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1.
Ann Oncol ; 29(2): 352-360, 2018 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-29069303

RESUMEN

Background: Genomic aberrations have been identified in metastatic castration-resistant prostate cancer (mCRPC), but molecular predictors of resistance to abiraterone acetate/prednisone (AA/P) treatment are not known. Patients and methods: In a prospective clinical trial, mCRPC patients underwent whole-exome sequencing (n = 82) and RNA sequencing (n = 75) of metastatic biopsies before initiating AA/P with the objective of identifying genomic alterations associated with resistance to AA/P. Primary resistance was determined at 12 weeks of treatment using criteria for progression that included serum prostate-specific antigen measurement, bone and computerized tomography imaging and symptom assessments. Acquired resistance was determined using the end point of time to treatment change (TTTC), defined as time from enrollment until change in treatment from progressive disease. Associations of genomic and transcriptomic alterations with primary resistance were determined using logistic regression, Fisher's exact test, single and multivariate analyses. Cox regression models were utilized for determining association of genomic and transcriptomic alterations with TTTC. Results: At 12 weeks, 32 patients in the cohort had progressed (nonresponders). Median study follow-up was 32.1 months by which time 58 patients had switched treatments due to progression. Median TTTC was 10.1 months (interquartile range: 4.4-24.1). Genes in the Wnt/ß-catenin pathway were more frequently mutated and negative regulators of Wnt/ß-catenin signaling were more frequently deleted or displayed reduced mRNA expression in nonresponders. Additionally, mRNA expression of cell cycle regulatory genes was increased in nonresponders. In multivariate models, increased cell cycle proliferation scores (≥ 50) were associated with shorter TTTC (hazard ratio = 2.11, 95% confidence interval: 1.17-3.80; P = 0.01). Conclusions: Wnt/ß-catenin pathway activation and increased cell cycle progression scores can serve as molecular markers for predicting resistance to AA/P therapy.


Asunto(s)
Acetato de Abiraterona/administración & dosificación , Resistencia a Antineoplásicos/genética , Prednisona/administración & dosificación , Neoplasias de la Próstata Resistentes a la Castración/genética , Vía de Señalización Wnt/genética , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ciclo Celular , Proliferación Celular , Estudio de Asociación del Genoma Completo , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/tratamiento farmacológico , Metástasis de la Neoplasia/genética , Estudios Prospectivos , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico
2.
Blood Cancer J ; 4: e183, 2014 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-24531446

RESUMEN

Massively parallel sequencing analyses have revealed a common mutation within the MYD88 gene (MYD88L265P) occurring at high frequencies in many non-Hodgkin lymphomas (NHLs) including the rare lymphoplasmacytic lymphoma, Waldenström's macroglobulinemia (WM). Using whole-exome sequencing, Sanger sequencing and allele-specific PCR, we validate the initial studies and detect the MYD88L265P mutation in the tumor genome of 97% of WM patients analyzed (n=39). Due to the high frequency of MYD88 mutation in WM and other NHL, and its known effects on malignant B-cell survival, therapeutic targeting of MYD88 signaling pathways may be clinically useful. However, we are lacking a thorough characterization of the role of intermediary signaling proteins on the biology of MYD88L265P-expressing B cells. We report here that MYD88L265P signaling is constitutively active in both WM and diffuse large B-cell lymphoma cells leading to heightened MYD88L265P, IRAK and TRAF6 oligomerization and NF-κB activation. Furthermore, we have identified the signaling protein, TAK1, to be an essential mediator of MYD88L265P-driven signaling, cellular proliferation and cytokine secretion in malignant B cells. Our studies highlight the biological significance of MYD88L265P in NHL and reveal TAK1 inhibition to be a potential therapeutic strategy for the treatment of WM and other diseases characterized by MYD88L265P.

3.
Child Abuse Negl ; 17(6): 715-29, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-8287285

RESUMEN

Psychological maltreatment is gaining recognition as one of the core concepts in child welfare, however, its utility has been limited by definitional problems and the absence of operationalized and validated instruments. These Psychological Maltreatment Rating Scales (PMRS) were developed for assessing psychological maltreatment in mother-child interaction, and were used to rate the videotaped interaction of 49 high-risk mother-child dyads and make predictions of child protective service involvement with the dyads. These predictions are compared with predictions based upon mothers' personal resources and social support. Results show that the PMRS is a moderately reliable and valid measure of psychologically maltreating and prosocial parental behavior that can discriminate between maltreating and comparison parents, and is a more effective predictor than maternal measures. Three factors of parenting emerged from an exploratory factor analysis: emotional abuse, and two factors of positive parenting. Psychological abuse was the presence of hostile behavior, and psychological neglect the absence of positive parenting.


Asunto(s)
Maltrato a los Niños/diagnóstico , Maltrato a los Niños/psicología , Relaciones Madre-Hijo , Responsabilidad Parental/psicología , Pruebas Psicológicas , Niño , Preescolar , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados
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