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A Comprehensive Review on the Role of Human Epidermal Growth Factor Receptor 2 (HER2) as a Biomarker in Extra-Mammary and Extra-Gastric Cancers 人表皮生长因子受体2 (HER2)作为乳腺外癌和胃癌外癌生物标志物的作用综述
Pub Date : 2023-05-26 DOI: 10.3390/onco3020008
Fnu Amisha, Paras Malik, P. Saluja, Nitesh Gautam, T. Patel, A. Roy, Sunny R. K. Singh, S. Malapati
The human epidermal growth factor receptors (HERs) are expressed abundantly in the human body. The tumorigenic potential of HER2/neu is linked to its overexpression, amplification or somatic mutation. The HER2 gene amplification leading to protein overexpression has been reported in 25–30% of breast cancers and 10–30% of gastric/gastroesophageal cancers. While HER2 is a well-documented predictive, prognostic, and therapeutic marker in breast and gastric/gastroesophageal cancers, its relevance has also been demonstrated in multiple other malignancies. In this article, we will conduct an extensive review of current data pertaining to HER2 amplification, overexpression, or mutation in cancers other than breast and gastric cancers.
人类表皮生长因子受体(HERs)在人体内大量表达。HER2/neu的致瘤潜力与其过表达、扩增或体细胞突变有关。据报道,在25-30%的乳腺癌和10-30%的胃癌/胃食管癌中,HER2基因扩增导致蛋白质过表达。虽然HER2在乳腺癌和胃癌/胃食管癌中是一种有充分证明的预测、预后和治疗标志物,但其相关性也已在多种其他恶性肿瘤中得到证实。在这篇文章中,我们将对乳腺癌和胃癌以外的癌症中HER2扩增、过表达或突变的当前数据进行广泛的综述。
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引用次数: 0
CT Radiomics and Clinical Feature Model to Predict Lymph Node Metastases in Early-Stage Testicular Cancer 预测早期癌症睾丸淋巴结转移的CT放射组学和临床特征模型
Pub Date : 2023-04-10 DOI: 10.3390/onco3020006
C. Lisson, Sabitha Manoj, Daniel Wolf, Jasper Schrader, S. Schmidt, Meinrad Beer, Michael Goetz, F. Zengerling, C. Lisson
Accurate retroperitoneal lymph node metastasis (LNM) prediction in early-stage testicular germ cell tumours (TGCTs) harbours the potential to significantly reduce over- or undertreatment and treatment-related morbidity in this group of young patients as an important survivorship imperative. We investigated the role of computed tomography (CT) radiomics models integrating clinical predictors for the individualised prediction of LNM in early-stage TGCT. Ninety-one patients with surgically proven testicular germ cell tumours and contrast-enhanced CT were included in this retrospective study. Dedicated radiomics software was used to segment 273 retroperitoneal lymph nodes and extract features. After feature selection, radiomics-based machine learning models were developed to predict LN metastasis. The robustness of the procedure was controlled by 10-fold cross-validation. Using multivariable logistic regression modelling, we developed three prediction models: a radiomics-only model, a clinical-only model, and a combined radiomics–clinical model. The models’ performances were evaluated using the area under the receiver operating characteristic curve (AUC). Finally, decision curve analysis was performed to estimate the clinical usefulness of the predictive model. The radiomics-only model for predicting lymph node metastasis reached a greater discrimination power than the clinical-only model, with an AUC of 0.87 (±0.04; 95% CI) vs. 0.75 (±0.08; 95% CI) in our study cohort. The combined model integrating clinical risk factors and selected radiomics features outperformed the clinical-only and the radiomics-only prediction models, and showed good discrimination with an area under the curve of 0.89 (±0.03; 95% CI). The decision curve analysis demonstrated the clinical usefulness of our proposed combined model. The presented combined CT-based radiomics–clinical model represents an exciting non-invasive tool for individualised LN metastasis prediction in testicular germ cell tumours. Multi-centre validation is required to generate high-quality evidence for its clinical application.
