Publications by authors named "Alan Venook"

Background: Gene signatures derived from transcriptomic-causal networks offer potential for tailoring clinical care in cancer treatment by identifying predictive and prognostic biomarkers. This study aimed to uncover such signatures in metastatic colorectal cancer (CRC) patients to aid treatment decisions.

Methods: We constructed transcriptomic-causal networks and integrated gene interconnectivity into overall survival (OS) analysis to control for confounding genes.

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Background: Early changes in alpha-fetoprotein (AFP) are a promising surrogate endpoint for systemic treatment outcomes in hepatocellular carcinoma (HCC).

Objectives: We sought to investigate the utility of AFP response across first-line sorafenib (1L SOR) and later-line checkpoint inhibitor (CPI) therapies.

Design: We conducted a multicenter, retrospective cohort study of patients with advanced HCC who received 1L SOR and any subsequent CPI.

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Background: A plant-based diet is associated with better survival among patients with nonmetastatic colorectal cancer (CRC), but its association in metastatic CRC is unknown.

Methods: Using an National Cancer Institute-sponsored trial (CALGB/SWOG 80405), we included 1284 patients who completed validated food frequency questionnaires at the initiation of metastatic CRC treatment. We calculated 3 indices: overall plant-based diet index (PDI), which emphasized consumption of all plant foods while reducing animal food intake; healthful plant-based diet index (hPDI), which emphasized consumption of healthful plant foods such as whole grains, fruits, and vegetables; and unhealthful plant-based diet index (uPDI), which emphasized consumption of less healthful plant foods such as fruit juices, refined grains, and sugar-sweetened beverages.

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Article Synopsis
  • - Determining the best treatment plan for rectal cancer is complicated, involving choices between curative or palliative surgery and considering impact on bowel function and quality of life, especially for distal rectal cancer patients.
  • - Patients with rectal cancer face a higher risk of pelvic recurrence compared to those with colon cancer, making careful patient selection and a multidisciplinary treatment approach essential for better outcomes.
  • - Recent updates to the NCCN Guidelines for Rectal Cancer include new treatment options like endoscopic submucosal dissection for early cases, revisions to the total neoadjuvant therapy strategy, and a nonoperative "watch-and-wait" option for patients who respond well to initial therapy.
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Purpose: Persistent gastrointestinal (GI) symptoms are frequently experienced by colon cancer survivors and may help identify patients with higher utilization of healthcare services. To assess the relationship between GI symptoms and specialty care utilization among colon cancer survivors.

Methods: A prospective longitudinal cohort study at an academic medical center of 126 adults surgically treated for stage I-IV colon cancer between February 2017 and June 2022.

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Article Synopsis
  • * Results showed that NLM patients generally had better overall survival (OS) and progression-free survival (PFS) than LM patients in first-line and second-line chemotherapy, while OR rates were higher for LM patients overall.
  • * The findings indicate that LM serves as a negative prognostic factor in mCRC, supporting its use in stratifying patients in future clinical trials.
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Dose-limiting toxicities remain a major barrier to drug development and therapy, revealing the limited predictive power of human genetics. Herein, we demonstrate the utility of a more comprehensive approach to studying drug toxicity through longitudinal study of the human gut microbiome during colorectal cancer (CRC) treatment (NCT04054908) coupled to cell culture and mouse experiments. 16S rRNA gene sequencing revealed significant shifts in gut microbial community structure during oral fluoropyrimidine treatment across multiple patient cohorts, in mouse small and large intestinal contents, and in patient-derived communities.

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Article Synopsis
  • Colorectal cancer (CRC) ranks as the fourth most common cancer and the second deadliest in the U.S.
  • Treatment for advanced metastatic CRC includes multiple active drugs used alone or in combination, depending on patient-specific factors.
  • The paper reviews the systemic therapy recommendations for metastatic CRC as outlined in the NCCN Guidelines for Colon Cancer.
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Background: Herein, we report results from a genome-wide study conducted to identify protein quantitative trait loci (pQTL) for circulating angiogenic and inflammatory protein markers in patients with metastatic colorectal cancer (mCRC). The study was conducted using genotype, protein marker, and baseline clinical and demographic data from CALGB/SWOG 80405 (Alliance), a randomized phase III study designed to assess outcomes of adding VEGF or EGFR inhibitors to systemic chemotherapy in mCRC patients. Germline DNA derived from blood was genotyped on whole-genome array platforms.

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Unlocking the full dimensionality of single-cell RNA sequencing data (scRNAseq) is the next frontier to a richer, fuller understanding of cell biology. We introduce q-diffusion, a framework for capturing the coexpression structure of an entire library of genes, improving on state-of-the-art analysis tools. The method is demonstrated via three case studies.

