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      Validation of the use of a fluorescent PARP1 inhibitor for the detection of oral, oropharyngeal and oesophageal epithelial cancers

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          Abstract

          For oral, oropharyngeal and oesophageal cancer, the early detection of tumours and of residual tumour after surgery are prognostic factors of recurrence rates and patient survival. Here, we report the validation, in animal models and a human, of the use of a previously described fluorescently labelled small-molecule inhibitor of the DNA-repair enzyme poly(ADP-ribose) polymerase 1 (PARP1) for the detection of cancers of the oral cavity, pharynx and oesophagus. We show that the fluorescent contrast agent can be used to quantify the expression levels of PARP1, and to detect oral, oropharyngeal and oesophageal tumours in mice, pigs and fresh human biospecimens when delivered topically or intravenously. The fluorescent PARP1 inhibitor can also detect oral carcinoma in a patient when applied as a mouthwash, and discriminate, between fresh biopsied samples of the oral tumour and the surgical resection margin with larger than 95% sensitivity and specificity. The PARP1 inhibitor could serve as the basis of a fast and sensitive assay for the early detection, and for the surgical-margin assessment, of epithelial cancers of the upper intestinal tract.

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          Critical evaluation of diagnostic aids for the detection of oral cancer.

          Historically, the screening of patients for signs of oral cancer and precancerous lesions has relied upon the conventional oral examination. A variety of commercial diagnostic aids and adjunctive techniques are available to potentially assist in the screening of healthy patients for evidence of otherwise occult cancerous change or to assess the biologic potential of clinically abnormal mucosal lesions. This manuscript systematically and critically examines the literature associated with current oral cancer screening and case-finding aids or adjuncts such as toluidine blue, brush cytology, tissue reflectance and autofluorescence. The characteristics of an ideal screening test are outlined and the authors pose several questions for clinicians and scientists to consider in the evaluation of current and future studies of oral cancer detection and diagnosis. Although the increased public awareness of oral cancer made possible by the marketing of recently-introduced screening adjuncts is commendable, the tantalizing implication that such technologies may improve detection of oral cancers and precancers beyond conventional oral examination alone has yet to be rigorously confirmed.
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            Socioeconomic inequalities and oral cancer risk: a systematic review and meta-analysis of case-control studies.

            There is uncertainty and limited recognition of the relationship between socioeconomic inequalities and oral cancer. We aimed to quantitatively assess the association between socioeconomic status (SES) and oral cancer incidence risk. A systematic review of case-control studies obtained published and unpublished estimates of the SES risk related to oral cancer. Studies were included which reported odds ratios (ORs) and corresponding 95% CIs of oral cancer with respect to SES, or if the estimates could be calculated or obtained. Meta-analyses were performed on subgroups: SES measure, age, sex, global region, development level, time-period and lifestyle factor adjustments; while sensitivity analyses were conducted based on study methodological issues. Forty-one studies provided 15,344 cases and 33,852 controls which met our inclusion criteria. Compared with individuals who were in high SES strata, the pooled ORs for the risk of developing oral cancer were 1.85 (95%CI 1.60, 2.15; n = 37 studies) for those with low educational attainment; 1.84 (1.47, 2.31; n = 14) for those with low occupational social class; and 2.41 (1.59, 3.65; n = 5) for those with low income. Subgroup analyses showed that low SES was significantly associated with increased oral cancer risk in high and lower income-countries, across the world, and remained when adjusting for potential behavioural confounders. Inequalities persist but are perhaps reducing over recent decades. Oral cancer risk associated with low SES is significant and comparable to lifestyle risk factors. Our results provide evidence to steer health policy which focus on lifestyles factors toward an integrated approach incorporating measures designed to tackle the root causes of disadvantage. (c) 2008 Wiley-Liss, Inc.
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              Upregulation of Poly (ADP-Ribose) Polymerase-1 (PARP1) in Triple-Negative Breast Cancer and Other Primary Human Tumor Types.

