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Pillai R, Chheda A, Agrawal S, Ravat S, Sankhe S, Muzumdar D. Skull-base temporal encephalocele: Hidden cause of temporal lobe epilepsy. J Postgrad Med 2024; 70:97-100. [PMID: 37555423 DOI: 10.4103/jpgm.jpgm_354_22] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/22/2022] [Indexed: 08/10/2023] Open
Abstract
ABSTRACT In the present study patients with previously diagnosed MRI-negative temporal lobe epilepsy (TLE) on long-term video electroencephalography (VEEG) monitoring were re-evaluated with high resolution 3T MRI brain to look out for a skull base temporal lobe encephalocoele (TE). A total of 234 VEEGs were analyzed. TLE had been diagnosed in 104 patients based on semiology, ictal, interictal EEG data, and brain positron emission tomography (PET) studies. Of these, 99 patients had temporal lobe abnormality (78 had mesial temporal sclerosis, 8 had tumor, 3 had focal cortical dysplasia, and 10 had mixed pathology). Out of the five 1.5T MRI-negative TLE patients, two patients were diagnosed with TE on subsequent 3T MRI brain scans and one patient underwent electrocorticography-guided tailored resection for complete removal of epileptogenic tissue; with Engels class I seizure freedom at one year follow-up. We propose that TE should be carefully searched for, as a cause of refractory TLE, using high-resolution MRI sequences.
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Affiliation(s)
- R Pillai
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - A Chheda
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - S Agrawal
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - S Ravat
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - S Sankhe
- Department of Radiology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - D Muzumdar
- Department of Neurosurgery, Seth GS Medical College and KEM Hospital, Mumbai, India
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2
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Wong J, Jackson R, Chen L, Song J, Pillai R, Afkhami M, Danilova O, Aoun P, Gaal KK, Kim Y. Determination of age-dependent bone marrow normocellularity. Am J Clin Pathol 2024; 161:170-176. [PMID: 37904278 DOI: 10.1093/ajcp/aqad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/06/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVES Determination of bone marrow cellularity is a key part of bone marrow examination because it provides a small window into a patient's current state of hematopoietic well-being. Traditionally, bone marrow cellularity is estimated semiquantitatively through microscopic examination of core biopsy specimens harvested from the iliac crest of the pelvic bone. Bone marrow cellularity is then designated as hypercellular, normocellular, or hypocellular based on the patient's age. This assessment can have significant clinical impact, but the variation in the age-adjusted normocellularity range is not sufficiently characterized because of a lack of study data, especially in older patients (those older than 70 years of age). This study further established the normal range of bone marrow cellularity, particularly in older adults. METHODS In this study, 570 benign staging and healthy donor bone marrows from patients 1 year to 93 years of age were analyzed for cellularity. RESULTS Linear regression modeling demonstrates that cellularity in adults declines approximately 3% per decade, including after the seventh decade of life. The 90% reference interval for normocellularity in United States is 30% to 75% for those aged 18 to 90 years. CONCLUSIONS The findings revealed a more stable and slower rate of decline in cellularity with age in adults than the widely used linear model of "100% minus the patient age in decades." Normocellularity is better modeled based on age group. In those younger than 20 years of age, normocellularity ranges from 45% to 85% (mean [SD], 65% [20%]), as defined by Friebert et al in 1998. Based on our study finding of a little less than 3% decline per decade of age, the following is our recommendation for normocellularity range: For individuals 20 to 40 years of age, it ranges from 40% to 70% (mean [SD], 55% [15%]); for individuals 40 to 60 years of age, it ranges from 35% to 65% (mean [SD], 50% [15%]); and for individuals older than 60 years of age, it ranges from 30% to 60% (mean [SD], 45% [15%]). Interestingly, those older than 70 years of age do not show a significant decrease from those aged 60 to 69 years.
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Affiliation(s)
- Jerry Wong
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, US
| | - Ryan Jackson
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Lu Chen
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Joo Song
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Raju Pillai
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Michelle Afkhami
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Olga Danilova
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Patricia Aoun
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Karl K Gaal
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
| | - Young Kim
- Department of Pathology City of Hope National Medical Center, Duarte, CA, US
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3
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Rhee JW, Pillai R, He T, Bosworth A, Chen S, Atencio L, Oganesyan A, Peng K, Guzman T, Lukas K, Sigala B, Iukuridze A, Lindenfeld L, Jamal F, Natarajan P, Goldsmith S, Krishnan A, Rosenzweig M, Wong FL, Forman SJ, Armenian S. Clonal Hematopoiesis and Cardiovascular Disease in Patients With Multiple Myeloma Undergoing Hematopoietic Cell Transplant. JAMA Cardiol 2024; 9:16-24. [PMID: 37938837 PMCID: PMC10633387 DOI: 10.1001/jamacardio.2023.4105] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/18/2023] [Indexed: 11/10/2023]
Abstract
Importance There is a paucity of information on the association between clonal hematopoiesis of indeterminate potential (CHIP) and cardiovascular disease (CVD) in patients with cancer, including those with multiple myeloma (MM) undergoing hematopoietic cell transplant (HCT), a population at high risk of developing CVD after HCT. Objective To examine the association between CHIP and CVD in patients with MM and to describe modifiers of CVD risk among those with CHIP. Design, Setting, and Participants This was a retrospective cohort study of patients with MM who underwent HCT between 2010 and 2016 at City of Hope Comprehensive Cancer Center in Duarte, California, and had pre-HCT mobilized peripheral blood stem cell (PBSC) products cryopreserved and accessible for CHIP analyses. The study team performed targeted panel DNA sequencing to detect the presence of CHIP (variant allele frequency 2% or more). Main Outcomes and Measures The primary end point was the 5-year cumulative incidence and risk for developing de novo CVD (heart failure, coronary artery disease, or stroke) after HCT. Results Of 1036 consecutive patients with MM (580 male [56%]; median age, 60.0 years) who underwent a first autologous HCT, 201 patients had at least 1 CHIP variant (19.4%) and 35 patients had 2 or more variants (3.4%). The 5-year incidence of CVD was significantly higher in patients with CHIP (21.1% vs 8.4%; P < .001) compared with those without CHIP; the 5-year incidence among those with 2 or more variants was 25.6%. In the multivariable model, CHIP was associated with increased risk of CVD (hazard ratio [HR], 2.72; 95% CI, 1.70-4.39), as well as of individual outcomes of interest, including heart failure (HR, 4.02; 95% CI, 2.32-6.98), coronary artery disease (HR, 2.22; 95% CI, 1.06-4.63), and stroke (HR, 3.02; 95% CI, 1.07-8.52). Patients who had both CHIP and preexisting hypertension or dyslipidemia were at nearly 7-fold and 4-fold increased risk of CVD, respectively (reference: no CHIP, no hypertension, or dyslipidemia). Conclusion and Relevance CHIP was significantly and independently associated with risk of CVD in patients with MM undergoing HCT and may serve as a novel biologically plausible biomarker for CVD in this cohort. Patients with MM and both CHIP and cardiovascular risk factors had an exceptionally high risk of CVD. Additional studies are warranted to determine if cardiovascular preventive measures can reduce CHIP-associated CVD risk.
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Affiliation(s)
- June-Wha Rhee
- Department of Medicine, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Raju Pillai
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Tianhui He
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Alysia Bosworth
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Sitong Chen
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Liezl Atencio
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Artem Oganesyan
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Kelly Peng
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Tati Guzman
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Kara Lukas
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Brianna Sigala
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Aleksi Iukuridze
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Lanie Lindenfeld
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Faizi Jamal
- Department of Medicine, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Pradeep Natarajan
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Scott Goldsmith
- Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Amrita Krishnan
- Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Michael Rosenzweig
- Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California
| | - F. Lennie Wong
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
| | - Stephen J. Forman
- Department of Hematology & Hematopoietic Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Saro Armenian
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte California
- Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, California
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Aldoss I, Tizro P, Bedi D, Mangan JK, Clark MC, Spencer D, Song JY, Cherian S, Pillai R, Kim Y, Mahajan N, Gendzekhadze K, James M, Jacobs K, Davidson-Moncada J, Forman SJ, Wang HY, Afkhami M. Myeloid lineage switch following CD7-targeted chimeric antigen receptor T-cell therapy in relapsed/refractory T-cell acute lymphoblastic leukemia. Haematologica 2023; 108:3511-3516. [PMID: 37470155 PMCID: PMC10690902 DOI: 10.3324/haematol.2023.283566] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
Not available.
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Affiliation(s)
- Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA.
| | | | - Davsheen Bedi
- Department of Pathology, University of California San Diego, La Jolla, CA
| | - James K Mangan
- Department of Medicine, Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Mary C Clark
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA
| | - David Spencer
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA
| | - Sindhu Cherian
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA
| | - Young Kim
- Department of Pathology, City of Hope, Duarte, CA
| | | | | | | | | | | | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA
| | - Huan-You Wang
- Department of Pathology, University of California San Diego, La Jolla, CA
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Warden CD, Cholli P, Qin H, Guo C, Wang Y, Kancharla C, Russell AM, Salvatierra S, Mutsvunguma LZ, Higa KK, Wu X, Wilczynski S, Pillai R, Ogembo JG. HPV genotyping by L1 amplicon sequencing of archived invasive cervical cancer samples: a pilot study. Infect Agent Cancer 2022; 17:44. [PMID: 35945577 PMCID: PMC9361560 DOI: 10.1186/s13027-022-00456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is the primary cause of invasive cervical cancer (ICC). The prevalence of various HPV genotypes, ranging from oncogenically low- to high-risk, may be influenced by geographic and demographic factors, which could have critical implications for the screening and prevention of HPV infection and ICC incidence. However, many technical factors may influence the identification of high-risk genotypes associated with ICC in different populations. METHODS We used high-throughput sequencing of a single amplicon within the HPV L1 gene to assess the influence of patient age, race/ethnicity, histological subtype, sample type, collection date, experimental factors, and computational parameters on the prevalence of HPV genotypes detected in archived DNA (n = 34), frozen tissue (n = 44), and formalin-fixed paraffin-embedded (FFPE) tissue (n = 57) samples collected in the Los Angeles metropolitan area. RESULTS We found that the percentage of off-target human reads and the concentration of DNA amplified from each sample varied by HPV genotype and by archive type. After accounting for the percentage of human reads and excluding samples with especially low levels of amplified DNA, the HPV prevalence was 95% across all ICC samples: HPV16 was the most common genotype (in 56% of all ICC samples), followed by HPV18 (in 21%). Depending upon the genotyping parameters, the prevalence of HPV58 varied up to twofold in our cohort. In archived DNA and frozen tissue samples, we detected previously established differences in HPV16 and HPV18 frequencies based on histological subtype, but we could not reproduce those findings using our FFPE samples. CONCLUSIONS In this pilot study, we demonstrate that sample collection, preparation, and analysis methods can influence the detection of certain HPV genotypes and must be carefully considered when drawing any biological conclusions based on HPV genotyping data from ICC samples.