准确预测早期睾丸生殖细胞肿瘤(TGCT)的腹膜后淋巴结转移(LNM),有可能显著降低这组年轻患者治疗过度或治疗不足以及治疗相关的发病率,这是重要的生存要求。我们研究了计算机断层扫描(CT)放射组学模型在早期TGCT中整合临床预测因素对LNM个性化预测的作用。本回顾性研究纳入了91例经手术证实的睾丸生殖细胞肿瘤和增强CT患者。使用专用的放射组学软件对273个腹膜后淋巴结进行分割并提取特征。在特征选择后,开发了基于放射组学的机器学习模型来预测LN转移。该程序的稳健性通过10倍交叉验证进行控制。使用多变量逻辑回归模型,我们开发了三个预测模型:仅放射组学模型、仅临床模型和放射组学-临床组合模型。使用受试者工作特性曲线下面积(AUC)评估模型的性能。最后,进行决策曲线分析,以评估预测模型的临床实用性。仅用于预测淋巴结转移的放射组学模型比仅用于临床的模型具有更大的辨别力,在我们的研究队列中,AUC为0.87(±0.04;95%置信区间)对0.75(±0.08;95%可信区间)。整合临床风险因素和选定放射组学特征的组合模型优于仅临床和仅放射组学预测模型,并显示出良好的辨别力,曲线下面积为0.89(±0.03;95%置信区间)。决策曲线分析证明了我们提出的联合模型的临床实用性。所提出的基于CT的放射组学-临床组合模型为睾丸生殖细胞肿瘤中的LN转移预测提供了一种令人兴奋的非侵入性工具。需要多中心验证才能为其临床应用提供高质量的证据。
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引用次数: 2
The Chart Diagnostic System Improves the Diagnostic Accuracy of Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinoma 图表诊断系统提高口腔鳞状细胞癌颈淋巴结转移的诊断准确性
Pub Date : 2023-02-07 DOI: 10.3390/onco3010005
Ayako Nomura, T. Ishida, Hiroshi Hijioka, Takuya Yoshimura, Hajime Suzuki, Eturo Nozoe, N. Nakamura
Purpose: To establish a diagnosis method based on imaging findings and histopathological factors associated with cervical lymph node metastasis. Methods: A total of 1587 cervical lymph nodes that were detected using imaging tools in 73 OSCC patients who underwent surgical treatment were enrolled to evaluate the association between imaging findings (long diameter, short diameter, long–short ratio, US findings (hilum and internal echo), contrast effect with enhanced CT, standardized uptake value (SUV) max and SUV average with 18F FDG-Positron Emission Tomography (PET)) and metastatic cervical lymph nodes. In 57 OSCC patients, biopsy specimens were evaluated for histopathologic factors (budding score, lymphatic invasion, vascular invasion, nerve invasion, and YK classification) and the presence of cervical lymph node metastases. Cervical lymph node metastasis was determined based on histopathological examination of the lymph nodes of patients with no metastasis observed 3 years after primary surgery. Results: In total, 22 of the 73 patients had cervical lymph node metastasis pathologically. In the comparison of the presence of metastatic lymph nodes, univariate analysis showed significant differences in cervical lymph node long and short diameter, long/short ratio, internal echo, rim enhancement, SUV max, SUV average, budding score, and vascular invasion. Multivariable analysis showed significant differences in internal echo, rim enhancement, SUV max, and budding score. Conclusions: We propose a chart diagnostic system that combines imaging and histopathological findings to improve the diagnosis of cervical lymph node metastasis.
