] values than those including CTC conversion (increase to CTCs ≥ 5). In COU-AA-301, the impact of CTC progression was independent of treatment arm. Conclusions Increasing CTCs during the first 12 weeks of treatment are independently associated with worse OS from advanced prostate cancer in patients with baseline CTCs < 5 treated with abiraterone or chemotherapy and improve models with established prognostic variables. These findings must be prospectively validated.
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Affiliation(s)
- D Lorente
- Medical Oncology Service, Hospital La Fe, Valencia, Spain; Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - D Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - J Mateo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey; Prostate Cancer Translational Research Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - D Dolling
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - D Bianchini
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - G Seed
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - P Flohr
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - M Crespo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - I Figueiredo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - S Miranda
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey
| | - H I Scher
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, USA
| | - L W M M Terstappen
- MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - J S de Bono
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, Surrey.
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11
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Lambros MB, Seed G, Sumanasuriya S, Gil V, Crespo M, Fontes M, Chandler R, Mehra N, Fowler G, Ebbs B, Flohr P, Miranda S, Yuan W, Mackay A, Ferreira A, Pereira R, Bertan C, Figueiredo I, Riisnaes R, Rodrigues DN, Sharp A, Goodall J, Boysen G, Carreira S, Bianchini D, Rescigno P, Zafeiriou Z, Hunt J, Moloney D, Hamilton L, Neves RP, Swennenhuis J, Andree K, Stoecklein NH, Terstappen LWMM, de Bono JS. Single-Cell Analyses of Prostate Cancer Liquid Biopsies Acquired by Apheresis. Clin Cancer Res 2018; 24:5635-5644. [PMID: 30093450 DOI: 10.1158/1078-0432.ccr-18-0862] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/01/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022]
Abstract
Purpose: Circulating tumor cells (CTCs) have clinical relevance, but their study has been limited by their low frequency.Experimental Design: We evaluated liquid biopsies by apheresis to increase CTC yield from patients suffering from metastatic prostate cancer, allow precise gene copy-number calls, and study disease heterogeneity.Results: Apheresis was well tolerated and allowed the separation of large numbers of CTCs; the average CTC yield from 7.5 mL of peripheral blood was 167 CTCs, whereas the average CTC yield per apheresis (mean volume: 59.5 mL) was 12,546 CTCs. Purified single CTCs could be isolated from apheresis product by FACS sorting; copy-number aberration (CNA) profiles of 185 single CTCs from 14 patients revealed the genomic landscape of lethal prostate cancer and identified complex intrapatient, intercell, genomic heterogeneity missed on bulk biopsy analyses.Conclusions: Apheresis facilitated the capture of large numbers of CTCs noninvasively with minimal morbidity and allowed the deconvolution of intrapatient heterogeneity and clonal evolution. Clin Cancer Res; 24(22); 5635-44. ©2018 AACR.
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Affiliation(s)
- Maryou B Lambros
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Veronica Gil
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mariane Fontes
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Rob Chandler
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Niven Mehra
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gemma Fowler
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Berni Ebbs
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Alan Mackay
- Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer, Research, London, United Kingdom
| | - Ana Ferreira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Rita Pereira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Ines Figueiredo
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Daniel Nava Rodrigues
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Adam Sharp
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jane Goodall
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Gunther Boysen
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne Carreira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Diletta Bianchini
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Zafeiris Zafeiriou
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joanne Hunt
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Deirdre Moloney
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Lucy Hamilton
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Rui P Neves
- Department of General, Visceral and Pediatric Surgery, University Hospital of the, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Joost Swennenhuis
- Department of Medical Cell BioPhysics, University of Twente, Enschede, the Netherlands
| | - Kiki Andree
- Department of Medical Cell BioPhysics, University of Twente, Enschede, the Netherlands
| | - Nikolas H Stoecklein
- Department of General, Visceral and Pediatric Surgery, University Hospital of the, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Leon W M M Terstappen
- Department of Medical Cell BioPhysics, University of Twente, Enschede, the Netherlands
| | - Johann S de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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12
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Nanou A, Crespo M, Flohr P, De Bono JS, Terstappen LWMM. Scanning Electron Microscopy of Circulating Tumor Cells and Tumor-Derived Extracellular Vesicles. Cancers (Basel) 2018; 10:E416. [PMID: 30384500 PMCID: PMC6266016 DOI: 10.3390/cancers10110416] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 01/08/2023] Open
Abstract
To explore morphological features of circulating tumor cells (CTCs) and tumor-derived extracellular vesicles (tdEVs), we developed a protocol for scanning electron microscopy (SEM) of CTCs and tdEVs. CTCs and tdEVs were isolated by immunomagnetic enrichment based on their Epithelial Cell Adhesion Molecule (EpCAM) expression or by physical separation through 5 μm microsieves from 7.5 mL of blood from Castration-Resistant Prostate Cancer (CRPC) patients. Protocols were optimized using blood samples of healthy donors spiked with PC3 and LNCaP cell lines. CTCs and tdEVs were identified among the enriched cells by fluorescence microscopy. The positions of DNA+, CK+, CD45- CTCs and DNA-, CK+, CD45- tdEVs on the CellSearch cartridges and microsieves were recorded. After gradual dehydration and chemical drying, the regions of interest were imaged by SEM. CellSearch CTCs retained their morphology revealing various shapes, some of which were clearly associated with CTCs undergoing apoptosis. The ferrofluid was clearly distinguishable, shielding major portions of all isolated objects. CTCs and leukocytes on microsieves were clearly visible, but revealed physical damage attributed to the physical forces that cells exhibit while entering one or multiple pores. tdEVs could not be identified on the microsieves as they passed through the pores. Insights on the underlying mechanism of each isolation technique could be obtained. Complete detailed morphological characteristics of CTCs are, however, masked by both techniques.
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Affiliation(s)
- Afroditi Nanou
- Department of Medical Cell BioPhysics, University of Twente, 7522 NH Enschede, The Netherlands.
| | - Mateus Crespo
- Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK.
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK.
| | - Johann S De Bono
- Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK.
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK.
| | - Leon W M M Terstappen
- Department of Medical Cell BioPhysics, University of Twente, 7522 NH Enschede, The Netherlands.
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13
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Andree KC, Mentink A, Zeune LL, Terstappen LWMM, Stoecklein NH, Neves RP, Driemel C, Lampignano R, Yang L, Neubauer H, Fehm T, Fischer JC, Rossi E, Manicone M, Basso U, Marson P, Zamarchi R, Loriot Y, Lapierre V, Faugeroux V, Oulhen M, Farace F, Fowler G, Sousa Fontes M, Ebbs B, Lambros M, Crespo M, Flohr P, de Bono JS. Toward a real liquid biopsy in metastatic breast and prostate cancer: Diagnostic LeukApheresis increases CTC yields in a European prospective multicenter study (CTCTrap). Int J Cancer 2018; 143:2584-2591. [PMID: 30006930 PMCID: PMC6637919 DOI: 10.1002/ijc.31752] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/18/2018] [Accepted: 06/25/2018] [Indexed: 01/02/2023]
Abstract
Frequently, the number of circulating tumor cells (CTC) isolated in 7.5 mL of blood is too small to reliably determine tumor heterogeneity and to be representative as a “liquid biopsy”. In the EU FP7 program CTCTrap, we aimed to validate and optimize the recently introduced Diagnostic LeukApheresis (DLA) to screen liters of blood. Here we present the results obtained from 34 metastatic cancer patients subjected to DLA in the participating institutions. About 7.5 mL blood processed with CellSearch® was used as “gold standard” reference. DLAs were obtained from 22 metastatic prostate and 12 metastatic breast cancer patients at four different institutions without any noticeable side effects. DLA samples were prepared and processed with different analysis techniques. Processing DLA using CellSearch resulted in a 0–32 fold increase in CTC yield compared to processing 7.5 mL blood. Filtration of DLA through 5 μm pores microsieves was accompanied by large CTC losses. Leukocyte depletion of 18 mL followed by CellSearch yielded an increase of the number of CTC but a relative decrease in yield (37%) versus CellSearch DLA. In four out of seven patients with 0 CTC detected in 7.5 mL of blood, CTC were detected in DLA (range 1–4 CTC). The CTC obtained through DLA enables molecular characterization of the tumor. CTC enrichment technologies however still need to be improved to isolate all the CTC present in the DLA. What's new? Circulating tumor cells (CTC) can mirror tumor heterogeneity but a standard blood sample (7.5 mL) is too small to truly represent the tumor. To increase the yield of CTC, the authors used Diagnostic LeukApheresis in which liters of blood are screened for the presence of CTC in metastatic cancer patients. They report a significant increase in CTC yield and consequently, a better molecular characterization of the tumor, encouraging further research into the use of leukapheresis as “liquid biopsy” in cancer patients.
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Affiliation(s)
- Kiki C Andree
- Department of Medical Cell BioPhysics, University of Twente, Enschede, The Netherlands
| | - Anouk Mentink
- Department of Medical Cell BioPhysics, University of Twente, Enschede, The Netherlands
| | - Leonie L Zeune
- Department of Medical Cell BioPhysics, University of Twente, Enschede, The Netherlands
| | - Leon W M M Terstappen
- Department of Medical Cell BioPhysics, University of Twente, Enschede, The Netherlands
| | - Nikolas H Stoecklein
- Department of General, Visceral and Pediatric Surgery, University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Rui P Neves
- Department of General, Visceral and Pediatric Surgery, University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christiane Driemel
- Department of General, Visceral and Pediatric Surgery, University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Rita Lampignano
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Liwen Yang
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Hans Neubauer
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tanja Fehm
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Elisabetta Rossi
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.,DiSCOG, University of Padova, Padova, Italy
| | | | - Umberto Basso
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Piero Marson
- Apheresis Unit, Blood Transfusion Service, University Hospital of Padova, Padova, Italy
| | - Rita Zamarchi
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Yohann Loriot
- Department of Medicine, Université Paris-Saclay, Gustave Roussy, Villejuif, France.,INSERM U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment", Gustave Roussy, Villejuif, France
| | - Valerie Lapierre
- Department of Medicine, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Vincent Faugeroux
- INSERM U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment", Gustave Roussy, Villejuif, France.,"Circulating Tumor Cells" Translational Platform, CNRS UMS3655 - INSERM US23 Ammica, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Marianne Oulhen
- "Circulating Tumor Cells" Translational Platform, CNRS UMS3655 - INSERM US23 Ammica, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Françoise Farace
- INSERM U981 "Identification of Molecular Predictors and New Targets for Cancer Treatment", Gustave Roussy, Villejuif, France.,"Circulating Tumor Cells" Translational Platform, CNRS UMS3655 - INSERM US23 Ammica, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Gemma Fowler
- Cancer Biomarkers, Institute of Cancer Research, Sutton, UK
| | - Mariane Sousa Fontes
- Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Berni Ebbs
- Cancer Biomarkers, Institute of Cancer Research, Sutton, UK
| | - Maryou Lambros
- Cancer Biomarkers, Institute of Cancer Research, Sutton, UK
| | - Mateus Crespo
- Cancer Biomarkers, Institute of Cancer Research, Sutton, UK
| | - Penny Flohr
- Cancer Biomarkers, Institute of Cancer Research, Sutton, UK
| | - Johann S de Bono
- Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
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14
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Mehra N, Dolling D, Sumanasuriya S, Christova R, Pope L, Carreira S, Seed G, Yuan W, Goodall J, Hall E, Flohr P, Boysen G, Bianchini D, Sartor O, Eisenberger MA, Fizazi K, Oudard S, Chadjaa M, Macé S, de Bono JS. Plasma Cell-free DNA Concentration and Outcomes from Taxane Therapy in Metastatic Castration-resistant Prostate Cancer from Two Phase III Trials (FIRSTANA and PROSELICA). Eur Urol 2018; 74:283-291. [PMID: 29500065 PMCID: PMC6090941 DOI: 10.1016/j.eururo.2018.02.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [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: 10/06/2017] [Accepted: 02/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Noninvasive biomarkers are needed to guide metastatic castration-resistant prostate cancer (mCRPC) treatment. OBJECTIVE To clinically qualify baseline and on-treatment cell-free DNA (cfDNA) concentrations as biomarkers of patient outcome following taxane chemotherapy. DESIGN, SETTING, AND PARTICIPANTS Blood for cfDNA analyses was prospectively collected from 571 mCRPC patients participating in two phase III clinical trials, FIRSTANA (NCT01308567) and PROSELICA (NCT01308580). Patients received docetaxel (75mg/m2) or cabazitaxel (20 or 25mg/m2) as first-line chemotherapy (FIRSTANA), and cabazitaxel (20 or 25mg/m2) as second-line chemotherapy (PROSELICA). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Associations between cfDNA concentration and prostate-specific antigen (PSA) response were tested using logistic regression models. Survival was estimated using Kaplan-Meier methods for cfDNA concentration grouped by quartile. Cox proportional hazard models, within each study, tested for associations with radiological progression-free survival (rPFS) and overall survival (OS), with multivariable analyses adjusting for baseline prognostic variables. Two-stage individual patient meta-analysis combined results for cfDNA concentrations for both studies. RESULTS AND LIMITATIONS In 2502 samples, baseline log10 cfDNA concentration correlated with known prognostic factors, shorter rPFS (hazard ratio [HR]=1.54; 95% confidence interval [CI]: 1.15-2.08; p=0.004), and shorter OS on taxane therapy (HR=1.53; 95% CI: 1.18-1.97; p=0.001). In multivariable analyses, baseline cfDNA concentration was an independent prognostic variable for rPFS and OS in both first- and second-line chemotherapy settings. Patients with a PSA response experienced a decline in log10 cfDNA concentrations during the first four cycles of treatment (per cycle -0.03; 95% CI: -0.044 to -0.009; p=0.003). Study limitations included the fact that blood sample collection was not mandated for all patients and the inability to specifically quantitate tumour-derived cfDNA fraction in cfDNA. CONCLUSIONS We report that changes in cfDNA concentrations correlate with both rPFS and OS in patients receiving first- and second-line taxane therapy, and may serve as independent prognostic biomarkers of response to taxanes. PATIENT SUMMARY In the past decade, several new therapies have been introduced for men diagnosed with metastatic prostate cancer. Although metastatic prostate cancer remains incurable, these novel agents have extended patient survival and improved their quality of life in comparison with the last decade. To further optimise treatment allocation and individualise patient care, better tests (biomarkers) are needed to guide the delivery of improved and more precise care. In this report, we assessed cfDNA in over 2500 blood samples from men with prostate cancer who were recruited to two separate international studies and received taxane chemotherapy. We quantified the concentration of cfDNA fragments in blood plasma, which partly originates from tumour. We identified that higher concentrations of circulating cfDNA fragments, prior to starting taxane chemotherapy, can be used to identify patients with aggressive prostate cancer. A decline in cfDNA concentration during the first 3-9 wk after initiation of taxane therapy was seen in patients deriving benefit from taxane chemotherapy. These results identified circulating cfDNA as a new biomarker of aggressive disease in metastatic prostate cancer and imply that the study of cfDNA has clinical utility, supporting further efforts to develop blood-based tests on this circulating tumour-derived DNA.