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Affiliation(s)
- Charles D Warden
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Preetam Cholli
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Hanjun Qin
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Chao Guo
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Yafan Wang
- Molecular Pathology Core, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Chetan Kancharla
- Research Informatics, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Angelique M Russell
- Clinical Informatics, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | | | - Lorraine Z Mutsvunguma
- Department of Immuno-Oncology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Kerin K Higa
- Office of Faculty and Institutional Support, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Sharon Wilczynski
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Raju Pillai
- Molecular Pathology Core, City of Hope National Medical Center, Duarte, CA, 91010, USA
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Javier Gordon Ogembo
- Department of Immuno-Oncology, City of Hope National Medical Center, Duarte, CA, 91010, USA.
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Andrews R, Di Geronimo R, Virk H, Goldman R, Pillai R, Rao S, King E, Shah A, Vu C. Abstract No. 587 Morbidity and mortality conferencing as a quality assessment tool in interventional radiology: a survey of Society of Interventional Radiology members. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.569] [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: 11/27/2022] Open
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Key C, Di Geronimo R, Jenner Z, Nelson A, Kim P, Khan A, Liou F, King E, Shah A, Pillai R, Vu C, Andrews R, Rao S. Abstract No. 257 Financial analysis of outpatient evaluation and management billing by interventional radiologists in comparison to other specialties. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.338] [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: 11/26/2022] Open
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Kim P, Di Geronimo R, Vu C, Pillai R, Rao S, Shah A, King E, Khan A, Liou F, Key C, Nelson A, Andrews R. Abstract No. 313 Trends in percutaneous musculoskeletal procedure volume among Medicare patients from 2010-2018 by specialty. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chang S, Sadimin E, Yao K, Hamilton S, Aoun P, Pillai R, Muirhead D, Schmolze D. Establishment of a whole slide imaging-based frozen section service at a cancer center. J Pathol Inform 2022; 13:100106. [PMID: 36268067 PMCID: PMC9577038 DOI: 10.1016/j.jpi.2022.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background In recent years, there has been a surge of interest in clinical digital pathology (DP). Hardware and software platforms have matured and become more affordable, and advances in artificial intelligence promise to transform the practice of pathology. At our institution, we are launching a stepwise process of DP adoption which will eventually encompass our entire workflow. Out of necessity, we began by establishing a whole slide imaging (WSI)-based frozen section service. Methods We proceeded in a systematic manner by first assembling a team of key stakeholders. We carefully evaluated the various options for digitizing frozen sections before deciding that a WSI-based solution made the most sense for us. We used a formalized evaluation system to quantify performance metrics that were relevant to us. After deciding on a WSI-based system, we likewise carefully considered the various whole slide scanners and digital slide management systems available before making decisions. Results During formal evaluation by pathologists, the WSI-based system outperformed competing platforms. Although implementation was relatively complex, we have been happy with the results and have noticed significant improvements in our frozen section turnaround time. Our users have been happy with the slide management system, which we plan on utilizing in future DP efforts. Conclusions There are various options for digitizing frozen section slides. Although WSI-based systems are more complex and expensive than some alternatives, they perform well and may make sense for institutions with a pre-existing or planned larger DP infrastructure.
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Liou F, Di Geronimo R, Rao S, Shah A, King E, Pillai R, Andrews R, Vu C, Goldman R. Abstract No. 92 Effect on intra-procedural metrics of repeat imaging with CT arteriography prior to conventional angiography: analysis of trauma patients with active extravasation on initial portal venous phase imaging. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Khan A, Di Geronimo R, Liou F, Kim P, Key C, Nelson A, King E, Shah A, Vu C, Jenner Z, Yap P, Pillai R, Andrews R, Rao S. Abstract No. 132 Trends in percutaneous ablation procedures among Medicare patients from 2010-2018: an analysis of procedure volume, specialty involvement, and reimbursement rates. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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12
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Pourhassan H, Yang D, Afkhami M, Pillai R, Ball B, Al Malki M, Salhotra A, Ali H, Artz A, Curtin P, Armenian S, Stein A, Forman SJ, Marcucci G, Pullarkat V, Nakamura R, Aldoss I. High prevalence and inferior long-term outcomes for TP53 mutations in therapy-related acute lymphoblastic leukemia. Am J Hematol 2022; 97:E171-E173. [PMID: 35132678 DOI: 10.1002/ajh.26490] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Hoda Pourhassan
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Dongyun Yang
- Department of Computational and Quantitative Medicine, City of Hope National Medical Center, Duarte, California, USA
| | - Michelle Afkhami
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - Brian Ball
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Monzr Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Amandeep Salhotra
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Haris Ali
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Andrew Artz
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Peter Curtin
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Saro Armenian
- Department of Pediatrics, City of Hope, Duarte, California, USA
| | - Anthony Stein
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Guido Marcucci
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
| | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, California, USA
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Mei M, Pillai R, Kim S, Estrada-Merly N, Afkhami M, Yang L, Meng Z, Abid MB, Aljurf M, Bacher U, Beitinjaneh A, Bredeson C, Cahn JY, Cerny J, Copelan E, Cutler C, DeFilipp Z, Perez MAD, Farhadfar N, Freytes CO, Gadalla SM, Ganguly S, Gale RP, Gergis U, Grunwald MR, Hamilton BK, Hashmi S, Hildebrandt GC, Lazarus HM, Litzow M, Munker R, Murthy HS, Nathan S, Nishihori T, Patel SS, Rizzieri D, Seo S, Shah MV, Solh M, Verdonck LF, Vij R, Sobecks RM, Oran B, Scott BL, Saber W, Nakamura R. The mutational landscape in chronic myelomonocytic leukemia and its impact on allogeneic hematopoietic cell transplantation outcomes: a Center for Blood and Marrow Transplantation Research (CIBMTR) analysis. Haematologica 2022; 108:150-160. [PMID: 35443559 PMCID: PMC9827167 DOI: 10.3324/haematol.2021.280203] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 02/05/2023] Open
Abstract
Somatic mutations are recognized as an important prognostic factor in chronic myelomonocytic leukemia (CMML). However, limited data are available regarding their impact on outcomes after allogeneic hematopoietic cell transplantation (HCT). In this registry analysis conducted in collaboration with the Center for International Blood and Marrow Transplantation Registry database/sample repository, we identified 313 adult patients with CMML (median age: 64 years, range, 28- 77) who underwent allogeneic HCT during 2001-2017 and had an available biospecimen in the form of a peripheral blood sample obtained prior to the start of conditioning. In multivariate analysis, a CMML-specific prognostic scoring system (CPSS) score of intermediate-2 (HR=1.46, P=0.049) or high (HR=3.22, P=0.0004) correlated significantly with overall survival. When the molecularly informed CPSS-Mol prognostic model was applied, a high CPSS-Mol score (HR=2 P=0.0079) correlated significantly with overall survival. The most common somatic mutations were in ASXL1 (62%), TET2 (35%), KRAS/NRAS (33% combined), and SRSF2 (31%). DNMT3A and TP53 mutations were associated with decreased overall survival (HR=1.70 [95% CI: 1.11-2.60], P=0.0147 and HR=2.72 [95% CI: 1.37-5.39], P=0.0042, respectively) while DNMT3A, JAK2, and TP53 mutations were associated with decreased disease-free survival (HR=1.66 [95% CI: 1.11-2.49], P=0.0138, HR=1.79 [95% CI: 1.06-3.03], P=0.0293, and HR=2.94 [95% CI: 1.50-5.79], P=0.0018, respectively). The only mutation associated with increased relapse was TP53 (HR=2.94, P=0.0201). Nonetheless, the impact of TP53 mutations specifically should be interpreted cautiously given their rarity in CMML. We calculated the goodness of fit measured by Harrell's C-index for both the CPSS and CPSS-Mol, which were very similar. In summary, via registry data we have determined the mutational landscape in patients with CMML who underwent allogeneic HCT, and demonstrated an association between CPSS-Mol and transplant outcomes although without major improvement in the risk prediction beyond that provided by the CPSS.
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Affiliation(s)
- Matthew Mei
- Department of Hematology/HCT, City of Hope National Medical Center, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
| | - Soyoung Kim
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA,CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Noel Estrada-Merly
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Lixin Yang
- Department of Pathology, City of Hope, Duarte, CA, USA
| | - Zhuo Meng
- Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Fl, USA
| | - Christopher Bredeson
- The Ottawa Hospital Transplant & Cellular Therapy Program, Ottawa, Ontario, Canada
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Corey Cutler
- Stem Cell Transplantation and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Zachariah DeFilipp
- Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, MA, USA
| | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | - César O. Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Shahinaz M. Gadalla
- Divsion of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, MD, USA
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS, USA
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Usama Gergis
- Department of Medical Oncology, Division of Hematological Malignancies, Thomas Jefferson University, Philadelphia, PA USA
| | - Michael R. Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Betty K. Hamilton
- Blood & Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | - Hillard M. Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Reinhold Munker
- Markey Cancer Center, University of Kentucky, Lexington, K Y, USA
| | - Hemant S. Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S. Patel
- Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - Leo F. Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Ravi Vij
- Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Betul Oran
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Bart L. Scott
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wael Saber
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA,*MM, RP, WS and RN contributed equally to this work
| | - Ryotaro Nakamura
- Department of Hematology/HCT, City of Hope National Medical Center, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
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14
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Ali SF, Cloe A, Siaghani PJ, Himchak E, Cantu D, Gaal K, Kim YS, Afkhami M, Pillai R, Chan W, Quirk E, Weisenburger DD, Aoun P, Song JY. Bone Marrow Collection: Comparison of Unassisted vs Assisted Bedside Collections by a Laboratory Technologist. Am J Clin Pathol 2022; 157:573-577. [PMID: 34788366 DOI: 10.1093/ajcp/aqab165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Bone marrow collections are often difficult, and creating quality smears and touch preparations at the bedside can prove challenging. The objective of this study is to compare the quality of bone marrow specimens between unassisted and assisted bone marrow collections by a bone marrow technologist. METHODS Data for this study were collected from 422 hematopathology reports over 14 months. We recorded the bone marrow quality of the different parts (aspirate smears, touch imprints, core biopsy, and clot/particle sections) as adequate, suboptimal, or inadequate. Student t test statistical analysis was performed between the corresponding parts in the two groups. RESULTS Our results demonstrate that the quality of assisted bone marrow specimens is significantly better compared with unassisted specimens, particularly for the aspirate smears (P < .0001) and touch imprints (P < .0001). Notably, the quality of aspirate smears was improved, which is important for cytologic evaluation. CONCLUSIONS We conclude that assistance by a bone marrow technologist resulted in a significant improvement in the quality of bone marrow collection.
