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  • 1
    In: Leukemia, Springer Science and Business Media LLC, Vol. 26, No. 1 ( 2012-01), p. 149-157
    Type of Medium: Online Resource
    ISSN: 0887-6924 , 1476-5551
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
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  • 2
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 426-426
    Abstract: Abstract 426 It is anticipated that inherited single nucleotide polymorphisms (SNPs) in genes involved in drug absorption, distribution, metabolism and excretion influence individual response to thalidomide therapies in Multiple Myeloma. We extracted peripheral blood DNA from 631 myeloma patients of European descent enrolled in the MRC Myeloma IX trial who had received induction thalidomide (50-200mg). We genotyped 3404 SNPs selected in 983 candidate genes that may influence myeloma disease response, toxicity, and/or survival, on a “Bank on a Cure” (BOAC) Affymetrix® true-tag array. The BOAC array is a custom genotyping chip focused on coding and predicted regulatory SNPs. Quality control (QC) measures were applied on the resulting genotype data such that individual samples failing a chip call rate ( 〉 95%), and SNP assays with missing data ( 〈 0.05%) or with extreme departures from Hardy-Weinberg equilibrium (p 〉 10-5) were excluded from the statistical analysis. We then performed 2-way log rank tests under recessive, dominant and trend genetic models for each SNP which passed QC for both overall survival and PFS on the training and validation sets. Our training set consisted of 379 myeloma patients from the intensive pathway of the Myeloma IX trial who received CTD (cyclophosphamide, thalidomide, dexamethasone), with a validation set of 252 myeloma patients from the non-intensive pathway who received an attenuated CTD regime. Although the overall and progression-free survival is shorter for individuals in the non-intensive arm in comparison to the younger and fitter patients in the intensive arm, we expected variants influencing overall survival and PFS related to thalidomide to associate with outcome, if both pathways were analysed separately. We looked for significant associations (log-rank chi-squares 〉 6.5, p 〉 10-3) across both the training and validation sets, and discounted associations where the number of cases in any one genotype group 〈 10. We detected significant cross validating associations in the survival analysis with genes involved in double-strand break repair: BLM, LIG1, MRE11A, SHFM1 and RAD51L3, and also saw associations with genes important in response to DNA damage stimulus: CYP19A1, GSTA4 and MGST1, along with other notably associations in genes NFKBIE, NFKB1 and SELL. We saw cross validating SNP associations in the progression-free survival analysis in genes including the cytokines: IL10, IL13, as well as NFATC1. In this large study we have seen results indicating that genetic variation plays a role in both overall and progression free survival following thalidomide treatment in multiple myeloma patients, and in doing so we have highlighted SNPs and pathways that may be important and informative in predictive classification of patients for overall survival and PFS following treatment with thalidomide containing regimes. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 3
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 1794-1794
    Abstract: Abstract 1794 Poster Board I-820 The proteasome inhibitor bortezomib has demonstrated high antitumor activity in multiple myeloma (MM). Peripheral neuropathy (PNP) is a dose-limiting toxicity of bortezomib, which typically occurs within the first cycles of bortezomib in 30-40% of MM patients. Although bortezomib induced PNP is manageable and reversible in most MM patients, no effective prophylactic treatment against PNP is available and bortezomib discontinuation is frequently required. Identifying patients at risk of neuropathy and understanding its pathogenesis is therefore of great importance. The mechanism underlying bortezomib induced PNP is unknown. To investigate whether genetic variation is associated with bortezomib induced PNP, a custom-built molecular inversion probe (MIP) based single nucleotide polymorphism (SNP) chip, designed by “Bank on a Cure” (BOAC)) was used, containing 3404 SNPs selected in “functional regions” within 983 genes representing cellular functions and pathways that may influence disease response, toxicities, complications, and survival. To explore SNP associations with bortezomib induced PNP we compared cases and controls in two phase 3 clinical trials. In the Dutch-German HOVON-65/GMMG-HD4 trial 3 cycles of