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Affiliation(s)
- Niven Mehra
- Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, UK
| | - David Dolling
- The Institute of Cancer Research Clinical Trials and Statistics Unit, London, UK
| | - Semini Sumanasuriya
- Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, UK
| | | | - Lorna Pope
- The Institute of Cancer Research, London, UK
| | | | - George Seed
- The Institute of Cancer Research, London, UK
| | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | | | - Emma Hall
- The Institute of Cancer Research Clinical Trials and Statistics Unit, London, UK
| | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | | | - Diletta Bianchini
- Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, UK
| | - Oliver Sartor
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Mario A Eisenberger
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Karim Fizazi
- Department of Medical Oncology, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - Stephane Oudard
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | - Johann S de Bono
- Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, UK.
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15
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Lambros MB, Gil V, Crespo M, Fontes MS, Mackay A, Folwer G, Folwer G, Ebbs B, Neves R, Flohr P, Miranda S, Sumanasuriya S, Rodrigues DN, Pereira R, Seed G, Yuan W, Hunt J, Moloney D, Ayanda D, Mehra N, Goodall J, Bertan C, Carreira S, Stoecklein NH, Terstappen LW, Boysen G, Bono JSD. Abstract A051: Liquid biopsy by apheresis: Molecular characterization of circulating tumor cells and their organoid culture reflects intrapatient heterogeneity and clonal evolution. Cancer Res 2018. [DOI: 10.1158/1538-7445.prca2017-a051] [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
Liquid biopsy components from blood, such as cell free DNA (cfDNA) and circulating tumor cells (CTCs), are prognostic for overall survival in advanced prostate cancer patients and allow the study of clonal evolution. cfDNA is easily obtained and has been widely used for molecular characterization and reflects pooled genomic profiles in a patient, but has limitations regarding gene copy number calls. CTC single-cell genomic studies generate precise gene copy number calls and elucidate intrapatient intercellular genomic heterogeneity. The main limitation of CTC analyses has been the low CTC count found in many cancer patients. We elected to study whether liquid biopsy by apheresis in advanced prostate cancer patients increases the yield of CTC to study tumor genomics, intrapatient heterogeneity, and ex vivo organotypic 3D models.
Advanced metastatic prostate cancer patients being considered for clinical trials were invited to consent to apheresis. Apheresis CTC counts using CellSearchTM (Menarini) were acquired from 16 patients. The contents of the CellSearch cartridges were sorted into pure single cells by fluorescence-activated cell sorting and subsequently assessed by array comparative genomic hybridization (aCGH, Agilent Technology) for copy number aberrations (CNA). Exome and aCGH from tissue biopsies were compared to the single cell aCGH results. We generated patient-derived organoid (PDOs) cultures from apheresis products by preenrichment using density gradient (Lymphoprep) and subsequent CTC enrichment by EpCAM positive selection (EasySep StemCell Technologies). PDOs were characterized by immunofluorescence (IF) as DAPI+/CK+/EpCAM+ and CD45- cells and subsequently by aCGH for CNA.
All sixteen patients (median age of 70 years; range 60-77 years) tolerated apheresis without any adverse effects. CTC counts from peripheral blood (PB) prior to apheresis ranged from 13 to 711 (median = 96), and did not significantly change post apheresis. The estimated CTC yield per apheresis ranged from 660-35473 per apheresis product (median = 3351). This constitutes an increase of 102-fold when compared to median CTC capture from 7.5mL of PB. A total of 170 single CTCs from 15 apheresis patients were genomically profiled and the copy number aberration profiles confirmed prostate cancer with multiple genomic hallmarks including CNAs such as AR amplification, chromosome 8q gain (MYC locus), and PTEN, RB1, BRCA2, TP53, CHD1 loss. CNA profiles of PDOs showed similar genomic aberrations to same patient CTCs and also reflected intrapatient heterogeneity detected by single CTC analysis.
In conclusion, apheresis from advanced prostate cancer patients is a well-tolerated procedure and in our study increased the CTC yield by 102-fold when compared to PB. CTC and PDOs from apheresis products shared similar CNA profile compared with tissues biopsies and furthermore gave us an insight of the tumor heterogeneity and clonal evolution.
Citation Format: Maryou B.K. Lambros, Veronica Gil, Mateus Crespo, Mariane S. Fontes, Alan Mackay, Gemma Folwer, Gemma Folwer, Berni Ebbs, Rui Neves, Penny Flohr, Susana Miranda, Semini Sumanasuriya, Daniel N. Rodrigues, Rita Pereira, Geroge Seed, Wei Yuan, Joanne Hunt, Deirdre Moloney, Dionne Ayanda, Niven Mehra, Jane Goodall, Claudia Bertan, Suzanne Carreira, Nikolas H. Stoecklein, Leon W.M.M. Terstappen, Gunther Boysen, Joahnn S. De Bono. Liquid biopsy by apheresis: Molecular characterization of circulating tumor cells and their organoid culture reflects intrapatient heterogeneity and clonal evolution [abstract]. In: Proceedings of the AACR Special Conference: Prostate Cancer: Advances in Basic, Translational, and Clinical Research; 2017 Dec 2-5; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(16 Suppl):Abstract nr A051.
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Affiliation(s)
| | - Veronica Gil
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Mateus Crespo
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | | | - Alan Mackay
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Gemma Folwer
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Gemma Folwer
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Berni Ebbs
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Rui Neves
- 2University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany,
| | - Penny Flohr
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Susana Miranda
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | | | | | - Rita Pereira
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Geroge Seed
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Wei Yuan
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Joanne Hunt
- 3The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom,
| | - Deirdre Moloney
- 3The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom,
| | - Dionne Ayanda
- 3The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom,
| | - Niven Mehra
- 3The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom,
| | - Jane Goodall
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Claudia Bertan
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Suzanne Carreira
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
| | - Nikolas H. Stoecklein
- 2University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany,
| | - Leon W.M.M. Terstappen
- 4Department of Medical Cell BioPhysics, University of Twente, Enschede, Overijssel, Netherlands
| | - Gunther Boysen
- 1The Institute of Cancer Research, Sutton, Surrey, United Kingdom,
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16
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Neves RPL, Anna SLRF, Raba K, Bongers EK, Behrens B, Dalum GV, Flohr P, Mateo J, Sumanasuriya S, Crespo M, Ebbs B, Fowler G, Rescigno P, Carreira S, Lambros M, Petrini E, Garonzi M, Manaresi N, Bono JD, Stoecklein NH. Abstract 4579: The genetic heterogeneity and the molecular evolution of systemic metastatic castration resistant prostate cancer during therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Circulating tumour cells (CTCs) have a significant prognostic impact in metastatic castration-resistant prostate cancer (mCRPC) and provide direct access to the systemic disease. Here, we performed genome-wide copy number analysis of CellSearchTM detected CTCs to follow the genomic evolution of mCRPC during systemic therapy.
Methods: Blood samples were collected from 13 patients with mCRPC before, during and after two different targeted therapy regimes. Single CTCs were isolated from CellSearchTM cartridges using the DEPArray™ system and the MoFlo XDP cell sorter. Genomes of sorted single cells were amplified using Ampli1™ WGA kit. Amplification products were analysed by array-based comparative genomic hybridization (aCGH) and low-pass sequencing (LPS) using Ampli1™ LowPass kit to detect somatic chromosomal copy number aberrations (CNAs) and explore the degree of genomic heterogeneity.
Results: We analysed >300 CTCs for CNAs by aCGH and/or LPS. Although most CTCs displayed CNAs typical for mCRPC, we identified three genomic CTC-groups across all cells with the EpCAMpos/CKpos/DAPIpos/CD45neg phenotype: CTCs with typical mCRPC CNAs (Type A; 80%), extremely aberrant CTCs (Type B; 11%), CNA-negative/low CTCs (Type C; 9%). The occurrence of Type B and C was almost mutually exclusive. At baseline, we noted different levels of CTC-heterogeneity and different CTC-aberration levels between the different patients. Interestingly, CTCs of patients with a relevant decrease in CTC-count under PARP-inhibition (CTC-responder) displayed significantly elevated CNAs at baseline compared to CTC-non-responders. During therapy, we could observe clonal changes among all patients.
Conclusions: Our data show that CTC-analysis enables the dissection of clinical relevant intra-patient heterogeneity and clonal evolution under therapy in mCRPC patients. Comprehensive genomic monitoring during therapy might help to tailor therapies more effectively and may pinpoint to molecular mechanism of therapeutic resistance.
Citation Format: Rui PL Neves, Streit LRF Anna, Katharina Raba, Elina-Katharina Bongers, Bianca Behrens, Guus van Dalum, Penny Flohr, Joaquin Mateo, Semini Sumanasuriya, Mateus Crespo, Berni Ebbs, Gemma Fowler, Pasquale Rescigno, Suzanne Carreira, Maryou Lambros, Edoardo Petrini, Marianna Garonzi, Nicolò Manaresi, Johann de Bono, Nikolas H. Stoecklein. The genetic heterogeneity and the molecular evolution of systemic metastatic castration resistant prostate cancer during therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4579.
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Affiliation(s)
- Rui PL Neves
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
| | - Streit LRF Anna
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
| | - Katharina Raba
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
| | - Elina-Katharina Bongers
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
| | - Bianca Behrens
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
| | - Guus van Dalum
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
| | - Penny Flohr
- 2The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- 2The Institute of Cancer Research, London, United Kingdom
| | | | - Mateus Crespo
- 2The Institute of Cancer Research, London, United Kingdom
| | - Berni Ebbs
- 2The Institute of Cancer Research, London, United Kingdom
| | - Gemma Fowler
- 2The Institute of Cancer Research, London, United Kingdom
| | | | | | - Maryou Lambros
- 2The Institute of Cancer Research, London, United Kingdom
| | | | | | | | - Johann de Bono
- 2The Institute of Cancer Research, London, United Kingdom
| | - Nikolas H. Stoecklein
- 1University Hospital and Medical Faculty of the Heinrich-Heine University Düsseldorf, Duesseldorf, Germany
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17
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Nanou A, Coumans FAW, van Dalum G, Zeune LL, Dolling D, Onstenk W, Crespo M, Fontes MS, Rescigno P, Fowler G, Flohr P, Brune C, Sleijfer S, de Bono JS, Terstappen LWMM. Circulating tumor cells, tumor-derived extracellular vesicles and plasma cytokeratins in castration-resistant prostate cancer patients. Oncotarget 2018; 9:19283-19293. [PMID: 29721202 PMCID: PMC5922396 DOI: 10.18632/oncotarget.25019] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/17/2018] [Indexed: 12/26/2022] Open
Abstract
Purpose The presence of Circulating Tumor Cells (CTCs) in Castration-Resistant Prostate Cancer (CRPC) patients is associated with poor prognosis. In this study, we evaluated the association of clinical outcome in 129 CRPC patients with CTCs, tumor-derived Extracellular Vesicles (tdEVs) and plasma levels of total (CK18) and caspase-cleaved cytokeratin 18 (ccCK18). Experimental Design CTCs and tdEVs were isolated with the CellSearch system and automatically enumerated. Cut-off values dichotomizing patients into favorable and unfavorable groups of overall survival were set on a retrospective data set of 84 patients and validated on a prospective data set of 45 patients. Plasma levels of CK18 and ccCK18 were assessed by ELISAs. Results CTCs, tdEVs and both cytokeratin plasma levels were significantly increased in CRPC patients compared to healthy donors (HDs). All biomarkers except for ccCK18 were prognostic showing a decreased median overall survival for the unfavorable groups of 9.2 vs 21.1, 8.1 vs 23.0 and 10.0 vs 21.5 months respectively. In multivariable Cox regression analysis, tdEVs remained significant. Conclusions Automated CTC and tdEV enumeration allows fast and reliable scoring eliminating inter- and intra- operator variability. tdEVs provide similar prognostic information to CTC counts.