              Poly (ADP-ribose) polymerase-1 (PARP1) is a key facilitator of DNA repair and is implicated in pathways of tumorigenesis. PARP inhibitors have gained recent attention as rationally designed therapeutics for the treatment of several malignancies, particularly those associated with dysfunctional DNA repair pathways, including triple-negative breast cancer (TNBC). We investigated the PARP1 gene expression profile in surgical samples from more than 8,000 primary malignant and normal human tissues. PARP1 expression was found to be significantly increased in several malignant tissues, including those isolated from patients with breast, uterine, lung, ovarian, and skin cancers, and non-Hodgkin's lymphoma. Within breast infiltrating ductal carcinoma (IDC) samples tested, mean PARP1 expression was significantly higher relative to normal breast tissue, with over 30% of IDC samples demonstrating upregulation of PARP1, compared with 2.9% of normal tissues. Because of known DNA repair defects, including BRCA1 dysfunction, associated with TNBC, exploration of PARP1 expression in breast cancers related to expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) led to the observation that negative expression of any of the 3 receptors was associated with upregulation of PARP1 expression, compared with receptor-positive tissues. To validate these observations, an independent set of breast adenocarcinomas was evaluated and demonstrated >2-fold upregulation of PARP1 in approximately 70% of primary breast adenocarcinomas, including TNBC, compared with syngeneic nonmalignant breast tissues. Immunohistochemistry (IHC) showed that upregulation of the PARP1 gene was consistent with increased protein expression in TNBC. These analyses suggest a potential biological role for PARP1 in several distinct malignancies, including TNBC. Further investigation of PARP1 as a biomarker for the therapeutic activity of PARP inhibitor-based therapy is warranted.
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                Author and article information

                Journal
                101696896
                45929
                Nat Biomed Eng
                Nat Biomed Eng
                Nature biomedical engineering
                2157-846X
                13 February 2020
                12 March 2020
                March 2020
                12 September 2020
                : 4
                : 3
                : 272-285
                Affiliations
                [1 ]Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
                [2 ]Department of Nuclear Medicine, University Hospital Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany
                [3 ]Integrated Head and Neck Oncology Research Program, Mazumdar Shaw Medical Foundation, Narayana Health, 258/A, Hosur Road Anekal, Taluk, Bommasandra Industrial Area, Bengaluru, Karnataka 560099, India
                [4 ]Head and Neck Oncology, Mazumdar Shaw Medical Center, Narayana Health, 258/A, Hosur Road Anekal, Taluk, Bommasandra Industrial Area, Bengaluru, Karnataka 560099, India
                [5 ]Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
                [6 ]Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
                [7 ]Summit Biomedical Imaging, LLC., 423W 127th St, New York, NY 10027, USA.
                [8 ]Department of Oral Medicine and Radiology, KLES Institute of Dental Sciences, # 20, Yeshwanthpur Suburb, II Stage, Tumkur Road, Bangalore - 560 022, Karnataka, India.
                [9 ]Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
                [10 ]Head and Neck Surgical Group, 425 W 59th St #1, New York, NY 10019, USA
                [11 ]Cochin Cancer Research Center, R.515/06, Ernakulam Government Medical College Compound, HMT Colony, North Kalamassery, Kochi, Kerala 683503, India
                [12 ]Department of Radiology, Weill Cornell Medical College, 1300 York Ave, New York, NY 10065, USA
                [13 ]Chemical Biology Program, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
                Author notes

                Author contributions: S.K., G.P., M.A.K., S.P., and T.R. conceived the study and designed the experiments. S.K., G.P., A.L.S., S.P.S., P.D.S.F., D.K.Z., C.B., R.G. V.S., P.B., N.H., R.D.R., A.S., and T.R. carried out the experiments and collected and analysed the data. S.K., S.P.S., P.D.S.F., D.K.Z., A.S., S.P., and T.R. wrote IRB protocols. A.M., M.G., G.P., and S.K. conducted statistical analysis of the data. M.S. and M.A.K. contributed experimental or analysis tools. S.K. and T.R. wrote the manuscript. All authors carefully reviewed and approved the manuscript.

                [* ] Correspondence and requests for materials should be addressed to reinert@ 123456mskcc.org
                Article
                NIHMS1558090
                10.1038/s41551-020-0526-9
                7136849
                32165735
                9cee27a7-5b45-499b-b3ea-38249d6854dc

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