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Affiliation(s)
- Saba F Ali
- Department of Pathology, Roswell Park, Buffalo, NY, USA
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Adam Cloe
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Quest Diagnostics, Woodland Hills, CA, USA
| | - Parwiz J Siaghani
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Long Beach Memorial Medical Center, Long Beach, CA, USA
| | - Evan Himchak
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Department of Pathology, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - David Cantu
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Department of Pathology, Creighton University School of Medicine, Omaha, NE, USA
| | - Karl Gaal
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Young S Kim
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Michelle Afkhami
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Wanda Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Elizabeth Quirk
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Patricia Aoun
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
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15
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Liu S, Song Y, Zhang IY, Zhang L, Gao H, Su Y, Yang Y, Yin S, Zheng Y, Ren L, Yin HH, Pillai R, Nath A, Medina EF, Cosgrove PA, Bild AH, Badie B. RAGE Inhibitors as Alternatives to Dexamethasone for Managing Cerebral Edema Following Brain Tumor Surgery. Neurotherapeutics 2022; 19:635-648. [PMID: 35226341 PMCID: PMC9226224 DOI: 10.1007/s13311-022-01207-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 10/19/2022] Open
Abstract
Resection of brain tumors frequently causes injury to the surrounding brain tissue that exacerbates cerebral edema by activating an inflammatory cascade. Although corticosteroids are often utilized peri-operatively to alleviate the symptoms associated with brain edema, they increase operative morbidities and suppress the efficacy of immunotherapy. Thus, novel approaches to minimize cerebral edema caused by neurosurgical procedures will have significant utility in the management of patients with brain tumors. We have studied the role of the receptor for advanced glycation end products (RAGE) and its ligands on inflammatory responses to neurosurgical injury in mice and humans. Blood-brain barrier (BBB) integrity and neuroinflammation were characterized by Nanostring, flow cytometry, qPCR, and immunoblotting of WT and RAGE knockout mice brains subjected to surgical brain injury (SBI). Human tumor tissue and fluid collected from the resection cavity of patients undergoing craniotomy were also analyzed by single-cell RNA sequencing and ELISA. Genetic ablation of RAGE significantly abrogated neuroinflammation and BBB disruption in the murine SBI model. The inflammatory responses to SBI were associated with infiltration of S100A9-expressing myeloid-derived cells into the brain. Local release of pro-inflammatory S100A9 was confirmed in patients following tumor resection. RAGE and S100A9 inhibitors were as effective as dexamethasone in attenuating neuroinflammation. However, unlike dexamethasone and S100A9 inhibitor, RAGE inhibition did not diminish the efficacy of anti-PD-1 immunotherapy in glioma-bearing mice. These observations confirm the role of the RAGE axis in surgically induced neuroinflammation and provide an alternative therapeutic option to dexamethasone in managing post-operative cerebral edema.
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Affiliation(s)
- Shunan Liu
- Institute of Translational Medicine, the First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Yanyan Song
- Department of Nephrology, The Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Ian Y Zhang
- Division of Neurosurgery, City of Hope Beckman Research Institute, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Leying Zhang
- Division of Neurosurgery, City of Hope Beckman Research Institute, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Hang Gao
- Department of Bone and Joint Surgery, No.1 Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Yanping Su
- College of Pharmacy, Fujian Province, Fujian Medical University, Fuzhou, People's Republic of China
| | - Yihang Yang
- Department of Neurosurgery, Shandong Province, Shandong Provincial Hospital Affiliated To Shandong University, Jinan, People's Republic of China
| | - Shi Yin
- Department of Neurosurgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yawen Zheng
- Department of Obstetrics & Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Lyuzhi Ren
- Division of Neurosurgery, City of Hope Beckman Research Institute, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Hongwei Holly Yin
- Department of Pathology, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Raju Pillai
- Department of Pathology, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Aritro Nath
- Department of Medical Oncology & Therapeutics Research, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Eric F Medina
- Department of Medical Oncology & Therapeutics Research, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Patrick A Cosgrove
- Department of Medical Oncology & Therapeutics Research, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Andrea H Bild
- Department of Medical Oncology & Therapeutics Research, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Behnam Badie
- Division of Neurosurgery, City of Hope Beckman Research Institute, 1500 East Duarte Road, Duarte, CA, 91010, USA.
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16
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Wei CH, Yang L, Stewart D, Bedell V, Schmolze D, Apple S, Murata-Collins JL, Pillai R, Mortimer JE. Abstract P3-09-05: Genomic and clinical characterization of breast tumors with unusual HER2 FISH pattern (ratio < 2, HER2 copy number ≥ 6): Are they mostly HER2 “positive?”. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-09-05] [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: Breast tumors with HER2/CEP17 fluorescent in situ hybridization (FISH) ratio < 2 and HER2 copy number ≥ 6, defined as Group 3 FISH pattern by the 2018 ASCO/CAP HER2 testing guidelines, are clinically rare. Their biologic and molecular characteristics are under-characterized. They require only a concomitant HER2 immunohistochemistry score of at least 2+ to merit HER2 “positive” status by the ASCO/CAP guidelines. We seek to characterize the genomic and tumor microenvironment landscape of breast tumors with this unique HER2 FISH pattern. Our second aim is to assess the clinicopathologic features with emphasis on HER2-targeted therapy response.Method: Breast cancers with Group 3 FISH pattern were evaluated by the following methods: 1) High-resolution genome-wide copy number alterations by molecular inversion probe (MIP) array; 2) molecular profiling of tumor immune microenvironment, tumor signaling pathways, and PAM50-based intrinsic subtypes by Nanostring nCounter Breast Cancer 360 Panel; 3) tumor infiltrating lymphocytes (TIL) histologic quantitation, and 4) clinical chart review. Classically amplified HER2 breast tumors (Group 1 FISH pattern; ratio ≥ 2 and HER2 copy number ≥ 2) were used as comparison. Results: Thirty-five (1.3%) cases were identified from 2731 consecutive clinical cases that underwent HER2 FISH testing from 2014 to 2019. Of those, thirteen consecutive cases (spanning 2014 - 2017) with sufficient genomic material were analyzed using MIP array. Group 3 tumors had a more complex karyotype and greater chromosomal instability, compared to classically amplified HER2 breast tumors. None of the Group 3 tumors showed HER2 locus amplification at 17q12. Instead, most showed gain of the 17q arm. Six of the Group 3 tumors were profiled by Nanostring nCounter. Compared to HER2 classically amplified tumors, Group 3 tumors were more immune cold, enriched in ER signaling and TGF-beta signaling pathways. In contrast, HER2 classically amplified tumors were enriched in immune infiltration, cytokine and chemokine signaling, PI3K and MAPK signaling, epithelial-mesenchymal transition signaling, and proliferation (P < 0.5 for all). PAM50 analysis showed that classically amplified tumors were more enriched for HER2-subtype (2/4; 50%), while the majority of the Group 3 tumors were enriched for Luminal B-subtype (5/6; 83%). TIL percentage was statistically higher in HER2 classically amplified tumors compare to Group 3 tumors (avg 53% vs 3%; P = 0.02). Clinicopathologic correlation revealed a high rate of ER positivity and high tumor grade in Group 3 tumors. Group 3 FISH pattern can occur as de novo or in the context of FISH status change following therapy. In the 17 evaluable patients for HER2-targeted treatment efficacy, none of the eight patients who received HER2-targeted neoadjuvant therapy achieved complete pathologic response. Nine of ten patients who received TDM-1 in the metastatic setting progressed with minimal treatment response. Significantly, most of these patients (16/17; 94%) were considered overall HER2 positive by the latest ASCO/CAP guideline. Conclusion: Breast tumors with Group 3 HER2 FISH pattern are molecularly and clinically dissimilar from classically amplified HER2 positive breast tumors. HER2-targeted therapy did not appear efficacious in either the neoadjuvant or metastatic/recurrent settings. The lack of apparent efficacy of HER2-targeted therapy, in the context of their HER2 positive status by the current HER2 guideline assessment, warrants further investigation of this HER2 FISH subtype.
Citation Format: Christina H Wei, Lixin Yang, Daphne Stewart, Victoria Bedell, Daniel Schmolze, Sophia Apple, Joyce L. Murata-Collins, Raju Pillai, Joanne E. Mortimer. Genomic and clinical characterization of breast tumors with unusual HER2 FISH pattern (ratio < 2, HER2 copy number ≥ 6): Are they mostly HER2 “positive?” [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-09-05.
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Affiliation(s)
| | - Lixin Yang
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | | | | | - Sophia Apple
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Raju Pillai
- City of Hope Comprehensive Cancer Center, Duarte, CA
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Abstract
Carbon nanotubes (CNTs) have long been heralded as the material of choice for next-generation membranes. Some studies have suggested that boron nitride nanotubes (BNNTs) may offer higher transport of pure water than CNTs, while others conclude otherwise. In this work, we use a combination of simulations and experimental data to uncover the causes of this discrepancy and investigate the flow resistance through BNNT membranes in detail. By dividing the resistance of the nanotube membranes into their contributing components, we study the effects of pore end configuration, membrane length, and BNNT atom partial charges. Most molecular simulation studies of BNNT membranes use short membranes connected to high and low pressure reservoirs. Here we find that flow resistances in these short membranes are dominated by the resistance at the pore ends, which can obscure the understanding of water transport performance through the nanotubes and comparison between different nanotube materials. In contrast, it is the flow resistance inside the nanotubes that dominates microscale-thick laboratory membranes, and end resistances tend to be negligible. Judged by the nanotube flow resistance alone, we therefore find that CNTs are likely to consistently outperform BNNTs. Furthermore, we find a large role played by the choice of partial charges on the BN atoms in the flow resistance measurements in our molecular simulations. This paper highlights a way forward for comparing molecular simulations and experimental results.
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Affiliation(s)
- S Mistry
- School of Engineering, Institute of Multiscale Thermofluids, The University of Edinburgh, Edinburgh EH9 3FB, UK.
| | - R Pillai
- School of Engineering, Institute of Multiscale Thermofluids, The University of Edinburgh, Edinburgh EH9 3FB, UK.
| | - D Mattia
- Department of Chemical Engineering and Centre for Advanced Separations Engineering, University of Bath, Bath BA2 7AY, UK
| | - M K Borg
- School of Engineering, Institute of Multiscale Thermofluids, The University of Edinburgh, Edinburgh EH9 3FB, UK.
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18
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Obeng R, Parihar V, Alexis D, Behera M, Owonikoko T, Pillai R, Ramalingam S, Sica G, Ahmed R. Mature tertiary lymphoid structures in lung adenocarcinoma are associated with better progression free survival. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
The presence of inducible lymphoid structures known as tertiary lymphoid structures in the tumor microenvironment has been shown to correlate with positive clinical outcome. However, the maturation states of lymphoid aggregates in lung adenocarcinoma are not completely understood.
Methods/Case Report
Seventy tumor samples from 69 patients diagnosed with lung adenocarcinoma (Stages I to III) between 2013 and 2015 were included in the study. The presence and maturation states of the lymphoid structures within the tumors were evaluated by conventional and 26 samples were further analyzed by multiplexed immunohistochemistry of formalin fixed paraffin embedded tissues and then quantified. Mature lymphoid follicles containing germinal centers were identified by the presence of CD21+ and BCL-6+ cells in an organized configuration within tight clusters of T and B cells.
Results (if a Case Study enter NA)
Samples with fully mature lymphoid structures (germinal centers) had larger tumors and higher disease stage. The number of mature lymphoid structures correlated with the total number of lymphoid aggregates present in the tumor microenvironment. Additionally, tumor samples with ≥10 mature lymphoid structures had more primary follicles. While there was no difference in overall survival, progression free survival was significantly longer in patients who had ≥10 mature lymphoid structures in comparison with patients who had <10 mature structures.
Conclusion
In conclusion, a spectrum of lymphoid aggregates in different stages of maturation are present in lung adenocarcinoma. An increase in the number of mature lymphoid structures may be associated with progression free survival in patients with lung adenocarcinoma.