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Affiliation(s)
- Afroditi Nanou
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - Frank A W Coumans
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Guus van Dalum
- Department of General, Visceral and Pediatric Surgery, University Hospital and Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany
| | - Leonie L Zeune
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, the Netherlands.,Department of Applied Mathematics, MIRA Institute and Faculty of EEMCS, University of Twente, Enschede, the Netherlands
| | - David Dolling
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Wendy Onstenk
- Department of Medical Oncology, Erasmus MC - Cancer Institute, Rotterdam, The Netherlands
| | - Mateus Crespo
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mariane Sousa Fontes
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom.,Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom.,Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gemma Fowler
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Christoph Brune
- Department of Applied Mathematics, MIRA Institute and Faculty of EEMCS, University of Twente, Enschede, the Netherlands
| | - Stefan Sleijfer
- Department of Medical Oncology, Erasmus MC - Cancer Institute, Rotterdam, The Netherlands
| | - Johann S de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom.,Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Leon W M M Terstappen
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, the Netherlands
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18
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Nanou A, Coumans FA, van Dalum G, Zeune LL, Dolling D, Onstenk W, Crespo M, Fontes MS, Rescigno P, Fowler G, Flohr P, Brune C, Sleijfer S, de Bono JS, Terstappen LW. Circulating tumor cells, tumor-derived extracellular vesicles and plasma cytokeratins in castration-resistant prostate cancer patients. Oncotarget 2018. [DOI: 10.18632/oncotarget.25019\] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Afroditi Nanou
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - Frank A.W. Coumans
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Guus van Dalum
- Department of General, Visceral and Pediatric Surgery, University Hospital and Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany
| | - Leonie L. Zeune
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, the Netherlands
- Department of Applied Mathematics, MIRA Institute and Faculty of EEMCS, University of Twente, Enschede, the Netherlands
| | - David Dolling
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Wendy Onstenk
- Department of Medical Oncology, Erasmus MC - Cancer Institute, Rotterdam, The Netherlands
| | - Mateus Crespo
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mariane Sousa Fontes
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gemma Fowler
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Christoph Brune
- Department of Applied Mathematics, MIRA Institute and Faculty of EEMCS, University of Twente, Enschede, the Netherlands
| | - Stefan Sleijfer
- Department of Medical Oncology, Erasmus MC - Cancer Institute, Rotterdam, The Netherlands
| | - Johann S. de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Prostate Cancer Targeted Therapies Group, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Leon W.M.M. Terstappen
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, Enschede, the Netherlands
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19
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Ferrarini A, Forcato C, Buson G, Tononi P, del Monaco V, Terracciano M, Bolognesi C, Fontana F, Medoro G, Neves R, Möhlendick B, Rihawi K, Ardizzoni A, Sumanasuriya S, Flohr P, Lambros M, de Bono J, Stoecklein NH, Manaresi N. A streamlined workflow for single-cells genome-wide copy-number profiling by low-pass sequencing of LM-PCR whole-genome amplification products. PLoS One 2018; 13:e0193689. [PMID: 29494651 PMCID: PMC5832318 DOI: 10.1371/journal.pone.0193689] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/19/2018] [Indexed: 11/23/2022] Open
Abstract
Chromosomal instability and associated chromosomal aberrations are hallmarks of cancer and play a critical role in disease progression and development of resistance to drugs. Single-cell genome analysis has gained interest in latest years as a source of biomarkers for targeted-therapy selection and drug resistance, and several methods have been developed to amplify the genomic DNA and to produce libraries suitable for Whole Genome Sequencing (WGS). However, most protocols require several enzymatic and cleanup steps, thus increasing the complexity and length of protocols, while robustness and speed are key factors for clinical applications. To tackle this issue, we developed a single-tube, single-step, streamlined protocol, exploiting ligation mediated PCR (LM-PCR) Whole Genome Amplification (WGA) method, for low-pass genome sequencing with the Ion Torrent™ platform and copy number alterations (CNAs) calling from single cells. The method was evaluated on single cells isolated from 6 aberrant cell lines of the NCI-H series. In addition, to demonstrate the feasibility of the workflow on clinical samples, we analyzed single circulating tumor cells (CTCs) and white blood cells (WBCs) isolated from the blood of patients affected by prostate cancer or lung adenocarcinoma. The results obtained show that the developed workflow generates data accurately representing whole genome absolute copy number profiles of single cell and allows alterations calling at resolutions down to 100 Kbp with as few as 200,000 reads. The presented data demonstrate the feasibility of the Ampli1™ WGA-based low-pass workflow for detection of CNAs in single tumor cells which would be of particular interest for genome-driven targeted therapy selection and for monitoring of disease progression.
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Affiliation(s)
| | | | - Genny Buson
- Menarini Silicon Biosystems spa, Bologna, Italy
| | | | | | | | | | | | | | - Rui Neves
- Department of General, Visceral and Pediatric Surgery, Medical Faculty, University Hospital of the Heinrich- Heine-University Düsseldorf, Düsseldorf, Germany
| | - Birte Möhlendick
- Department of General, Visceral and Pediatric Surgery, Medical Faculty, University Hospital of the Heinrich- Heine-University Düsseldorf, Düsseldorf, Germany
| | - Karim Rihawi
- Unità Operativa di Oncologia Medica, Policlinico Sant’Orsola – Malpighi, Bologna, Italy
| | - Andrea Ardizzoni
- Unità Operativa di Oncologia Medica, Policlinico Sant’Orsola – Malpighi, Bologna, Italy
| | - Semini Sumanasuriya
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Penny Flohr
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Maryou Lambros
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann de Bono
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nikolas H. Stoecklein
- Department of General, Visceral and Pediatric Surgery, Medical Faculty, University Hospital of the Heinrich- Heine-University Düsseldorf, Düsseldorf, Germany
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20
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Shenoy TR, Boysen G, Wang MY, Xu QZ, Guo W, Koh FM, Wang C, Zhang LZ, Wang Y, Gil V, Aziz S, Christova R, Rodrigues DN, Crespo M, Rescigno P, Tunariu N, Riisnaes R, Zafeiriou Z, Flohr P, Yuan W, Knight E, Swain A, Ramalho-Santos M, Xu DY, de Bono J, Wu H. CHD1 loss sensitizes prostate cancer to DNA damaging therapy by promoting error-prone double-strand break repair. Ann Oncol 2018; 28:1495-1507. [PMID: 28383660 DOI: 10.1093/annonc/mdx165] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
Background Deletion of the chromatin remodeler chromodomain helicase DNA-binding protein 1 (CHD1) is a common genomic alteration found in human prostate cancers (PCas). CHD1 loss represents a distinct PCa subtype characterized by SPOP mutation and higher genomic instability. However, the role of CHD1 in PCa development in vivo and its clinical utility remain unclear. Patients and methods To study the role of CHD1 in PCa development and its loss in clinical management, we generated a genetically engineered mouse model with prostate-specific deletion of murine Chd1 as well as isogenic CHD1 wild-type and homozygous deleted human benign and PCa lines. We also developed patient-derived organoid cultures and screened patients with metastatic PCa for CHD1 loss. Results We demonstrate that CHD1 loss sensitizes cells to DNA damage and causes a synthetic lethal response to DNA damaging therapy in vitro, in vivo, ex vivo, in patient-derived organoid cultures and in a patient with metastatic PCa. Mechanistically, CHD1 regulates 53BP1 stability and CHD1 loss leads to decreased error-free homologous recombination (HR) repair, which is compensated by increased error-prone non-homologous end joining (NHEJ) repair for DNA double-strand break (DSB) repair. Conclusions Our study provides the first in vivo and in patient evidence supporting the role of CHD1 in DSB repair and in response to DNA damaging therapy. We uncover mechanistic insights that CHD1 modulates the choice between HR and NHEJ DSB repair and suggest that CHD1 loss may contribute to the genomic instability seen in this subset of PCas.
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Affiliation(s)
- T R Shenoy
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - G Boysen
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M Y Wang
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Q Z Xu
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - W Guo
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - F M Koh
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - C Wang
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - L Z Zhang
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Y Wang
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - V Gil
- The Institute of Cancer Research, London, UK
| | - S Aziz
- The Institute of Cancer Research, London, UK
| | - R Christova
- The Institute of Cancer Research, London, UK
| | - D N Rodrigues
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M Crespo
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - P Rescigno
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - N Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - R Riisnaes
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Z Zafeiriou
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - P Flohr
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - W Yuan
- The Institute of Cancer Research, London, UK
| | - E Knight
- The Institute of Cancer Research, London, UK
| | - A Swain
- The Institute of Cancer Research, London, UK
| | - M Ramalho-Santos
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - D Y Xu
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - J de Bono
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - H Wu
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA.,The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
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21
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Goodall J, Mateo J, Yuan W, Mossop H, Porta N, Miranda S, Perez-Lopez R, Dolling D, Robinson DR, Sandhu S, Fowler G, Ebbs B, Flohr P, Seed G, Rodrigues DN, Boysen G, Bertan C, Atkin M, Clarke M, Crespo M, Figueiredo I, Riisnaes R, Sumanasuriya S, Rescigno P, Zafeiriou Z, Sharp A, Tunariu N, Bianchini D, Gillman A, Lord CJ, Hall E, Chinnaiyan AM, Carreira S, de Bono JS. Circulating Cell-Free DNA to Guide Prostate Cancer Treatment with PARP Inhibition. Cancer Discov 2017; 7:1006-1017. [PMID: 28450425 PMCID: PMC6143169 DOI: 10.1158/2159-8290.cd-17-0261] [Citation(s) in RCA: 299] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/15/2017] [Accepted: 04/26/2017] [Indexed: 12/13/2022]
Abstract
Biomarkers for more precise patient care are needed in metastatic prostate cancer. We have reported a phase II trial (TOPARP-A) of the PARP inhibitor olaparib in metastatic prostate cancer, demonstrating antitumor activity associating with homologous recombination DNA repair defects. We now report targeted and whole-exome sequencing of serial circulating cell-free DNA (cfDNA) samples collected during this trial. Decreases in cfDNA concentration independently associated with outcome in multivariable analyses (HR for overall survival at week 8: 0.19; 95% CI, 0.06-0.56; P = 0.003). All tumor tissue somatic DNA repair mutations were detectable in cfDNA; allele frequency of somatic mutations decreased selectively in responding patients (χ2P < 0.001). At disease progression, following response to olaparib, multiple subclonal aberrations reverting germline and somatic DNA repair mutations (BRCA2, PALB2) back in frame emerged as mechanisms of resistance. These data support the role of liquid biopsies as a predictive, prognostic, response, and resistance biomarker in metastatic prostate cancer.Significance: We report prospectively planned, serial, cfDNA analyses from patients with metastatic prostate cancer treated on an investigator-initiated phase II trial of olaparib. These analyses provide predictive, prognostic, response, and resistance data with "second hit" mutations first detectable at disease progression, suggesting clonal evolution from treatment-selective pressure and platinum resistance. Cancer Discov; 7(9); 1006-17. ©2017 AACR.See related commentary by Domchek, p. 937See related article by Kondrashova et al., p. 984See related article by Quigley et al., p. 999This article is highlighted in the In This Issue feature, p. 920.
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Affiliation(s)
- Jane Goodall
- The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - Helen Mossop
- The Institute of Cancer Research, London, United Kingdom
| | - Nuria Porta
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | - Raquel Perez-Lopez
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David Dolling
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Gemma Fowler
- The Institute of Cancer Research, London, United Kingdom
| | - Berni Ebbs
- The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gunther Boysen
- The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Mark Atkin
- The Institute of Cancer Research, London, United Kingdom
| | - Matthew Clarke
- The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | | | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Zafeiris Zafeiriou
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Adam Sharp
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alexa Gillman
- The Institute of Cancer Research, London, United Kingdom
| | | | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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22
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Nombela Blanco P, Lozano Mejorada R, Lorente Estelles D, Reid A, Romero Laorden N, Attard G, Cendón Flórez Y, Mateo J, Sandhu S, Massard C, Montesa A, Flohr P, Sáez M, Pacheco M, Castro Marcos E, de Bono J, Olmos Hidalgo D. Exploratory study of CK-M30 and pHH3 expression in Circulating Tumor Cells (CTCs) as biomarkers of docetaxel (DOC) efficacy in metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.046] [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: 11/13/2022] Open
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23
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Lambros MB, Gil VS, Crespo M, Fontes MS, Neves RN, Mahra N, Fowler G, Ebbs B, Flohr P, Seed G, Yuan W, Hunt J, Moloney D, Ayanda D, Swennenhuis JF, Andree KC, Sumanasuriya S, Clarke M, Rescigno P, Zafeiriou Z, Mateo J, Bianchini D, Stoecklein NH, Terstappen LW, Boysen G, Bono JSD. Abstract 993: Diagnostic leukapheresis (DLA): Molecular characterisation and organoid culture of circulating tumor cells (CTC) from metastatic castration resistant prostate cancer (mCRPC). Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-993] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: CTC count is an independent predictor of overall survival in mCRPC. Isolation of CTC from peripheral blood (PB) for genomic and functional analysis is challenging, especially in patients (pts) with low CTC count. It has been shown that DLA increases CTC yield. However, it has yet to be proven whether CTC isolation from DLA can be used in complementary studies such as molecular characterization and growth of organoid culture for drug sensitivity studies. Here we present preliminary data of an on-going study, which evaluates DLA in mCRPC pts, focusing on safety, CTC enrichment, molecular characterization and feasibility for organoid culture. Methods: mCRPC pts considered for clinical trials were selected according to performance status (ECOG 0-1) and number of CTC found in 7.5ml PB (>20 cells/7.5mL). DLA products (200x106 cells) were processed using the CellSearch CTC kit (Janssen Diagnostics, LLC) according to manufacturer procedures. The contents of CellSearch cartridges were sorted into single cell by fluorescence activated cell sorting (FACS) and subsequently assessed by array comparative genomic hybridization (aCGH) for copy number aberrations (CNA). Enrichment of CTC for organoid culture was performed by density gradient of mononuclear cells followed by positive selection using magnetic beads. Results: Overall 12 mCRPC patients underwent DLA without any complication or toxicity. The mean CTC count was 90 CTC/7.5 ml peripheral blood (median = 31) and ranged from 20 to 324. CellSearch CTC count in the DLA yielded a mean of 466 (median=203) and ranged from 60 to 2496 with an up to 40-fold increase (mean = 13, median = 6) in CTC count separation when comparing 1mL of PB to 1mL of DLA. Molecular analyses of FACS single CTC from the DLA by aCGH showed that these CTC genomic profiles had the typical hallmarks of mCRPC with CNAs including AR and MYC locus (8q) amplification, and PTEN, RB1, TP53, CHD1 loss. Additionally, ex vivo culture of CTC-derived organoids was successfully achieved. aCGH of these organoids matched the genomic profile that of the CTC from the same patient. Conclusion: DLA from mCRPC pts was well tolerated and yields higher CTC capture than PB and may provide an alternative to tissue biopsy and routine blood volumes. Our strategy allowed us to isolate genomic DNA with good quality for molecular characterization and viable CTC for organoid culture and functional studies.