目的:建立一种基于影像学表现和组织病理因素的颈淋巴转移诊断方法。方法:选取73例手术治疗的OSCC患者,通过影像学检查发现的1587个颈部淋巴结,评价影像学表现(长径、短径、长短比、US表现(门部和内回声)、增强CT造影剂效果、18F fdg -正电子发射断层扫描(PET)标准化吸收值(SUV)最大值和平均值与转移性颈部淋巴结的关系。在57例OSCC患者中,对活检标本进行组织病理学因素(出芽评分、淋巴浸润、血管浸润、神经浸润和YK分类)和颈部淋巴结转移的存在进行评估。颈部淋巴结转移是根据初次手术后3年未观察到转移的患者的淋巴结组织病理学检查来确定的。结果:73例患者中22例出现颈部淋巴结病理转移。在转移性淋巴结是否存在的比较中,单因素分析显示,颈部淋巴结长、短直径、长/短比值、内部回声、边缘增强、SUV max、SUV average、出芽评分、血管浸润等指标存在显著差异。多变量分析显示,内部回声、边缘增强、SUV max和出芽评分存在显著差异。结论:我们提出了一种结合影像学和组织病理学检查的图表诊断系统,以提高颈部淋巴结转移的诊断。
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引用次数: 0
Fractionated Volumetric Modulated Arc Therapy (FVMAT) for Oligometastatic Brain Tumor 分割体积调节弧线疗法(FVMAT)治疗少转移性脑瘤
Pub Date : 2023-02-02 DOI: 10.3390/onco3010004
C. Yeh, Peng-An Lai, Fang-Hui Liu, Chin-Chiao He
Intracranial metastasis is very common in adult cancer patients with an overall incidence of approximately 10–40%. The most common primary tumors responsible for this in adults are lung and breast cancer. Brain metastasis signifies a grave prognosis, with a median survival of 6 to 12 months. They are traditionally managed with palliative care and whole brain radiotherapy (WBRT). WBRT was an effective method to control brain metastases, decreasing corticosteroid use to control tumor-associated edema, and potentially improving overall survival; however, WBRT was found to be associated with a serious neurocognitive degeneration, this adverse effect (AE) follows a biphasic pattern beginning with a transient decline in mental functioning at around 4 months post-treatment, slowly leading to an irreversible neurologic impairment from months to years later. Evidence supports that WBRT can cause radiation injury to the hippocampus, which in turn will lead to a decline in neurocognitive function (NCF). Volumetric modulated arc therapy (VMAT) is a relatively new type of image-guided radiotherapy that treats multiple brain metastasis simultaneously and efficiently with less neurocognitive sequelae. Eighteen cancer patients with limited (≤5 brain tumors) or oligometastatic brain tumor were treated with a spatially fractionated VMAT technique for a total dose of 30 Gy in 10 fractions, the patients tolerated the VMAT treatment with no radiation-induced neurologic toxicities after a mean follow-up of 1 year. Local control rate was 84%, and the median survival for these 19 patients was 11.3 months (range: 9.1–22.4 months). In conclusion, the VMAT is a suitable technique that is a safe and effective treatment for brain oligometastases.
颅内转移在成年癌症患者中非常常见,总发病率约为10-40%。在成人中最常见的原发性肿瘤是肺癌和乳腺癌癌症。脑转移预示着严重的预后,中位生存期为6-12个月。传统上,他们通过姑息治疗和全脑放射治疗(WBRT)进行治疗。WBRT是控制脑转移的有效方法,减少皮质类固醇用于控制肿瘤相关水肿,并有可能提高总生存率;然而,WBRT被发现与严重的神经认知退化有关,这种不良反应(AE)遵循双相模式,从治疗后4个月左右的短暂精神功能下降开始,慢慢导致数月至数年后的不可逆转的神经损伤。有证据表明,WBRT会对海马体造成辐射损伤,进而导致神经认知功能(NCF)下降。体积调制电弧疗法(VMAT)是一种相对较新的图像引导放射治疗方法,可同时有效地治疗多发性脑转移,神经认知后遗症较少。对18例癌症局限性(≤5例脑肿瘤)或少转移性脑肿瘤患者进行了空间分割VMAT技术治疗,总剂量为30 Gy,分为10个部分,平均随访1年后,患者耐受了VMAT治疗,无放射性神经毒性。局部控制率为84%,这19名患者的中位生存期为11.3个月(范围:9.1–22.4个月)。总之,VMAT是一种安全有效治疗脑少转移瘤的合适技术。
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引用次数: 0
Risk Factors and Prevention of Gastric Cancer Development—What Do We Know and What Can We Do? 胃癌发生的危险因素和预防——我们知道什么和我们能做什么?
