Publications by authors named "Rena Xian"

Detecting somatic structural variants (SVs), copy number variants (CNVs), and mutations in bone and soft tissue tumors is essential for accurately diagnosing, treating, and prognosticating outcomes. Optical genome mapping (OGM) holds promise to yield useful data on SVs and CNVs but requires fresh or snap-frozen tissues. This study aimed to evaluate the clinical utility of data from OGM compared with current standard-of-care cytogenetic testing.

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  • Genomic reports in molecular diagnostics are often narrative and inconsistent in content and format, despite existing regulatory guidelines.
  • A study evaluated 69 reports from 31 laboratories across five disciplines, finding that most met compliance but exhibited variability in how required elements were presented.
  • The findings highlight a need for improved consistency in report formatting to enhance communication of genetic test results to healthcare providers and patients.
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  • The study discusses a patient with metastatic breast cancer who has a genetic mutation in the PALB2 gene, which is linked to DNA repair processes.
  • The patient developed resistance to a class of drugs known as PARP inhibitors (PARPi) after initial treatment, raising concerns about treatment effectiveness.
  • Researchers found that the cancer evolved in multiple ways (convergent evolution) to develop this resistance, highlighting the complexity of managing cancer treatments over time.
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  • * Researchers monitored 47 newly diagnosed adults with HL over 18 months, finding that advanced disease and significant symptoms were prevalent among all participants, regardless of HIV status.
  • * Results indicated that PWH experienced higher early mortality and lower overall survival at one year compared to HIV-negative patients, suggesting a need for better tailored treatments and understanding the factors leading to these poor outcomes.
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There is a critical need for a streamlined process to identify genotype-matched individuals eligible for enrollment into clinical trials and/or targeted therapies, as current methodologies face challenges in integrating diverse molecular data sources. We have developed a precision oncology platform to assist molecular tumor boards and community oncologists in reviewing patients' phenotypes, evaluating related knowledge, and identifying genotype-matched therapies.

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1q jumping translocation (JT) is rare and its molecular profiles in myeloid malignancies are not well-known. This study evaluated gene mutations in 1q-JT cohorts (0.38%) from hematological malignant specimens that underwent genetic analysis at the Johns Hopkins Hospital (nā€‰=ā€‰11,908) and the MD Anderson Cancer Center.

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  • Epstein-Barr virus (EBV) is linked to classical Hodgkin lymphoma (cHL), but the role of antibodies against EBV in cHL patients isn't fully understood, prompting a study to investigate this connection.
  • Researchers conducted a custom protein microarray study comparing antibody responses in EBV-positive cHL patients from East Asia with healthy controls, discovering a specific antibody profile unique to this population.
  • The study found that a majority of these antibodies were also associated with cHL in a separate European population, indicating that certain EBV antibodies may serve as reliable biomarkers for EBV-positive cHL across different demographics.
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Lymphoid malignancies are a broad and heterogeneous group of neoplasms. In the past decade, the genetic landscape of these tumors has been explored and cataloged in fine detail offering a glimpse into the mechanisms of lymphomagenesis and new opportunities to translate these findings into patient management. A myriad of studies have demonstrated both distinctive and overlapping molecular and chromosomal abnormalities that have influenced the diagnosis and classification of lymphoma, disease prognosis, and treatment selection.

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Myelodysplastic syndrome (MDS), also known as "myelodysplastic neoplasm," is a heterogeneous group of clonal myeloid neoplasms that typically affects older adults. The clinical phenotype, symptoms, and complications relate to the depth of cytopenia and progression to acute myeloid leukemia (AML). The diagnosis of MDS relies on morphologic criteria, such as evidence of dysplasia, disordered maturation, and increasing blast counts, which separate the disease into histologic subtypes with different probabilities for progression to AML.

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The emerging field of liquid biopsy stands at the forefront of novel diagnostic strategies for cancer and other diseases. Liquid biopsy allows minimally invasive molecular characterization of cancers for diagnosis, patient stratification to therapy, and longitudinal monitoring. Liquid biopsy strategies include detection and monitoring of circulating tumor cells, cell-free DNA, and extracellular vesicles.