Citation Format: Maryou B. Lambros, Veronica S. Gil, Mateus Crespo, Mariane S. Fontes, Rui N. Neves, Niven Mahra, Gemma Fowler, Berni Ebbs, Penny Flohr, George Seed, Wei Yuan, Joanne Hunt, Deirdre Moloney, Dionne Ayanda, Joost F. Swennenhuis, Kiki C. Andree, Semini Sumanasuriya, Matthew Clarke, Pasquale Rescigno, Zafeiris Zafeiriou, Joaquin Mateo, Diletta Bianchini, Nikolas H. Stoecklein, Leon W. Terstappen, Gunther Boysen, Johann S. De Bono. Diagnostic leukapheresis (DLA): Molecular characterisation and organoid culture of circulating tumor cells (CTC) from metastatic castration resistant prostate cancer (mCRPC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 993. doi:10.1158/1538-7445.AM2017-993
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Affiliation(s)
| | | | - Mateus Crespo
- 1The Institute of Cancer Research, London, United Kingdom
| | | | - Rui N. Neves
- 3University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Niven Mahra
- 1The Institute of Cancer Research, London, United Kingdom
| | - Gemma Fowler
- 1The Institute of Cancer Research, London, United Kingdom
| | - Berni Ebbs
- 1The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- 1The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- 1The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- 1The Institute of Cancer Research, London, United Kingdom
| | - Joanne Hunt
- 2The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Deirdre Moloney
- 2The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Dionne Ayanda
- 2The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | | | - Matthew Clarke
- 1The Institute of Cancer Research, London, United Kingdom
| | | | | | - Joaquin Mateo
- 2The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Nikolas H. Stoecklein
- 3University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Gunther Boysen
- 1The Institute of Cancer Research, London, United Kingdom
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24
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Luedeke M, Rinckleb AE, FitzGerald LM, Geybels MS, Schleutker J, Eeles RA, Teixeira MR, Cannon-Albright L, Ostrander EA, Weikert S, Herkommer K, Wahlfors T, Visakorpi T, Leinonen KA, Tammela TL, Cooper CS, Kote-Jarai Z, Edwards S, Goh CL, McCarthy F, Parker C, Flohr P, Paulo P, Jerónimo C, Henrique R, Krause H, Wach S, Lieb V, Rau TT, Vogel W, Kuefer R, Hofer MD, Perner S, Rubin MA, Agarwal AM, Easton DF, Al Olama AA, Benlloch S, Hoegel J, Stanford JL, Maier C. Prostate cancer risk regions at 8q24 and 17q24 are differentially associated with somatic TMPRSS2:ERG fusion status. Hum Mol Genet 2016; 25:5490-5499. [PMID: 27798103 PMCID: PMC5418832 DOI: 10.1093/hmg/ddw349] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/23/2016] [Accepted: 10/07/2016] [Indexed: 12/15/2022] Open
Abstract
Molecular and epidemiological differences have been described between TMPRSS2:ERG fusion-positive and fusion-negative prostate cancer (PrCa). Assuming two molecularly distinct subtypes, we have examined 27 common PrCa risk variants, previously identified in genome-wide association studies, for subtype specific associations in a total of 1221 TMPRSS2:ERG phenotyped PrCa cases. In meta-analyses of a discovery set of 552 cases with TMPRSS2:ERG data and 7650 unaffected men from five centers we have found support for the hypothesis that several common risk variants are associated with one particular subtype rather than with PrCa in general. Risk variants were analyzed in case-case comparisons (296 TMPRSS2:ERG fusion-positive versus 256 fusion-negative cases) and an independent set of 669 cases with TMPRSS2:ERG data was established to replicate the top five candidates. Significant differences (P < 0.00185) between the two subtypes were observed for rs16901979 (8q24) and rs1859962 (17q24), which were enriched in TMPRSS2:ERG fusion-negative (OR = 0.53, P = 0.0007) and TMPRSS2:ERG fusion-positive PrCa (OR = 1.30, P = 0.0016), respectively. Expression quantitative trait locus analysis was performed to investigate mechanistic links between risk variants, fusion status and target gene mRNA levels. For rs1859962 at 17q24, genotype dependent expression was observed for the candidate target gene SOX9 in TMPRSS2:ERG fusion-positive PrCa, which was not evident in TMPRSS2:ERG negative tumors. The present study established evidence for the first two common PrCa risk variants differentially associated with TMPRSS2:ERG fusion status. TMPRSS2:ERG phenotyping of larger studies is required to determine comprehensive sets of variants with subtype-specific roles in PrCa.
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Affiliation(s)
- Manuel Luedeke
- Institute of Human Genetics, University of Ulm, Ulm, Germany
- Department of Urology, University of Ulm, Ulm, Germany
| | - Antje E. Rinckleb
- Institute of Human Genetics, University of Ulm, Ulm, Germany
- Department of Urology, University of Ulm, Ulm, Germany
| | - Liesel M. FitzGerald
- Fred Hutchinson Cancer Research Center, Division of Public Health Science, Seattle, Washington, USA
- Cancer, Genetics and Immunology, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Milan S. Geybels
- Fred Hutchinson Cancer Research Center, Division of Public Health Science, Seattle, Washington, USA
| | - Johanna Schleutker
- Institute of Biomedical Technology/BioMediTech, University of Tampere, Tampere, Finland
- Department of Medical Biochemistry and Genetics, University of Turku, and Tyks Microbiology and Genetics, Department of Medical Genetics, Turku University Hospital, Turku, Finland
| | - Rosalind A. Eeles
- The Institute of Cancer Research, London, UK
- Royal Marsden National Health Service Foundation Trust, London and Sutton, UK
| | - Manuel R. Teixeira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Lisa Cannon-Albright
- Division of Genetic Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | | | - Steffen Weikert
- Department of Urology, Vivantes Humboldt Hospital, Berlin, Germany
- Department of Urology, University Hospital Charité, Berlin, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Tiina Wahlfors
- Institute of Biomedical Technology/BioMediTech, University of Tampere, Tampere, Finland
| | - Tapio Visakorpi
- Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | | | - Teuvo L.J. Tammela
- Department of Urology, Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland
| | - Colin S. Cooper
- The Institute of Cancer Research, London, UK
- Department of Biological Science, University of East Anglia, Norwich, UK
| | | | | | - Chee L. Goh
- The Institute of Cancer Research, London, UK
| | | | - Chris Parker
- Royal Marsden National Health Service Foundation Trust, London and Sutton, UK
| | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | - Paula Paulo
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Carmen Jerónimo
- Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
- Department of Pathology, Portuguese Oncology Institute, Porto, Portugal
| | - Rui Henrique
- Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
- Department of Pathology, Portuguese Oncology Institute, Porto, Portugal
| | - Hans Krause
- Department of Urology, University Hospital Charité, Berlin, Germany
| | - Sven Wach
- Department of Urology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Verena Lieb
- Department of Urology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Tilman T. Rau
- Institute of Pathology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
- Institute of Pathology, University Bern, Bern Switzerland
| | - Walther Vogel
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Rainer Kuefer
- Department of Urology, Klinik am Eichert, Göppingen, Germany
| | - Matthias D. Hofer
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sven Perner
- Pathology of the University Medical Center Schleswig-Holstein, Campus Luebeck and the Research Center Borstel, Leibniz Center for Medicine and Biosciences, Luebeck and Borstel, Germany
| | - Mark A. Rubin
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA
| | | | - Doug F. Easton
- Centre for Cancer Genetics Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Ali Amin Al Olama
- Centre for Cancer Genetics Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Sara Benlloch
- Centre for Cancer Genetics Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | | | - Josef Hoegel
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Janet L. Stanford
- Fred Hutchinson Cancer Research Center, Division of Public Health Science, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Christiane Maier
- Institute of Human Genetics, University of Ulm, Ulm, Germany
- Department of Urology, University of Ulm, Ulm, Germany
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25
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MATEO JOAQUIN, Carreira S, Mossop H, Rescigno P, Kolinsky M, Castro E, Balasopoulou A, Hunt J, Roda D, Bertan C, Goodall J, Miranda S, Flohr P, Porta N, Kote-Jarai Z, Olmos D, Lord CJ, Hall E, Eeles R, de Bono JS. Abstract 4340: DNA repair genes aberrations in germline DNA in metastatic castration-resistant prostate cancer patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-4340] [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
INTRODUCTION: DNA repair defects are found in mCRPC and are therapeutically actionable; germline BRCA mutation-associated (gBRCA) prostate cancer has a poor prognosis. We hypothesized that metastatic castration resistant prostate cancer (mCRPC) is enriched for germline DNA repair mutations and that these may be relevant to patient outcome.
METHODS: Targeted-sequencing for DNA repair genes was conducted in germline DNA from patients consenting to 3 clinical trials between 2013-2015. Germline DNA was extracted from saliva or buccal swabs using the Oragene kit; libraries were constructed using a customized Qiagen panel and sequenced using the Illumina MiSeq. Family history and clinical data were prospectively collected. For time to event analyses unadjusted Cox regression models were used and comparisons were made using log-rank tests.
RESULTS: Germline samples from 154 mCRPC patients were available. Median age at diagnosis was 61years (y), median time to castration-resistance was 14.5 months (m) and median overall survival (OS) from initial diagnosis of prostate cancer was 106.8m; 69% (91/131; 24 N/A) of patients were initially diagnosed with Gleason≥8 tumors. 130/154 (84.4%) and 131/154 (85.0%) received Docetaxel and Abiraterone respectively. Of 154 patients, 4 were previously known to be gBRCA2 mutation carriers and were removed from the prevalence analysis but included in the clinical analyses; 22/150 (14.7%, 95%CI 9.4-21.4%) harboured a truncating or frameshift mutation in a DNA repair gene (9 BRCA2, 6%; 4 ATM, 2.7%; 2 PALB2, 1.3%, 1 each for CHEK2, FANCI, MRE11A, NBN, RAD51C, RAD51D and MSH6). Overall, patients with any germline DNA repair aberrations had a worse median OS (75.8 vs 106.8 m; log-rank p = 0.04). Time to resistance to primary hormonal ablation was shorter specifically for gBRCA2 mutations carriers (11.0 vs 14.8 m; log-rank p = 0.01) but not for non-BRCA2 repair aberrations. Age at diagnosis was similar in patients with or without DNA repair germline mutations (median 61.3 vs 61.7y, Mann-Whitney p = 0.41) as well as frequency of Gleason≥8 tumors (16/21 [76%] vs 75/109 [68%]; Mann-Whitney p = 0.23) Response rates to Docetaxel (14/18 [77.8%] vs 64/94 [68.1%]; Fisher exact p = 0.67) and Abiraterone (10/21 [47.6%] vs 44/94 [46.8%]; Fisher exact p = 0.73) were similar among individuals with and without mutations. Family cancer history was collected in 125/154 cases (81%). While having cases of ovarian/prostate/breast/pancreas cancers in these patients’ families associated with a higher likelihood of finding a germline mutation (Odds Ratio 3.36, p = 0.03), 5 of 68 (7.4%) men with no cases of ovarian/prostate/breast/pancreas cancers registered in their families carried a germline mutation in a DNA repair gene.
CONCLUSIONS: mCRPC is enriched for patients with germline mutations in DNA repair genes (15%), with 6% having gBRCA2 mutation. Germline DNA repair aberrations are associated with a worse prognosis from mCRPC.
Citation Format: JOAQUIN MATEO, Suzanne Carreira, Helen Mossop, Pasquale Rescigno, Michael Kolinsky, Elena Castro, Ada Balasopoulou, Jo Hunt, Desamparados Roda, Claudia Bertan, Jane Goodall, Susana Miranda, Penny Flohr, Nuria Porta, Zsofia Kote-Jarai, David Olmos, Christopher J. Lord, Emma Hall, Ros Eeles, Johann S. de Bono. DNA repair genes aberrations in germline DNA in metastatic castration-resistant prostate cancer patients. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4340.
