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  • 1
    In: Blood Cancer Journal, Springer Science and Business Media LLC, Vol. 11, No. 10 ( 2021-10-04)
    Abstract: To investigate the efficacy and toxicities of CPX-351 outside a clinical trial, we analyzed 188 patients (median age 65 years, range 26–80) treated for therapy-related acute myeloid leukemia (t-AML, 29%) or AML with myelodysplasia-related changes (AML-MRC, 70%). Eighty-six percent received one, 14% two induction cycles, and 10% received consolidation (representing 22% of patients with CR/CRi) with CPX-351. Following induction, CR/CRi rate was 47% including 64% of patients with available information achieving measurable residual disease (MRD) negativity ( 〈 10 −3 ) as measured by flow cytometry. After a median follow-up of 9.3 months, median overall survival (OS) was 21 months and 1-year OS rate 64%. In multivariate analysis, complex karyotype predicted lower response ( p  = 0.0001), while pretreatment with hypomethylating agents ( p  = 0.02) and adverse European LeukemiaNet 2017 genetic risk ( p   〈  0.0001) were associated with lower OS. Allogeneic hematopoietic cell transplantation (allo-HCT) was performed in 116 patients (62%) resulting in promising outcome (median survival not reached, 1-year OS 73%), especially in MRD-negative patients ( p  = 0.048). With 69% of patients developing grade III/IV non-hematologic toxicity following induction and a day 30-mortality of 8% the safety profile was consistent with previous findings. These real-world data confirm CPX-351 as efficient treatment for these high-risk AML patients facilitating allo-HCT in many patients with promising outcome after transplantation.
    Type of Medium: Online Resource
    ISSN: 2044-5385
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 2
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 3598-3598
    Abstract: Mutations in the metabolic enzymes isocitrate dehydrogenase 1 (IDH1) and 2 (IDH2) are frequently found in patients with glioma, acute myeloid leukemia (AML), melanoma, thyroid cancer, cholangiocellular carcinoma and chondrosarcoma. Mutant IDH produces R-2-hydroxyglutarate (R2HG), which induces histone- and DNA-hypermethylation through inhibition of epigenetic regulators, thus linking metabolism to tumorigenesis. We recently established an in vivo mouse model and investigated the function of mutant IDH1. By computational drug screening, we identified an inhibitor of mutant IDH1 (HMS-101), which inhibits mutant IDH1 cell proliferation, decreases R2HG levels in vitro, and efficiently blocks colony formation of AML cells from IDH1 mutated patients but not of normal CD34+ bone marrow cells. In the present study we investigated the effect of the inhibitor in our IDH1/HoxA9-induced mouse model of leukemia in vivo. To identify the maximally tolerated dose of HMS-101, we treated normal C57BL/6 mice with variable doses of HMS-101 for 9 days and measured the serum concentration. Mice receiving 0.5 mg and 1mg intraperitoneally once a day tolerated the drug well with mean plasma concentrations of 0.1 to 0.3 µM. To evaluate the effect of HMS-101 in the IDH1 mouse model, we transduced IDH1 R132C in HoxA9-immortalized murine bone marrow cells. Sorted transgene positive cells were then transplanted into lethally irradiated mice. After 5 days of transplantation, mice were treated with HMS-101 intraperitoneally for 5 days/week. The R/S-2HG ratio in serum was reduced 3-fold in HMS-101 treated mice after 8 weeks of treatment compared to control treated mice. HMS-101 or PBS treated mice had similar levels of transduced leukemic cells in peripheral blood at 2 and 6 weeks after transplantation. However, from week 6 to week 15 leukemic cells in peripheral blood decreased from 76% to 58, 63% to 29%, 67% to 7%, and 74% to 38% in 4/6 mice treated with HMS-101. In one mouse the percentage of leukemic cells was constant, and in one mouse it increased from week 6 to week 15 after transplantation. Leukemic cells increased constantly in peripheral blood until death in control treated mice. While the control cohort developed severe leukocytosis, anemia and thrombocytopenia around 8 to 10 weeks post transplantation, mice treated with HMS-101 still had normal WBC, RBC and platelet counts at 15 weeks after transplantation. Moreover, the HMS-101 treated mice had significantly more differentiated Gr1+CD11b+ cells in peripheral blood than control mice at 6 weeks and 15 weeks after transplantation and at death (P=.01). Morphologic evaluation of blood cells at 15 weeks or death from HMS-101 treated mice revealed a high proportion of mature