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1. Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events

Author

Jokimäki, A. (Anna), Hietala, H. (Henna), Lemma, J. (Jasmiini), Karhapää, H. (Hanna), Rintala, A. (Anna), Kaikkonen, J.-P. (Jari-Pekka), Sunela, K. (Kaisa), Boman, E. (Eva), Jukkola, A. (Arja), Tiainen, S. (Satu), Seppälä, J. (Jan), Rönkä, A. (Aino), Hakkarainen, H. (Heikki), Kärnä, A. (Aarno), Iivanainen, S. (Sanna), Koivunen, J. (Jussi), Auvinen, P. (Päivi), Hernberg, M. (Micaela), Kuusisto, M. (Milla), Selander, T. (Tuomas), Kuittinen, O. (Outi), Jokimäki, A. (Anna), Hietala, H. (Henna), Lemma, J. (Jasmiini), Karhapää, H. (Hanna), Rintala, A. (Anna), Kaikkonen, J.-P. (Jari-Pekka), Sunela, K. (Kaisa), Boman, E. (Eva), Jukkola, A. (Arja), Tiainen, S. (Satu), Seppälä, J. (Jan), Rönkä, A. (Aino), Hakkarainen, H. (Heikki), Kärnä, A. (Aarno), Iivanainen, S. (Sanna), Koivunen, J. (Jussi), Auvinen, P. (Päivi), Hernberg, M. (Micaela), Kuusisto, M. (Milla), Selander, T. (Tuomas), and Kuittinen, O. (Outi)

Abstract

Background: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear. Methods: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed. Results: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT −/AE + group, 26.7% in the RT −/AE − group and 18.3% in the RT + /AE − group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT −/AE − and RT + /AE − groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT −/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582–0.935; p = 0.012, and HR 0.620; 95% CI 0.499–0.769; p < 0.001, respectively). Conclusions: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.

