Association of Placental Tissue Metabolite Levels with Gestational Diabetes Mellitus: a Metabolomics Study.

The purpose of the study is to investigate the metabolic characteristics of placental tissue in patients diagnosed with gestational diabetes mellitus (GDM). Ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) was employed to qualitatively and quantitatively analyze the metabolites in placental tissues obtained from 25 healthy pregnant women and 25 pregnant women diagnosed with GDM. Multilevel statistical methods are applied to process intricate metabolomics data. Meanwhile, we applied machine learning techniques to identify biomarkers that could potentially predict the risk of long-term complications in patients with GDM as well as their offspring. We identified 1902 annotated metabolites, out of which 212 metabolites exhibited significant differences in GDM placentas. In addition, the study identifies a set of risk biomarkers that effectively predict the likelihood of long-term complications in both pregnant women with GDM and their offspring. The accuracy of this panel was measured by the area under the receiver operating characteristic curve (ROC), which was found to be 0.992 and 0.960 in the training and validation sets, respectively. This study enhances our understanding of GDM pathogenesis through metabolomics. Furthermore, the panel of risk markers identified could prove to be a valuable tool in predicting potential long-term complications for both GDM patients and their offspring.

Prognostic significance of anaplastic lymphoma kinase rearrangement in patients with completely resected lung adenocarcinoma.

BACKGROUND: Reports of the prognostic significance of anaplastic lymphoma kinase (ALK) rearrangement in early stage lung adenocarcinoma have been contradictory. This study aimed to identify the associations of ALK rearrangement with clinicopathologic features and prognosis in patients with surgically resected stage I-IIIA lung adenocarcinoma. METHODS: Analysis of ALK status was performed by a fully-automated immunochemistry assay (with rabbit monoclonal Ventana D5F3 antibody) in tissue sections of 2,103 patients with surgically-resected stage I-IIIA lung adenocarcinoma. ALK positive patients were matched with negative patients in a 1:1 ratio using propensity score matching (PSM). Clinical outcomes were assessed by disease-free survival (DFS) and overall survival (OS) after surgery. Initial recurrence pattern was also investigated according to ALK status. RESULTS: Among 2,103 stage I-IIIA lung adenocarcinoma cases, 81 (3.9%) were ALK positive. ALK positivity was significantly associated with younger age (P<0.001), solid predominant adenocarcinoma (P<0.001), variants of invasive adenocarcinoma (P<0.001), higher frequency of pleura invasion (P=0.040), smaller tumor size (P=0.014), mediastinal lymph node involvement (N2; P<0.001) and later pathologic stage (IIIA; P=0.001). In the match cohort, ALK positivity was not associated with DFS [hazard ratio (HR), 0.58; 95% confidence interval (CI): 0.33-1.03, P=0.063] or OS (HR, 0.61; 95% CI: 0.22-1.67, P=0.334). Lymph node involvement (HR: 5.36, 95% CI, 3.01-9.65, P<0.001) and solid predominant adenocarcinoma subtype (HR, 2.02; 95% CI: 1.07-3.79; P=0.029) were the independent prognostic factors of inferior DFS, and lymph node involvement was the independent prognostic factors of worse OS (HR, 6.61; 95% CI: 2.43-17.94; P<0.001). ALK positive patients had a higher risk of developing tumor recurrence in liver (P=0.043). CONCLUSIONS: ALK rearrangement was not an independent prognostic factor in stage I-IIIA lung adenocarcinoma patients but leaded to a higher risk of developing recurrence in liver.

C3: Consensus Cancer Driver Gene Caller.

Next-generation sequencing has allowed identification of millions of somatic mutations in human cancer cells. A key challenge in interpreting cancer genomes is to distinguish drivers of cancer development among available genetic mutations. To address this issue, we present the first web-based application, consensus cancer driver gene caller (C3), to identify the consensus driver genes using six different complementary strategies, i.e., frequency-based, machine learning-based, functional bias-based, clustering-based, statistics model-based, and network-based strategies. This application allows users to specify customized operations when calling driver genes, and provides solid statistical evaluations and interpretable visualizations on the integration results. C3 is implemented in Python and is freely available for public use at http://drivergene.rwebox.com/c3.

Model-based understanding of single-cell CRISPR screening.