Pub Date : 2023-01-30 DOI: 10.3390/onco3010003
Paulina Helisz, Weronika Gwioździk, Karolina Krupa-Kotara, M. Grajek, J. Głogowska-Ligus, J. Słowiński
Gastric cancer (GC) is one of the most common causes of cancer-related deaths. Gastric tumors show a high aggressiveness, which, in turn, contributes to a low survival rate of fewer than 12 months. Considering the above, it was decided to review the current scientific studies that indicate the potential prevention of gastric cancer and clarify the relationship between gastric cancer and the composition of the microorganisms inhabiting the human body. Accordingly, a review paper was prepared based on 97 scientific sources from 2011 to 2022. Particular attention was paid to the most recent scientific studies from the last five years, which account for more than 80% of the cited sources. Taking care of one’s overall health, including undertaking treatment for Helicobacter pylori infection, and following a diet high in anti-inflammatory and immunomodulatory ingredients are the most important factors in reducing the risk of developing gastric cancer.
癌症(GC)是癌症相关死亡最常见的原因之一。胃肿瘤表现出高度的侵袭性,这反过来又导致不到12个月的低存活率。考虑到上述情况,决定回顾目前表明有可能预防癌症的科学研究,并澄清癌症与人体内微生物组成之间的关系。因此,根据2011年至2022年的97个科学来源编写了一份综述文件。特别关注过去五年的最新科学研究,这些研究占引用来源的80%以上。照顾自己的整体健康,包括治疗幽门螺杆菌感染,以及遵循富含抗炎和免疫调节成分的饮食,是降低癌症风险的最重要因素。
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引用次数: 1
Regulation of Epithelial–Mesenchymal Transition Pathway and Artificial Intelligence-Based Modeling for Pathway Activity Prediction 上皮-间质转化通路的调控及基于人工智能的通路活性预测模型
Pub Date : 2023-01-06 DOI: 10.3390/onco3010002
Shihori Tanabe, Sabina Quader, Ryuichi Ono, Horacio Cabral, Kazuhiko Aoyagi, Akihiko Hirose, Edward J. Perkins, Hiroshi Yokozaki, Hiroki Sasaki
Because activity of the epithelial–mesenchymal transition (EMT) is involved in anti-cancer drug resistance, cancer malignancy, and shares some characteristics with cancer stem cells (CSCs), we used artificial intelligence (AI) modeling to identify the cancer-related activity of the EMT-related pathway in datasets of gene expression. We generated images of gene expression overlayed onto molecular pathways with Ingenuity Pathway Analysis (IPA). A dataset of 50 activated and 50 inactivated pathway images of EMT regulation in the development pathway was then modeled by the DataRobot Automated Machine Learning platform. The most accurate models were based on the Elastic-Net Classifier algorithm. The model was validated with 10 additional activated and 10 additional inactivated pathway images. The generated models had false-positive and false-negative results. These images had significant features of opposite labels, and the original data were related to Parkinson’s disease. This approach reliably identified cancer phenotypes and treatments where EMT regulation in the development pathway was activated or inactivated thereby identifying conditions where therapeutics might be applied or developed. As there are a wide variety of cancer phenotypes and CSC targets that provide novel insights into the mechanism of CSCs’ drug resistance and cancer metastasis, our approach holds promise for modeling and simulating cellular phenotype transition, as well as predicting molecular-induced responses.