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Identification of genomic signatures with consistent clinicopathological features in myelodysplastic/myeloproliferative neoplasm (MDS/MPN) is critical for improved diagnosis, elucidation of biology, inclusion in clinical trials, and development of therapies. We describe clinical and pathological features with co-existence of mutations in ASXL1 (missense or nonsense), SRSF2, and SKI homologous region of SETBP1, in 18 patients. Median age was 68 years with a male predominance (83%).

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Introduction: The highest incidence of colorectal cancer (CRC) is in patients diagnosed at 80 years or older highlighting a need for understanding the clinical and molecular features of these tumors. Methods. In this retrospective cohort study, 544 CRCs underwent next generation sequencing and mismatch repair (MMR) evaluation.

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While molecular testing of hematologic malignancies is now standard of care, there is variability in practice and testing capabilities between different academic laboratories, with common questions arising on how to best meet clinical expectations. A survey was sent to hematopathology subgroup members of the Genomics Organization for Academic Laboratories consortium to assess current and future practice and potentially establish a reference for peer institutions. Responses were received from 18 academic tertiary-care laboratories regarding next-generation sequencing (NGS) panel design, sequencing protocols and metrics, assay characteristics, laboratory operations, case reimbursement, and development plans.

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Viral-associated cancers are a distinct group of malignancies with a unique pathogenesis and epidemiology. Liquid biopsy is a minimally invasive way to identify tumor-associated abnormalities in blood derivatives, such as plasma, to guide the diagnosis, prognosis, and treatment of patients with cancer. Liquid biopsy encompasses a multitude of circulating analytes with the most extensively studied being cell-free DNA (cfDNA).

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  • Predictive biomarker testing is crucial for identifying which metastatic breast cancer patients can benefit from targeted therapies.
  • Guidelines from the National Comprehensive Cancer Network emphasize testing for hormone receptors, HER2, and BRCA1/2 mutations, among others, for newly metastatic cases.
  • Emerging techniques, like analyzing circulating tumor DNA for PIK3CA mutations, are enhancing the landscape of biomarker testing in breast cancer.
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Context.ā€”: Clinical testing for tumor cell-free DNA (cfDNA) has evolved rapidly, but no practice guidelines exist.

Objective.

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Objective: Fine needle aspiration (FNA) is an early step in the work-up of lymphadenopathy in people with HIV (PWH). We set out to characterize the FNA cytology in PWH and report on the time to lymphoma diagnosis through the FNA clinics in the public healthcare system in Johannesburg, South Africa.

Design: Retrospective review of laboratory database.

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Purpose: Given the pace of predictive biomarker and targeted therapy development, it is unknown whether repeat annotation of the same next-generation sequencing data can identify additional clinically actionable targets that could be therapeutically leveraged. In this study, we sought to determine the predictive yield of serial reanalysis of clinical tumor sequencing data.

Experimental Design: Using artificial intelligence (AI)-assisted variant annotation, we retrospectively reanalyzed sequencing data from 2,219 patients with cancer from a single academic medical center at 3-month intervals totaling 9 months in 2020.

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Herein, we report the first case presentation of paraneoplastic myelofibrosis associated with cancer. Paraneoplastic syndromes occur in some patients with thoracic malignancies; however, myelofibrosis is not commonly seen in non-small cell lung cancer (NSCLC). We report a case of myelofibrosis in a patient with a new diagnosis of NSCLC that resolved after stereotactic ablative radiotherapy (SABR).

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  • Predictive biomarker testing is crucial for identifying which metastatic breast cancer patients qualify for targeted therapies, based on specific tumor characteristics.
  • The National Comprehensive Cancer Network suggests testing for hormone receptors, HER2, BRCA1/2 mutations, and other markers like PD-L1 and PIK3CA mutations depending on the cancer subtype.
  • Advances in biomarker testing are underway, including methods to detect PIK3CA mutations in circulating tumor DNA, highlighting the fast progress in cancer diagnostics.
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