Published
2023

2. Germline HOXB13 mutations p.G84E and p.R217C do not confer an increased breast cancer risk

Author

Liu, J. (Jingjing), Prager-van der Smissen, W.J.C. (Wendy), Collée, J.M. (J Margriet), Bolla, M.K. (Manjeet K.), Wang, Q. (Qin), Michailidou, K. (Kyriaki), Dennis, J. (Joe), Ahearn, T.U. (Thomas U.), Aittomäki, K. (Kristiina), Ambrosone, C.B. (Christine), Andrulis, I.L. (Irene L.), Anton-Culver, H. (Hoda), Antonenkova, N.N. (Natalia N.), Arndt, V. (Volker), Arnold, N. (Norbert), Aronson, K.J. (Kristan J.), Augustinsson, A. (Annelie), Auvinen, P. (Päivi), Becher, H. (Heiko), Beckmann, M.W. (Matthias), Behrens, T.W. (Timothy), Bermisheva, M. (Marina), Bernstein, L. (Leslie), Bogdanova, N.V. (Natalia V.), Bogdanova-Markov, N. (Nadja), Bojesen, S.E. (Stig), Brauch, H. (Hiltrud), Brenner, H. (Hermann), Briceno, I. (Ignacio), Brucker, S.Y. (Sara Y.), Brüning, T. (Thomas), Burwinkel, B. (Barbara), Cai, Q. (Qiuyin), Cai, H. (Hui), Campa, D. (Daniele), Canzian, F. (Federico), Castelao, J.E. (Jose ), Chang-Claude, J. (Jenny), Chanock, S.J. (Stephen), Choi, J.-Y. (J.), Christiaens, M. (Melissa), Clarke, C. (Christine), Couch, F.J. (Fergus), Czene, K. (Kamila), Daly, M.B. (Mary), Devilee, P. (Peter), Santos Silva, I. (Isabel) dos, Dwek, M. (Miriam), Eccles, D.M. (Diana M.), Eliassen, A.H. (A Heather), Fasching, P.A. (Peter), Figueroa, J.D. (Jonine), Flyger, H. (Henrik), Fritschi, L. (Lin), Gago-Dominguez, M. (Manuela), Gapstur, S.M. (Susan M.), García-Closas, M. (Montserrat), García-Sáenz, J.A. (José A), Gaudet, M.M. (Mia M.), Giles, G.G. (Graham G.), Goldberg, M.S. (Mark), Radice, P. (Paolo), Guénel, P. (Pascal), Haiman, C.A. (Christopher), Håkansson, N. (Niclas), Hall, P. (Per), Harrington, P.A. (Patricia A.), Hart, S.N. (Steven N.), Hartman, J.M. (Joost), Hillemanns, P. (Peter), Hopper, J.L. (John), Hou, M.-F. (Ming-Feng), Hunter, D.J. (David), Huo, D. (Dezheng), Ito, H. (Hidemi), Iwasaki, M. (Motoki), Jakimovska, M. (Milena), Jakubowska, A. (Anna), John, E.M. (Esther), Kaaks, R. (Rudolf), Kang, D. (Daehee), Keeman, R. (Renske), Khusnutdinova, E.K. (Elza), Kim, S.-W. (Sung-Won), Kraft, P. (Peter), Kristensen, V. (Vessela), Kurian, A.W. (Allison W.), Le Marchand, L. (Loic), Li, J. (Jingmei), Lindblom, A. (Annika), Lophatananon, A. (Artitaya), Luben, R.N. (Robert N.), Lubinski, J. (Jan), Mannermaa, A. (Arto), Manoochehri, M. (Mehdi), Manoukian, S. (Siranoush), Margolin, S. (Sara), Mariapun, S. (Shivaani), Matsuo, K. (Keitaro), Maurer, T. (Tabea), Mavroudis, D. (Dimitris), Meindl, A. (Alfons), Menon, U. (Usha), Milne, R.L. (Roger), Muir, K. (Kenneth), Mulligan, A.-M. (Anna-Marie), Floris, O.A.M., Nevanlinna, H. (Heli), Offit, K. (Kenneth), Olopade, O.I. (Olofunmilayo), Olson, J.E. (Janet), Olsson, H. (Håkan), Orr, N. (Nick), Park, S.K. (Sue K.), Peterlongo, P. (Paolo), Peto, J. (Julian), Plaseska-Karanfilska, D. (Dijana), Presneau, N. (Nadege), Rack, B. (Brigitte), Rau-Murthy, R. (Rohini), Rennert, G. (Gad), Rennert, H.S. (Hedy S.), Rhenius, V. (Valerie), Romero, A. (Atocha), Ruebner, M. (Matthias), Saloustros, E. (Emmanouil), Schmutzler, R.K. (Rita), Schneeweiss, A. (Andreas), Scott, C.G. (Christopher G.), Shah, M. (Mitul), Shen, C.-Y. (Chen-Yang), Shu, X.-O. (Xiao-Ou), Simard, J. (Jacques), Sohn, C. (Christof), Southey, M.C. (Melissa), Spinelli, J.J. (John J.), Tamimi, R. (Rulla), Tapper, W.J. (William J.), Teo, S.H. (Soo H.), Terry, M.B. (Mary Beth), Torres, D. (Diana), Truong, T. (Thérèse), Untch, M. (Michael), Vachon, C. (Celine), van Asperen, C.J. (Christi J.), Wolk, K. (Kerstin), Yamaji, T. (Taiki), Zheng, W. (Wei), Ziogas, A. (Argyrios), Ziv, E. (Elad), Torres-Mejía, G. (Gabriela), Dörk, T. (Thilo), Swerdlow, A.J. (Anthony ), Hamann, U. (Ute), Schmidt, M.K. (Marjanka), Dunning, A.M. (Alison M.), Pharoah, P.D.P. (Paul), Adamo, P. (Pio) d', Hooning, M.J. (Maartje