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Affiliation(s)
- R Obeng
- Pathology, Northwestern University, Chicago, Illinois, UNITED STATES
| | - V Parihar
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - D Alexis
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - M Behera
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - T Owonikoko
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - R Pillai
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - S Ramalingam
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - G Sica
- Winship Cancer Institute, Emory University, Atlanta, Georgia, UNITED STATES
| | - R Ahmed
- Emory Vaccine Center, Emory University, Atlanta, Georgia, UNITED STATES
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19
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Pillai R, Tincello D, Potdar N. P–397 Threatened Miscarriage and increase in Perinatal Morbidity. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Are women presenting with bleeding in the first trimester of pregnancy at a higher risk for perinatal complications later in pregnancy?
Summary answer
Women presenting with bleeding in the first trimester of pregnancy are more likely to experience perinatal and neonatal morbidity in pregnancy.
What is known already
Observational studies and a previously reported systematic review showed that women who experienced threatened miscarriage are more likely to have still birth, intra uterine growth restriction (IUGR), low birth weight, pre-eclampsia, placental abruption, placenta previa, preterm labour, preterm prelabour rupture of membrane, neonatal asphyxia and congenital anomalies in pregnancy. However, the evidence has been inconclusive and currently the women who experience threatened miscarriage receive low risk care.
Study design, size, duration
This was a prospective cohort study conducted on 298 women with threatened miscarriage (Cohort A) and 107 asymptomatic women (Cohort B). The women were recruited over a period of 18 months and were followed up for 9 months until delivery.
Participants/materials, setting, methods
Cohort A were women who presented with bleeding in the early pregnancy assessment unit and had a confirmed heartbeat on ultrasound scan between 6 weeks and 11 + 6 weeks of pregnancy and cohort B were women who were asymptomatic and booked with the community midwives as low risk. Both groups of women were followed up prospectively until delivery and data were collected on any perinatal outcomes and complications for both mother and the neonate.
Main results and the role of chance
The analysis showed that women who had bleeding in early pregnancy were more likely to have preterm delivery (RR 95% CI; 2.98 (1.07 – 8.27)); IUGR (unable to calculate the RR, as none of the women who continued their pregnancies beyond 24 weeks of gestation, developed IUGR in the asymptomatic control cohort. Nonetheless, IUGR occurred more frequently in the threatened miscarriage cohort than the asymptomatic cohort (P-value 0.02)); LBW (RR 95% CI; 6.14 (1.49 – 25.19), neonatal asphyxia (unable to calculate the RR, as none of the babies who were born to women in the asymptomatic control cohort develop neonatal asphyxia. Nonetheless, neonatal asphyxia occurred more frequently in the threatened miscarriage cohort than the asymptomatic cohort (P-value 0.02)). Preterm prelabour rupture of membrane was not significant with a P-value of 0.07.
Limitations, reasons for caution
The major limitation of this study was lower sample size and hence due to the rarity of many of the perinatal and neonatal outcomes, we were unable to calculate the relative risk.
Wider implications of the findings: Current study agrees with the existing literature and reaffirms the association of perinatal and neonatal morbidities with threatened miscarriage and this group of women need to be managed as high-risk group antenatally.
Trial registration number
Not applicable
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Affiliation(s)
- R Pillai
- Newcastle Fertility Centre at Life and University of Leicester, Department of Reproductive Medicine and Surgery and Department of Health Sciences, Leicester, United Kingdom
| | - D Tincello
- University of Leicester and University Hospitals of Leicester NHS Trust, Department of Health Sciences and Department of Obstetrics and Gynaecology, Leicester, United Kingdom
| | - N Potdar
- University of Leicester and University Hospitals of Leicester NHS Trust, Department of Health Sciences and Department of Obstetrics and Gynaecology, Leicester, United Kingdom
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Roosan MR, Mambetsariev I, Pharaon R, Fricke J, Baroz AR, Chao J, Chen C, Nasser MW, Chirravuri-Venkata R, Jain M, Smith L, Yost SE, Reckamp KL, Pillai R, Arvanitis L, Afkhami M, Wang EW, Chung V, Cristea M, Fakih M, Koczywas M, Massarelli E, Mortimer J, Yuan Y, Batra SK, Pal S, Salgia R. Evaluation of Somatic Mutations in Solid Metastatic Pan-Cancer Patients. Cancers (Basel) 2021; 13:2776. [PMID: 34204917 PMCID: PMC8199748 DOI: 10.3390/cancers13112776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
Metastasis continues to be the primary cause of all cancer-related deaths despite the recent advancements in cancer treatments. To evaluate the role of mutations in overall survival (OS) and treatment outcomes, we analyzed 957 metastatic patients with seven major cancer types who had available molecular testing results with a FoundationOne CDx® panel. The most prevalent genes with somatic mutations were TP53, KRAS, APC, and LRP1B. In this analysis, these genes had mutation frequencies higher than in publicly available datasets. We identified that the somatic mutations were seven mutually exclusive gene pairs and an additional fifty-two co-occurring gene pairs. Mutations in the mutually exclusive gene pair APC and CDKN2A showed an opposite effect on the overall survival. However, patients with CDKN2A mutations showed significantly shorter OS (HR: 1.72, 95% CI: 1.34-2.21, p < 0.001) after adjusting for cancer type, age at diagnosis, and sex. Five-year post metastatic diagnosis survival analysis showed a significant improvement in OS (median survival 28 and 43 months in pre-2015 and post-2015 metastatic diagnosis, respectively, p = 0.00021) based on the year of metastatic diagnosis. Although the use of targeted therapies after metastatic diagnosis prolonged OS, the benefit was not statistically significant. However, longer five-year progression-free survival (PFS) was significantly associated with targeted therapy use (median 10.9 months (CI: 9.7-11.9 months) compared to 9.1 months (CI: 8.1-10.1 months) for non-targeted therapy, respectively, p = 0.0029). Our results provide a clinically relevant overview of the complex molecular landscape and survival mechanisms in metastatic solid cancers.
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Affiliation(s)
- Moom R. Roosan
- School of Pharmacy, Chapman University, Irvine, CA 92618, USA;
| | - Isa Mambetsariev
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Rebecca Pharaon
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Jeremy Fricke
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Angel R. Baroz
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Joseph Chao
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Chen Chen
- Applied AI and Data Science, City of Hope, Duarte, CA 91010, USA;
| | - Mohd W. Nasser
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.W.N.); (R.C.-V.); (M.J.); (S.K.B.)
| | - Ramakanth Chirravuri-Venkata
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.W.N.); (R.C.-V.); (M.J.); (S.K.B.)
| | - Maneesh Jain
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.W.N.); (R.C.-V.); (M.J.); (S.K.B.)
| | - Lynette Smith
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Susan E. Yost
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Karen L. Reckamp
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
- Cedars-Sinai Medical Center, Department of Medicine, Division of Medical Oncology, Los Angeles, CA 90048, USA
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA 91010, USA; (R.P.); (L.A.); (M.A.)
| | - Leonidas Arvanitis
- Department of Pathology, City of Hope, Duarte, CA 91010, USA; (R.P.); (L.A.); (M.A.)
| | - Michelle Afkhami
- Department of Pathology, City of Hope, Duarte, CA 91010, USA; (R.P.); (L.A.); (M.A.)
| | - Edward W. Wang
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Vincent Chung
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Mihaela Cristea
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Marwan Fakih
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Marianna Koczywas
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Erminia Massarelli
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Joanne Mortimer
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Yuan Yuan
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Surinder K. Batra
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (M.W.N.); (R.C.-V.); (M.J.); (S.K.B.)
| | - Sumanta Pal
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
| | - Ravi Salgia
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, CA 91010, USA; (I.M.); (R.P.); (J.F.); (A.R.B.); (J.C.); (S.E.Y.); (K.L.R.); (E.W.W.); (V.C.); (M.C.); (M.F.); (M.K.); (E.M.); (J.M.); (Y.Y.)
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Pavithran A, Gowda BG, Pillai R, Corr J, Deshpande A. 311 Can We Predict Extraprostatic Extension (EPE) Prior To Radical Prostatectomy? – A Single Institution Comparison of Pre-Operative Biopsy Histology and Multiparametric MRI (mpMRI) With Radical Prostatectomy Specimen Histology. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Prostate biopsies and mpMRI play an integral role in diagnosis of prostate cancer. The aim of our study was to assess the ability to predict EPE based on pre-operative histology and mpMRI.
Method
We retrospectively analysed 235 patients who underwent radical prostatectomy between January 2015 and April 2017. All patients underwent pre-biopsy mpMRI scans and prostate biopsies. All mpMRIs were reported by dedicated uro-radiologists and all histology was reported by dedicated uro-pathologists.
Results
17/25 patients showing EPE on mpMRI had it confirmed on final histology.
a53/210 patients showing organ-confirmed disease on mpMRI had EPE on final histology.
40/49 patients who had Gleason 6 adenocarcinoma were organ-confined.
61/186 patients with > Gleason 7 adenocarcinoma had EPE.
Sensitivity of mpMRI was 25% with a specificity of 95%. The positive predictive value (PPV) was 68% and negative predictive value (NPV) was 75%.
The specificity of pre-biopsy Gleason score > 7 to predict EPE was 81% and sensitivity was 33% with a PPV of 87%.
Conclusions
Our data suggests that by using > Gleason 7 and mpMRI as a combination, we can reliably predict EPE on final histology which in turn will help counsel patients appropriately for treatment options. Further data collection is ongoing at our institution.
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Affiliation(s)
- A Pavithran
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - B G Gowda
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - R Pillai
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - J Corr
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - A Deshpande
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
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22
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Jenner Z, Di Geronimo R, Goldman R, Pillai R, Albertson T, Roudsari B. Abstract No. 534 Evolving role of radiology in performing basic procedures for Medicare beneficiaries from 1996 to 2018. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.343] [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: 11/25/2022] Open
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23
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Yap S, Liou F, Khan A, Pillai R, Vu C, Andrews R, King E, Shah A, Goldman R. Abstract No. 472 Alternate venous access sites for ported catheters: experience at a single quaternary care institution. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Di Geronimo R, Kim P, Andrews R, King E, Shah A, Vu C, Pillai R, Goldman R. Abstract No. 568 Interpretation of diagnostic vascular imaging studies for Medicare patients by interventional radiologists: a comparison to other specialties and implications for interventional radiology. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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25
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Khan S, Sun Z, Pillai R, Dahlberg S, Malhotra J, Keresztes R, Ikpeazu C, Ma P, Ramalingam S. MA01.09 Efficacy and Safety of Glembatumumab Vedotin in Patients With Advanced or Metastatic Squamous Cell Carcinoma of the Lung (PrECOG 0504). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Nguyen H, Perry A, Skrabek P, Nasr M, Herrera AF, Bedell V, Murata-Collins J, Pillai R, Xu M, Chen L, Chan WC, Weisenburger DD, Scott DW, Song JY. Validation of the Double-Hit Gene Expression Signature (DLBCL90) in an Independent Cohort of Patients with Diffuse Large B-Cell Lymphoma of Germinal Center Origin. J Mol Diagn 2021; 23:658-664. [PMID: 33636392 DOI: 10.1016/j.jmoldx.2021.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022] Open
Abstract
The prognosis of diffuse large B-cell lymphoma (DLBCL) has been associated with clinical parameters, cell of origin, and various genetic aberrations. Recently, a NanoString gene expression assay (DLBCL90) was developed, which identifies DLBCL cases with an outcome similar to those with double- or triple-hit DLBCL with both MYC and BCL2 rearrangements. This study validates the predictive ability of the DLBCL90 assay in an independent cohort of patients with the germinal center B-cell subtype DLBCL. A customized targeted sequencing panel was used to analyze the mutational profile in these patients. Cases with a double or triple hit by conventional fluorescence in situ hybridization cytogenetic analysis are known to have a poor prognosis, and the DLBCL90 gene expression signature identified these cases, as well as additional cases that would have otherwise been missed by fluorescence in situ hybridization analysis. Our findings validate use of the DLBCL90 assay for identifying high-risk patients for new and innovative therapies.