由于上皮-间充质转化(epithelial-mesenchymal transition, EMT)的活性参与抗癌耐药、癌症恶性,并且与癌症干细胞(cancer stem cells, CSCs)有一些共同的特征,我们使用人工智能(AI)建模来识别基因表达数据集中EMT相关通路的癌症相关活性。我们使用独创性途径分析(Ingenuity Pathway Analysis, IPA)生成了覆盖在分子途径上的基因表达图像。然后通过datarrobot自动化机器学习平台对发育路径中50个激活和50个未激活的EMT调控通路图像进行建模。最准确的模型是基于Elastic-Net Classifier算法。用另外10张激活和失活的通路图像对模型进行验证。生成的模型有假阳性和假阴性结果。这些图像具有明显的反标签特征,原始数据与帕金森病有关。这种方法可靠地确定了癌症表型和治疗方法,其中EMT调节在发育途径中被激活或灭活,从而确定了可能应用或开发治疗方法的条件。由于有各种各样的癌症表型和CSC靶点,为CSC耐药和癌症转移的机制提供了新的见解,我们的方法有望建模和模拟细胞表型转变,以及预测分子诱导的反应。
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引用次数: 2
Review of Template-Based Neuroimaging Tools in Neuro-Oncology: Novel Insights 神经肿瘤学中基于模板的神经成像工具综述:新的见解
Pub Date : 2022-12-23 DOI: 10.3390/onco3010001
J. Germann, Andrew Yang, Clement Chow, Brendan Santyr, N. Samuel, Artur Vetkas, C. Sarica, G. Elias, M. Voisin, W. Kucharczyk, G. Zadeh, A. Lozano, A. Boutet
Background: A common MRI reference space allows for easy communication of findings, and has led to high-impact discoveries in neuroscience. Brain MRI of neuro-oncology patients with mass lesions or surgical cavities can now be accurately transformed into reference space, allowing for a reliable comparison across patients. Despite this, it is currently seldom used in neuro-oncology, leaving analytic tools untapped. The aim of this study was to systematically review the neuro-oncology literature utilizing reference space. Methods: A systematic review of the neuro-oncology publications was conducted according to PRISMA statement guidelines. Studies specially reporting the use of the Montreal Neurological Institute (MNI) reference space were included. Studies were categorized according to their type of input data and their contributions to the field. A sub-analysis focusing on connectomics and transcriptomics was also included. Results: We identified only 101 articles that utilized the MNI brain in neuro-oncology research. Tumor locations (n = 77) and direct electrocortical stimulation (n = 19) were the most common source of data. A majority of studies (n = 51) provided insights on clinical factors such as tumor subtype, growth progression, and prognosis. A small group of studies (n = 21) have used the novel connectomic and transcriptomic tools. Conclusions: Brain MRI of neuro-oncology patients can be accurately transformed to MNI space. This has contributed to enhance our understanding of a wide variety of clinical questions ranging from tumor subtyping to symptom mapping. Many advanced tools such as connectomics and transcriptomics remain relatively untapped, thereby hindering our knowledge of neuro-oncology.