neutrophils that were GFP positive and thus derived from IDH1 transduced cells, whereas control treated mice had monocytic morphology with a high proportion of immature cells. Importantly, HMS-101 treated mice survived significantly longer with a median latency of 87 days (range 80-118), whereas PBS-treated mice died with a median latency of 66 days (range 64-69) after transplantation (P 〈 .001). Of note, HMS-101 was found to be specific for mutant IDH1, as mutant IDH2 cells were not preferentially inhibited over IDH2 wildtype cells in vitro. This data demonstrates that HMS-101 specifically inhibits R2HG-production of mutant IDH1 in vivo, inhibits proliferation, induces differentiation in leukemic cells, and thus prolongs survival of IDH1mutant leukemic mice. Therefore, HMS-101 - a novel inhibitor of mutant IDH1 - shows promising activity in vivo and warrants further development towards clinical use in IDH1 mutated patients. Disclosures Chaturvedi: Hannover Medical School: Patents & Royalties. Preller:Hannover Medical School: Patents & Royalties. Heuser:Hannover Medical School: Patents & Royalties.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
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  • 3
    In: Blood, American Society of Hematology, Vol. 117, No. 17 ( 2011-04-28), p. 4561-4568
    Abstract: To integrate available clinical and molecular information for cytogenetically normal acute myeloid leukemia (CN-AML) patients into one risk score, 275 CN-AML patients from multicenter treatment trials AML SHG Hannover 0199 and 0295 and 131 patients from HOVON/SAKK protocols as external controls were evaluated for mutations/polymorphisms in NPM1, FLT3, CEBPA, MLL, NRAS, IDH1/2, and WT1. Transcript levels were quantified for BAALC, ERG, EVI1, ID1, MN1, PRAME, and WT1. Integrative prognostic risk score (IPRS) was modeled in 181 patients based on age, white blood cell count, mutation status of NPM1, FLT3-ITD, CEBPA, single nucleotide polymorphism rs16754, and expression levels of BAALC, ERG, MN1, and WT1 to represent low, intermediate, and high risk of death. Complete remission (P = .005), relapse-free survival (RFS, P 〈 .001), and overall survival (OS, P 〈 .001) were significantly different for the 3 risk groups. In 2 independent validation cohorts of 94 and 131 patients, the IPRS predicted different OS (P 〈 .001) and RFS (P 〈 .001). High-risk patients with related donors had longer OS (P = .016) and RFS (P = .026) compared with patients without related donors. In contrast, intermediate-risk group patients with related donors had shorter OS (P = .003) and RFS (P = .05). Donor availability had no impact on outcome of patients in the low-risk group. Thus, the IPRS may improve consolidation treatment stratification in CN-AML patients. Study registered at www.clinicaltrials.gov as #NCT00209833.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
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  • 4
    In: Nature, Springer Science and Business Media LLC, Vol. 616, No. 7957 ( 2023-04-20), p. 543-552
    Abstract: Intratumour heterogeneity (ITH) fuels lung cancer evolution, which leads to immune evasion and resistance to therapy 1 . Here, using paired whole-exome and RNA sequencing data, we investigate intratumour transcriptomic diversity in 354 non-small cell lung cancer tumours from 347 out of the first 421 patients prospectively recruited into the TRACERx study 2,3 . Analyses of 947 tumour regions, representing both primary and metastatic disease, alongside 96 tumour-adjacent normal tissue samples implicate the transcriptome as a major source of phenotypic variation. Gene expression levels and ITH relate to patterns of positive and negative selection during tumour evolution. We observe frequent copy number-independent allele-specific expression that is linked to epigenomic dysfunction. Allele-specific expression can also result in genomic–transcriptomic parallel evolution, which converges on cancer gene disruption. We extract signatures of RNA single-base substitutions and link their aetiology to the activity of the RNA-editing enzymes ADAR and APOBEC3A, thereby revealing otherwise undetected ongoing APOBEC activity in tumours. Characterizing the transcriptomes of primary–metastatic tumour pairs, we combine multiple machine-learning approaches that leverage genomic and transcriptomic variables to link metastasis-seeding potential to the evolutionary context of mutations and increased proliferation within primary tumour regions. These results highlight the interplay between the genome and transcriptome in influencing ITH, lung cancer evolution and metastasis.