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Affiliation(s)
- Ha Nguyen
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Anamarija Perry
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | | | - Michel Nasr
- Department of Pathology, Upstate Medical University, Syracuse, New York
| | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Victoria Bedell
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Joyce Murata-Collins
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Minlin Xu
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Lu Chen
- Information Sciences, City of Hope National Medical Center, Duarte, California
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | | | - David W Scott
- BC Cancer Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, California.
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27
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Song JY, Perry AM, Herrera AF, Chen L, Skrabek P, Nasr MR, Ottesen RA, Nikowitz J, Bedell V, Murata-Collins J, Li Y, McCarthy C, Pillai R, Wang J, Wu X, Zain J, Popplewell L, Kwak LW, Nademanee AP, Niland JC, Scott DW, Gong Q, Chan WC, Weisenburger DD. Double-hit Signature with TP53 Abnormalities Predicts Poor Survival in Patients with Germinal Center Type Diffuse Large B-cell Lymphoma Treated with R-CHOP. Clin Cancer Res 2021; 27:1671-1680. [PMID: 33414134 DOI: 10.1158/1078-0432.ccr-20-2378] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/28/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We performed detailed genomic analysis on 87 cases of de novo diffuse large B-cell lymphoma of germinal center type (GCB DLBCL) to identify characteristics that are associated with survival in those treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). EXPERIMENTAL DESIGN The cases were extensively characterized by combining the results of IHC, cell-of-origin gene expression profiling (GEP; NanoString), double-hit GEP (DLBCL90), FISH cytogenetic analysis for double/triple-hit lymphoma, copy-number analysis, and targeted deep sequencing using a custom mutation panel of 334 genes. RESULTS We identified four distinct biologic subgroups with different survivals, and with similarities to the genomic classifications from two large retrospective studies of DLBCL. Patients with the double-hit signature, but no abnormalities of TP53, and those lacking EZH2 mutation and/or BCL2 translocation, had an excellent prognosis. However, patients with an EZB-like profile had an intermediate prognosis, whereas those with TP53 inactivation combined with the double-hit signature had an extremely poor prognosis. This latter finding was validated using two independent cohorts. CONCLUSIONS We propose a practical schema to use genomic variables to risk-stratify patients with GCB DLBCL. This schema provides a promising new approach to identify high-risk patients for new and innovative therapies.
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Affiliation(s)
- Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, California. .,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Anamarija M Perry
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Alex F Herrera
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Lu Chen
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Information Sciences, City of Hope National Medical Center, Duarte, California
| | - Pamela Skrabek
- Department of Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Michel R Nasr
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
| | - Rebecca A Ottesen
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - Janet Nikowitz
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - Victoria Bedell
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Joyce Murata-Collins
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Yuping Li
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Christine McCarthy
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Jinhui Wang
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California
| | - Jasmine Zain
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Leslie Popplewell
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Larry W Kwak
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Auayporn P Nademanee
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Joyce C Niland
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - David W Scott
- British Columbia Research Center, Vancouver, British Columbia, Canada
| | - Qiang Gong
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
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Srivastava S, Pang KM, Iida M, Nelson MS, Liu J, Nam A, Wang J, Mambetsariev I, Pillai R, Mohanty A, McDaniel N, Behal A, Kulkarni P, Wheeler DL, Salgia R. Activation of EPHA2-ROBO1 Heterodimer by SLIT2 Attenuates Non-canonical Signaling and Proliferation in Squamous Cell Carcinomas. iScience 2020; 23:101692. [PMID: 33196021 PMCID: PMC7644594 DOI: 10.1016/j.isci.2020.101692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/21/2020] [Accepted: 10/13/2020] [Indexed: 12/25/2022] Open
Abstract
The tyrosine kinase receptor ephrin receptor A2 (EPHA2) is overexpressed in lung (LSCC) and head and neck (HNSCC) squamous cell carcinomas. Although EPHA2 can inhibit tumorigenesis in a ligand-dependent fashion via phosphorylation of Y588 and Y772, it can promote tumorigenesis in a ligand-independent manner via phosphorylation of S897. Here, we show that EPHA2 and Roundabout Guidance Receptor 1 (ROBO1) interact to form a functional heterodimer. Furthermore, we show that the ROBO1 ligand Slit Guidance Ligand 2 (SLIT2) and ensartinib, an inhibitor of EPHA2, can attenuate growth of HNSCC cells and act synergistically in LSCC cells. Our results suggest that patients with LSCC and HNSCC may be stratified and treated based on their EPHA2 and ROBO1 expression patterns. Although ~73% of patients with LSCC could benefit from SLIT2+ensartinib treatment, ~41% of patients with HNSCC could be treated with either SLIT2 or ensartinib. Thus, EPHA2 and ROBO1 represent potential LSCC and HNSCC theranostics.
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Affiliation(s)
- Saumya Srivastava
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Ka Ming Pang
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Mari Iida
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Wisconsin Institute for Medical Research, Madison, WI 53705-2275, USA
| | - Michael S. Nelson
- Light Microscopy Core, City of Hope National Medical Center, Duarte, CA, USA
| | - Jiayi Liu
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Arin Nam
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Jiale Wang
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Isa Mambetsariev
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Atish Mohanty
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Nellie McDaniel
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Wisconsin Institute for Medical Research, Madison, WI 53705-2275, USA
| | - Amita Behal
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Prakash Kulkarni
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Deric L. Wheeler
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Wisconsin Institute for Medical Research, Madison, WI 53705-2275, USA
| | - Ravi Salgia
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
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Mohanty A, Pharaon R, Nam A, Yin H, Chang S, Guo L, Pillai R, Kulkarni P, Salgia R, Massarelli E. Abstract 6397: Focal adhesion kinase (FAK) inhibition overcomes cisplatin resistance in head and neck squamous cell carcinoma (HNSCC). Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: FAK is a non-receptor tyrosine kinase activated in response to interactions between transmembrane integrins and extracellular matrix involved in the activation of the PI3K–Akt pathway, required for cell proliferation and survival. Amplification of chromosome region 8q23-24, encoding FAK, is significantly associated with smoking, higher grade of dysplasia and progression from premalignant lesions to HNSCC. Multimodality treatment (surgery, radiation and platinum-based chemotherapy) is standard for locally advanced HNSCC. Local relapse/distant metastasis develop in 25-40% of patients with occurrence of platinum resistance. We hypothesize that FAK inhibition overcomes platinum resistance and immunosuppression in HNSCC.
Methods: RNA was extracted from normal and cancer tissue of 12 retrospectively surgically collected formalin-fixed paraffin-embedded HNSCC samples and analyzed by NanoString PanCancer Pathway and Immune Profiling panels. 93VU and SCC1 cell lines were used and cell-derived spheroids were generated on attachment plates. Cell proliferation, wound healing and apoptosis were measured by IncuCyte S3 Live-Cell Analysis System (Essen BioScience). Cells were treated with the following commercially available FAK small molecule inhibitors: NVP-TAE-226 (Novartis); PF-573228, PF-562271, PF-431396 (Pfizer); GSK2256098 (GlaxoSmithKline); VS-6063 (Verastem). FAK expression was measured by western blotting and qPCR analysis.
Results: In The Cancer Genome Atlas (TCGA) HNSCC dataset, FAK RNA expression was significantly higher in stage IV compared to stage I–III cancers (p<0.001). Among the genes significantly overexpressed (>2-fold change) in the 12 HNSCC samples analyzed by Nanostring pathway and immune profile panels, 17 were involved in PI3K-Akt signaling activation and 15 of these were also involved in the anchorage-dependent cell proliferation and FAK activation including the alpha form of integrins (ITGA2, ITGA6, ITGA3), the beta form of integrins (ITGB4, ITGB6), collagens (COL5A2, COL1A1, COL27A1, COL4A6, COL11A1), and laminins (LAMA3, LAMB3, LAMC2). We screened and identified that the 93VU and SCC1 cell lines were tolerant to cisplatin up to a dose of 10 uM. TAE-226 was the most effective FAK inhibitor in significantly blocking cell proliferation and wound healing in 93VU and SCC1 cell lines. TAE-226 treatment also effectively inhibited spheroid growth and proliferation in 3D culture. FAK inhibition decreased expression of chemokines and cytokines known to promote immunosuppression and metastasis such as CSF3, CXCL1, CXCL2, IL8, GPI, LIF, and CCL1.
Conclusion: Our data suggests that FAK expression is associated with higher cancer stage. Its inhibition might have a role in overcoming cisplatin resistance and in affecting immunosuppressive signals in HNSCC. Immunocompetent syngeneic HNSCC animal models are currently ongoing.
Citation Format: Atish Mohanty, Rebecca Pharaon, Arin Nam, Holly Yin, Sue Chang, Linlin Guo, Raju Pillai, Prakash Kulkarni, Ravi Salgia, Erminia Massarelli. Focal adhesion kinase (FAK) inhibition overcomes cisplatin resistance in head and neck squamous cell carcinoma (HNSCC) [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6397.
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Papp K, Menter A, Leonardi C, Soung J, Weiss S, Pillai R, Jacobson A. Long-term efficacy and safety of brodalumab in psoriasis through 120 weeks and after withdrawal and retreatment: subgroup analysis of a randomized phase III trial (AMAGINE-1). Br J Dermatol 2020; 183:1037-1048. [PMID: 32286683 PMCID: PMC7754427 DOI: 10.1111/bjd.19132] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Brodalumab is efficacious for the treatment of moderate-to-severe plaque psoriasis through 52 weeks. OBJECTIVES To evaluate the efficacy and safety of brodalumab through 120 weeks, including following withdrawal and retreatment. METHODS At baseline, patients were randomized to brodalumab (n = 222) or placebo (n = 220). At week 12, patients achieving a static Physician's Global Assessment (sPGA) score of 0 or 1 (sPGA 0/1) with brodalumab were rerandomized to brodalumab (n = 83) or placebo (n = 84; later re-treated with brodalumab if sPGA ≥ 3 occurred), and patients receiving placebo switched to brodalumab (n = 208). Safety was assessed by exposure-adjusted rates of treatment-emergent adverse events. RESULTS Among those who achieved sPGA 0/1 at week 12 and were rerandomized to brodalumab, 96% and 80% using observed data, respectively, and 74% and 61% using nonresponder imputation, respectively, achieved 75% improvement in Psoriasis Area and Severity Index (PASI 75) and PASI 100 at week 120. Following withdrawal from brodalumab, return of disease occurred after a mean ± SD duration of 74·7 ± 50·5 days. Among those who switched from brodalumab to placebo at week 12, PASI 75 rates using observed data and nonresponder imputation were 55% and 51% at week 20, respectively and 94% and 75% at week 120, respectively; PASI 100 rates at week 120 were 75% and 60%, respectively. Efficacy was maintained through week 120 in those receiving brodalumab after placebo. No new safety signals were observed. CONCLUSIONS These findings indicate that brodalumab is efficacious and safe for continuous long-term treatment of psoriasis, and support the potential for response after discontinuation and retreatment.