Bortezomib/Doxorubicin/Dexamethason were given for induction, and 52 PNP grade 2,3,4 cases (37 %) were identified during this treatment against 84 controls. In the French IFM 2005-01 trial 4 cycles of Bortezomib/Dexamethasone were given, and 74 PNP grade 2,3,4 cases (34 %) versus 144 controls were identified. A Cochran-Armitage trend test was applied on the combined data set using the program PLINK. To account for multiple testing we carried out label swapping procedures. A set of SNPs was identified that was highly associated with bortezomib induced PNP. The 5 most significant SNPs are rs3136516 in F2 (thrombin) (p=2.0×10-4; Odds Ratio (OR)=0.53, 95% confidence interval (CI)=0.38-0.72), rs2686184 in FDFT1 (p=2.1×10-4; OR=1.6, 1.17-2.19), rs2137975 in DPYD (p=2.3×10-4; OR=1.60, 1.17-2.20), rs2857605 in TNF (p=3.0×10-3; OR=0.53, 0.35-0.79), rs12198787 in TNF (p=4.9×10-3; OR=0.48, 0.30-0.79). In addition, 3 significant SNPs (rs10979601, rs10759326 and rs838827) were located in IKBKAP, a gene involved in hereditary sensory neuropathies. Another interesting associated SNP, rs7096206 (p=8.5×10-3; OR=1.60, 1.10-2.32), is known to lead to reduced MBL2 serum levels. Significant associations were also seen in ADME genes (drug absorption, distribution, metabolism, and excretion) such as ABCC1, CYP2C9, CYP1A1, CYP1A2, CYP11B1, CYP17A1, CYP3A4, ABCB11, FMO2 and SLC22A4. Overall, the set of associated SNPs were enriched for genes in pathways involved in DNA replication, DNA repair, cell-to-cell signaling and drug metabolism. In conclusion, we identified a set of SNPs which are highly associated with bortezomib mediated PNP. Both ADME and critical biological pathways are implicated, which suggests a critical role for bortezomib metabolism and biological effects in PNP development. Our results open the way to develop a classifier predicting PNP in MM patients. Disclosures Off Label Use: Use of Bortezomib in first line treatment of Multiple Myeloma. Goldschmidt:Johnson and Johnson: Research Funding, Speakers Bureau. Lokhorst:Celgene: Consultancy. Sonneveld:Johnson and Johnson: Research Funding, Speakers Bureau.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 4
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 1800-1800
    Abstract: Abstract 1800 Poster Board I-826 Background The prevalence of peripheral neuropathy (PNP) during the treatment of MM with Bortezomib is high. About 20% of patients develop a grade 3-4 PNP due to this treatment, and as a result Bortezomib treatment is stopped or a reduced dose is given. Therefore, there is a strong need to find markers which predict the susceptibility of a patient to develop Bortezomib related PNP. Materials and methods: Bortezomib treated patients from the Dutch/German Hovon 65 GMMG-HD4 trial and the French IFM-2005/01 trial were used for this analysis. In both trials, the efficacy of Bortezomib as induction treatment prior to high-dose therapy is evaluated and PNP status was recorded. Samples were genotyped using a custom-built molecular inversion probe (MIP)-based single nucleotide polymorphism (SNP) chip containing 3404 SNPs (Bank on a Cure program; Van Ness et al., 2008). In total, 232 patients who did not develop PNP were compared to 210 PNP cases (grade 1, n=82; grade 2 n=86, grade 3, n=31, grade 4, n=11). Results The data were processed on the basis of the following criteria. First, SNPs genotyped in less than 75% of the samples were removed (n=155). This resulted in elimination of 59% of the data with unknown genotype while only 1% of the genotyped data were lost. The remaining 41% of the missing data were imputed using BIMBAM (Guan et al., PLoS Genet. 4:e1000279, 2008). As reference panels, the data sets of the BOAC chips from this study, 500 random samples from the Rotterdam ERGO study (Köttgen et al., Nat. Genet. 41, 712–717, 2009) and 60 phased CEU HAPMAP samples were used. Secondly, SNPs were excluded which did not show any genotype variance and which were not in Hardy Weinberg equilibrium. As a last step the data was adjusted for stratification using Eigenstrat (Price et al., Nat. Genet. 38: 904–909, 2006). By removing 21 SNPs and 14 samples the variance between the IFM and Hovon was reduced to an acceptable level (p = 0.011). The resulting combined IFM/Hovon dataset now contained 2764 SNP and 428 samples. The data set was divided in 6/7 (n=367) part as a learning set and 1/7 (n=61) as a validation set. Possibly informative SNPs were selected using information gain as a feature selection method (Cover et al., Elements of information theory. New York, John Wiley, 1991). 