The recently developed single-cell CRISPR screening techniques, independently termed Perturb-Seq, CRISP-seq, or CROP-seq, combine pooled CRISPR screening with single-cell RNA-seq to investigate functional CRISPR screening in a single-cell granularity. Here, we present MUSIC, an integrated pipeline for model-based understanding of single-cell CRISPR screening data. Comprehensive tests applied to all the publicly available data revealed that MUSIC accurately quantifies and prioritizes the individual gene perturbation effect on cell phenotypes with tolerance for the substantial noise that exists in such data analysis. MUSIC facilitates the single-cell CRISPR screening from three perspectives, i.e., prioritizing the gene perturbation effect as an overall perturbation effect, in a functional topic-specific way, and quantifying the relationships between different perturbations. In summary, MUSIC provides an effective and applicable solution to elucidate perturbation function and biologic circuits by a model-based quantitative analysis of single-cell-based CRISPR screening data.

MiR-516a-5p inhibits the proliferation of non-small cell lung cancer by targeting HIST3H2A.

The dysregulation of microRNAs (miRNAs) is associated with the pathogenesis of non-small cell lung cancer (NSCLC). However, the mechanisms by which miR-516a-5p contributes to NSCLC remain unclear. The association between miR-516a-5p expression and the clinicopathological characteristics and prognosis in patients with NSCLC was analyzed by The Cancer Genome Atlas (TCGA) data set. The targets of miR-516a-5p were identified by bioinformatic analysis and luciferase report assay. MTT and soft agar assays were conducted to investigate the function of miR-516a-5p in NSCLC cells. We found that the expression of miR-516a-5p was decreased in NSCLC tissues and associated with the age, pathological stage, and tumor size, acting as an independent prognostic factor of tumor recurrence in patients with NSCLC. Restoration of miR-516a-5p inhibited the cell viability and anchorage-independent growth of NSCLC cells, but its inhibitor had the opposite effects. Histone cluster 3 H2A (HIST3H2A) was further identified as a direct target of miR-516a-5p and displayed a negative correlation with miR-516a-5p expression in NSCLC tissues. Overexpression of HIST3H2A reversed the anti-proliferation effects induced by miR-516a-5p and acted as an independent prognostic factor of poor survival in patients with NSCLC. Altogether, our findings demonstrate that miR-516a-5p may function as a tumor suppressive factor in NSCLC cells by targeting HIST3H2A and might represent a potential indicator of tumor recurrence in patients with NSCLC.

A novel lung cancer detection algorithm for CADs based on SSP and Level Set.

The fuzzy degree of lung nodule boundary is the most important cue to judge the lung cancer in CT images. Based on this feature, the paper proposes a novel lung cancer detection method for CT images based on the super-pixels and the level set segmentation methods. In the proposed methods, the super-pixels method is used to segment the lung region and the suspected lung cancer lesion region in the CT image. The super-pixels method and a level set method are used to segment the suspected lung cancer lesion region simultaneously. Finally, the cancer is determined by the difference between results of the two segmentation methods. Experimental results show that the proposed algorithm has a high accuracy for lung cancer detection in CT images. For gross glass nodule, pleural nodule, the vascular nodules and solitary nodules, the sensitivity of the detection algorithm are respectively 91.3%, 96.3%, 80.9% and 82.3%.

Genome-wide DNA Methylation Analysis Reveals GABBR2 as a Novel Epigenetic Target for EGFR 19 Deletion Lung Adenocarcinoma with Induction Erlotinib Treatment.