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Affiliation(s)
- JOAQUIN MATEO
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Helen Mossop
- 2The Institute of Cancer Research, London, United Kingdom
| | - Pasquale Rescigno
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Michael Kolinsky
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Elena Castro
- 3CNIO - Spanish National Cancer Research Center, Madrid, Spain
| | - Ada Balasopoulou
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jo Hunt
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Desamparados Roda
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Claudia Bertan
- 2The Institute of Cancer Research, London, United Kingdom
| | - Jane Goodall
- 2The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- 2The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- 2The Institute of Cancer Research, London, United Kingdom
| | - Nuria Porta
- 2The Institute of Cancer Research, London, United Kingdom
| | | | - David Olmos
- 3CNIO - Spanish National Cancer Research Center, Madrid, Spain
| | | | - Emma Hall
- 2The Institute of Cancer Research, London, United Kingdom
| | - Ros Eeles
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann S. de Bono
- 1The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Lorente D, Olmos D, Mateo J, Bianchini D, Seed G, Fleisher M, Danila DC, Flohr P, Crespo M, Figueiredo I, Miranda S, Baeten K, Molina A, Kheoh T, McCormack R, Terstappen LWMM, Scher HI, de Bono JS. Decline in Circulating Tumor Cell Count and Treatment Outcome in Advanced Prostate Cancer. Eur Urol 2016; 70:985-992. [PMID: 27289566 PMCID: PMC5568108 DOI: 10.1016/j.eururo.2016.05.023] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [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: 01/02/2016] [Accepted: 05/16/2016] [Indexed: 01/08/2023]
Abstract
Background Treatment response biomarkers are urgently needed for castration-resistant prostate cancer (CRPC). Baseline and post-treatment circulating tumor cell (CTC) counts of ≥5 cells/7.5 ml are associated with poor CRPC outcome. Objective To determine the value of a ≥30% CTC decline as a treatment response indicator. Design, setting, and participants We identified patients with a baseline CTC count ≥5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials. Intervention Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials. Outcome measures and statistical analysis The association between a ≥30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices. Results Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count ≥5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36–0.56; p < 0.001), 8 wk (HR 0.41, 95% CI 0.33–0.53; p < 0.001), and 12 wk (HR 0.39, 95% CI 0.3–0.5; p < 0.001) in univariable and multivariable analyses. Stable CTC count (<30% fall or <30% increase) was not associated with a survival benefit when compared with increased CTC count. The association between a 30% CTC decline after treatment and survival was independent of baseline CTC count. CTC declines significantly improved the AUC at all time-points. Finally, in the COU-AA-301 trial, patients with CTC ≥5 cells/7.5 ml and a 30% CTC decline had similar overall survival in both arms. Conclusions A 30% CTC decline after treatment from an initial count ≥5 cells/7.5 ml is independently associated with CRPC overall survival following abiraterone and chemotherapy, improving the performance of a multivariable model as early as 4 wk after treatment. This potential surrogate must now be prospectively evaluated. Patient summary Circulating tumor cells (CTCs) are cancer cells that can be detected in the blood of prostate cancer patients. We analyzed changes in CTCs after treatment with abiraterone and chemotherapy in two large clinical trials, and found that patients who have a decline in CTC count have a better survival outcome.
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Affiliation(s)
- David Lorente
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK; Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - David Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; CNIO-IBIMA Genitourinary Cancer Unit, Department of Medical Oncology, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
| | - Joaquin Mateo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Diletta Bianchini
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - George Seed
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | | | | | - Penny Flohr
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Mateus Crespo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Ines Figueiredo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Susana Miranda
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Kurt Baeten
- Medical Affairs, Janssen Diagnostics, Beerse, Belgium
| | | | - Thian Kheoh
- Janssen Research & Development, La Jolla, CA, USA
| | | | - Leon W M M Terstappen
- MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, Twente, The Netherlands
| | - Howard I Scher
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Johann S de Bono
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK.
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Lorente D, Omlin A, Zafeiriou Z, Nava-Rodrigues D, Pérez-López R, Pezaro C, Mehra N, Sheridan E, Figueiredo I, Riisnaes R, Miranda S, Crespo M, Flohr P, Mateo J, Altavilla A, Ferraldeschi R, Bianchini D, Attard G, Tunariu N, de Bono J. Castration-Resistant Prostate Cancer Tissue Acquisition From Bone Metastases for Molecular Analyses. Clin Genitourin Cancer 2016; 14:485-493. [PMID: 27246360 PMCID: PMC5132155 DOI: 10.1016/j.clgc.2016.04.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/18/2016] [Accepted: 04/22/2016] [Indexed: 11/18/2022]
Abstract
Background The urgent need for castration-resistant prostate cancer molecular characterization to guide treatment has been constrained by the disease's predilection to metastasize primarily to bone. We hypothesized that the use of clinical and imaging criteria could maximize tissue acquisition from bone marrow biopsies (BMBs). We aimed to develop a score for the selection of patients undergoing BMB. Materials and Methods A total of 115 BMBs were performed in 101 patients: 57 were included in a derivation set and 58 were used as the validation set. The clinical and laboratory data and prebiopsy computed tomography parameters (Hounsfield units [HUs]) were determined. A score for the prediction of biopsy positivity was developed from logistic regression analysis of the derivation set and tested in the validation set. Results Of the 115 biopsy specimens, 75 (62.5%) were positive; 35 (61.4%) in the test set and 40 (69%) in the validation set. On univariable analysis, hemoglobin (P = .019), lactate dehydrogenase (P = .003), prostate-specific antigen (P = .005), and mean HUs (P = .004) were selected. A score based on the LDH level (≥ 225 IU/L) and mean HUs (≥ 125) was developed in multivariate analysis and was associated with BMB positivity in the validation set (odds ratio, 5.1; 95% confidence interval, 1.9%-13.4%; P = .001). The area under the curve of the score was 0.79 in the test set and 0.77 in the validation set. Conclusion BMB of the iliac crest is a feasible technique for obtaining tumor tissue for genomic analysis in patients with castration-resistant prostate cancer metastatic to the bone. A signature based on the mean HUs and LDH level can predict a positive yield with acceptable internal validity. Prospective studies of independent cohorts are needed to establish the external validity of the score.
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Affiliation(s)
- David Lorente
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Aurelius Omlin
- Oncohematology Department, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Zafeiris Zafeiriou
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Daniel Nava-Rodrigues
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Raquel Pérez-López
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Carmel Pezaro
- Eastern Health Medicine School, Monash University, Box Hill, VC, Australia
| | - Niven Mehra
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Elizabeth Sheridan
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Ines Figueiredo
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Ruth Riisnaes
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Susana Miranda
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Mateus Crespo
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Penny Flohr
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Joaquín Mateo
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Amelia Altavilla
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Roberta Ferraldeschi
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Diletta Bianchini
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Gerhardt Attard
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Nina Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Johann de Bono
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden National Health Services Foundation Trust and The Institute of Cancer Research, Sutton, UK.
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Romanel A, Gasi Tandefelt D, Conteduca V, Jayaram A, Casiraghi N, Wetterskog D, Salvi S, Amadori D, Zafeiriou Z, Rescigno P, Bianchini D, Gurioli G, Casadio V, Carreira S, Goodall J, Wingate A, Ferraldeschi R, Tunariu N, Flohr P, De Giorgi U, de Bono JS, Demichelis F, Attard G. Plasma AR and abiraterone-resistant prostate cancer. Sci Transl Med 2015; 7:312re10. [PMID: 26537258 PMCID: PMC6112410 DOI: 10.1126/scitranslmed.aac9511] [Citation(s) in RCA: 330] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Androgen receptor (AR) gene aberrations are rare in prostate cancer before primary hormone treatment but emerge with castration resistance. To determine AR gene status using a minimally invasive assay that could have broad clinical utility, we developed a targeted next-generation sequencing approach amenable to plasma DNA, covering all AR coding bases and genomic regions that are highly informative in prostate cancer. We sequenced 274 plasma samples from 97 castration-resistant prostate cancer patients treated with abiraterone at two institutions. We controlled for normal DNA in patients' circulation and detected a sufficiently high tumor DNA fraction to quantify AR copy number state in 217 samples (80 patients). Detection of AR copy number gain and point mutations in plasma were inversely correlated, supported further by the enrichment of nonsynonymous versus synonymous mutations in AR copy number normal as opposed to AR gain samples. Whereas AR copy number was unchanged from before treatment to progression and no mutant AR alleles showed signal for acquired gain, we observed emergence of T878A or L702H AR amino acid changes in 13% of tumors at progression on abiraterone. Patients with AR gain or T878A or L702H before abiraterone (45%) were 4.9 and 7.8 times less likely to have a ≥50 or ≥90% decline in prostate-specific antigen (PSA), respectively, and had a significantly worse overall [hazard ratio (HR), 7.33; 95% confidence interval (CI), 3.51 to 15.34; P = 1.3 × 10(-9)) and progression-free (HR, 3.73; 95% CI, 2.17 to 6.41; P = 5.6 × 10(-7)) survival. Evaluation of plasma AR by next-generation sequencing could identify cancers with primary resistance to abiraterone.
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Affiliation(s)
- Alessandro Romanel
- Centre for Integrative Biology, University of Trento, Trento 38123, Italy
| | | | - Vincenza Conteduca
- The Institute of Cancer Research, London SW7 3RP, UK. Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola 47014, Italy
| | - Anuradha Jayaram
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Nicola Casiraghi
- Centre for Integrative Biology, University of Trento, Trento 38123, Italy
| | | | - Samanta Salvi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola 47014, Italy
| | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola 47014, Italy
| | - Zafeiris Zafeiriou
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Pasquale Rescigno
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Diletta Bianchini
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Giorgia Gurioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola 47014, Italy
| | - Valentina Casadio
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola 47014, Italy
| | | | - Jane Goodall
- The Institute of Cancer Research, London SW7 3RP, UK
| | - Anna Wingate
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Roberta Ferraldeschi
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Nina Tunariu
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Penny Flohr
- The Institute of Cancer Research, London SW7 3RP, UK
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola 47014, Italy
| | - Johann S de Bono
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Francesca Demichelis
- Centre for Integrative Biology, University of Trento, Trento 38123, Italy. Institute for Computational Biomedicine, Weill Cornell Medicine, NY 10021, USA. Institute for Precision Medicine, Weill Cornell Medicine, NY 10021, USA.
| | - Gerhardt Attard
- The Institute of Cancer Research, London SW7 3RP, UK. The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK.
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Mateo J, Carreira S, Sandhu S, Miranda S, Mossop H, Perez-Lopez R, Nava Rodrigues D, Robinson D, Omlin A, Tunariu N, Boysen G, Porta N, Flohr P, Gillman A, Figueiredo I, Paulding C, Seed G, Jain S, Ralph C, Protheroe A, Hussain S, Jones R, Elliott T, McGovern U, Bianchini D, Goodall J, Zafeiriou Z, Williamson CT, Ferraldeschi R, Riisnaes R, Ebbs B, Fowler G, Roda D, Yuan W, Wu YM, Cao X, Brough R, Pemberton H, A'Hern R, Swain A, Kunju LP, Eeles R, Attard G, Lord CJ, Ashworth A, Rubin MA, Knudsen KE, Feng FY, Chinnaiyan AM, Hall E, de Bono JS. DNA-Repair Defects and Olaparib in Metastatic Prostate Cancer. N Engl J Med 2015; 373:1697-708. [PMID: 26510020 PMCID: PMC5228595 DOI: 10.1056/nejmoa1506859] [Citation(s) in RCA: 1601] [Impact Index Per Article: 177.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Prostate cancer is a heterogeneous disease, but current treatments are not based on molecular stratification. We hypothesized that metastatic, castration-resistant prostate cancers with DNA-repair defects would respond to poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibition with olaparib. METHODS We conducted a phase 2 trial in which patients with metastatic, castration-resistant prostate cancer were treated with olaparib tablets at a dose of 400 mg twice a day. The primary end point was the response rate, defined either as an objective response according to Response Evaluation Criteria in Solid Tumors, version 1.1, or as a reduction of at least 50% in the prostate-specific antigen level or a confirmed reduction in the circulating tumor-cell count from 5 or more cells per 7.5 ml of blood to less than 5 cells per 7.5 ml. Targeted next-generation sequencing, exome and transcriptome analysis, and digital polymerase-chain-reaction testing were performed on samples from mandated tumor biopsies. RESULTS Overall, 50 patients were enrolled; all had received prior treatment with docetaxel, 49 (98%) had received abiraterone or enzalutamide, and 29 (58%) had received cabazitaxel. Sixteen of 49 patients who could be evaluated had a response (33%; 95% confidence interval, 20 to 48), with 12 patients receiving the study treatment for more than 6 months. Next-generation sequencing identified homozygous deletions, deleterious mutations, or both in DNA-repair genes--including BRCA1/2, ATM, Fanconi's anemia genes, and CHEK2--in 16 of 49 patients who could be evaluated (33%). Of these 16 patients, 14 (88%) had a response to olaparib, including all 7 patients with BRCA2 loss (4 with biallelic somatic loss, and 3 with germline mutations) and 4 of 5 with ATM aberrations. The specificity of the biomarker suite was 94%. Anemia (in 10 of the 50 patients [20%]) and fatigue (in 6 [12%]) were the most common grade 3 or 4 adverse events, findings that are consistent with previous studies of olaparib. CONCLUSIONS Treatment with the PARP inhibitor olaparib in patients whose prostate cancers were no longer responding to standard treatments and who had defects in DNA-repair genes led to a high response rate. (Funded by Cancer Research UK and others; ClinicalTrials.gov number, NCT01682772; Cancer Research UK number, CRUK/11/029.).