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Affiliation(s)
- K Papp
- Probity Medical Research and K Papp Clinical Research, Waterloo, ON, Canada
| | - A Menter
- Baylor Scott & White, Dallas, TX, USA
| | | | - J Soung
- Southern California Dermatology, Santa Ana, CA, USA
| | - S Weiss
- Direct Dermatology, Palo Alto, CA, USA
| | - R Pillai
- Bausch Health US, LLC, Petaluma, CA, USA
| | - A Jacobson
- Ortho Dermatologics (a division of Bausch Health US, LLC), Bridgewater, NJ, USA
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Zhang XH, Yin Z, Zhang A, Pillai R, Armstrong B, Rosen ST. DNMT1 and p38γ are inversely expressed in reactive non‐metastatic lymph nodes burdened with colorectal adenocarcinoma. eJHaem 2020; 1:300-303. [PMID: 35847731 PMCID: PMC9176054 DOI: 10.1002/jha2.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 02/03/2023]
Abstract
Lymph nodes are important front‐line defense immune tissues, which also act against inflammatory diseases and cancer. Lymph nodes undergo extensive upheavals within newly formed germinal centers (GCs) when exposed to antigens, the molecular mechanisms of which remain elusive. Recently, p38γ was identified as an important target for multiple cancers, including cutaneous T‐cell lymphoma (CTCL). We previously observed that p38γ is overexpressed in CTCL versus normal cells, but it is not clear if p38γ is expressed in B or T lymphocytes of GCs of patients in response to a stress such as cancer. Therefore, in this study, we obtained non‐metastatic reactive lymph nodes adjacent to cancer lesions (colorectal adenocarcinoma), then performed multicolor immunohistochemical staining for p38γ and other relevant markers. We observed for the first time that p38γ was expressed in the light zone of activated B cells and T helper cells in GCs, whereas DNA‐methyltransferase 1 (DNMT1), a marker for GC B cells, was highly expressed in centrocytes and in the dark zone of GCs. This inverse relationship suggests a novel function for p38γ in T cells that cross‐talk to B cells in response to stress.
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Affiliation(s)
- Xu Hannah Zhang
- Department of HematologyCity of Hope National Medical Center Duarte California USA
| | - Zhirong Yin
- Department of Pathology Solid Tumor CoreCity of Hope National Medical Center Duarte California USA
| | - Aimin Zhang
- Department of Pathology Solid Tumor CoreCity of Hope National Medical Center Duarte California USA
| | - Raju Pillai
- Department of Pathology Solid Tumor CoreCity of Hope National Medical Center Duarte California USA
| | - Brian Armstrong
- Light microscopy coreCity of Hope National Medical Center, Duarte, California, City of Hope National Medical CenterBeckman Research Institute Duarte California USA
| | - Steven T Rosen
- Department of HematologyCity of Hope National Medical Center Duarte California USA
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Gold LFS, Lebwohl M, Bhatia N, Lin T, Pillai R. 605 Long-term management of moderate-to-severe plaque psoriasis: Maintenance of treatment success following cessation of halobetasol propionate 0.01%/tazarotene 0.045% lotion. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mohanty A, Afkhami M, Pharaon R, Yin H, Sun J, Nam A, Chang S, Gernon T, Kang R, Amini A, Sampath S, Vora N, Salehian B, Pillai R, Salgia R, Maghami E, Massarelli E. Inhibition of BRAF induces PD-L1 expression in BRAF-mutated papillary thyroid carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mambetsariev I, Wang Y, Chen C, Nadaf S, Pharaon R, Fricke J, Amanam I, Amini A, Bild A, Chu P, Erhunmwunsee L, Kim J, Munu J, Pillai R, Raz D, Sampath S, Vora L, Qiu F, Smith L, Batra SK, Massarelli E, Koczywas M, Reckamp K, Salgia R. Precision medicine and actionable alterations in lung cancer: A single institution experience. PLoS One 2020; 15:e0228188. [PMID: 32045431 PMCID: PMC7012442 DOI: 10.1371/journal.pone.0228188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 01/10/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Oncology has become more reliant on new testing methods and a greater use of electronic medical records, which provide a plethora of information available to physicians and researchers. However, to take advantage of vital clinical and research data for precision medicine, we must initially make an effort to create an infrastructure for the collection, storage, and utilization of this information with uniquely designed disease-specific registries that could support the collection of a large number of patients. MATERIALS AND METHODS In this study, we perform an in-depth analysis of a series of lung adenocarcinoma patients (n = 415) with genomic and clinical data in a recently created thoracic patient registry. RESULTS Of the 415 patients with lung adenocarcinoma, 59% (n = 245) were female; the median age was 64 (range, 22-92) years with a median OS of 33.29 months (95% CI, 29.77-39.48). The most common actionable alterations were identified in EGFR (n = 177/415 [42.7%]), ALK (n = 28/377 [7.4%]), and BRAF V600E (n = 7/288 [2.4%]). There was also a discernible difference in survival for 222 patients, who had an actionable alteration, with a median OS of 39.8 months as compared to 193 wild-type patients with a median OS of 26.0 months (P<0.001). We identified an unprecedented number of actionable alterations [53.5% (222/415)], including distinct individual alteration rates, as compared with 15.0% and 22.3% in TCGA and GENIE respectively. CONCLUSION The use of patient registries, focused genomic panels and the appropriate use of clinical guidelines in community and academic settings may influence cohort selection for clinical trials and improve survival outcomes.
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Affiliation(s)
- Isa Mambetsariev
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Yingyu Wang
- Center for Informatics, City of Hope, Duarte, California, United States of America
| | - Chen Chen
- Center for Informatics, City of Hope, Duarte, California, United States of America
| | - Sorena Nadaf
- Center for Informatics, City of Hope, Duarte, California, United States of America
| | - Rebecca Pharaon
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Jeremy Fricke
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Idoroenyi Amanam
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Arya Amini
- Department of Radiation Oncology, City of Hope, Duarte, California, United States of America
| | - Andrea Bild
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Peiguo Chu
- Department of Pathology, City of Hope, Duarte, California, United States of America
| | - Loretta Erhunmwunsee
- Department of Thoracic Surgery, City of Hope, Duarte, California, United States of America
| | - Jae Kim
- Department of Thoracic Surgery, City of Hope, Duarte, California, United States of America
| | - Janet Munu
- Center for Informatics, City of Hope, Duarte, California, United States of America
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, California, United States of America
| | - Dan Raz
- Department of Thoracic Surgery, City of Hope, Duarte, California, United States of America
| | - Sagus Sampath
- Department of Radiation Oncology, City of Hope, Duarte, California, United States of America
| | - Lalit Vora
- Department of Diagnostic Radiology, City of Hope, Duarte, California, United States of America
| | - Fang Qiu
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Lynette Smith
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Surinder K. Batra
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Erminia Massarelli
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Marianna Koczywas
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Karen Reckamp
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, United States of America
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Zhang IY, Zhou H, Liu H, Zhang L, Gao H, Liu S, Song Y, Alizadeh D, Yin HH, Pillai R, Badie B. Local and Systemic Immune Dysregulation Alters Glioma Growth in Hyperglycemic Mice. Clin Cancer Res 2020; 26:2740-2753. [PMID: 32019861 DOI: 10.1158/1078-0432.ccr-19-2520] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/08/2020] [Accepted: 01/31/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Unlike most cancers, no clear epidemiological correlation between diabetes (Db) and malignant glioma progression exists. Because hyperglycemia activates proinflammatory pathways through the receptor for advanced glycation endproducts (RAGE), we hypothesized that Db can also promote malignant glioma progression. EXPERIMENTAL DESIGN We compared the growth of two phenotypically diverse syngeneic glioma models in control and diabetic mice. Tumor growth and antitumor immune responses were evaluated in orthotopic and heterotopic models and correlated to RAGE and RAGE ligand expression. RESULTS Irrespective of tumor implantation site, growth of a "classical" glioma model, GL261, increased in hyperglycemic mice and was mediated by upregulation of RAGE and its ligand, HMGB1. However, growth of a "mesenchymal" glioma subtype, K-Luc, depended on tumor implantation site. Whereas heterotopic K-Luc tumors progressed rapidly in Db mice, intracranial K-Luc tumors grew slower. We further showed that hyperglycemia inhibited the innate antitumor inflammatory responses in both models. Although this contributed to the accelerated growth of heterotopic tumors, suppression of tumor inflammatory responses dampened the growth of orthotopic K-Luc gliomas. CONCLUSIONS Hyperglycemia may enhance glioma growth through promotion of RAGE expression and suppression of antitumor immune responses. However, abrogation of the proinflammatory milieu in tumors may also dampen the growth of inflammatory glioma subtypes in the brains of diabetic mice. This dichotomy in glioma growth response to hyperglycemia may partly explain why conflicting epidemiological studies show both an increased risk and a protective effect of Db in patients with malignant gliomas.
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Affiliation(s)
- Ian Y Zhang
- Division of Neurosurgery, City of Hope Beckman Research Institute, Duarte, California
| | - Hui Zhou
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, P.R. China
| | - Huili Liu
- Division of Neurosurgery, City of Hope Beckman Research Institute, Duarte, California
| | - Leying Zhang
- Division of Neurosurgery, City of Hope Beckman Research Institute, Duarte, California
| | - Hang Gao
- Department of Bone and Joint Surgery, No. 1 Hospital of Jilin University, Changchun, Jilin Province, P.R. China
| | - Shunan Liu
- Department of Pharmacology, The Pharmacy School of Jilin University, Changchun, Jilin Province, P.R. China
| | - Yanyan Song
- Department of Nephrology, The Second Hospital of Jilin University, Changchun, Jilin Province, P.R. China
| | - Darya Alizadeh
- Division of Neurosurgery, City of Hope Beckman Research Institute, Duarte, California
| | - Hongwei Holly Yin
- Department of Pathology, City of Hope Beckman Research Institute, Duarte, California
| | - Raju Pillai
- Department of Pathology, City of Hope Beckman Research Institute, Duarte, California
| | - Behnam Badie
- Division of Neurosurgery, City of Hope Beckman Research Institute, Duarte, California. .,Department of Cancer Immunotherapeutics and Tumor Immunology, City of Hope Beckman Research Institute, Duarte, California
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Wang C, Park J, Ouyang C, Longmate JA, Tajon M, Chao J, Lim D, Sandhu J, Yin HH, Pillai R, Gozo MC, Avalos C, Egelston CA, Lee PP, Fakih M. A Pilot Feasibility Study of Yttrium-90 Liver Radioembolization Followed by Durvalumab and Tremelimumab in Patients with Microsatellite Stable Colorectal Cancer Liver Metastases. Oncologist 2019; 25:382-e776. [PMID: 31857446 DOI: 10.1634/theoncologist.2019-0924] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 10/15/2019] [Accepted: 11/14/2019] [Indexed: 01/14/2023] Open
Abstract
LESSONS LEARNED Radioembolization with yttrium-90 resin microspheres can be combined safely with full doses of durvalumab and tremelimumab in patients with metastatic colorectal cancer. Regional radioembolization with yttrium-90 resin microspheres did not result in any hepatic or extrahepatic responses to a combination of durvalumab and tremelimumab. The lack of immunomodulatory responses to yttrium-90 on biopsies before and after treatment rules out a potential role for this strategy in converting a "cold tumor" into an "inflamed," immune responsive tumor. BACKGROUND PD-1 inhibitors have been ineffective in microsatellite stable (MSS) metastatic colorectal cancer (CRC). Preclinical models suggest that radiation therapy may sensitize MSS CRC to PD-1 blockade. METHODS Patients with MSS metastatic CRC with liver-predominant disease who progressed following at least one prior line of treatment were treated with yttrium-90 (Y90) radioembolization to the liver (SIR-Spheres; Sirtex, Woburn, MA) followed 2-3 weeks later by the combination of durvalumab and tremelimumab. A Simon two-stage design was implemented, with a planned expansion to 18 patients if at least one response was noted in the first nine patients. RESULTS Nine patients enrolled in the first stage of the study, all with progressive disease (PD) during or after their first two cycles of treatment. Per preplanned design, the study was closed because of futility. No treatment-related grade 3 or greater toxicities were recorded. Correlative studies with tumor biopsies showed low levels of tumor-infiltrating lymphocyte (TIL) infiltration in tumor cancer islands before and after Y90 radioembolization. CONCLUSION Y90 radioembolization can be added safely to durvalumab and tremelimumab but did not promote tumor-directed immune responses against liver-metastasized MSS CRC.