Purpose: The past decade has witnessed the rapid development of personalized targeted therapies in lung cancer. It is still unclear whether epigenetic changes are involved in the response to tyrosine kinase inhibitor (TKI) treatment in epidermal growth factor receptor (EGFR)-mutated lung cancer.Experimental Design: Methyl-sensitive cut counting sequencing (MSCC) was applied to investigate the methylation changes in paired tissues before and after erlotinib treatment for 42 days with partial response (PR) from stage IIIa (N2) lung adenocarcinoma patients (N = 2) with EGFR 19 deletion. The Sequenom EpiTYPER assay was used to validate the changed methylated candidate genes. Up- or downregulation of the candidate gene was performed to elucidate the potential mechanism in the regulation of erlotinib treatment response.Results: Sixty aberrant methylated genes were screened using MSCC sequencing. Two aberrant methylated genes, CBFA2T3 and GABBR2, were clearly validated. A same differential methylated region (DMR) between exon 2 and exon 3 of GABBR2 gene was confirmed consistently in both patients. GABBR2 was significantly downregulated in EGFR 19 deletion cells, HCC4006 and HCC827, but remained conserved in EGFR wild-type A549 cells after erlotinib treatment. Upregulation of GABBR2 expression significantly rescued erlotinib-induced apoptosis in HCC827 cells. GABBR2 was significantly downregulated, along with the reduction of S6, p-p70 S6, and p-ERK1/2, demonstrating that GABBR2 may play an important role in EGFR signaling through the ERK1/2 pathway.Conclusions: We demonstrated that GABBR2 gene might be a novel potential epigenetic treatment target with induction erlotinib treatment for stage IIIa (N2) EGFR 19 deletion lung adenocarcinoma. Clin Cancer Res; 23(17); 5003-14. ©2017 AACR.

Integrated discovery of FOXO1-DNA stabilizers from marine natural products to restore chemosensitivity to anti-EGFR-based therapy for metastatic lung cancer.

The transcription factor forkhead box O1 (FOXO1) negatively regulates activated EGFR signaling by turning on the gene expression of tumor suppressor Kruppel-like factor 6. Here, we propose that the chemosensitivity to anti-EGFR-based lung cancer therapy can be restored by stabilization of the FOXO1-DNA complex architecture using small-molecule marine natural medicines. A synthetic protocol that integrates computational ligand-protein-DNA binding analysis and an experimental fluorescence binding assay was applied against a large library of structurally diverse, drug-like marine natural products to discover novel stabilizers of DNA-bound FOXO1 conformation. The screening utilized chemical similarity analysis to exclude structurally redundant compounds, and then carried out high-throughput molecular docking and computational binding analysis to identify potential marine natural product candidates. Consequently, eight commercially available hits were selected and tested in vitro, from which four marine natural product compounds (tanzawaic acid D, hymenidin, cribrostatin 6 and barbamide) were found to have high or moderate potency to selectively bind to the FOXO1 DNA-binding domain (DBD) in the presence of its cognate DNA partner. Atomistic molecular dynamics (MD) simulations revealed that the identified stabilizers do not directly interact with DNA; instead, they can effectively stabilize the free FOXO1 DBD domain in the DNA-bound conformation and thus promote the binding of FOXO1 to DNA.

Design and implementation of a mobile system for lung cancer patient follow-up in China and initial report of the ongoing patient registry.

INTRODUCTION: Management of lung cancer remains a challenge. Although clinical and biological patient data are crucial for cancer research, these data may be missing from registries and clinical trials. Biobanks provide a source of high-quality biological material for clinical research; however, linking these samples to the corresponding patient and clinical data is technically challenging. We describe the mobile Lung Cancer Care system (mLCCare), a novel tool which integrates biological and clinical patient data into a single resource. METHODS: mLCCare was developed as a mobile device application (app) and an internet website. Data storage is hosted on cloud servers, with the mobile app and website acting as a front-end to the system. mLCCare also facilitates communication with patients to remind them to take their medication and attend follow-up appointments. RESULTS: Between January 2014 and October 2015, 5,080 patients with lung cancer have been registered with mLCCare. Data validation ensures all the patient information is of consistently high-quality. Patient cohorts can be constructed via user-specified criteria and data exported for statistical analysis by authorized investigators and collaborators. mLCCare forms the basis of establishing an ongoing lung cancer registry and could form the basis of a high-quality multisite patient registry. Integration of mLCCare with SMS messaging and WeChat functionality facilitates communication between physicians and patients. CONCLUSION: It is hoped that mLCCare will prove to be a powerful and widely used tool that will enhance both research and clinical practice.

Integrated In Silico-In Vitro Discovery of Lung Cancer-related Tumor Pyruvate Kinase M2 (PKM2) Inhibitors.