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 5
    In: Nature, Springer Science and Business Media LLC, Vol. 616, No. 7957 ( 2023-04-20), p. 563-573
    Abstract: B cells are frequently found in the margins of solid tumours as organized follicles in ectopic lymphoid organs called tertiary lymphoid structures (TLS) 1,2 . Although TLS have been found to correlate with improved patient survival and response to immune checkpoint blockade (ICB), the underlying mechanisms of this association remain elusive 1,2 . Here we investigate lung-resident B cell responses in patients from the TRACERx 421 (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy) and other lung cancer cohorts, and in a recently established immunogenic mouse model for lung adenocarcinoma 3 . We find that both human and mouse lung adenocarcinomas elicit local germinal centre responses and tumour-binding antibodies, and further identify endogenous retrovirus (ERV) envelope glycoproteins as a dominant anti-tumour antibody target. ERV-targeting B cell responses are amplified by ICB in both humans and mice, and by targeted inhibition of KRAS(G12C) in the mouse model. ERV-reactive antibodies exert anti-tumour activity that extends survival in the mouse model, and ERV expression predicts the outcome of ICB in human lung adenocarcinoma. Finally, we find that effective immunotherapy in the mouse model requires CXCL13-dependent TLS formation. Conversely, therapeutic CXCL13 treatment potentiates anti-tumour immunity and synergizes with ICB. Our findings provide a possible mechanistic basis for the association of TLS with immunotherapy response.
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 6
    In: Nature Medicine, Springer Science and Business Media LLC, Vol. 29, No. 4 ( 2023-04), p. 833-845
    Type of Medium: Online Resource
    ISSN: 1078-8956 , 1546-170X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 7
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 12_Supplement ( 2022-06-15), p. 1603-1603
    Abstract: Background: Genomic intra-tumor heterogeneity (ITH) drives tumor evolution, leading to immune evasion and resistance to therapy. Emerging evidence implicates the transcriptome as a source of important variation that impacts tumor phenotype. Here, we perform a genomic-transcriptomic analysis of intra-tumor transcriptomic diversity upon 941 tumor regions taken from 357 TRACERx non-small cell lung cancers (NSCLC) across primary and metastatic disease subjected to high-depth bulk DNA and RNA sequencing, as well as 91 tumor-adjacent normal tissue samples. Results: Genomic and transcriptomic diversity are linked across primary and metastatic disease, with expression signatures of proliferation being enriched in the metastasis seeding subclone of the primary tumor relative to non-metastasis seeding subclones. Copy-number independent allele-specific expression (CN-independent ASE), a source of transcriptome-specific diversity, affects 1% (± 0.5%) of genes and is underpinned by aberrant allele-specific methylation (OR=7.58, p≤2.2x10-16), thus providing a window to the NSCLC epigenomic landscape. Driver mutations in chromatin remodellers and histone modifiers, in particular SETD2 and KDM5C, are associated with increased global levels of CN-independent ASE (p=0.0001). In genomically stable tumors, high levels of CN-independent ASE are linked to expression signatures consistent with genomic instability and proliferation (R=0.58, p=0.001), highlighting convergence between the genome and transcriptome in tumor evolution. For the first time, we uncover mutational signatures of RNA editing. Analysis of their activity links the expression of ADAR and APOBEC enzymes to editing processes revealing otherwise hidden APOBEC activity within tumors at sampling (RNA APOBEC activity identified in 188 tumor regions (32%) without evidence of DNA APOBEC activity). RNA editing activity is shared between primary tumors and paired metastasis, but not paired tumor-adjacent normal tissue, suggestive of heritability of this somatic transcriptional process. Finally, we combine multiple measures of genomic and transcriptomic variation in a multi-region