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Affiliation(s)
- Joaquin Mateo
- From the Institute of Cancer Research (J.M., S.C., S.S., S.M., H.M., R.P.-L., D.N.R., A.O., N.T., G.B., N.P., P.F., A.G., I.F., C.P., G.S., D.B., J.G., Z.Z., C.T.W., R.F., R.R., B.E., G.F., D. Roda, W.Y., R.B., H.P., R.A., A.S., R.E., G.A., C.J.L., A.A., E.H., J.S.B.), the Royal Marsden NHS Foundation Trust (J.M., S.S., R.P.-L., A.O., N.T., D.B., Z.Z., R.F., D. Roda, R.E., G.A., J.S.B.), and University College London Hospital (U.M.), London, Queen's University, Belfast (S.J.), University of Leeds, Leeds (C.R.), Churchill Hospital, Oxford (A.P.), University of Liverpool, Liverpool (S.H.), Beatson West of Scotland Cancer Centre, Glasgow (R.J.), and Christie Hospital, Manchester (T.E.) - all in the United Kingdom; the University of Michigan, Ann Arbor (D. Robinson, Y.-M.W., X.C., L.P.K., F.Y.F., A.M.C.); Weill Cornell Medical College, New York (M.A.R.); and Thomas Jefferson University, Philadelphia (K.E.K.)
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Robinson D, Van Allen EM, Wu YM, Schultz N, Lonigro RJ, Mosquera JM, Montgomery B, Taplin ME, Pritchard CC, Attard G, Beltran H, Abida W, Bradley RK, Vinson J, Cao X, Vats P, Kunju LP, Hussain M, Feng FY, Tomlins SA, Cooney KA, Smith DC, Brennan C, Siddiqui J, Mehra R, Chen Y, Rathkopf DE, Morris MJ, Solomon SB, Durack JC, Reuter VE, Gopalan A, Gao J, Loda M, Lis RT, Bowden M, Balk SP, Gaviola G, Sougnez C, Gupta M, Yu EY, Mostaghel EA, Cheng HH, Mulcahy H, True LD, Plymate SR, Dvinge H, Ferraldeschi R, Flohr P, Miranda S, Zafeiriou Z, Tunariu N, Mateo J, Perez-Lopez R, Demichelis F, Robinson BD, Sboner A, Schiffman M, Nanus DM, Tagawa ST, Sigaras A, Eng KW, Elemento O, Sboner A, Heath EI, Scher HI, Pienta KJ, Kantoff P, de Bono JS, Rubin MA, Nelson PS, Garraway LA, Sawyers CL, Chinnaiyan AM. Integrative Clinical Genomics of Advanced Prostate Cancer. Cell 2015; 162:454. [PMID: 28843286 DOI: 10.1016/j.cell.2015.06.053] [Citation(s) in RCA: 370] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Robinson D, Van Allen EM, Wu YM, Schultz N, Lonigro RJ, Mosquera JM, Montgomery B, Taplin ME, Pritchard CC, Attard G, Beltran H, Abida W, Bradley RK, Vinson J, Cao X, Vats P, Kunju LP, Hussain M, Feng FY, Tomlins SA, Cooney KA, Smith DC, Brennan C, Siddiqui J, Mehra R, Chen Y, Rathkopf DE, Morris MJ, Solomon SB, Durack JC, Reuter VE, Gopalan A, Gao J, Loda M, Lis RT, Bowden M, Balk SP, Gaviola G, Sougnez C, Gupta M, Yu EY, Mostaghel EA, Cheng HH, Mulcahy H, True LD, Plymate SR, Dvinge H, Ferraldeschi R, Flohr P, Miranda S, Zafeiriou Z, Tunariu N, Mateo J, Perez-Lopez R, Demichelis F, Robinson BD, Schiffman M, Nanus DM, Tagawa ST, Sigaras A, Eng KW, Elemento O, Sboner A, Heath EI, Scher HI, Pienta KJ, Kantoff P, de Bono JS, Rubin MA, Nelson PS, Garraway LA, Sawyers CL, Chinnaiyan AM. Integrative clinical genomics of advanced prostate cancer. Cell 2015; 161:1215-1228. [PMID: 26000489 PMCID: PMC4484602 DOI: 10.1016/j.cell.2015.05.001] [Citation(s) in RCA: 2238] [Impact Index Per Article: 248.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/06/2015] [Accepted: 04/27/2015] [Indexed: 12/15/2022]
Abstract
Toward development of a precision medicine framework for metastatic, castration-resistant prostate cancer (mCRPC), we established a multi-institutional clinical sequencing infrastructure to conduct prospective whole-exome and transcriptome sequencing of bone or soft tissue tumor biopsies from a cohort of 150 mCRPC affected individuals. Aberrations of AR, ETS genes, TP53, and PTEN were frequent (40%-60% of cases), with TP53 and AR alterations enriched in mCRPC compared to primary prostate cancer. We identified new genomic alterations in PIK3CA/B, R-spondin, BRAF/RAF1, APC, β-catenin, and ZBTB16/PLZF. Moreover, aberrations of BRCA2, BRCA1, and ATM were observed at substantially higher frequencies (19.3% overall) compared to those in primary prostate cancers. 89% of affected individuals harbored a clinically actionable aberration, including 62.7% with aberrations in AR, 65% in other cancer-related genes, and 8% with actionable pathogenic germline alterations. This cohort study provides clinically actionable information that could impact treatment decisions for these affected individuals.
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Affiliation(s)
- Dan Robinson
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
| | - Yi-Mi Wu
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Nikolaus Schultz
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Robert J Lonigro
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Juan-Miguel Mosquera
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; New York Presbyterian Hospital, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Bruce Montgomery
- Computational Biology Program, Public Health Sciences Division and Basic Science Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA; Department of Medicine and VAPSHCS, University of Washington, Seattle, WA 98109, USA
| | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Colin C Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, WA 98195, USA
| | - Gerhardt Attard
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Himisha Beltran
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; New York Presbyterian Hospital, New York, NY 10021, USA; Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Wassim Abida
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Genitourinary Oncology Service, Department of Medicine, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Robert K Bradley
- Computational Biology Program, Public Health Sciences Division and Basic Science Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA
| | - Jake Vinson
- Prostate Cancer Clinical Trials Consortium, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Xuhong Cao
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Pankaj Vats
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Lakshmi P Kunju
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Maha Hussain
- Department of Internal Medicine, Division of Hematology Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Felix Y Feng
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Scott A Tomlins
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Kathleen A Cooney
- Department of Internal Medicine, Division of Hematology Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - David C Smith
- Department of Internal Medicine, Division of Hematology Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Christine Brennan
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Javed Siddiqui
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Rohit Mehra
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Yu Chen
- Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Genitourinary Oncology Service, Department of Medicine, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Dana E Rathkopf
- Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Genitourinary Oncology Service, Department of Medicine, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Michael J Morris
- Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Genitourinary Oncology Service, Department of Medicine, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Stephen B Solomon
- Interventional Radiology, Department of Radiology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jeremy C Durack
- Interventional Radiology, Department of Radiology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Anuradha Gopalan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jianjiong Gao
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Massimo Loda
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA; Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Pathology, Brigham & Women's Hospital, Boston, MA 02115, USA
| | - Rosina T Lis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Michaela Bowden
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Pathology, Brigham & Women's Hospital, Boston, MA 02115, USA
| | - Stephen P Balk
- Division of Hematology-Oncology, Department of Medicine, Beth Israel Deaconess Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Glenn Gaviola
- Department of Musculoskeletal Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Carrie Sougnez
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
| | - Manaswi Gupta
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
| | - Evan Y Yu
- Department of Medicine and VAPSHCS, University of Washington, Seattle, WA 98109, USA
| | - Elahe A Mostaghel
- Computational Biology Program, Public Health Sciences Division and Basic Science Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA; Department of Medicine and VAPSHCS, University of Washington, Seattle, WA 98109, USA
| | - Heather H Cheng
- Computational Biology Program, Public Health Sciences Division and Basic Science Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA; Department of Medicine and VAPSHCS, University of Washington, Seattle, WA 98109, USA
| | - Hyojeong Mulcahy
- Department of Radiology, University of Washington, Seattle, WA 98109, USA
| | - Lawrence D True
- Department of Pathology, University of Washington Medical Center, Seattle, WA 98109, USA
| | - Stephen R Plymate
- Department of Medicine and VAPSHCS, University of Washington, Seattle, WA 98109, USA
| | - Heidi Dvinge
- Computational Biology Program, Public Health Sciences Division and Basic Science Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA
| | - Roberta Ferraldeschi
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Penny Flohr
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Susana Miranda
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Zafeiris Zafeiriou
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Nina Tunariu
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Joaquin Mateo
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Raquel Perez-Lopez
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Francesca Demichelis
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Laboratory of Computational Oncology, CIBIO, Centre for Integrative Biology, University of Trento, 38123 Mattarello TN, Italy
| | - Brian D Robinson
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; New York Presbyterian Hospital, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Marc Schiffman
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Division of Interventional Radiology, Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - David M Nanus
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; New York Presbyterian Hospital, New York, NY 10021, USA; Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Scott T Tagawa
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; New York Presbyterian Hospital, New York, NY 10021, USA; Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Alexandros Sigaras
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Medical College of Cornell University, New York, NY 10021, USA; Department of Physiology & Biophysics, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Kenneth W Eng
- Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Medical College of Cornell University, New York, NY 10021, USA; Department of Physiology & Biophysics, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Olivier Elemento
- Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Andrea Sboner
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Medical College of Cornell University, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Elisabeth I Heath
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA; Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Howard I Scher
- Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Genitourinary Oncology Service, Department of Medicine, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Kenneth J Pienta
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Philip Kantoff
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Johann S de Bono
- Cancer Biomarkers Team, Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK; Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Mark A Rubin
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; Institute for Precision Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA; New York Presbyterian Hospital, New York, NY 10021, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Peter S Nelson
- Department of Medicine and VAPSHCS, University of Washington, Seattle, WA 98109, USA; Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Meyer Cancer, Weill Medical College of Cornell University, New York, NY 10021, USA
| | - Levi A Garraway
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA 02142, USA
| | - Charles L Sawyers
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Howard Hughes Medical Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Arul M Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI 48109, USA.
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Crespo M, van Dalum G, Ferraldeschi R, Zafeiriou Z, Sideris S, Lorente D, Bianchini D, Rodrigues DN, Riisnaes R, Miranda S, Figueiredo I, Flohr P, Nowakowska K, de Bono JS, Terstappen LWMM, Attard G. Androgen receptor expression in circulating tumour cells from castration-resistant prostate cancer patients treated with novel endocrine agents. Br J Cancer 2015; 112:1166-74. [PMID: 25719830 PMCID: PMC4385957 DOI: 10.1038/bjc.2015.63] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [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: 10/18/2014] [Revised: 01/19/2015] [Accepted: 01/27/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Abiraterone and enzalutamide are novel endocrine treatments that abrogate androgen receptor (AR) signalling in castration-resistant prostate cancer (CRPC). Here, we developed a circulating tumour cells (CTCs)-based assay to evaluate AR expression in real-time in CRPC and investigated nuclear AR expression in CTCs in patients treated with enzalutamide and abiraterone. METHODS CTCs were captured and characterised using the CellSearch system. An automated algorithm to identify CTCs and quantify AR expression was employed. The primary aim was to evaluate the association between CTC AR expression and prior treatment with abiraterone or enzalutamide. RESULTS AR expression in CTCs was evaluated in 94 samples from 48 metastatic CRPC patients. We observed large intra-patient heterogeneity of AR expression in CTCs. Prior exposure to abiraterone or enzalutamide was not associated with a change in CTCs AR expression (median intensity and distribution of AR-positive classes). In support of this, we also confirmed maintained nuclear AR expression in tissue samples collected after progression on abiraterone. AR staining also identified additional AR-positive CD45-negative circulating cells that were CK-negative/weak and therefore missed using standard protocols. The number of these events correlated with traditional CTCs and was associated with worse outcome on univariate analysis. CONCLUSIONS We developed a non-invasive method to monitor AR nuclear expression in CTCs. Our studies confirm nuclear AR expression in CRPC patients progressing on novel endocrine treatments. Owing to the significant heterogeneity of AR expression in CTCs, studies in larger cohorts of patients are required to identify associations with outcome.
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Affiliation(s)
- M Crespo
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - G van Dalum
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, 7522ND, Enschede, The Netherlands
| | - R Ferraldeschi
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
| | - Z Zafeiriou
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
| | - S Sideris
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
| | - D Lorente
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
| | - D Bianchini
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
| | - D N Rodrigues
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - R Riisnaes
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - S Miranda
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - I Figueiredo
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - P Flohr
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - K Nowakowska
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
| | - J S de Bono
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
| | - L W M M Terstappen
- Department of Medical Cell BioPhysics, MIRA Institute, University of Twente, 7522ND, Enschede, The Netherlands
| | - G Attard
- Section of Medicine, The Institute of Cancer Research, Sutton, Surrey, SM2 5NG, UK
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5NG, UK
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Eichholz A, Merson S, Clark J, Brewer D, Flohr P, Yang Z, Cuzick J, Fisher G, Scardino P, Cooper C. PD-0123 ANDROGEN RECEPTOR FISH ASSAY PREDICTS POOR SURVIVAL IN EARLY HUMAN PROSTATE CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70462-0] [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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Abstract
Background Formalin-fixed prostate biopsies are frequently the only tissue collected at the time of prostate cancer diagnosis. There is therefore a requirement for techniques that allow the use of these prostate biopsy specimens in a high-throughput analysis of immunohistochemical and fluorescence-in-situ-hybridisation-detected biomarkers. Methods The authors have previously described methods that allow tissue microarray (TMA) construction from prostate biopsies. Here, we describe significant technical innovations that provide an easier and more robust system of biopsy–TMA construction. Results and discussion The TMAs produced are of a high density (up to 104 cores each, 8×13) and allow a multiplex analysis of biomarkers in the context of clinical trials.