背景:一个通用的MRI参考空间可以方便地交流研究结果,并在神经科学中产生了高影响力的发现。有肿块病变或手术腔的神经肿瘤患者的脑MRI现在可以准确地转换到参考空间,从而在患者之间进行可靠的比较。尽管如此,它目前很少用于神经肿瘤学,分析工具尚未开发。本研究的目的是利用参考空间系统地回顾神经肿瘤学文献。方法:根据PRISMA声明指南对神经肿瘤学出版物进行系统综述。包括专门报告蒙特利尔神经研究所(MNI)参考空间使用情况的研究。研究根据其输入数据的类型及其对该领域的贡献进行了分类。还包括一个侧重于连接组学和转录组学的子分析。结果:我们只发现了101篇在神经肿瘤学研究中使用MNI大脑的文章。肿瘤位置(n=77)和直接皮层电刺激(n=19)是最常见的数据来源。大多数研究(n=51)提供了关于肿瘤亚型、生长进展和预后等临床因素的见解。一小群研究(n=21)使用了新的连接组学和转录组学工具。结论:神经肿瘤患者的脑MRI可以准确地转换到MNI空间。这有助于增强我们对从肿瘤分型到症状图谱等各种临床问题的理解。许多先进的工具,如连接组学和转录组学,仍然相对未开发,从而阻碍了我们对神经肿瘤学的了解。
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引用次数: 0
Gene Screening in High-Throughput Right-Censored Lung Cancer Data. 高通量右删减肺癌数据的基因筛选。
Pub Date : 2022-12-01 DOI: 10.3390/onco2040017
Chenlu Ke, Dipankar Bandyopadhyay, Mario Acunzo, Robert Winn

Background: Advances in sequencing technologies have allowed collection of massive genome-wide information that substantially advances lung cancer diagnosis and prognosis. Identifying influential markers for clinical endpoints of interest has been an indispensable and critical component of the statistical analysis pipeline. However, classical variable selection methods are not feasible or reliable for high-throughput genetic data. Our objective is to propose a model-free gene screening procedure for high-throughput right-censored data, and to develop a predictive gene signature for lung squamous cell carcinoma (LUSC) with the proposed procedure.

Methods: A gene screening procedure was developed based on a recently proposed independence measure. The Cancer Genome Atlas (TCGA) data on LUSC was then studied. The screening procedure was conducted to narrow down the set of influential genes to 378 candidates. A penalized Cox model was then fitted to the reduced set, which further identified a 6-gene signature for LUSC prognosis. The 6-gene signature was validated on datasets from the Gene Expression Omnibus.

Results: Both model-fitting and validation results reveal that our method selected influential genes that lead to biologically sensible findings as well as better predictive performance, compared to existing alternatives. According to our multivariable Cox regression analysis, the 6-gene signature was indeed a significant prognostic factor (p-value < 0.001) while controlling for clinical covariates.

Conclusions: Gene screening as a fast dimension reduction technique plays an important role in analyzing high-throughput data. The main contribution of this paper is to introduce a fundamental yet pragmatic model-free gene screening approach that aids statistical analysis of right-censored cancer data, and provide a lateral comparison with other available methods in the context of LUSC.

背景:测序技术的进步使大量全基因组信息的收集成为可能,这大大提高了肺癌的诊断和预后。确定临床终点的有影响力的标志物是统计分析管道中不可或缺的关键组成部分。然而,传统的变量选择方法对于高通量遗传数据并不可行或可靠。我们的目标是为高通量右审查数据提出一种无模型基因筛选程序,并利用所提出的程序开发肺鳞状细胞癌(LUSC)的预测性基因标记。方法:基于最近提出的独立性措施,开发了一种基因筛选程序。然后对LUSC的癌症基因组图谱(TCGA)数据进行研究。筛选程序是为了将一组有影响的基因缩小到378个候选基因。然后将惩罚Cox模型拟合到简化集,进一步确定了LUSC预后的6个基因特征。在基因表达Omnibus的数据集上验证了6个基因的签名。结果:模型拟合和验证结果都表明,与现有的替代方法相比,我们的方法选择了有影响的基因,从而导致生物学上合理的发现以及更好的预测性能。根据我们的多变量Cox回归分析,在控制临床协变量的情况下,6基因特征确实是一个重要的预后因素(p值< 0.001)。结论:基因筛选作为一种快速降维技术,在高通量数据分析中具有重要作用。本文的主要贡献是介绍了一种基本而实用的无模型基因筛选方法,该方法有助于对右审查癌症数据进行统计分析,并提供了与LUSC背景下其他可用方法的横向比较。