J.), Martens, J.W.M. (John), Hollestelle, A. (Antoinette), Liu, J. (Jingjing), Prager-van der Smissen, W.J.C. (Wendy), Collée, J.M. (J Margriet), Bolla, M.K. (Manjeet K.), Wang, Q. (Qin), Michailidou, K. (Kyriaki), Dennis, J. (Joe), Ahearn, T.U. (Thomas U.), Aittomäki, K. (Kristiina), Ambrosone, C.B. (Christine), Andrulis, I.L. (Irene L.), Anton-Culver, H. (Hoda), Antonenkova, N.N. (Natalia N.), Arndt, V. (Volker), Arnold, N. (Norbert), Aronson, K.J. (Kristan J.), Augustinsson, A. (Annelie), Auvinen, P. (Päivi), Becher, H. (Heiko), Beckmann, M.W. (Matthias), Behrens, T.W. (Timothy), Bermisheva, M. (Marina), Bernstein, L. (Leslie), Bogdanova, N.V. (Natalia V.), Bogdanova-Markov, N. (Nadja), Bojesen, S.E. (Stig), Brauch, H. (Hiltrud), Brenner, H. (Hermann), Briceno, I. (Ignacio), Brucker, S.Y. (Sara Y.), Brüning, T. (Thomas), Burwinkel, B. (Barbara), Cai, Q. (Qiuyin), Cai, H. (Hui), Campa, D. (Daniele), Canzian, F. (Federico), Castelao, J.E. (Jose ), Chang-Claude, J. (Jenny), Chanock, S.J. (Stephen), Choi, J.-Y. (J.), Christiaens, M. (Melissa), Clarke, C. (Christine), Couch, F.J. (Fergus), Czene, K. (Kamila), Daly, M.B. (Mary), Devilee, P. (Peter), Santos Silva, I. (Isabel) dos, Dwek, M. (Miriam), Eccles, D.M. (Diana M.), Eliassen, A.H. (A Heather), Fasching, P.A. (Peter), Figueroa, J.D. (Jonine), Flyger, H. (Henrik), Fritschi, L. (Lin), Gago-Dominguez, M. (Manuela), Gapstur, S.M. (Susan M.), García-Closas, M. (Montserrat), García-Sáenz, J.A. (José A), Gaudet, M.M. (Mia M.), Giles, G.G. (Graham G.), Goldberg, M.S. (Mark), Radice, P. (Paolo), Guénel, P. (Pascal), Haiman, C.A. (Christopher), Håkansson, N. (Niclas), Hall, P. (Per), Harrington, P.A. (Patricia A.), Hart, S.N. (Steven N.), Hartman, J.M. (Joost), Hillemanns, P. (Peter), Hopper, J.L. (John), Hou, M.-F. (Ming-Feng), Hunter, D.J. (David), Huo, D. (Dezheng), Ito, H. (Hidemi), Iwasaki, M. (Motoki), Jakimovska, M. (Milena), Jakubowska, A. (Anna), John, E.M. (Esther), Kaaks, R. (Rudolf), Kang, D. (Daehee), Keeman, R. (Renske), Khusnutdinova, E.K. (Elza), Kim, S.-W. (Sung-Won), Kraft, P. (Peter), Kristensen, V. (Vessela), Kurian, A.W. (Allison W.), Le Marchand, L. (Loic), Li, J. (Jingmei), Lindblom, A. (Annika), Lophatananon, A. (Artitaya), Luben, R.N. (Robert N.), Lubinski, J. (Jan), Mannermaa, A. (Arto), Manoochehri, M. (Mehdi), Manoukian, S. (Siranoush), Margolin, S. (Sara), Mariapun, S. (Shivaani), Matsuo, K. (Keitaro), Maurer, T. (Tabea), Mavroudis, D. (Dimitris), Meindl, A. (Alfons), Menon, U. (Usha), Milne, R.L. (Roger), Muir, K. (Kenneth), Mulligan, A.-M. (Anna-Marie), Floris, O.A.M., Nevanlinna, H. (Heli), Offit, K. (Kenneth), Olopade, O.I. (Olofunmilayo), Olson, J.E. (Janet), Olsson, H. (Håkan), Orr, N. (Nick), Park, S.K. (Sue K.), Peterlongo, P. (Paolo), Peto, J. (Julian), Plaseska-Karanfilska, D. (Dijana), Presneau, N. (Nadege), Rack, B. (Brigitte), Rau-Murthy, R. (Rohini), Rennert, G. (Gad), Rennert, H.S. (Hedy S.), Rhenius, V. (Valerie), Romero, A. (Atocha), Ruebner, M. (Matthias), Saloustros, E. (Emmanouil), Schmutzler, R.K. (Rita), Schneeweiss, A. (Andreas), Scott, C.G. (Christopher G.), Shah, M. (Mitul), Shen, C.-Y. (Chen-Yang), Shu, X.-O. (Xiao-Ou), Simard, J. (Jacques), Sohn, C. (Christof), Southey, M.C. (Melissa), Spinelli, J.J. (John J.), Tamimi, R. (Rulla), Tapper, W.J. (William J.), Teo, S.H. (Soo H.), Terry, M.B. (Mary Beth), Torres, D. (Diana), Truong, T. (Thérèse), Untch, M. (Michael), Vachon, C. (Celine), van Asperen, C.J. (Christi J.), Wolk, K. (Kerstin), Yamaji, T. (Taiki), Zheng, W. (Wei), Ziogas, A. (Argyrios), Ziv, E. (Elad), Torres-Mejía, G. (Gabriela), Dörk, T. (Thilo), Swerdlow, A.J. (Anthony ), Hamann, U. (Ute), Schmidt, M.K. (Marjanka), Dunning, A.M. (Alison M.), Pharoah, P.D.P. (Paul), Adamo, P. (Pio) d', Hooning, M.J. (Maartje J.), Martens, J.W.M. (John), and Hollestelle, A. (Antoinette)