BACKGROUND: The tumor pyruvate kinase M2 (PKM2) is involved in the glycolytic pathway of lung cancer and targeting this kinase has been observed to radiosensitize non-small cell lung cancer (NSCLC). OBJECTIVE: An integration of in silico virtual screening and in vitro kinase assay was described to discover novel PKM2 inhibitors from a candidate library containing >400,000 commercially available compounds. METHOD: The method is a stepwise screening scheme that first used empirical strategies to fast exclude those undruggable compounds in the library and then employed molecular docking and molecular dynamics (MD)-based rescoring to identify few potential hits. Subsequently, the computational findings were substantiated using a standard kinase assay protocol. RESULTS: Four compounds, i.e. nalidixic acid, indoprofen, hematoxylin and polydatin, were identified to inhibit PKM2 kinase at micromolar level, with IC50 values of 53, 21, 340 and 128 .M, respectively. CONCLUSION: Structural analysis revealed that hydrogen bonds, salt bridges, π-π stacking and hydrophobic forces co-confer high stability and strong specificity to PKM2-inhibitor binding.

Long noncoding RNA ENST00000434223 suppressed tumor progression in non-small cell lung cancer.

In spite of the fact that the great progress has been made in the treatment of non-small cell lung cancer (NSCLC), the prognosis of NSCLC remains comparatively dismal. Therefore, it is of great value to identify novel effective diagnostic biomarkers and therapeutic targets of NSCLC. Emerging evidence has demonstrated the vital roles of long noncoding RNAs (lncRNAs) in cancer development. ENST00000434223 was recently identified as a lncRNA that is downregulated in early stage lung adenocarcinoma in a profiling study. However, little is known about its role in the development of NSCLC. In the present study, we found that ENST00000434223 was greatly downregulated in cancer tissues compared to adjacent normal tissues. ENST00000434223 overexpression suppressed the proliferation and migration in NSCLC cell lines in vitro. Moreover, ENST00000434223 overexpression reversed the epithelial-mesenchymal transition in NSCLC cell line. Our study suggests that ENST00000434223 may be a potential biomarker and a therapeutic target of NSCLC.

Maintenance Therapy Improves Survival Outcomes in Patients with Advanced Non-small Cell Lung Cancer: A Meta-analysis of 14 Studies.

PURPOSE: The aim was to investigate whether maintenance therapy (MT) is sufficient or not to improve overall survival (OS) and progress-free survival (PFS) of advanced non-small cell lung cancer (NSCLC) patients. METHODS: Randomized controlled trials (RCTs) published between 1990 and 2013 were retrieved from PubMed, EMBASE, ISTP, clinicaltrials.org, and ASCO conference proceeding. Patients' characteristics, OS, progress-free survival, and hazard ratios were extracted. Data were analyzed using RevMan 5.2. Fourteen RCTs involving 6198 individuals were included. RESULTS: Compared with placebo, observation or best supportive care (BSC), patients receiving single agent (SA) MT had an improved OS (hazard ratio, HR 0.85, 95% CI 0.79-0.91; p < 0.05) and PFS (HR 0.65, 95% CI 0.57-0.73; p < 0.05). In a sub-group analysis of SA MT versus placebo, observation or BSC, we found that switch MT using SA provided an improved OS (HR 0.85, 95% CI 0.79-0.91; p < 0.05). For multiple agent (MA) versus SA MT, a prolonged PFS (HR 0.68, 95% CI 0.52-0.88; p < 0.05) but not OS (HR 0.96, 95% CI 0.86-1.07; p > 0.05) was observed for MA. A significant prolonged PFS was observed in MA switch MT (HR 0.71, 95% CI 0.58-0.86; p < 0.05) versus SA MT. However, no significant improvement in OS was observed for MA versus SA MT, indicating that switch MT (HR 0.90, 95% CI 0.73-1.12; p > 0.05) and continuous MT (HR 0.98, 95% CI 0.86-1.11; p > 0.05) showed similar effect on OS. CONCLUSION: SA switch MT is associated with improved OS and PFS in patients with advanced NSCLC. MA switch MT is sufficient to improve PFS, but not OS.

17-AAG suppresses growth and invasion of lung adenocarcinoma cells via regulation of the LATS1/YAP pathway.