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Affiliation(s)
- Chongkai Wang
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - John Park
- Department of Diagnostic Radiology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Ching Ouyang
- Center for Informatics, Department of Computational and Quantitative Medicine, City of Hope National Medical Center, Duarte, California, USA
| | - Jeff A Longmate
- Division of Biostatistics, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Michael Tajon
- Clinical Trial Office, City of Hope National Medical Center, Duarte, California, USA
| | - Joseph Chao
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Dean Lim
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Jaideep Sandhu
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Hongwei Holly Yin
- Department of Pathology, City of Hope National Medical Center, Duarte, Calilfornia, USA
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, Calilfornia, USA
| | - Maricel C Gozo
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Christian Avalos
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Colt A Egelston
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Peter P Lee
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Marwan Fakih
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Chung V, Frankel P, Shibata S, Mambetsariev I, Yin H, Mirzapoiazova T, Mambetsariev B, Kulkarni P, Lim D, Li D, Chao J, Fakih M, Bild A, Pillai R, Adalsteinsson O, Hirsh S, Salgia R. Abstract B13: Pilot trial of gemcitabine, nab-paclitaxel, metformin, and a standardized dietary supplement in patients with unresectable pancreatic cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.panca19-b13] [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: Dietary supplement use has increased over the last decade, and the prevalence is estimated to be 76% of the adult US population as reported by the Council for Responsible Nutrition. However, consistent regular use has only been reported in about 33% of subjects. Pancreatic cancer patients commonly present with weight loss and seek out supplements to improve nutrition but also for any potential anticancer properties that may exist. We conducted a pilot trial to evaluate the tolerability of a standardized combination of dietary supplements with metformin and gemcitabine plus nab-paclitaxel chemotherapy.
Methods: The study was IRB approved at City of Hope. The primary endpoint was feasibility, compliance, and toxicity of the combination with metformin, gemcitabine, and nab-paclitaxel. The secondary endpoints were response rate, PFS, and overall survival. The supplements were formulated to minimize the quantity that patients would need to take and were custom designed by a nutritionally trained oncologist. 17 supplements were given as 12 pills and 2 smoothie packets divided twice per day. Patients began metformin day (D) -6 to evaluate GI tolerance before starting the DS day -3. On day 1, gemcitabine and nab-paclitaxel at standard doses were administered. Serial blood samples were obtained for biomarker analysis and FACT-G questionnaires completed.
Results: 21 patients were accrued and the combination was well tolerated. Grade 3 adverse events (AE) of interest seen in patients include neutropenia 14%, peripheral neuropathy 14%, thrombocytopenia 5%, and fatigue 5%. During days -6 to start of chemotherapy, 7 patients experienced grade 1 gastrointestinal symptoms possibly related to the intervention (3 possibly related to metformin, 2 possibly related to DS/smoothie, 2 possibly related to both), with three also possibly related to disease. 1 patient also reported grade 1 dizziness possibly related to DS/smoothie. The median progression-free survival and overall survival were 5.4 months (95% CI 1.5-10.9) and 8.9 months (95% CI 2.2-18.4), respectively. 6 patients (29%) achieved a partial response. 14 patients reported on FACT-G quality of life changes between start of metformin and Day 1 of cycle 1. Overall FACT-G score decreased in 9 patients, was unchanged in 1 patient, and improved in 4 patients. RNA was extracted from PBMC and run with NanoString Immune Profiling and PanCancer Pathway. Preliminary observation includes the best response is associated with initial decreased expression of myc and IL7R, also downregulation in TGF-B, MAPK, and Wnt pathways. Additional analysis in ongoing.
Conclusions: Pancreatic cancer patients commonly have gastrointestinal issues that may affect tolerance to treatment. Our trial showed the combination of chemotherapy and dietary supplements was feasible. The common grade 3 AEs were less frequent than observed in the MPACT trial; however, this is a small study and additional trials would need to be done to confirm this. (ClinicalTrials.gov Identifier: NCT02336087.)
Citation Format: Vincent Chung, Paul Frankel, Stephen Shibata, Isa Mambetsariev, Holly Yin, Tamara Mirzapoiazova, Bolot Mambetsariev, Prakash Kulkarni, Dean Lim, Daneng Li, Joseph Chao, Marwan Fakih, Andrea Bild, Raju Pillai, Orn Adalsteinsson, Steven Hirsh, Ravi Salgia. Pilot trial of gemcitabine, nab-paclitaxel, metformin, and a standardized dietary supplement in patients with unresectable pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2019 Sept 6-9; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2019;79(24 Suppl):Abstract nr B13.
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Barlesi F, Audigier-Valette C, Felip E, Ciuleanu TE, Jao K, Rijavec E, Urban L, Aucoin JS, Zannori C, Vermaelen K, Frontera OA, Ready N, Curioni A, Linardou H, Poddubskaya E, Fischer J, Pillai R, Li S, Acevedo A, Paz-Ares L. Nivolumab Plus Low-Dose IPILIMUMAB as First-Line Treatment of Advanced NSCLC: Overall Survival Analysis of Checkmate 817. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lee JS, Yost SE, Blanchard S, Schmolze D, Yin HH, Pillai R, Robinson K, Tang A, Martinez N, Portnow J, Wen W, Yim JH, Brauer HA, Ren Y, Luu T, Mortimer J, Yuan Y. Phase I clinical trial of the combination of eribulin and everolimus in patients with metastatic triple-negative breast cancer. Breast Cancer Res 2019; 21:119. [PMID: 31703728 PMCID: PMC6839083 DOI: 10.1186/s13058-019-1202-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 07/08/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Alteration of the PI3K/AKT/mTOR pathway is a common genomic abnormality detected in triple-negative breast cancer (TNBC). Everolimus acts synergistically with eribulin in TNBC cell lines and xenograft models. This phase I trial was designed to test the safety and tolerability of combining eribulin and everolimus in patients with metastatic TNBC. METHODS The primary objective of this study was to evaluate the safety and toxicities of the combination. Patients with metastatic TNBC who had up to four lines of prior chemotherapies were enrolled. The combination of eribulin and everolimus was tested using three dosing levels: A1 (everolimus 5 mg daily; eribulin 1.4 mg/m2 days 1 and 8 every 3 weeks), A2 (everolimus 7.5 mg daily; eribulin 1.4 mg/m2, days 1 and 8 every 3 weeks), and B1 (everolimus 5 mg daily; eribulin 1.1 mg/m2 days 1 and 8 every 3 weeks). RESULTS Twenty-seven patients with median age 55 years were enrolled. Among 8 evaluable patients who received dose level A1, 4 had dose-limiting toxicities (DLTs). Among 3 evaluable patients treated with dose level A2, 2 had DLTs. Among 12 evaluable patients who received dose level B1, 4 had DLTs. The DLTs were neutropenia, stomatitis, and hyperglycemia. Over the study period, 59% had a ≥ grade 3 toxicity, 44% had ≥ grade 3 hematologic toxicities, and 22% had grade 4 hematologic toxicities. The most common hematological toxicities were neutropenia, leukopenia, and lymphopenia. Thirty-three percent had grade 3 non-hematologic toxicities. The most common non-hematological toxicities were stomatitis, hyperglycemia, and fatigue. The median number of cycles completed was 4 (range 0-8). Among 25 eligible patients, 9 patients (36%) achieved the best response as partial response, 9 (36%) had stable disease, and 7 (28%) had progression. The median time to progression was 2.6 months (95% CI [2.1, 4.0]), and median overall survival (OS) was 8.3 months (95% CI [5.5, undefined]). CONCLUSION Eribulin 1.1 mg/m2 days 1 and 8 every 3 weeks with everolimus 5 mg daily was defined as the highest dose with acceptable toxicity (RP2D). The combination is safe, and efficacy is modest. A post hoc analysis showed that participants that used dexamethasone mouthwash stayed on treatment for one additional cycle. TRIAL REGISTRATION ClinicalTrials.gov, NCT02120469. Registered 18 April 2014.
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Affiliation(s)
- Jin Sun Lee
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Susan E Yost
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Suzette Blanchard
- Department of Biostatistics, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - Daniel Schmolze
- Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - Hongwei Holly Yin
- Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - Kim Robinson
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Aileen Tang
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Norma Martinez
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Jana Portnow
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Wei Wen
- Department of Surgery, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - John H Yim
- Department of Surgery, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | | | - Yuqi Ren
- NanoString Technologies, Inc., Seattle, WA, USA
| | | | - Joanne Mortimer
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
| | - Yuan Yuan
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center and Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
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Afkhami M, Schmolze D, Yost SE, Frankel PH, Dagis A, Amanam IU, Telatar M, Nguyen K, Yu KW, Luu T, Pillai R, Aoun PA, Mortimer J, Yuan Y. Mutation and immune profiling of metaplastic breast cancer: Correlation with survival. PLoS One 2019; 14:e0224726. [PMID: 31693690 PMCID: PMC6834262 DOI: 10.1371/journal.pone.0224726] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 08/23/2019] [Accepted: 10/21/2019] [Indexed: 12/18/2022] Open
Abstract
The goal of this study is to characterize the genomic and immune profiles of metaplastic breast cancer (MpBC) and identify the association with survival through an analysis of archived tumor tissue. A next-generation sequencing-based mutational assay (Onco-48) was performed for 21 MpBC patients. Clinicopathologic characteristics were captured, including relapse free survival (RFS) and overall survival (OS). Immunohistochemistry (IHC) for CD3, CD4, CD8, and programmed death-ligand 1 (PD-L1) was also performed. Recurrence free survival (RFS) at 5 years was 57% (95% CI 0.34-0.75) and overall survival (OS) at 5 years was 66% (95% CI 0.41-0.82). The most commonly altered genes were TP53 (68.4%, 13/19), PIK3CA (42.1%, 8/19), and PTEN (15.8%, 3/19. For patients with PIK3CA mutations, RFS and OS were significantly worse than for those without (HR 5.6, 95% CI 1.33-23.1 and HR 8.0, 95% CI 1.53-41.7, respectively). Cox regression estimated that PD-L1 expression was associated with worse RFS and OS (HR 1.08, 95% CI 1.01-1.16 and HR 1.05, 95% CI 1.00-1.11, respectively, for an absolute increase in PD-L1 expression of 1%). In conclusion, PIK3CA mutation and PD-L1 expression confer poor prognosis in this cohort of patients with MpBC.