66 SNPs with an information gain in allele and genotype frequency were selected (p value 〈 0.05 after permutation test (n=10000)). Classifiers generated by Partial C4.5 decision tree (PART), support vector machine (SVM) and Random forest learned on this set reached a better than random performance. Sensitivity, specificity, positive predictive value and negative predictive value were respectively 55%, 70%, 60%, and 66% for the PART classifier. Conclusion Preliminary classifiers generated by this dataset suggest that building a classifier with clinically relevant performance may be within reach. To this end, we will report on the outcome of different combinations of existing classifier methods and feature selection methods. Van Ness, B, Ramos, C, Haznadar, M, Hoering, A,Haessler, J, Crowley, J, Jacobus, S, Oken, M, Rajkumar, V, Greipp, P, Barlogie, B, Durie, B, Katz, M, Atluri, G, Ganf, G, Gupta, R, Steinbach, M, Kumar, V, Mushlin, R, Johnson, D, and Morgan, G. (2008). Genomic Variation in Myeloma: Design, content, and initial application of the Bank On A Cure SNP Panel to analysis of survival. BMC Medicine. 6:26. Disclosures Hanifi-Moghaddam: Skyline Diagnostics: Employment.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 5
    In: Blood, American Society of Hematology, Vol. 112, No. 13 ( 2008-12-15), p. 4924-4934
    Abstract: A venous thromboembolism (VTE) with the subsequent risk of pulmonary embolism is a major concern in the treatment of patients with multiple myeloma with thalidomide. The susceptibility to developing a VTE in response to thalidomide therapy is likely to be influenced by both genetic and environmental factors. To test genetic variation associated with treatment related VTE in patient peripheral blood DNA, we used a custom-built molecular inversion probe (MIP)–based single nucleotide polymorphism (SNP) chip containing 3404 SNPs. SNPs on the chip were selected in “functional regions” within 964 genes spanning 67 molecular pathways thought to be involved in the pathogenesis, treatment response, and side effects associated with myeloma therapy. Patients and controls were taken from 3 large clinical trials: Medical Research Council (MRC) Myeloma IX, Hovon-50, and Eastern Cooperative Oncology Group (ECOG) EA100, which compared conventional treatments with thalidomide in patients with myeloma. Our analysis showed that the set of SNPs associated with thalidomide-related VTE were enriched in genes and pathways important in drug transport/metabolism, DNA repair, and cytokine balance. The effects of the SNPs associated with thalidomide-related VTE may be functional at the level of the tumor cell, the tumor-related microenvironment, and the endothelium. The clinical trials described in this paper have been registered as follows: MRC Myeloma IX: ISRCTN68454111; Hovon-50: NCT00028886; and ECOG EA100: NCT00033332.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
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    detail.hit.zdb_id: 80069-7
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  • 6
    In: The Hematology Journal, Springer Science and Business Media LLC, Vol. 5, No. 3 ( 2004), p. 285-285
    Type of Medium: Online Resource
    ISSN: 1466-4860 , 1476-5632
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    Language: Unknown
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2004
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  • 7
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 4517-4517
    Abstract: Objective: To fully contextualize the benefit of novel agents such as daratumumab (DARA) monotherapy for the treatment of patients with heavily pre-treated and highly refractory multiple myeloma (MM), it is critical to understand the real-world outcomes of this patient population on current standard of care (SOC) therapies. The objective of this study was to perform adjusted comparisons to determine the comparative effectiveness of DARA monotherapy versus real-world SOC therapies. Methods: Data for patients treated with DARA 16 mg/kg monotherapy were available from clinical trials MMY2002 (n=106) and GEN501 (n=42), while patients treated with SOC therapies were derived from the International Myeloma Foundation (IMF) chart review of patients with MM who had ≥3 prior lines of therapy and were double refractory to a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD) (n=543) (Kumar et al., ASH 2016; submitted). The pooled DARA studies demonstrated a median overall survival (OS) of 20.1 months versus 13.0 months for SOC based on the IMF cohort (Usmani et al., Blood 2016; Kumar et al., ASH 2016; submitted). The relative treatment effect of DARA versus SOC was estimated using two adjusted comparison methodologies, propensity score matching (PSM) and multivariate Cox