DDR

DDR
  • 文章类型: Journal Article
    原发性食管恶性黑色素瘤(PMME)是一种极为罕见但高度侵袭性的恶性肿瘤,预后不良。由于缺乏驱动基因改变,需要更多的临床数据来全面描述其分子改变.本研究回顾了来自三个医疗中心的26例PMME病例。在14例和12例中对295个和1021个基因进行了基于杂交捕获的靶向测序,分别。我们发现PMME患者的肿瘤突变负荷相对较低(中位数,2.88个突变/Mb),并同时伴有KIT等基因的突变(6/26,23%),TP53(6/26,23%),SF3B1(4/26,15%),和NRAS(3/26,12%)。KIT,NRAS,和BRAF是相互排斥的,SF3B1与KIT突变和扩增共同发生。受影响的最常见途径是丝裂原激活的蛋白激酶和DNA损伤反应(DDR)途径。IV期是无进展生存期(风险比[HR]=5.14,95%置信区间[CI]=1.32-19.91)和总生存期(OS)的危险因素。HR=4.33,95%CI=1.22-15.30)。使用免疫检查点抑制剂(ICIs)治疗是有利OS的独立因素(HR=0.10,95%CI=0.01-0.91)。总的来说,PMME是一种复杂的恶性肿瘤,具有多种基因改变,特别是对ICIs潜在反应的DDR改变。
    Primary malignant melanoma of the esophagus (PMME) is an extremely rare but highly aggressive malignancy with a poor prognosis. Due to the scarcity of driver gene alterations, there is a need for more clinical data to comprehensively depict its molecular alterations. This study reviewed 26 PMME cases from three medical centers. Hybrid capture-based targeted sequencing of 295 and 1021 genes was performed in 14 and 12 cases, respectively. We found that PMME patients had a relatively low tumor mutation burden (median, 2.88 mutations per Mb) and were simultaneously accompanied by mutations in genes such as KIT (6/26, 23%), TP53 (6/26, 23%), SF3B1 (4/26, 15%), and NRAS (3/26, 12%). KIT, NRAS, and BRAF were mutually exclusive, and SF3B1 co-occurred with KIT mutation and amplification. The most common pathways affected were the mitogen-activated protein kinases and DNA damage response (DDR) pathways. Stage IV was a risk factor for both progression-free survival (hazard ratio [HR] = 5.14, 95% confidence interval [CI] = 1.32-19.91) and overall survival (OS), HR = 4.33, 95% CI = 1.22-15.30). Treatment with immune-checkpoint inhibitors (ICIs) was an independent factor for favorable OS (HR = 0.10, 95% CI = 0.01-0.91). Overall, PMME is a complex malignancy with diverse gene alterations, especially with harboring DDR alterations for potentially response from ICIs.
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  • 文章类型: Clinical Trial Protocol
    PARP抑制剂与雄激素受体靶向疗法的组合已证明在治疗转移性去势抵抗性前列腺癌(mCRPC)中具有潜力。这里,我们描述了跨国公司的设计和基本原理,第三阶段,由两部分组成的TALAPRO-2研究比较了talazoparib联合恩杂鲁胺与安慰剂联合恩杂鲁胺作为mCRPC伴或不伴DNA损伤反应(DDR)改变患者的一线治疗。这项研究有两个共同的主要终点:通过在所有人群(队列1)和DDR改变患者(队列2)中进行盲法独立临床评估的放射学无进展生存期(rPFS)。TALAPRO-2将证明在分子未选择和DDR缺陷的mCRPC患者中,他唑帕利联合恩杂鲁胺是否可以显着提高恩杂鲁胺在rPFS方面的疗效(NCT03395197)。临床试验注册:NCT03395197(ClinicalTrials.gov)。
    PARP inhibitors in combination with androgen receptor-targeted therapy have demonstrated potential in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Here, we describe the design and rationale of the multinational, phase III, two-part TALAPRO-2 study comparing talazoparib plus enzalutamide versus placebo plus enzalutamide as a first-line treatment for patients with mCRPC with or without DNA damage response (DDR) alterations. This study has two co-primary end points: radiographic progression-free survival (rPFS) by blinded independent clinical review in all-comers (cohort 1) and in patients with DDR alterations (cohort 2). TALAPRO-2 will demonstrate whether talazoparib plus enzalutamide can significantly improve the efficacy of enzalutamide in terms of rPFS in both molecularly unselected and DDR-deficient patients with mCRPC (NCT03395197). Clinical Trial Registration: NCT03395197 (ClinicalTrials.gov).