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引用次数: 0
ERBB1/EGFR and JAK3 Tyrosine Kinases as Potential Therapeutic Targets in High-Risk Multiple Myeloma. ERBB1/EGFR 和 JAK3 酪氨酸激酶是高危多发性骨髓瘤的潜在治疗靶点。
Pub Date : 2022-12-01 Epub Date: 2022-10-14 DOI: 10.3390/onco2040016
Fatih M Uckun, Sanjive Qazi

Our main objective was to identify abundantly expressed tyrosine kinases in multiple myeloma (MM) as potential therapeutic targets. We first compared the transcriptomes of malignant plasma cells from newly diagnosed MM patients who were risk-categorized based on the patient-specific EMC-92/SKY-92 gene expression signature values vs. normal plasma cells from healthy volunteers using archived datasets from the HOVON65/GMMG-HD4 randomized Phase 3 study evaluating the clinical efficacy of bortezomib induction/maintenance versus classic cytotoxic drugs and thalidomide maintenance. In particular, ERBB1/EGFR was significantly overexpressed in MM cells in comparison to normal control plasma cells, and it was differentially overexpressed in MM cells from high-risk patients. Amplified expression of EGFR/ERBB1 mRNA in MM cells was positively correlated with increased expression levels of mRNAs for several DNA binding proteins and transcription factors with known upregulating activity on EGFR/ERBB1 gene expression. MM patients with the highest ERBB1/EGFR expression level had significantly shorter PFS and OS times than patients with the lowest ERBB1/EGFR expression level. High expression levels of EGFR/ERBB1 were associated with significantly increased hazard ratios for unfavorable PFS and OS outcomes in both univariate and multivariate Cox proportional hazards models. The impact of high EGFR/ERBB1 expression on the PFS and OS outcomes remained significant even after accounting for the prognostic effects of other covariates. These results regarding the prognostic effect of EGFR/ERBB1 expression were validated using the MMRF-CoMMpass RNAseq dataset generated in patients treated with more recently applied drug combinations included in contemporary induction regimens. Our findings provide new insights regarding the molecular mechanism and potential clinical significance of upregulated EGFR/ERBB1 expression in MM.

我们的主要目的是确定多发性骨髓瘤(MM)中表达丰富的酪氨酸激酶,并将其作为潜在的治疗靶点。我们首先利用HOVON65/GMMG-HD4随机3期研究的存档数据集,比较了根据患者特异性EMC-92/SKY-92基因表达特征值进行风险分类的新诊断MM患者恶性浆细胞与健康志愿者正常浆细胞的转录组,该研究评估了硼替佐米诱导/维持治疗与传统细胞毒药物和沙利度胺维持治疗的临床疗效。与正常对照血浆细胞相比,ERBB1/EGFR在MM细胞中明显过表达,而且在高危患者的MM细胞中也有不同程度的过表达。MM细胞中表皮生长因子受体/表皮生长因子受体ERBB1 mRNA的扩增表达与已知对表皮生长因子受体/表皮生长因子受体ERBB1基因表达具有上调活性的几种DNA结合蛋白和转录因子的mRNA表达水平的升高呈正相关。ERBB1/EGFR表达水平最高的MM患者的PFS和OS时间明显短于ERBB1/EGFR表达水平最低的患者。在单变量和多变量考克斯比例危险模型中,表皮生长因子受体/ERBB1的高表达水平与不利的PFS和OS结果的危险比明显增加有关。即使考虑了其他协变量的预后影响,表皮生长因子受体/ERBB1高表达对PFS和OS结果的影响仍然显著。这些关于表皮生长因子受体/ERBB1表达对预后影响的研究结果通过MMRF-CoMMpass RNAseq数据集得到了验证,该数据集是在接受现代诱导方案中最新应用的药物组合治疗的患者中生成的。我们的研究结果提供了有关 MM 中表皮生长因子受体/ERBB1 表达上调的分子机制和潜在临床意义的新见解。
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引用次数: 0
The Dependence of Compensation Dose on Systematic and Random Interruption Treatment Time in Radiation Therapy 放射治疗中补偿剂量与系统和随机中断治疗时间的关系