regression analyses. Both methodologies utilized individual patient data to compare OS. Modeled covariates for the PSM were age, gender, prior lines of therapy, albumin, and refractory status to bortezomib (BOR), carfilzomib (CAR), lenalidomide (LEN), and pomalidomide (POM). PSM was performed using caliper matching with a caliper width 25% of the standard deviation of the logit-transformed propensity score, using sampling without replacement. For the regression analysis, the covariates included in the multivariate proportional hazards regression model were age, gender, prior lines of therapy, albumin, beta-2 microglobulin, prior exposure to POM and CAR, and PI/IMiD refractory status. Clustering of observations at the treatment-line level within patients was controlled for using the robust sandwich estimate for the covariance matrix, making confidence intervals (CIs) more conservative. For both PSM and regression, statistical significance testing was performed using a two-tailed p-value of 〈 0.05, and all comparisons between treatment groups were reported with hazard ratios (HRs) and 95% CIs. Results: Prior to PSM, imbalances between the DARA and SOC groups were significant for prior lines of therapy and proportions of patients refractory to POM, CAR, BOR, and LEN. After PSM, the DARA and SOC groups were well balanced for all covariates included in propensity score calculations. After PSM, comparisons found significant improvement in favor of DARA relative to SOC for OS (HR=0.44 [95% CI 0.31-0.63]) (Figure 1). Regression analyses revealed consistent results. After adjustment for differences in all covariates included in regression between the DARA and SOC groups, results showed significant improvement in favor of DARA compared with SOC for OS (HR=0.43 [95% CI 0.32-0.59] ) (Figure 2). Conclusions: Findings from both PSM and regression analyses were consistent and suggest that DARA is associated with significant gains in OS compared with SOC therapies for patients with heavily pre-treated and highly refractory MM. References: 1. Usmani SZ, Weiss BM, Plesner T, Bahlis NJ, Belch A et al. (2016) Clinical efficacy of daratumumab monotherapy in patients with heavily pretreated relapsed or refractory multiple myeloma. Blood 128 (1): 37-44. 2. Kumar SK, et al. (2016) Natural history of relapsed myeloma, refractory to immunomodulatory drugs and proteasome inhibitors: a multicenter IMWG study. The 58th Annual Meeting of the American Society of Hematology: submitted. Disclosures Kumar: Celgene: Consultancy, Research Funding; Noxxon: Consultancy, Honoraria; Janssen: Research Funding; AbbVie: Research Funding; BMS: Consultancy; Amgen: Consultancy, Research Funding; Takeda: Consultancy, Research Funding; Sanofi: Consultancy, Research Funding; Skyline: Consultancy, Honoraria. Durie:Amgen: Consultancy; Takeda: Consultancy; Janssen: Consultancy. Su:Janssen: Research Funding. Diels:Johnson & Johnson: Employment, Equity Ownership. Hutton:Essai Canada: Consultancy; Cornerstone Research Group: Consultancy; Janssen: Research Funding. Lam:Janssen: Employment. Tetsuro:Johnson & Johnson: Equity Ownership; Janssen: Employment.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
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  • 8
    In: The Lancet Oncology, Elsevier BV, Vol. 22, No. 3 ( 2021-03), p. e105-e118
    Type of Medium: Online Resource
    ISSN: 1470-2045
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2049730-1
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  • 9
    Online Resource
    Online Resource
    American Association for the Advancement of Science (AAAS) ; 1978
    In:  Science Vol. 200, No. 4349 ( 1978-06-30), p. 1496-1497
    In: Science, American Association for the Advancement of Science (AAAS), Vol. 200, No. 4349 ( 1978-06-30), p. 1496-1497
    Type of Medium: Online Resource
    ISSN: 0036-8075 , 1095-9203
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    Language: English
    Publisher: American Association for the Advancement of Science (AAAS)
    Publication Date: 1978
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    detail.hit.zdb_id: 2066996-3
    detail.hit.zdb_id: 2060783-0
    SSG: 11
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 1979
    In:  Pediatric Research Vol. 13, No. 10 ( 1979-10), p. 1137-1140
    In: Pediatric Research, Springer Science and Business Media LLC, Vol. 13, No. 10 ( 1979-10), p. 1137-1140
    Type of Medium: Online Resource
    ISSN: 0031-3998 , 1530-0447
    Language: Unknown
    Publisher: Springer Science and Business Media LLC
    Publication Date: 1979
    detail.hit.zdb_id: 2031217-9
    SSG: 12
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