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  • 文章类型: Journal Article
    目的:本研究的目的是检测稳定型心绞痛(SA)和非ST段抬高型心肌梗死(NSTEMI)患者DNA连接酶活性和DNA损伤反应途径(DDR)基因的表达,并确定它们是否与斑块形态相关。
    背景:冠状动脉疾病(CAD)患者有外周血单核细胞(PBMC)中脱氧核糖核酸(DNA)损伤的证据。尚不清楚这是否代表过度损伤或DNA修复活性缺陷。
    方法:在患者的PBMC(SA(n=47)和NSTEMI(n=42))以及年龄和性别匹配的对照组(n=35)中测量了DNA连接酶活性和22个DDR基因的表达。采用频域光学相干断层扫描对靶病变进行解剖评估。
    结果:三组患者的DNA连接酶活性不同(对照组=119±53,NSTEMI=115.6±85.1,SA=81±55.7单位/g核蛋白;方差分析p=0.023)。成对比较表明这种显著性是由于对照和SA患者之间的差异(p=0.046)。参与双链断裂修复和核苷酸切除修复途径的基因在SA和NSTEMI患者中差异表达。在SA患者中,纤维钙化斑块与GTSE1、DDB1、MLH3和ERCC1表达密切相关。相比之下,在NSTEMI患者中,纤维斑块与ATM和XPA表达之间的相关性最强.
    结论:来自CAD患者的PBMC表现出DNA连接酶活性和DDR基因表达的差异。某些DDR基因的表达水平与斑块形态密切相关,可能在斑块发育和进展中起作用。试用注册号URL:www.Clinicaltrials.gov;NCT02335086。
    OBJECTIVE: The aim of this study was to examine DNA ligase activity and expression of DNA damage response pathway (DDR) genes in patients with stable angina (SA) and non-ST elevation myocardial infarction (NSTEMI) and determine whether they correlate with plaque morphology.
    BACKGROUND: Patients with coronary artery disease (CAD) have evidence of deoxyribonucleic acid (DNA) damage in peripheral blood mononuclear cells (PBMCs). It is unclear whether this represents excess damage or defective DNA repair activity.
    METHODS: DNA ligase activity and the expression of 22 DDR genes were measured in PBMCs of patients (both SA (n = 47) and NSTEMI (n = 42)) and in age and gender-matched controls (n = 35). Target lesion anatomical assessment was undertaken with frequency domain optical coherent tomography.
    RESULTS: DNA ligase activity was different across the three groups of patients (control = 119 ± 53, NSTEMI = 115.6 ± 85.1, SA = 81 ± 55.7 units/g of nuclear protein; ANOVA p = 0.023). Pair wise comparison demonstrated that this significance is due to differences between the control and SA patients (p = 0.046). Genes involved in double strand break repair and nucleotide excision repair pathways were differentially expressed in patients with SA and NSTEMI. In SA patients, fibrocalcific plaques were strongly associated with GTSE1, DDB1, MLH3 and ERCC1 expression. By contrast, in NSTEMI patients the strongest association was observed between fibrous plaques and ATM and XPA expression.
    CONCLUSIONS: PBMCs from patients with CAD exhibit differences in DNA ligase activity and expression of DDR genes. Expression levels of certain DDR genes are strongly associated with plaque morphology and may play a role in plaque development and progression. Trial Registration Number URL: www.Clinicaltrials.gov; NCT02335086.
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  • 文章类型: Journal Article
    癌症是老年人的疾病,老年是其最大的风险因素。随着年龄的增长,DNA损伤不断累积,增加恶性转化的机会。斑马鱼已成为研究这些过程的重要脊椎动物模型。可以在斑马鱼的整个生命过程中研究关键机制,例如DNA损伤反应和细胞衰老。此外,斑马鱼正在成为研究衰老过程中端粒生物学的重要资源,再生和癌症。在这里,我们回顾了斑马鱼研究人员开发的一些工具和资源,并讨论了它们在DNA损伤研究中的潜在用途,癌症和衰老相关疾病。
    Cancer is a disease of the elderly, and old age is its largest risk factor. With age, DNA damage accumulates continuously, increasing the chance of malignant transformation. The zebrafish has emerged as an important vertebrate model to study these processes. Key mechanisms such as DNA damage responses and cellular senescence can be studied in zebrafish throughout its life course. In addition, the zebrafish is becoming an important resource to study telomere biology in aging, regeneration and cancer. Here we review some of the tools and resources that zebrafish researchers have developed and discuss their potential use in the study of DNA damage, cancer and aging related diseases.