Abstract

In breast cancer, high levels of homeobox protein Hox-B13 (HOXB13) have been associated with disease progression of ER-positive breast cancer patients and resistance to tamoxifen treatment. Since HOXB13 p.G84E is a prostate cancer risk allele, we evaluated the association between HOXB13 germline mutations and breast cancer risk in a previous study consisting of 3,270 familial non-BRCA1/2 breast cancer cases and 2,327 controls from the Netherlands. Although both recurrent HOXB13 mutations p.G84E and p.R217C were not associated with breast cancer risk, the risk estimation for p.R217C was not very precise. To provide more conclusive evidence regarding the role of HOXB13 in breast cancer susceptibility, we here evaluated the association between HOXB13 mutations and increased breast cancer risk within 81 studies of the international Breast Cancer Association Consortium containing 68,521 invasive breast cancer patients and 54,865 controls. Both HOXB13 p.G84E and p.R217C did not associate with the development of breast cancer in European women, neither in the overall analysis (OR = 1.035, 95% CI = 0.859-1.246, P = 0.718 and OR = 0.798, 95% CI = 0.482-1.322, P = 0.381 respectively), nor in specific high-risk subgroups or breast cancer subtypes. Thus, although involved in breast cancer progression, HOXB13 is not a material breast cancer susceptibility gene.

Published
2020
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3. Strong prolyl hydroxylase domain 1 expression predicts poor outcome in radiotherapy-treated patients with classical Hodgkin’s lymphoma

Author

Bur, H. (Hamid), Haapasaari, K.-M. (Kirsi-Maaria), Turpeenniemi-Hujanen, T. (Taina), Kuittinen, O. (Outi), Auvinen, P. (Päivi), Marin, K. (Katja), Soini, Y. (Ylermi), Karihtala, P. (Peeter), Bur, H. (Hamid), Haapasaari, K.-M. (Kirsi-Maaria), Turpeenniemi-Hujanen, T. (Taina), Kuittinen, O. (Outi), Auvinen, P. (Päivi), Marin, K. (Katja), Soini, Y. (Ylermi), and Karihtala, P. (Peeter)