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Affiliation(s)
- Michelle Afkhami
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Daniel Schmolze
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Susan E. Yost
- Department of Medical Oncology & Therapeutic Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Paul H. Frankel
- Department of Biostatistics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Andrew Dagis
- Department of Biostatistics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Idoroenyi U. Amanam
- Department of Medical Oncology & Therapeutic Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Milhan Telatar
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Kim Nguyen
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Kim Wai Yu
- Department of Clinical Pharmacy, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Thehang Luu
- Department of Medical Oncology & Therapeutic Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Raju Pillai
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Patricia A. Aoun
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Joanne Mortimer
- Department of Medical Oncology & Therapeutic Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Yuan Yuan
- Department of Medical Oncology & Therapeutic Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
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Obeng R, Behera M, Owonikoko T, Pillai R, Ahmed R, Ramalingam S, Sica G. P1.15 The Presence of Secondary Follicles in Early Stage Lung Adenocarcinoma Reflects Disease Burden. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aldoss I, Yang D, Pillai R, Sanchez JF, Mei M, Aribi A, Ali H, Sandhu K, Al Malki MM, Salhotra A, Khaled S, Sun W, O'Donnell M, Snyder D, Nakamura R, Stein AS, Forman SJ, Marcucci G, Pullarkat V. Association of leukemia genetics with response to venetoclax and hypomethylating agents in relapsed/refractory acute myeloid leukemia. Am J Hematol 2019; 94:E253-E255. [PMID: 31259427 DOI: 10.1002/ajh.25567] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Ibrahim Aldoss
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Dongyun Yang
- Department of Information SciencesCity of Hope Medical Center Duarte California
| | - Raju Pillai
- Department of PathologyCity of Hope Medical Center Duarte California
| | - James F. Sanchez
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Matthew Mei
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Ahmed Aribi
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Haris Ali
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Karamjeet Sandhu
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Monzr M. Al Malki
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Amandeep Salhotra
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Samer Khaled
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Weili Sun
- Department of PediatricsCity of Hope Medical Center Duarte California
| | - Margaret O'Donnell
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - David Snyder
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Ryotaro Nakamura
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Anthony S. Stein
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Stephen J. Forman
- Department of PathologyCity of Hope Medical Center Duarte California
| | - Guido Marcucci
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
| | - Vinod Pullarkat
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell TransplantationCity of Hope Medical Center Duarte California
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Tian S, Switchenko J, Patel P, Shelton J, Kahn S, Pillai R, Steuer C, Owonikoko T, Behera M, Curran W, Higgins K. MA01.02 Lung Stereotactic Body Radiotherapy and Concurrent Immunotherapy: A Multi-Center Safety and Toxicity Analysis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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44
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Aldoss I, Zhang J, Pillai R, Shouse G, Sanchez JF, Mei M, Nakamura R, Stein AS, Forman SJ, Marcucci G, Pullarkat V. Venetoclax and hypomethylating agents in TP53-mutated acute myeloid leukaemia. Br J Haematol 2019; 187:e45-e48. [PMID: 31441045 DOI: 10.1111/bjh.16166] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Jianying Zhang
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, USA
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA, USA
| | - Geoffrey Shouse
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - James F Sanchez
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Matthew Mei
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Anthony S Stein
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Guido Marcucci
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
| | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA
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Wang C, Park J, Ouyang C, Pillai R, Longmate J, Yin H, Avalos C, Gozo M, Egelston C, Lee PP, Fakih MG. Abstract 528: Radioembolization followed by durvalumab and tremelimumab does not induce immune responses against liver-metastasized MSS colorectal cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-528] [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: PD-1 inhibitors have been ineffective in microsatellite stable (MSS) metastatic colorectal cancer (mCRC). Preclinical models suggest that radiation therapy may sensitize MSS CRC to PD-1 blockade. This constitutes the rationale for combining radioembolization to the liver in patients (pts) with MSS CRC with liver metastasis.
Methods: Pts with MSS mCRC with liver predominant disease who progressed following at least 1 prior line of treatment, were eligible for study treatment. Treatment consisted of Y90 radioembolization to the liver (SIRTEX®) followed 2-3 weeks later by the intravenous (IV) combination of durvalumab (D) at 1500 mg and tremelimumab (T) at 75 mg Q4W for 4 months, followed by D 1500 mg Q4W x 8 cycles, or until disease progression (PD). Tumor biopsies were obtained at baseline, 1-2 weeks post SIR-Spheres®, and 2-3 weeks after D+T. A Simon 2-stage design was implemented, with a planned expansion to 18 patients if at least 1 response is noted in the 1st 9 pts. Correlative studies included tumor and peripheral blood flow cytometry, serum cytokine assays, and tumor IHC multiplex assay for CD8, CD4, CD68 and Cytokeratin20 expression. Immune and cancer related gene expression of the tumor microenvironment was analyzed via NanoString.
Results: 9 pts enrolled in the 1st stage of the study, all with PD within or after their first 2 cycles of treatment. Per pre-planned design, the study was closed for futility. Here we report our correlative study for this trial. Based on IHC, intratumoral TILs (CD4 and CD8 T cells) were not detectable on any of the serial tumor biopsies (pre-Y90, post-Y90, and post D+T), while heavy CD68+ macrophage infiltration was consistently observed. Such observations were statistically validated by comparing paired serial samples using NanoString. Increased expression of collagen genes, such as COL1A1, COL1A2, and COL3A1, following Y90 was noted, as reported in literatures for cases with chemo and radiation resistance. MDM2, known to associate with resistance to PD-1/PD-L1 inhibitors, was also upregulated following Y90. Furthermore, flow cytometry results showed no difference in CD4+ T cells, CD8+T cells, CD20+B cells, CD33+HLA-DR-MDSCs, and CD4+Foxp3+ regulatory T cells based on paired serial PBMC samples. However, we observed a significant increase in PD-1+CD4+ and PD-1+CD8+ T cell subpopulations in PBMC following D+T, which agrees with other reports that PD-1/PD-L1 targeting leads to the expansion of PD-1+ T cells. In addition, CD3-CD56+ NK cell population was increased following D+T when compared with Y90.
Conclusion: Y90 radioembolization can be added safely to D+T but did not promote tumor-directed immune responses against liver-metastasized MSS CRC. The associated correlative studies do not support a role for Y90 radioembolization to convert immunologically ‘cold’ tumors into ‘hot’ tumors.
Citation Format: Chongkai Wang, John Park, Ching Ouyang, Raju Pillai, Jeffrey Longmate, Holly Yin, Christian Avalos, Maricel Gozo, Colt Egelston, Peter P. Lee, Marwan G. Fakih. Radioembolization followed by durvalumab and tremelimumab does not induce immune responses against liver-metastasized MSS colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 528.
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Langley R, Armstrongi A, Lebwohl M, Blauvelt A, Hsu S, Tyring S, Rastogi S, Pillai R, Israel R. Brodalumab in patients who had inadequate response to ustekinumab. Br J Dermatol 2019. [DOI: 10.1111/bjd.17471] [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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Langley R, Armstrongi A, Lebwohl M, Blauvelt A, Hsu S, Tyring S, Rastogi S, Pillai R, Israel R. Brodalumab 用于对乌司奴单抗应答不足的患者. Br J Dermatol 2019. [DOI: 10.1111/bjd.17484] [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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48
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Langley RG, Armstrong AW, Lebwohl MG, Blauvelt A, Hsu S, Tyring S, Rastogi S, Pillai R, Israel R. Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase III trials. Br J Dermatol 2018; 180:306-314. [PMID: 30328108 DOI: 10.1111/bjd.17318] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Brodalumab, a fully human anti-interleukin-17 receptor A monoclonal antibody, has demonstrated superior efficacy and safety over ustekinumab as induction therapy for moderate-to-severe psoriasis. OBJECTIVES To evaluate the efficacy and safety of brodalumab through week 52 in patients who had inadequate responses to ustekinumab. METHODS A subgroup analysis of the phase III AMAGINE-2/-3 double-blind randomized controlled trials was performed. Participants were aged 18-75 years and had a Psoriasis Area and Severity Index (PASI) ≥ 12, static Physician's Global Assessment score ≥ 3 and involvement of ≥ 10% body surface area. The studies were registered at ClinicalTrials.gov: AMAGINE-2, NCT01708603; AMAGINE-3, NCT01708629. RESULTS At baseline, patients with or without prior biologic experience who had an adequate response at week 16 on ustekinumab or brodalumab had lower rates of involved body surface area, PASI, prior biologic use, psoriatic arthritis and body mass index than patients who experienced inadequate response at or after week 16. Among patients who experienced inadequate response to ustekinumab, those rescued with brodalumab had PASI ≥ 75%, ≥ 90% and 100% improvement response rates of 72·6%, 58·1% and 36·3%, respectively, at week 52 compared with 61·7%, 25·5% and 5·4%, respectively, in patients who continued ustekinumab. Exposure-adjusted rates of treatment-emergent adverse events were similar among patients rescued with brodalumab (377·3 adverse events per 100 patient-years) and those who remained on ustekinumab (389·9 adverse events per 100 patient-years). CONCLUSIONS Among patients who experienced inadequate responses to ustekinumab, rescue with brodalumab improved skin clearance outcomes compared with continuing ustekinumab.
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Affiliation(s)
| | - A W Armstrong
- University of Southern California, Los Angeles, CA, U.S.A
| | - M G Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, U.S.A
| | - S Hsu
- Temple University School of Medicine, Philadelphia, PA, U.S.A
| | - S Tyring
- University of Texas Health Science Center, Houston, TX, U.S.A
| | - S Rastogi
- Ortho Dermatologics, Bridgewater, NJ, U.S.A
| | - R Pillai
- Dow Pharmaceutical Sciences, Petaluma, CA, U.S.A
| | - R Israel
- Valeant Pharmaceuticals North America LLC, Bridgewater, NJ, U.S.A
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Press R, Buchwald Z, Steuer C, Pillai R, Owonikoko T, Ramalingam S, Curran W, Higgins K. Report of Neurotoxicity after Concurrent Whole Brain Radiation Therapy and Checkpoint Blockade Immunotherapy for Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chao J, Yin H, Lee J, Klempner S, Pillai R. Immune gene expression profiling (GEP) of resected gastric adenocarcinomas (GAs) to identify biomarkers associated with immune checkpoint inhibitor (ICPI) response in early stage disease. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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