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Martin MV, Aguilar-Rosas S, Franke K, Pieterse M, van Langelaar J, Schreurs RR, Bijlsma MF, Besselink MG, Koster J, Timens W, Khasraw M, Ashley DM, Keir ST, Ottensmeier CH, King EV, Verheij J, Waasdorp C, Valk PJM, Engels SA, Oostenbach E, van Dinter JT, Hofman DA, Mok JY, van Esch WJE, Wilmink H, Monkhorst K, Verheul HMW, Poel D, Hiltermann TJN, van Kempen LC, Groen HJ, Aerts JGJV, van Heesch S, Lowenberg B, Plasterk R, Kloosterman WP. The neo-open reading frame peptides that comprise the tumor framome are a rich source of neoantigens for cancer immunotherapy. Cancer Immunol Res 2024:742916. [PMID: 38573707 DOI: 10.1158/2326-6066.cir-23-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/22/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024]
Abstract
Identification of immunogenic cancer neoantigens as targets for therapy is challenging. Here, we integrate cancer whole genome and long-read transcript sequencing to identify the collection of novel open reading frame peptides (NOPs) expressed in tumors, termed the framome. NOPs represent tumor-specific peptides that are different from wild-type proteins and may be strongly immunogenic. We describe an uncharacterized class of hidden NOPs, which derive from structural genomic variants involving an upstream protein coding gene driving expression and translation of non-coding regions of the genome downstream of a rearrangement breakpoint. NOPs represent a vast amount of possible neoantigens particularly in tumors with many (complex) structural genomic variants and a low number of missense mutations. We show that NOPs are immunogenic and epitopes derived from NOPs can bind to MHC class I molecules. Finally, we provide evidence for the presence of memory T-cells specific for hidden NOPs in lung cancer patient peripheral blood.
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Affiliation(s)
| | | | - Katka Franke
- CureVac Netherlands B.V., Amsterdam, Netherlands
| | | | | | | | - Maarten F Bijlsma
- Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | | | - Jan Koster
- Amsterdam UMC, University of Amsterdam, Amsterdam, NH, Netherlands
| | - Wim Timens
- University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| | | | | | | | | | - Emma V King
- University Hospitals Dorset, Poole, United Kingdom
| | | | | | | | - Sem Ag Engels
- The Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Ellen Oostenbach
- The Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Jip T van Dinter
- Princess Máxima Center for Pediatric Oncology, Utrecht, Utrecht, Netherlands
| | - Damon A Hofman
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Juk Yee Mok
- Sanquin Reagents, Sanquin, Amsterdam, Netherlands
| | | | | | - Kim Monkhorst
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Dennis Poel
- Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - T Jeroen N Hiltermann
- University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Léon C van Kempen
- University Medical Center Groningen, Groningen, I am not in the U.S. or Canada, Netherlands
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Fijn R, Engels SA, Brouwers JR, Knaap RJ, De Jong-Van den Berg LT. Dutch hospital drug formularies: pharmacotherapeutic variation and conservatism, but concurrence with national pharmacotherapeutic guidelines. Br J Clin Pharmacol 2000; 49:254-63. [PMID: 10718781 PMCID: PMC2014915 DOI: 10.1046/j.1365-2125.2000.00166.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 08/02/1999] [Accepted: 12/22/1999] [Indexed: 11/20/2022] Open
Abstract
AIMS This research examines current hospital drug formularies (HDFs) of all Dutch general hospitals. It assesses the extent to which they recommend the same drugs, the breadth of their coverage in terms of therapeutic areas, drug groups incorporated and individuals drugs included, and their extent of conservatism by considering the year of introduction of the drugs included within groups. Furthermore, it considers the extent to which their recommendations concur and comply with those of national pharmacotherapeutic guidelines and the WHO Essential Drugs List (EDL). METHODS Seventy-eight (81%) out of all 96 current Dutch HDFs were received of which 62 were suitable for study. Differences between HDFs and eventual associations with hospital characteristics were researched by statistical testing and case-control studies. To evaluate HDFs' concurrence with national guidelines and compliance with the WHO EDL, nine drug groups were studied in detail: benzodiazepines, calcium channel blockers, beta-adrenoceptor blocking agents, ACE-inhibitors, angiotensin-II inhibitors, NSAIDs, H2-receptor antagonists, 5HT3-antagonists, and H+-pump inhibitors. Concurrence and compliance with national guidelines and the WHO EDL was defined as inclusion of recommended drugs. Non-concurrence was defined as inclusion of nonrecommended drugs. RESULTS The total number of indications addressed and drug groups incorporated within HDFs varied from 28 to 72 (median 56) and from 30 to 123 (median 97), respectively. The total number of individual drug entities (pharmacological substances) included ranged from 239 to 658 (median 430) and the total number of drug products, including all different dosage forms, from 412 to 1121 (median 655). Within drug groups, drug entities first marketed were most frequently included. Teaching hospitals were most likely to include recently marketed drugs. Depending on the drug group, HDFs' concurrence and compliance with national guidelines and the WHO EDL ranged from 35% to 100%. CONCLUSIONS Findings indicate that Dutch HDFs are rather uniform in the indications addressed and the drug groups incorporated. However, the number of individual drug entities and drug products included within groups varies considerably. Furthermore, Dutch HDFs are considered rather conservative, as older drugs are favoured over more recent drugs. Generally, with some drug exceptions, Dutch HDFs concur and comply with recommendations in national pharmacotherapeutic guidelines and with the WHO EDL over 90%.
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Affiliation(s)
- R Fijn
- Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Groningen
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Fijn R, de Vries CS, Engels SA, Brouwers JR, de Blaey CJ, de Jong-van den Berg LT. The quality of Dutch hospital drug formularies: evaluation of technical features and organisational information. Pharm World Sci 1999; 21:120-6. [PMID: 10427581 DOI: 10.1023/a:1008680021854] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Hospital drug formularies (HDFs) are widely used tools to help influence clinicians' prescribing behaviour. Besides the therapeutic quality of HDFs, the available information and the way in which this is presented are key factors in HDFs' success or failure to influence prescribing behaviour and enhance prescribing quality. This research evaluates the technical features and organisational information of Dutch HDFs. METHODS Seventy-two (75%) of all Dutch HDFs were evaluated based on criteria retrieved from international literature and additional criteria drafted by occupational groups working with HDFs. Aspects that were studied were physical appearance and layout, practicability with respect to the available information and how easily this could be retrieved from the HDFs, information regarding drug choice policies such as seamless care, and the available type of therapeutic and pharmaceutical information. RESULTS Thirty-three (46%) of the HDFs were less than 3 years old. Physical appearance of all HDFs was very well looked after. Two (3%) HDFs were disease-oriented rather than drug-oriented. Changes from pre-admission therapy were addressed in 30 (42%) of the HDFs, but other seamless care policies were addressed in less than 20% of the HDFs. Finally, less than 50% provided therapeutic information that clinicians indicated as important. DISCUSSION Although Dutch HDFs are technically practicable with respect to user-convenience, practice-oriented features are capable of improvements. Furthermore, Dutch HDFs lack important clinical information for daily practice. To enhance seamless care across healthcare, generic prescribing and prescribing on admission from and discharge to any other sectors should be addressed more specifically.
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Affiliation(s)
- R Fijn
- Groningen-Utrecht Institute for Drug Exploration (GUIDE), Department of Social Pharmacy & Pharmacoepidemiology, University of Groningen, The Netherlands
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