Abstract

Background: Hypoxia-inducible factors (HIFs) and prolyl hydroxylase domain (PHD) proteins control cellular oxygen homeostasis and a wide range of other processes. Materials and Methods: We immunohistochemically assessed the expression of HIF1α, HIF2α, PHD1, PHD2 and PHD3 in 115 cases of classical Hodgkin’s lymphoma, all treated in the first line with doxorubicin, bleomycin, vinblastine and darcabazine (ABVD) chemotherapy. Results: In advanced-stage patients treated with involved-field radiotherapy (IFRT), nuclear HIF1α expression in reactive cellular infiltrate predicted prolonged relapse-free survival (RFS) (p=0.026). Strong cytoplasmic PHD1 expression in Reed–Sternberg cells was associated with poor RFS among patients treated with IFRT and advanced-stage patients treated with ABVD and IFRT (p=0.0028 and p=0.0058, respectively). In Cox regression analysis, PHD1 was a more significant predictor of relapse (risk ratio=18.383; 95% confidence interval(CI)=1.521–222.246; p=0.022) than the International Prognostic Score. Conclusion: HIF and PHD expression appear to be novel prognostic biomarkers in classical Hodgkin’s lymphoma.

Published
2018

4. Low Rap1-interacting factor 1 and sirtuin 6 expression predict poor outcome in radiotherapy-treated Hodgkin lymphoma patients

Author

Bur, H. (Hamid), Haapasaari, K.-M. (Kirsi-Maria), Turpeenniemi-Hujanen, T. (Taina), Kuittinen, O. (Outi), Auvinen, P. (Päivi), Marin, K. (Katja), Soini, Y. (Ylermi), Karihtala, P. (Peeter), Bur, H. (Hamid), Haapasaari, K.-M. (Kirsi-Maria), Turpeenniemi-Hujanen, T. (Taina), Kuittinen, O. (Outi), Auvinen, P. (Päivi), Marin, K. (Katja), Soini, Y. (Ylermi), and Karihtala, P. (Peeter)

Abstract

Sirtuins (SIRTs) are a family of histone deacetylases, which widely regulate cellular metabolism and are also involved in DNA repair. Rap1-interacting factor 1 (Rif1) and O⁶-alkylguanine DNA alkyltransferase (MGMT) are DNA-repair enzymes, which may potentially be involved in resistance to treatment of classical Hodgkin lymphoma (HL). We assessed the expression levels of (previously unstudied) SIRT1, SIRT4, SIRT6, Rif1, and MGMT immunohistochemically in 85 patients with untreated classical HL. Aberrant distributions of SIRT1, SIRT4, and SIRT6 were detected in Hodgkin neoplastic Reed–Sternberg (RS) cells compared with reactive elements. Low-level expression of both Rif1 and SIRT6 predicted dismal relapse-free survival in radiotherapy-treated patients (multivariate analysis; HR 8.521; 95% CI 1.714–42.358; p = .0088). Expression levels of SIRT1, 4, and 6 were abnormally distributed in RS cells, suggesting a putative role of aberrant acetylation in classical HL carcinogenesis. Rif1 and SIRT6 may also have substantial prognostic and even predictive roles in classical HL.

Published
2018

5. High-level cytoplasmic claudin 3 expression is an independent predictor of poor survival in triple-negative breast cancer

Author

Jääskeläinen, A. (Anniina), Soini, Y. (Ylermi), Jukkola-Vuorinen, A. (Arja), Auvinen, P. (Päivi), Haapasaari, K.-M. (Kirsi-Maria), Karihtala, P. (Peeter), Jääskeläinen, A. (Anniina), Soini, Y. (Ylermi), Jukkola-Vuorinen, A. (Arja), Auvinen, P. (Päivi), Haapasaari, K.-M. (Kirsi-Maria), and Karihtala, P. (Peeter)