The large tumour suppressor 1 (LATS1) signalling network has been proved to be an essential regulator within the cell, participating in multiple cellular phenotypes. However, it is unclear concerning the clinical significance of LATS1 and the regulatory mechanisms of 17-Allylamino-17- demethoxygeldanamycin (17-AAG) in lung adenocarcinoma (LAC). The aim of the present study was to investigate the correlation of LATS1 and yes-associated protein (YAP) expression with clinicopathological characteristics in LAC patients, and the effects of 17-AAG on biological behaviours of LAC cells. Subcutaneous LAC tumour models were further established to observe the tumour growth in nude mice. The results showed that the positive expression of LATS1 was significantly lowered (26.7% versus 68.0%, P < 0.001), while that of YAP was elevated (76.0% versus 56.0%, P = 0.03) in LAC tissues compared to the adjacent non-cancerous tissues; LAST1 expression was negatively correlated with YAP expression (r = 0.432, P < 0.001) and lymphatic invasion of the tumour (P = 0.015). In addition, 17-AAG inhibited proliferation and invasion, and induced cell apoptosis and cycle arrest in LAC cells together with increased expression of E-cadherin and p-LATS1, and decreased expression of YAP and connective tissue growth factor. Tumour volumes and weight were much smaller in 17-AAG-treated groups than those in untreated group (P < 0.01). Taken together, our findings indicate that decreased expression of LATS1 is associated with lymphatic invasion of LAC, and 17-AAG suppresses growth and invasion of LAC cells via regulation of the LATS1/YAP pathway in vitro and in vivo, suggesting that we may provide a promising therapeutic strategy for the treatment of human LAC.

Trim44 facilitates the migration and invasion of human lung cancer cells via the NF-κB signaling pathway.

BACKGROUND: Trim44 is an important member of the tripartite motif-containing protein (TRIM) family. Recent research reported that Trim44 might play an important role in tumorigenesis, although its role in non-small cell lung cancer (NSCLC) and the related mechanisms is not yet known. METHODS: In this study we analyzed 30 pairs of NSCLC tumors and the matched adjacent normal tissue to define the relationship between Trim44 and NSCLC tumors. The function of Trim44 in cell migration and invasion was determined by overexpression of Trim44 in normal bronchial epithelial cell line 16HE or knockdown of Trim44 in A549 cells, respectively. Whether Trim44-mediated NF-κB signaling activation was involved in Trim44-mediated promotion of lung cancer was tested by q-PCR analysis and cell migration and invasion assay using PDTC, an inhibitor of NF-κB. RESULTS: We found that Trim44 was upregulated in NSCLC tumors (14/30 cases; 46.7%). Furthermore, Trim44 was upregulated in many NSCLC cell lines, especially in A549 and H441. Moreover, Trim44 significantly enhanced cell migration and invasion ability, which was related to increased CXCR6 and matrix metalloproteinase 9 (MMP9). Knockdown of Trim44 in A549 cells by siRNA showed a diminished effect in cell migration and invasion. Further investigation revealed that blocking the NF-κB signaling pathway using PDTC, an inhibitor of NF-κB, reversed the expression of CXCR6 and MMP9, and alleviated the promotion of migration and invasion mediated by Trim44. CONCLUSIONS: Our data suggest that Trim44 promotes NSCLC development through activation of NF-κB signaling via upregulating CXCL16 and MMP9 expression.

FBXL5-mediated degradation of single-stranded DNA-binding protein hSSB1 controls DNA damage response.

Human single-strand (ss) DNA binding proteins 1 (hSSB1) has been shown to participate in DNA damage response and maintenance of genome stability by regulating the initiation of ATM-dependent signaling. ATM phosphorylates hSSB1 and prevents hSSB1 from ubiquitin-proteasome-mediated degradation. However, the E3 ligase that targets hSSB1 for destruction is still unknown. Here, we report that hSSB1 is the bona fide substrate for an Fbxl5-containing SCF (Skp1-Cul1-F box) E3 ligase. Fbxl5 interacts with and targets hSSB1 for ubiquitination and degradation, which could be prevented by ATM-mediated hSSB1 T117 phosphorylation. Furthermore, cells overexpression of Fbxl5 abrogated the cellular response to DSBs, including activation of ATM and phosphorylation of ATM targets and exhibited increased radiosensitivity, chemosensitivity and defective checkpoint activation after genotoxic stress stimuli. Moreover, the protein levels of hSSB1 and Fbxl5 showed an inverse correlation in lung cancer cells lines and clinical lung cancer samples. Therefore, Fbxl5 may negatively modulate hSSB1 to regulate DNA damage response, implicating Fbxl5 as a novel, promising therapeutic target for lung cancers.