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  • 文章类型: Comparative Study
    This experimental study compares the appropriateness of direct digital radiography (DDR) and ultrasonography at detecting soft-tissue wooden foreign bodies (FBs) in extremities.
    Varying wooden FB splinters (2 mm, 5 mm and 10 mm) were inserted into eight porcine feet to simulate a patient presenting with a soft-tissue FB injury. Each of the FBs was placed in muscle distant, behind and near bone in the porcine feet. Control groups were used to check for false-positive diagnoses and, based on the presence of FBs; images were given a score depending on the level of visibility by the researcher.
    A higher detection rate was achieved for all FBs in muscle distant from bone using ultrasound. All of the 2 mm and 5 mm wooden FBs were not detected using DDR. The sensitivity in detecting the FBs was 5.8% and 30% in DDR and ultrasound respectively.
    Poor sensitivities and specificities were identified in this study. However, this study shows that ultrasound remains superior to DDR at identifying small foreign body objects. This study demonstrates that ultrasound can be a clinically effective tool for detecting suspected wooden FBs >5 mm in the foot and thus should be considered as the primary imaging modality of choice for referring clinicians.
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  • 文章类型: Clinical Trial, Phase II
    Chemotherapy may exert immunomodulatory effects, thereby combining favorably with the immune checkpoint blockade. The pharmacodynamic effects of such combinations, and potential predictive biomarkers, remain unexplored.
    To determine the safety, efficacy, and immunomodulatory effects of gemcitabine and cisplatin (GC) plus ipilimumab and explore the impact of somatic DNA damage response gene alterations on antitumor activity.
    Multicenter single arm phase 2 study enrolling 36 chemotherapy-naïve patients with metastatic urothelial cancer. Peripheral blood flow cytometry was performed serially on all patients and whole exome sequencing of archival tumor tissue was performed on 28/36 patients.
    Two cycles of GC followed by four cycles of GC plus ipilimumab.
    The primary endpoint was 1-yr overall survival (OS). Secondary endpoints included safety, objective response rate, and progression-free survival.
    Grade ≥3 adverse events occurred in 81% of patients, the majority of which were hematologic. The objective response rate was 69% and 1-yr OS was 61% (lower bound 90% confidence interval: 51%). On exploratory analysis, there were no significant changes in the composition and frequency of circulating immune cells after GC alone. However, there was a significant expansion of circulating CD4 cells with the addition of ipilimumab which correlated with improved survival. The response rate was significantly higher in patients with deleterious somatic DNA damage response mutations (sensitivity=47.6%, specificity=100%, positive predictive value=100%, and negative predictive value=38.9%). Limitations are related to the sample size and single-arm design.
    GC+ipilimumab did not achieve the primary endpoint of a lower bound of the 90% confidence interval for 1-yr OS of >60%. However, within the context of a small single-arm trial, the results may inform current approaches combining chemotherapy plus immunotherapy from the standpoint of feasibility, appropriate cytotoxic backbones, and potential predictive biomarkers.
    ClinicalTrials.gov NCT01524991.
    Combining chemotherapy and immune checkpoint blockade in patients with metastatic urothelial cancer is feasible. Further studies are needed to refine optimal combinations and evaluate tests that might identify patients most likely to benefit.
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  • 文章类型: Journal Article
    Research has identified appetitive aggression, i.e., the perception of committed, violent acts as appealing, exciting and fascinating, as a common phenomenon within populations living in precarious and violent circumstances. Investigating demobilized soldiers in the Democratic Republic of Congo (DRC) demonstrated that violent offending is associated with appetitive aggression and not necessarily with symptoms of posttraumatic stress. In the present study, we sought to replicate these results in an independent and larger sample of demobilized soldiers from Burundi. As with the Congolese ex-combatants, random forest regression revealed that the number of lifetime perpetrated violent acts is the most important predictor of appetitive aggression and the number of lifetime experienced traumatic events is the main predictor for posttraumatic stress. Perpetrated violent acts with salient cues of hunting (pursuing the victim, the sight of blood, etc.) were most predictive for perceiving violent cues appealingly after demobilization. Moreover, the association of violent acts and appetitive aggression as well as traumatic events and posttraumatic stress remains strong even years after demobilization. Patterns of traumatic events and perpetrated acts as predictors for posttraumatic stress and appetitive aggression seem to be robust among different samples of ex-combatants who fought in civil wars. Psychotherapeutic interventions that address these complementary facets of combat-related disorders-namely, posttraumatic stress and appetitive aggression-are indispensable for a successful reintegration of those who fought in armed conflicts and to achieve a successful transition to peace.
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