Abstract

Background: The subtype of claudin-low breast cancer can be reliably determined only by gene-expression profiling. Attempts have been made to develop immunohistochemical surrogates, which nearly always focus on membranous claudin expression. Methods: We assessed the immunohistochemical expression of both membranous and cytoplasmic claudins 3, 4 and 7 in a series of 197 non-metastatic breast cancers, enriched with triple-negative breast cancers (TNBCs; 60%). The expression of epithelial-to-mesenchymal transition-regulating transcription factors Sip1, Zeb1 and vimentin had previously been determined in the same material. Results: In multivariate analysis, strong cytoplasmic claudin 3 expression was associated with poor relapse-free survival (RFS), disease-free survival, distant disease-free survival, breast cancer-specific survival and overall survival among TNBC patients (for RFS, RR 5.202, 95% CI 1.210–22.369, p = 0.027, vs. T-class, RR 0.663, 95% CI 0.168–2.623, p = 0.558, and N-class, RR 3.940, 95% CI 0.933–16.631, p = 0.062). Cytoplasmic claudin 3 expression was also associated with strong nuclear Sip1 expression (p = 0.000053), TNBC phenotype (p = 0.012) and within them, non-basal-like phenotype (p = 0.026). Cytoplasmic claudin 7 was associated with dismal RFS (RR 6.328, 95% CI 1.401–28.593, p = 0.016, vs. T-class, RR 0.692, 95% CI 0.242–1.982, p = 0.493, and N-class, RR 2.981, 95% CI 1.1016–8.749, p = 0.047). Low cytoplasmic expression of claudins 3, 4 and 7 together also predicted poor RFS (RR 6.070, 95% CI 1.347–27.363, p = 0.019, vs. T-class, RR 0.677, 95% CI 0.237–1.934, p = 0.467, and N-class, RR 3.167, 95% CI 1.079–9.290, p = 0.036). Conclusions: Immunohistochemical expression levels of cytoplasmic claudins 3 and 7 appear to be novel prognostic factors in TNBC.

Published
2018

6. Prognostic and predictive role of spatially positioned tumour infiltrating lymphocytes in metastatic HER2 positive breast cancer treated with trastuzumab

Author

Honkanen, T. J. (Tiia J.), Moilanen, T. (Tiina), Karihtala, P. (Peeter), Tiainen, S. (Satu), Auvinen, P. (Päivi), Väyrynen, J. P. (Juha P.), Mäkinen, M. (Markus), Koivunen, J. P. (Jussi P.), Honkanen, T. J. (Tiia J.), Moilanen, T. (Tiina), Karihtala, P. (Peeter), Tiainen, S. (Satu), Auvinen, P. (Päivi), Väyrynen, J. P. (Juha P.), Mäkinen, M. (Markus), and Koivunen, J. P. (Jussi P.)

Abstract

Disease outcomes of HER2+ breast cancers have dramatically changed after targeted therapies, such as trastuzumab, came to clinical practice but predictive factors for trastuzumab sensitivity and resistance are frequently unknown. Current work included metastatic breast cancer patients (n = 48), who were treated with trastuzumab and had pre-treatment tumour samples available. The tumours were immunostained for T-cell (CD3, CD8), natural killer (NK)-cell (CD56) and macrophage (CD68) markers and quantitative analysis of the immune cells was carried out using a computer-assisted image analysis in different tumour locations. High number of CD3 and CD8 positive T-cells was associated with significant survival benefit in the center of the tumour (CT) (p = 0.007, p = 0.001) but not in the invasive margin. The number of NK-cells and macrophages in the CT showed non-significant tendency towards improved survival. In subgroup analyses, high density of CD8 CT cells was associated with significant survival benefit in non-bone only disease, in TX or T1-3, and in ER+ tumours (p = 0.006, p = 0.003, p = 0.001). Moreover, high CD8 CT cell density associated significantly with long trastuzumab interruption periods in response. The results suggest important prognostic and predictive role of tumour infiltrating lymphocytes in center of the tumours in metastatic HER2+ breast cancer.

Published
2017

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