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Affiliation(s)
- F McCarthy
- Institute of Cancer Research, Male Urological Cancer Research Centre, Sutton, UK
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35
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Reid A, Attard G, Ambroisine L, Fisher G, Kovacs G, Brewer D, Clark J, Flohr P, Edwards S, Berney DM, Foster CS, Fletcher A, Gerald WL, Moller H, Reuter VE, Scardino PT, Cuzick J, De Bono JS, Cooper CS. Abstract 662: Molecular characterisation of ERG, ETV-1 and PTEN- gene loci identifies patients at low and high risk of death from prostate cancer. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-662] [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: The discovery of ERG/ETV-1-gene rearrangements and PTEN-gene loss suggests their use in a mechanism-based prognostic classification of prostate cancer (PCa).
Purpose: To evaluate the potential clinical significance and natural history of different disease categories by combining ERG/ETV-1-gene rearrangements and PTEN-gene loss status.
Methods: We utilized fluorescence in situ hybridization (FISH) assays to detect PTEN-gene loss and ERG/ETV-1-gene rearrangements in 308 conservatively managed PCa patients with survival outcome data.
Results: ERG/ETV-1-gene rearrangements alone and PTEN-gene loss alone each failed to show a link to survival in multivariate analyses. However, there was a strong interaction between ERG/ETV-1-gene rearrangements and PTEN-gene loss (p<0.001). The largest subgroup of patients (54%), lacking both PTEN-gene loss and ERG/ETV-1-gene rearrangements comprised a ‘good prognosis’ population exhibiting favourable cancer-specific survival (85.5% alive at 11 years). The presence of PTEN-gene loss in the absence of ERG/ETV-1-gene rearrangements identified a patient population (6%) with poorer cancer-specific survival that was highly significant (HR = 4.87, p<0.001 in multivariate analysis, 13.7% survival at 11 years) when compared to the ‘good prognosis’ group. ERG/ETV-1-gene rearrangement and PTEN-gene loss status should now prospectively be incorporated into a predictive model to establish whether predictive performance is improved.
Conclusions: Our data suggest that FISH studies of PTEN-gene loss and ERG/ETV-1-gene rearrangements could be pursued for patient stratification, selection and hypothesis-generating sub-group analyses in future PCa clinical trials and potentially in patient management.
Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 662.
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Affiliation(s)
- Alison Reid
- 1Institute of Cancer Research/ Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Gerhardt Attard
- 1Institute of Cancer Research/ Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Laurence Ambroisine
- 2Queen Mary University of London, Barts and the London School of Medicine, United Kingdom
| | - Gabrielle Fisher
- 2Queen Mary University of London, Barts and the London School of Medicine, United Kingdom
| | - Gyula Kovacs
- 3Ruprecht-Karls-Universitat, Heidelberg, Germany
| | - Daniel Brewer
- 4Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Jeremy Clark
- 4Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Penny Flohr
- 4Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Sandra Edwards
- 4Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Daniel M. Berney
- 5Barts and the London School of Medicine and Dentistry, London, United Kingdom
| | - Chris S. Foster
- 6Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Anne Fletcher
- 4Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | | | - Henrik Moller
- 1Institute of Cancer Research/ Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | | | | | - Jack Cuzick
- 2Queen Mary University of London, Barts and the London School of Medicine, United Kingdom
| | - Johann S. De Bono
- 1Institute of Cancer Research/ Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Colin S. Cooper
- 4Institute of Cancer Research, Sutton, Surrey, United Kingdom
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McCarthy F, Fletcher A, Dennis N, Cummings C, O'Donnell H, Clark J, Flohr P, Vergis R, Jhavar S, Parker C, Cooper CS. An improved method for constructing tissue microarrays from prostate needle biopsy specimens. J Clin Pathol 2009; 62:694-8. [PMID: 19638540 PMCID: PMC2709943 DOI: 10.1136/jcp.2009.065201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: Prostate cancer diagnosis is routinely made by the histopathological examination of formalin fixed needle biopsy specimens. Frequently this is the only cancer tissue available from the patient for the analysis of diagnostic and prognostic biomarkers. There is, therefore, an urgent need for methods that allow the high-throughput analysis of these biopsy samples using immunohistochemical (IHC) markers and fluorescence in situ hybridisation (FISH) analysis based markers. Methods: A method that allows the construction of tissue microarrays (TMAs) from diagnostic prostate needle biopsy cores has previously been reported. However, the technique only allows the production of low-density biopsy TMAs with a maximum of 20 cores per TMA. Here two methods are presented that allow the rapid and uniform production of biopsy TMAs containing between 54 and 72 biopsy cores. IHC and FISH techniques were used to detect biomarker status. Results: Biopsy TMAs were constructed from prostate needle biopsy specimens taken from 102 patients entered into an active surveillance trial and 201 patients in a radiotherapy trial. The detection rate for cancer in slices of these biopsy TMAs was 66% and 79% respectively. Slices of a biopsy TMA prepared from biopsies from active surveillance patients were used to detect multiple IHC markers and to score TMPRSS2-ERG fusion status in a FISH-based assay. Conclusions: The construction of biopsy TMAs provides an effective method for the multiplex analysis of IHC and FISH markers and for their assessment as prognostic biomarkers in the context of clinical trials.
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Affiliation(s)
- F McCarthy
- Institute of Cancer Research, Male Urological Cancer Research Centre, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK.
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Jhavar S, Brewer D, Edwards S, Kote-Jarai Z, Attard G, Clark J, Flohr P, Christmas T, Thompson A, Parker M, Shepherd C, Stenman UH, Marchbank T, Playford RJ, Woodhouse C, Ogden C, Fisher C, Kovacs G, Corbishley C, Jameson C, Norman A, De-Bono J, Bjartell A, Eeles R, Cooper CS. Integration ofERGgene mapping and gene-expression profiling identifies distinct categories of human prostate cancer. BJU Int 2009; 103:1256-69. [DOI: 10.1111/j.1464-410x.2008.08200.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Attard G, Jameson C, Moreira J, Flohr P, Parker C, Dearnaley D, Cooper CS, de Bono JS. Hormone-sensitive prostate cancer: a case of ETS gene fusion heterogeneity. J Clin Pathol 2008; 62:373-6. [DOI: 10.1136/jcp.2008.061515] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Attard G, Clark J, Ambroisine L, Mills IG, Fisher G, Flohr P, Reid A, Edwards S, Kovacs G, Berney D, Foster C, Massie CE, Fletcher A, De Bono JS, Scardino P, Cuzick J, Cooper CS. Heterogeneity and clinical significance of ETV1 translocations in human prostate cancer. Br J Cancer 2008; 99:314-20. [PMID: 18594527 PMCID: PMC2480965 DOI: 10.1038/sj.bjc.6604472] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A fluorescence in situ hybridisation (FISH) assay has been used to screen for ETV1 gene rearrangements in a cohort of 429 prostate cancers from patients who had been diagnosed by trans-urethral resection of the prostate. The presence of ETV1 gene alterations (found in 23 cases, 5.4%) was correlated with higher Gleason Score (P=0.001), PSA level at diagnosis (P=<0.0001) and clinical stage (P=0.017) but was not linked to poorer survival. We found that the six previously characterised translocation partners of ETV1 only accounted for 34% of ETV1 re-arrangements (eight out of 23) in this series, with fusion to the androgen-repressed gene C15orf21 representing the commonest event (four out of 23). In 5'-RACE experiments on RNA extracted from formalin-fixed tissue we identified the androgen-upregulated gene ACSL3 as a new 5'-translocation partner of ETV1. These studies report a novel fusion partner for ETV1 and highlight the considerable heterogeneity of ETV1 gene rearrangements in human prostate cancer.
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Affiliation(s)
- G Attard
- Institute of Cancer Research, Male Urological Cancer Research Centre, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
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40
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Attard G, Clark J, Ambroisine L, Fisher G, Kovacs G, Flohr P, Berney D, Foster CS, Fletcher A, Gerald WL, Moller H, Reuter V, De Bono JS, Scardino P, Cuzick J, Cooper CS. Duplication of the fusion of TMPRSS2 to ERG sequences identifies fatal human prostate cancer. Oncogene 2007; 27:253-63. [PMID: 17637754 PMCID: PMC2646890 DOI: 10.1038/sj.onc.1210640] [Citation(s) in RCA: 346] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
New predictive markers for managing prostate cancer are urgently required because of the highly variable natural history of this disease. At the time of diagnosis, Gleason score provides the gold standard for assessing the aggressiveness of prostate cancer. However, the recent discovery of TMPRSS2 fusions to the ERG gene in prostate cancer raises the possibility of using alterations at the ERG locus as additional mechanism-based prognostic indicators. Fluorescence in situ hybridization (FISH) assays were used to assess ERG gene status in a cohort of 445 prostate cancers from patients who had been conservatively managed. The FISH assays detected separation of 5' (labelled green) and 3' (labelled red) ERG sequences, which is a consequence of the TMPRSS2-ERG fusion, and additionally identify interstitial deletion of genomic sequences between the tandemly located TMPRSS2 and ERG gene sequences on chromosome 21. Cancers lacking ERG alterations exhibited favourable cause-specific survival (90% survival at 8 years). We identify a novel category of prostate cancers, characterized by duplication of the fusion of TMPRSS2 to ERG sequences together with interstitial deletion of sequences 5' to ERG (called '2+Edel'), which by comparison exhibited extremely poor cause-specific survival (hazard ratio=6.10, 95% confidence ratio=3.33-11.15, P<0.001, 25% survival at 8 years). In multivariate analysis, '2+Edel' provided significant prognostic information (P=0.003) in addition to that provided by Gleason score and prostate-specific antigen level at diagnosis. Other individual categories of ERG alteration were associated with intermediate or good prognosis. We conclude that determination of ERG gene status, including duplication of the fusion of TMPRSS2 to ERG sequences in 2+Edel, allows stratification of prostate cancer into distinct survival categories.
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Affiliation(s)
- G Attard
- Institute of Cancer Research, Male Urological Cancer Research Centre, Surrey, UK
- The Royal Marsden NHS Trust Foundation Hospital, Surrey, UK
| | - J Clark
- Institute of Cancer Research, Male Urological Cancer Research Centre, Surrey, UK
| | - L Ambroisine
- Wolfson Institute of Preventive Medicine, University of London, London, UK
| | - G Fisher
- Wolfson Institute of Preventive Medicine, University of London, London, UK
| | - G Kovacs
- Ruprecht-Karls-Universitat, Medical Faculty, Laboratory of Molecular Oncology, Heidelberg, Germany
| | - P Flohr
- Institute of Cancer Research, Male Urological Cancer Research Centre, Surrey, UK
| | - D Berney
- Department of Histopathology, St Bartholomew’s Hospital, London, UK
| | - CS Foster
- Department of Pathology, Royal Liverpool University Hospital, Liverpool, UK
| | - A Fletcher
- Institute of Cancer Research, Male Urological Cancer Research Centre, Surrey, UK
| | - WL Gerald
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - H Moller
- Kings College, Thames Cancer Registry, London, UK
| | - V Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - JS De Bono
- The Royal Marsden NHS Trust Foundation Hospital, Surrey, UK
| | - P Scardino
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - J Cuzick
- Wolfson Institute of Preventive Medicine, University of London, London, UK
| | - CS Cooper
- Institute of Cancer Research, Male Urological Cancer Research Centre, Surrey, UK
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Clark J, Merson S, Jhavar S, Flohr P, Edwards S, Foster CS, Eeles R, Martin FL, Phillips DH, Crundwell M, Christmas T, Thompson A, Fisher C, Kovacs G, Cooper CS. Diversity of TMPRSS2-ERG fusion transcripts in the human prostate. Oncogene 2006; 26:2667-73. [PMID: 17043636 DOI: 10.1038/sj.onc.1210070] [Citation(s) in RCA: 202] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
TMPRSS2-ERG gene fusions have recently been reported to be present in a high proportion of human prostate cancers. In the current study, we show that great diversity exists in the precise structure of TMPRSS2-ERG hybrid transcripts found in human prostates. Fourteen distinct hybrid transcripts are characterized, each containing different combinations of sequences from the TMPRSS2 and ERG genes. The transcripts include two that are predicted to encode a normal full-length ERG protein, six that encode N-terminal truncated ERG proteins and one that encodes a TMPRSS2-ERG fusion protein. Interestingly, distinct patterns of hybrid transcripts were found in samples taken from separate regions of individual cancer-containing prostates, suggesting that TMPRSS2-ERG gene fusions may be arising independently in different regions of a single prostate.
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Affiliation(s)
- J Clark
- Institute of Cancer Research, Male Urological Cancer Research Centre, Sutton, Surrey, UK.