Pub Date : 2022-09-05 DOI: 10.3390/onco2030015
R. Abolfath, M. Khalili, A. Senejani, Balachandran Kodery, R. Ivker
Introduction: In this work, we develop a multi-scale model to calculate corrections to the prescription dose to predict compensation required for the DNA repair mechanism and the repopulation of the cancer cells due to the occurrence of patient scheduling variabilities and the treatment time-gap in fractionation scheme. Methods: A system of multi-scale, time-dependent birth-death Master equations is used to describe stochastic evolution of double-strand breaks (DSBs) formed on DNAs and post-irradiation intra and inter chromosomes end-joining processes in cells, including repair and mis-repair mechanisms in microscopic scale, with an extension appropriate for calculation of tumor control probability (TCP) in macroscopic scale. Variabilities in fractionation time due to systematic shifts in patient’s scheduling and randomness in inter-fractionation treatment time are modeled. For an illustration of the methodology, we focus on prostate cancer. Results: We derive analytical corrections to linear-quadratic radiobiological indices α and β as a function of variabilities in treatment time and shifts in patient’s scheduling. We illustrate the dependence of the absolute value of the compensated dose on radio-biological sensitivity, α/β, DNA repair half-time, T1/2, tumor cells repopulation rate, and the time-gaps among treatment fractions due to inter-patient variabilities. At a given tumor size, delays between fractions totaling 24 h over the entire course of treatment, in a typical prostate cancer fractionation scheme, e.g., 81 Gy, 1.8 Gy per fraction and 45 treatment days, require up to 10% compensation dose if the sublethal DNA repair half-time, T1/2, spans over 10 h. We show that the contribution of the fast DNA repair mechanisms to the total dose is negligible. Instead, any compensation to the total dose stems from the tumor cell repopulation that may go up to a significant fraction of the original dose for a time gap of up to one week. Conclusions: We recommend implementation of time irregularities in treatment scheduling in the clinic settings to be taken into account. To achieve a clinical endpoint, corrections to the prescription dose must be assessed, in particular, if modern external beam therapy techniques such as IMRT/VMAT are used for the treatment of cancer.
简介:在这项工作中,我们开发了一个多尺度模型来计算处方剂量的校正,以预测由于分级方案中患者调度变量和治疗时间间隔的发生,癌症细胞的DNA修复机制和重新繁殖所需的补偿。方法:使用多尺度、时间依赖的出生-死亡主方程系统来描述DNA上形成的双链断裂(DSBs)的随机进化以及细胞中辐照后染色体内和染色体间末端连接过程,包括微观尺度的修复和错误修复机制,其扩展适用于在宏观尺度上计算肿瘤控制概率(TCP)。由于患者日程安排的系统性变化和分级间治疗时间的随机性,分级时间的可变性被建模。为了说明方法,我们将重点放在前列腺癌症上。结果:我们推导了线性二次放射生物学指数α和β的分析校正,作为治疗时间变化和患者日程安排变化的函数。我们说明了补偿剂量的绝对值对放射生物学敏感性、α/β、DNA修复半时间、T1/2、肿瘤细胞再增殖率以及由于患者间差异导致的治疗组分之间的时间间隔的依赖性。在给定的肿瘤大小下,在典型的前列腺癌症分级方案中,在整个治疗过程中总共24小时的级分之间的延迟,例如,81 Gy,每个级分1.8 Gy和45个治疗日,如果亚致死DNA修复半时T1/2跨越10小时,则需要高达10%的补偿剂量。我们表明,快速DNA修复机制对总剂量的贡献可以忽略不计。相反,对总剂量的任何补偿都源于肿瘤细胞的重新增殖,在长达一周的时间间隔内,肿瘤细胞的数量可能会增加到原始剂量的很大一部分。结论:我们建议在临床环境中考虑治疗计划中的时间不规则性。为了达到临床终点,必须评估处方剂量的校正,特别是如果使用IMRT/VMAT等现代外部射束治疗技术治疗癌症。
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