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Article Synopsis
  • Monoclonal antibody therapies have improved cancer survival rates, but individual responses vary, necessitating the identification of cancer subtypes and biomarkers for effective treatment.* -
  • This study focused on colorectal cancer, combining genotype and RNA-seq data to find biomarkers linked to overall survival for patients treated with cetuximab or bevacizumab.* -
  • Notably, a gene found to be overexpressed in certain subtypes was linked to shorter survival for cetuximab patients, suggesting that specific subtypes may respond better to certain treatments.*
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Article Synopsis
  • * High gene expression was linked to improved progression-free survival (PFS) and overall survival (OS), with cetuximab showing a survival advantage over bevacizumab in patients with high expression levels, while the opposite was true for low expression levels.
  • * The study concluded that tumor gene expression is both prognostic and predictive, suggesting that measuring this expression can help tailor treatment, with patients having low expression potentially benefiting more from bevacizumab therapy.
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Unlabelled: Sorafenib blocks nonstructural protein 5A (NS5A)-recruited c-Raf-mediated hepatitis C virus (HCV) replication and gene expression. Release of Raf-1-Ask-1 dimer and inhibition of Raf-1 via sorafenib putatively differ in the presence or absence of doxorubicin. Cancer and Leukemia Group B (CALGB) 80802 (Alliance) randomized phase III trial of doxorubicin plus sorafenib versus sorafenib in patients with advanced hepatocellular carcinoma (HCC), showed no improvement in median overall survival (OS).

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Background: CDC37 is a key determinant of client kinase recruitment to the HSP90 chaperoning system. We hypothesized that kinase-specific dependency on CDC37 alters the efficacy of targeted therapies for metastatic colorectal cancer (mCRC).

Material And Methods: Two independent mCRC cohorts were analyzed to compare the survival outcomes between CDC37-high and CDC37-low patients (stratified by the median cutoff values): the CALGB/SWOG 80405 trial (226 and 207 patients receiving first-line bevacizumab- and cetuximab-containing chemotherapies, respectively) and Japanese retrospective (50 refractory patients receiving regorafenib) cohorts.

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Background: The C-C motif chemokine receptor 5 (CCR5)/C-C motif chemokine ligand 5 (CCL5) axis plays a major role in colorectal cancer (CRC). We aimed to characterize the molecular features associated with / expression in CRC and to determine whether / levels could impact treatment outcomes.

Methods: 7604 CRCs tested with NextGen Sequencing on DNA and RNA were analyzed.

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Article Synopsis
  • This study focused on identifying gene interconnectivity, specifically in metastatic colorectal cancer (CRC), to improve patient treatment by linking gene networks to overall survival (OS) outcomes.
  • Researchers analyzed data from 1,165 patients in a clinical trial comparing treatments with cetuximab and bevacizumab, discovering gene signatures that predict patient survival based on specific treatments.
  • The identified gene signatures not only showed downregulation in CRC tumors compared to normal tissue but also highlighted proteins that interact functionally, indicating their potential as novel biomarkers for personalized cancer treatment.
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  • This study identified protein quantitative trait loci (pQTL) related to angiogenic and inflammatory proteins in patients with metastatic colorectal cancer (mCRC) using genetic and protein data from a large clinical trial.
  • The analysis revealed a new pQTL associated with TGF-2 protein levels, validated in additional cancer patient datasets, and confirmed previously reported associations with VEGF-A and other protein markers.
  • The findings enhance our understanding of how genetic variants influence protein levels in mCRC, potentially guiding future cancer treatments and research.
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  • The CALGB (Alliance)/SWOG 80405 trial investigated the impact of specific gene mutations on survival and treatment response in metastatic colorectal cancer patients receiving bevacizumab or cetuximab with chemotherapy.
  • Sequencing of tumor DNA from 548 patients revealed varying numbers of mutations, with higher mutation rates in those with microsatellite instability-high tumors and notable differences in mutation frequency between Black and White patients.
  • The study identified that certain mutations, especially in specific genes, correlated with improved overall survival, suggesting potential for better patient prognosis predictions and more tailored treatment approaches in diverse populations.
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Background: Colorectal cancer (CRC) is more prevalent among some racial and ethnic minority and low socioeconomic status populations. Although the gut microbiota is a risk factor for CRC and varies with race and ethnicity, its role in CRC disparities remains poorly understood.

Methods: We examined the feasibility of recruiting sociodemographically diverse CRC patients for a microbiome study involving a home stool collection.

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  • About one-third of stage III colon cancer patients face tumor recurrence, and the impact of physical activity during and after chemotherapy on survival is unclear.
  • A study involving 399 patients measured their physical activity levels (in MET-hours/week) and its effects on survival after recurrence, revealing that higher activity levels (≥18.0 MET-h/week) improved survival by 33%.
  • The findings suggest that increased postoperative physical activity could enhance survival rates, which is significant for patients at high risk of recurrence despite receiving the best medical care.
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Unlabelled: Metastatic colorectal cancer (mCRC) is a heterogeneous disease that can evoke discordant responses to therapy among different lesions in individual patients. The Response Evaluation Criteria in Solid Tumors (RECIST) criteria do not take into consideration response heterogeneity. We explored and developed lesion-based measurement response criteria to evaluate their prognostic effect on overall survival (OS).

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Background: Adherence to the American Cancer Society (ACS) guidelines of avoiding obesity, maintaining physical activity, and consuming a diet rich in fruits, vegetables, and whole grains is associated with longer survival in colorectal cancer (CRC) survivors. Dietary components of the ACS guidelines may act in part by changing the microbiome, which is implicated in CRC outcomes.

Objectives: We conducted a pilot cross-sectional study to explore associations between ACS guidelines and the gut microbiome.

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Introduction: The primary objective of this study was to determine whether workplace culture in academic oncology differed by gender, during the COVID-19 pandemic.

Materials And Methods: We used the Culture Conducive to Women's Academic Success (CCWAS), a validated survey tool, to investigate the academic climate at an NCI-designated Cancer Center. We adapted the CCWAS to be applicable to people of all genders.

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