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Edwards S, Campbell C, Flohr P, Shipley J, Giddings I, te-Poele R, Dodson A, Foster C, Clark J, Jhavar S, Kovacs G, Cooper CS. Expression analysis onto microarrays of randomly selected cDNA clones highlights HOXB13 as a marker of human prostate cancer. Br J Cancer 2005; 92:376-81. [PMID: 15583692 PMCID: PMC2361840 DOI: 10.1038/sj.bjc.6602261] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
In a strategy aimed at identifying novel markers of human prostate cancer, we performed expression analysis using microarrays of clones randomly selected from a cDNA library prepared from the LNCaP prostate cancer cell line. Comparisons of expression profiles in primary human prostate cancer, adjacent normal prostate tissue, and a selection of other (nonprostate) normal human tissues, led to the identification of a set of clones that were judged as the best candidate markers of normal and/or malignant prostate tissue. DNA sequencing of the selected clones revealed that they included 10 genes that had previously been established as prostate markers: NKX3.1, KLK2, KLK3 (PSA), FOLH1 (PSMA), STEAP2, PSGR, PRAC, RDH11, Prostein and FASN. Following analysis of the expression patterns of all selected and sequenced genes through interrogation of SAGE databases, a further three genes from our clone set, HOXB13, SPON2 and NCAM2, emerged as additional candidate markers of human prostate cancer. Quantitative RT-PCR demonstrated the specificity of expression of HOXB13 in prostate tissue and revealed its ubiquitous expression in a series of 37 primary prostate cancers and 20 normal prostates. These results demonstrate the utility of this expression-microarray approach in hunting for new markers of individual human cancer types.
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Affiliation(s)
- S Edwards
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - C Campbell
- Department of Engineering Mathematics, University of Bristol, Bristol BS8 1TR, UK
| | - P Flohr
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - J Shipley
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - I Giddings
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - R te-Poele
- CRUK Centre for Cancer Therapeutics, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - A Dodson
- Department of Pathology & Molecular Genetics, University of Liverpool, Duncan Building, Daulby Street, Liverpool L69 3GA, UK
| | - C Foster
- Department of Pathology & Molecular Genetics, University of Liverpool, Duncan Building, Daulby Street, Liverpool L69 3GA, UK
| | - J Clark
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - S Jhavar
- Section of Cancer Genetics, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - G Kovacs
- Laboratory of Molecular Oncology, University Surgical Hospital, Im Neuenheimer Feld 365, Heidelberg 69120, Germany
| | - C S Cooper
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
- Section of Molecular Carcinogenesis, Male Urological Cancer Research Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK. E-mail:
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43
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Lee YF, John M, Falconer A, Edwards S, Clark J, Flohr P, Roe T, Wang R, Shipley J, Grimer RJ, Mangham DC, Thomas JM, Fisher C, Judson I, Cooper CS. A Gene Expression Signature Associated with Metastatic Outcome in Human Leiomyosarcomas. Cancer Res 2004; 64:7201-4. [PMID: 15492233 DOI: 10.1158/0008-5472.can-04-1673] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Metastasis is a major factor associated with poor prognosis in cancer, but little is known of its molecular mechanisms. Although the clinical behavior of soft tissue sarcomas is highly variable, few reliable determinants of outcome have been identified. New markers that predict clinical outcome, in particular the ability of primary tumors to develop metastatic tumors, are urgently needed. Here, we have chosen leiomyosarcoma as a model for examining the relationship between gene expression profile and the development of metastasis in soft tissue sarcomas. Using cDNA microarray, we have identified a gene expression signature associated with metastasis in sarcoma that allowed prediction of the future development of metastases of primary tumors (Kaplan-Meier analysis P = 0.001). Our finding may aid the tailoring of therapy for individual sarcoma patients, where the aggressiveness of treatment is affected by the predicted outcome of disease.
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Affiliation(s)
- Yin-Fai Lee
- The Male Urological Cancer Research Centre, Institute of Cancer Research, Surrey, United Kingdom.
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44
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Feber A, Clark J, Goodwin G, Dodson AR, Smith PH, Fletcher A, Edwards S, Flohr P, Falconer A, Roe T, Kovacs G, Dennis N, Fisher C, Wooster R, Huddart R, Foster CS, Cooper CS. Amplification and overexpression of E2F3 in human bladder cancer. Oncogene 2004; 23:1627-30. [PMID: 14716298 DOI: 10.1038/sj.onc.1207274] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We demonstrate that, in human bladder cancer, amplification of the E2F3 gene, located at 6p22, is associated with overexpression of its encoded mRNA transcripts and high levels of expression of E2F3 protein. Immunohistochemical analyses of E2F3 protein levels have established that around one-third (33/101) of primary transitional cell carcinomas of the bladder overexpress nuclear E2F3 protein, with the proportion of tumours containing overexpressed nuclear E2F3 increasing with tumour stage and grade. When considered together with the established role of E2F3 in cell cycle progression, these results suggest that the E2F3 gene represents a candidate bladder cancer oncogene that is activated by DNA amplification and overexpression.
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Affiliation(s)
- Andrew Feber
- Section of Molecular Carcinogenesis and Male Urological Cancer Research, Centre, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
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45
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Clark J, Edwards S, Feber A, Flohr P, John M, Giddings I, Crossland S, Stratton MR, Wooster R, Campbell C, Cooper CS. Genome-wide screening for complete genetic loss in prostate cancer by comparative hybridization onto cDNA microarrays. Oncogene 2003; 22:1247-52. [PMID: 12606952 DOI: 10.1038/sj.onc.1206247] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We demonstrate that comparative genomic hybridization (CGH) onto cDNA microarrays may be used to carry out genome-wide screens for regions of genetic loss, including homozygous (complete) deletions that may represent the possible location of tumour suppressor genes in human cancer. Screening of the prostate cancer cell lines LNCaP, PC3 and DU145 allowed the mapping of specific regions where genome copy number appeared altered and led to the identification of two novel regions of complete loss at 17q21.31 (500 kb spanning STAT3) and at 10q23.1 (50-350 kb spanning SFTPA2) in the PC3 cell line.
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Affiliation(s)
- Jeremy Clark
- Molecular Carcinogenesis Section, Male Urological Cancer Research Center, Institute of Cancer Research, Sutton, Surrey, UK.
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46
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Lee YF, John M, Edwards S, Clark J, Flohr P, Maillard K, Edema M, Baker L, Mangham DC, Grimer R, Wooster R, Thomas JM, Fisher C, Judson I, Cooper CS. Molecular classification of synovial sarcomas, leiomyosarcomas and malignant fibrous histiocytomas by gene expression profiling. Br J Cancer 2003; 88:510-5. [PMID: 12592363 PMCID: PMC2377178 DOI: 10.1038/sj.bjc.6600766] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In this study, we have used genome-wide expression profiling to categorise synovial sarcomas, leiomyosarcomas and malignant fibrous histiocytomas (MFHs). Following hierarchical clustering analysis of the expression data, the best match between tumour clusters and conventional diagnosis was observed for synovial sarcomas. Eight of nine synovial sarcomas examined formed a cluster that was characterised by higher expression of a set of 48 genes. In contrast, sarcomas conventionally classified as leiomyosarcomas and MFHs did not match the clusters defined by hierarchical clustering analysis. One major cluster contained a mixture of both leiomyosarcomas and MFHs and was defined by the lower expression of a set of 202 genes. A cluster containing a subgroup of MFHs was also detected. These results may have implications for the classification of soft tissue sarcomas, and are consistent with the view that sarcomas conventionally defined as MFHs do not represent a separate diagnostic category.
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Affiliation(s)
- Y-F Lee
- The Male Urological Cancer Research Centre, Institute of Cancer Research, Sutton, Surrey, UK.
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47
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Clark J, Edwards S, John M, Flohr P, Gordon T, Maillard K, Giddings I, Brown C, Bagherzadeh A, Campbell C, Shipley J, Wooster R, Cooper CS. Identification of amplified and expressed genes in breast cancer by comparative hybridization onto microarrays of randomly selected cDNA clones. Genes Chromosomes Cancer 2002; 34:104-14. [PMID: 11921288 DOI: 10.1002/gcc.10039] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Microarray analysis using sets of known human genes provides a powerful platform for identifying candidate oncogenes involved in DNA amplification events but suffers from the disadvantage that information can be gained only on genes that have been preselected for inclusion on the array. To address this issue, we have performed comparative genome hybridization (CGH) and expression analyses on microarrays of clones, randomly selected from a cDNA library, prepared from a cancer containing the DNA amplicon under investigation. Application of this approach to the BT474 breast carcinoma cell line, which contains amplicons at 20q13, 17q11-21, and 17q22-23, identified 50 amplified and expressed genes, including genes from these regions previously proposed as candidate oncogenes. When considered together with data from microarray expression profiles and Northern analyses, we were able to propose five genes as new candidate oncogenes where amplification in breast cancer cell lines was consistently associated with higher levels of RNA expression. These included the HB01 histone acetyl transferase gene at 17q22-23 and the TRAP100 gene, which encodes a thyroid hormone receptor-associated protein coactivator, at 17q11-21. The results demonstrate the utility of this microarray-based CGH approach in hunting for candidate oncogenes within DNA amplicons.
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Affiliation(s)
- Jeremy Clark
- Section of Molecular Carcinogenesis, The Haddow Laboratories, Institute of Cancer Research, Sutton, Surrey, United Kingdom
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48
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Abstract
Questionnaires were mailed anonymously to 150 German shock wave centers. Twenty questions addressed the following areas of interest: Facilities of the extracorporeal shock wave lithotripsy (ESWL) center (technical, personnel, laboratory, etc.) Cooperation at ESWL center with referring urologists Laboratory facilities versus actual metabolic work-up. The return rate was 114 of 150 (76%). Surprisingly, at 58% of the centers the average number of treatments is less than two per day. In 30% of the centers only chemical stone analysis is done! The final conclusion was that ESWL has largely replaced the causal metabolic work-up and subsequent metaphylaxis as a symptomatic measure against urolithiasis.
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Affiliation(s)
- P Flohr
- Urologische Universitätsklinik Ulm
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49
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de Petriconi R, Kleinschmidt K, Flohr P, Paiss T, Hautmann R. [Ileal neobladder with anastomosis to the female urethra]. Urologe A 1996; 35:284-90. [PMID: 8928356] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Orthotopic reconstruction to the native urethra has revolutionized urinary diversion, allowing patients to void per the urethra. This form of urinary diversion was initially performed solely in male patients after cystectomy. More recently, however, with a better understanding of the female continence mechanism, including the urethral/vaginal support mechanism, and the ability to select appropriate female candidates properly for this type of surgery, orthotopic reconstruction has become a viable option in women. Since November 1986, 24 women aged 53 years (range 17-76) have undergone orthotopic reconstruction using the ileal neobladder. Indications for cystectomy included transitional cell carcinoma of the bladder (8), fibrotic radiated bladder (4), interstitial cystitis (5), tuberculotic bladder (2), urge incontinence (2), neurogenic fibrotic bladder (2), and fibrotic bladder of unknown etiology (1). Nineteen patients are available with a median follow-up of 48 months (range 3 to 109 months). There were no perioperative deaths, with few early and late complications. Two women previously irradiated developed a neovesicovaginal fistula and had to be diverted by an ileal loop. Three patients from the far East are no longer available for follow-up. Ten years of experience with 24 patients have led to a nerve- and urethral-support-sparing cystectomy technique with the ileal neobladder anastomosed to the proximal urethra. However, even then, retention in 20% of the patients rather than the expected incontinence is the critical issue. Incontinence has never been a problem. The advent of orthotopic lower urinary reconstruction in women is a major achievement in the evolution of urinary diversion. With our increasing understanding of the continence mechanism in women and with increasing evidence that the female urethra can be safely preserved after cystectomy, orthotopic lower urinary tract reconstruction by the ileal neobladder can now be offered safely not only to males, but also to female patients undergoing cystectomy, and the functional results are superb.
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Abstract
From April 1986 through May 1995, 306 men with primary urothelial carcinoma underwent radical cystoprostatectomy and orthotopic bladder substitution via the ileal neobladder. Altogether, 7.5% of the patients suffered general early complications, including thrombosis, embolism, wound infection, and pneumonia. Specific early complications directly related to formation of the neobladder and requiring surgery included ileus (4%), abscess drainage (2%), and leakage of the ileal anastomosis (0.5%). The early reoperation rate was 6.5%. Early complications that required temporary percutaneous drainage were lymphocele formation (3%) or ureteral obstruction (6%). In all, 9% of our patients required prolonged catheter drainage for leakage of the ileouretheral anastomosis. Late complications requiring reoperation were ileus (2%), abscess drainage (1%), neobladder fistula to the colon (1.5%), ureteral reimplantation because of obstruction (3.6%), and nephrectomy for hydronephrosis (1%). A transurethral incision of the ileouretheral anastomosis was necessary in 7% of cases. Continence was separately addressed by sending each patient and his home physician a detailed questionnaire: Using our criteria (no diapers, no awakenings) the night and day continence rate increased from 67% at 6 months, to 72% at 1 year to 85% at 2 years, finally reacting 90% after 4 years. In part II of this presentation we address the question as to whether the option of orthotopic bladder replacement has any impact on the patient's and physician's decision toward earlier cystectomy. We compared our ileal neobladder cohort with a group of 137 patients that had been operated on during the same time span by the same group of surgeons. There was no negative selection with regard of the tumor stage of our patients. However, as compared with the conduit group, the neobladder cohort had a significantly improved survival rate. This phenomenon is explainable by the significantly lower number of previous transurethral resections of the bladder (TUR-Bs) performed in the neobladder group. The time span between primary diagnosis and cystectomy was 10 months in the neobladder group as compared with 18 months in the conduit patients. These data reinforce our belief that orthotopic bladder replacement using the ileal neobladder yields an extraordinary functional result that can be accomplished with a high degree of patient satisfaction and minimal complication. The availability of orthotopic bladder replacement does indeed stimulate the physicians and patients decision toward earlier cystectomy.
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Affiliation(s)
- P Flohr
- Department of Urology, Faculty of Medicine, University of Ulm, Germany
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