The polycomb group protein EZH2 inhibits lung cancer cell growth by repressing the transcription factor Nrf2.

EZH2 is a key component of the polycomb PRC2 complex and functions as a histone H3 Lys27 (H3K27) trimethyltransferase. Here we show that EZH2 is down-regulated in human non-small cell lung cancer and low EZH2 expression predicts poor survival. Further we demonstrate that EZH2 inhibits lung cancer cell proliferation and colony formation in vitro and growth in vivo. We found that EZH2 binds to the promoter of Nrf2, where it increases H3K27me3 and represses Nrf2 expression. Finally, Nrf2 seems to be essential for the hyper proliferation of lung cancer cells in the absence of EZH2.

The histone acetylranseferase hMOF acetylates Nrf2 and regulates anti-drug responses in human non-small cell lung cancer.

BACKGROUND AND PURPOSE: The histone acetyltransferase MOF is a member of the MYST family. In mammals, MOF plays critical roles by acetylating histone H4 at K16 and non-histone substrates such as p53. Here we have investigated the role of MOF in human lung cancer and possible new substrates of hMOF. EXPERIMENTAL APPROACH: Samples of human non-small cell lung cancer (NSCLC) were used to correlate MOF with clinicopathological parameters and NF-E2-related factor 2 (Nrf2) downstream genes. 293T-cells were used to study interactions between MOF and Nrf2, and acetylation of Nrf2 by MOF. Mouse embryonic fibroblast and A549 cells were utilized to assess involvement of MOF in antioxidative and anti-drug responses. A549 cells were used to analysis the role of MOF in anti-drug response in vitro and in vivo. KEY RESULTS: hMOF was overexpressed in human NSCLC tissues and was associated with large tumour size, advanced disease stage and metastasis, and with poor prognosis. hMOF levels were positively correlated with Nrf2-downstream genes. MOF/hMOF physically interacted with and acetylated Nrf2 at Lys(588) . MOF-mediated acetylation increased nuclear retention of Nrf2 and transcription of its downstream genes. Importantly, MOF/hMOF was essential for anti-oxidative and anti-drug responses in vitro and regulated tumour growth and drug resistance in vivo in an Nrf2-dependent manner. CONCLUSION AND IMPLICATIONS: hMOF was overexpressed in human NSCLC and was a predictor of poor survival. hMOF-mediated Nrf2 acetylation and nuclear retention are essential for anti-oxidative and anti-drug responses. hMOF may provide a therapeutic target for the treatment of NSCLC.

Polymorphisms of microRNA sequences or binding sites and lung cancer: a meta-analysis and systematic review.

OBJECTIVE: Functional single nucleotide polymorphisms (SNPs) of microRNA (miRNA) sequences or binding sites (miRNA-SNPs) are associated with lung cancer risk and survival. The objective of this study was to systematically review genetic association studies about miRNA-SNPs in lung cancer. METHODS: Eligible genetic association studies were retrieved from databases of PubMed, EMBASE, China National Knowledge Infrastructure and SinoMed. Two investigators selected related studies and assessed methodological quality independently. Quantitative data synthesis was conducted for common SNPs of miRNA (miRNA-196a2 rs11614913, miRNA146a rs2910164, miRNA149 rs2292832, miRNA-605 rs2043556 and miRNA499 rs3746444). GRADE profiler was used to grade the quality of evidence for each miRNA-SNP. RESULTS: 15 eligible studies and 27 miRNA-SNPs were retrieved and 10 miRNA-SNPs were reported with a significant association with susceptibility to or survival of lung cancer. Methodological quality of eligible studies was adequate with an average score of 8.5. miRNA-196a2 rs11614913 polymorphism was associated with increased lung cancer risk (homozygote comparison, OR = 1.299, 95% CI: 1.096-1.540; dominant model, OR = 1.217, 95% CI: 1.041-1.421) and decreased survival. And according to GRADE profiler, quality of evidence was moderate for MYCL1 rs3134615, while quality of the other significant associations was low. CONCLUSIONS: Based on this first systematic review about miRNA-SNPs in lung cancer, quality of evidence was low for most genetic association studies. Polymorphisms of miRNA-196a2 rs11614913 and MYCL1 rs3134615 could be potential biomarkers of lung cancer.