approach to define important variation within cancer genes. We illustrate examples that would be missed with a purely genomic focus and demonstrate genomic-transcriptomic parallel evolution, converging on disruption to single cancer genes, such as FAT1 and APC, in different regions of a tumor. Conclusions: This work highlights the importance of the transcriptome during tumor evolution, as well as the power of integrative multi-omic assessments of ITH, and provides novel insight into the role of transcriptomic variation in lung cancer. Citation Format: James R. M. Black, Carlos Martinez-Ruiz, Clare Puttick, Jonas Demeulemeester, Elizabeth Larose Cadieux, Kerstin Thol, Thomas P. Jones, Selvaraju Veeriah, Cristina Naceur-Lombardelli, Andrew Rowan, Sophia Ward, Michelle Dietzen, Ariana Huebner, Maise Al Bakir, Miljana Tanic, Thomas B. Watkins, Emilia L. Lim, Ali M. Al Rashed, Daniel E. Cook, Rachel Rosenthal, Gareth Wilson, Alexander M. Frankell, Nnennaya Kanu, Kevin Litchfield, Nicolai J. Birkbak, Allan Hackshaw, Stephan Beck, Peter Van Loo, Mariam Jamal-Hanjani, the lung TRACERx Consortium, Charles Swanton, Nicholas McGranahan. Genomic transcriptomic evolution in TRACERx lung cancer and metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1603.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 8
    In: SSRN Electronic Journal, Elsevier BV
    Type of Medium: Online Resource
    ISSN: 1556-5068
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 9
    In: British Journal of Haematology, Wiley, Vol. 158, No. 2 ( 2012-07), p. 208-215
    Abstract: In acute myeloid leukaemia with normal karyotype ( CN ‐ AML ), gene mutations (e.g. NPM 1 , FLT 3 , CEBPA ) as well as deregulated gene expression affect outcome. High expression of ID 1 was described as a negative prognostic factor. We have shown that CEBPA regulates ID 1 expression. Therefore, we analysed the prognostic impact of ID 1 expression in 269 patients (aged 16–60 years) with CN ‐ AML in the context of other molecular markers, particularly CEBPA mutations. ID 1 high status was an independent negative prognostic factor for overall survival ( OS ) in multivariate analysis when analysed together with age, extramedullary disease, platelets, expression of BAALC and WT 1 , FLT 3 ‐internal tandem duplication, NPM 1 , WT 1 single nucleotide polymorphism rs16754 and IDH 1 . ID 1 expression was higher in CEBPA wildtype patients than in patients with monoallelic CEBPA mutations and these patients showed higher ID 1 expression compared to patients with biallelic CEBPA mutations. Thus, when CEBPA mutations were considered, ID 1 expression lost its prognostic impact. Likewise, the negative impact of ID 1 high status on relapse‐free survival ( RFS ) was lost when CEBPA mutations were included in the analysis. In CEBPA wildtype patients, ID 1 expression had no impact on complete remission‐rate, OS or RFS . In conclusion, CEBPA mutations seem to deregulate ID 1 expression. Therefore, ID 1 expression is not an independent prognostic factor in CN ‐ AML .
    Type of Medium: Online Resource
    ISSN: 0007-1048 , 1365-2141
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2012
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Genome Medicine Vol. 14, No. 1 ( 2022-12-07)
    In: Genome Medicine, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2022-12-07)
    Abstract: Cancer development is an evolutionary process. A key selection pressure is exerted by therapy, one of the few players in cancer evolution that can be controlled. As such, an understanding of how treatment acts to sculpt the tumour and its microenvironment and how this influences a tumour’s subsequent evolutionary trajectory is critical. In this review, we examine cancer evolution and intra-tumour heterogeneity in the context of therapy. We focus on how radiotherapy, chemotherapy and immunotherapy shape both tumour development and the environment in which tumours evolve and how resistance can develop or be selected for during treatment.
    Type of Medium: Online Resource
    ISSN: 1756-994X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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