A study of ethnic differences in TGFß1 gene polymorphisms and effects on the risk of radiation pneumonitis in non-small-cell lung cancer.

BACKGROUND: To investigate whether Chinese non-small-cell lung cancer (NSCLC) patients with risk of radiation pneumonitis (RP) (grade ≥ 3) caused by radiotherapy display reliable single-nucleotide polymorphism (SNP) marker(s) located on the transforming growth factor-beta-1 (TGFß1) gene. METHODS: DNA was isolated from blood samples obtained from NSCLC patients (n = 167) treated with radiotherapy alone (n = 23) or chemoradiation (n = 144) with the median total radiation dose of 56 Gy between 2007 and 2010. A comprehensive approach toward characterizing the TGFß1 SNPs in Chinese patients was carried out in this study. Eight SNPs of the TGFß1 gene (rs1800469, rs1800471, rs1982073, rs4803455, rs11466345, rs12983047, rs10417924, and rs10980942) were finally genotyped by the direct DNA sequencing method. Kaplan-Meier cumulative probability was used to assess the risk of RP of grade 3 or higher. Cox proportional hazard analysis was used to evaluate the effect of TGFß1 genotypes on RP risk. RESULTS: A total of 46 patients (27.5%) developed RP of grade 3 or higher, based on Common Terminology Criteria for Adverse Events version 3.0, with a median follow-up of 29.5 months (range, 16-58). The rs1982073 SNP, associated with RP risk in whites, was not found to be associated with the risk of RP of grade 3 or higher in Chinese NSCLC patients. Multivariate analysis found AG/GG genotypes of the novel TGFß1 SNP rs11466345 to be associated with a significantly higher risk of RP of grade 3 or higher compared with the AA genotypes, after adjustment for age, smoking status, and dosimetric parameters (for mean lung dose, adjusted hazards ratio = 2.295, 95% confidence interval: 1.101-4.783, p = 0.027; for volume of normal lung receiving 20 GY or more radiation, adjusted hazards ratio = 2.142, 95% confidence interval: 1.033-4.441, p = 0.041). CONCLUSION: The AG/GG genotypes of novel TGFß1 rs11466345 were associated with a higher risk of RP in Chinese NSCLC patients treated with radiotherapy. The rs1982073 SNP, associated with RP risk in whites, was not correlated with higher RP risk in the Chinese patients studied. Further studies are warranted to confirm these findings in different ethnic populations.

[Short-term intermittent prophylactic administration of recombinant human thrombopoietin attenuates chemotherapy-induced thrombocytopenia in lung cancer patients].

OBJECTIVE: To evaluate the efficacy of short-term intermittent prophylactic use of a recombinant human thrombopoietin (rhTPO) in chemotherapy-induced severe thrombocytopenia in lung cancer patients. METHODS: 24 advanced non-small cell lung cancer (NSCLC) patients who experienced severe thrombocytopenia in the last chemotherapy cycle received prophylactic rhTPO treatment in the next chemotherapy cycle (prophylactic treated cycle, PTC). rhTPO was given subcutaneously 300 U×kg(-1)×d(-1) on days 2, 4, 6, and 9 after the initiation of chemotherapy. Platelet count was monitored and compared with that in the previous treatment cycle (control cycle, CC). RESULTS: The lowest platelet count in the prophylactic rhTPO cycle was significantly higher than that in control cycle [(56 ± 16) × 10(9)/L vs. (28 ± 13) × 10(9)/L, P < 0.001]. The duration of thrombocytopenia was also shortened by the prophylactic rhTPO [(8 ± 2) d vs. (12 ± 3) d, P < 0.001]. The area under curve (AUC) of platelet count (21 days) was significantly increased [(3517 ± 685) × 10(9)/L vs. (2063 ± 436) × 10(9)/L, P < 0.001]. The time to platelet nadir and peak was not affected. CONCLUSION: Prophylactic use of rhTPO can attenuate the severity and shorten the duration of chemotherapy-induced thrombocytopenia in lung cancer patients.