Single-cell dissection of intratumoral heterogeneity and lineage diversity in metastatic gastric adenocarcinoma.


Journal

Nature medicine
ISSN: 1546-170X
Titre abrégé: Nat Med
Pays: United States
ID NLM: 9502015

Informations de publication

Date de publication:
01 2021
Historique:
received: 04 08 2019
accepted: 09 10 2020
pubmed: 6 1 2021
medline: 23 1 2021
entrez: 5 1 2021
Statut: ppublish

Résumé

Intratumoral heterogeneity (ITH) is a fundamental property of cancer; however, the origins of ITH remain poorly understood. We performed single-cell transcriptome profiling of peritoneal carcinomatosis (PC) from 15 patients with gastric adenocarcinoma (GAC), constructed a map of 45,048 PC cells, profiled the transcriptome states of tumor cell populations, incisively explored ITH of malignant PC cells and identified significant correlates with patient survival. The links between tumor cell lineage/state compositions and ITH were illustrated at transcriptomic, genotypic, molecular and phenotypic levels. We uncovered the diversity in tumor cell lineage/state compositions in PC specimens and defined it as a key contributor to ITH. Single-cell analysis of ITH classified PC specimens into two subtypes that were prognostically independent of clinical variables, and a 12-gene prognostic signature was derived and validated in multiple large-scale GAC cohorts. The prognostic signature appears fundamental to GAC carcinogenesis and progression and could be practical for patient stratification.

Identifiants

pubmed: 33398161
doi: 10.1038/s41591-020-1125-8
pii: 10.1038/s41591-020-1125-8
pmc: PMC8074162
mid: NIHMS1688918
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

141-151

Subventions

Organisme : NCI NIH HHS
ID : R01 CA160433
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Organisme : NIH HHS
ID : S10 OD024977
Pays : United States
Organisme : U.S. Department of Defense (United States Department of Defense)
ID : CA150334
Pays : International
Organisme : U.S. Department of Defense (United States Department of Defense)
ID : CA160433
Pays : International
Organisme : U.S. Department of Defense (United States Department of Defense)
ID : CA170906
Pays : International
Organisme : U.S. Department of Defense (United States Department of Defense)
ID : CA160445
Pays : International

Références

Bray, F. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 68, 394–424 (2018).
pubmed: 30207593 doi: 10.3322/caac.21492
Ikoma, N. et al. Preoperative chemoradiation therapy induces primary-tumor complete response more frequently than chemotherapy alone in gastric cancer: analyses of the National Cancer Database 2006–2014 using propensity score matching. Gastric Cancer 21, 1004–1013 (2018).
pubmed: 29730720 pmcid: 6515902 doi: 10.1007/s10120-018-0832-z
Mizrak Kaya, D. et al. Risk of peritoneal metastases in patients who had negative peritoneal staging and received therapy for localized gastric adenocarcinoma. J. Surg. Oncol. 117, 678–684 (2018).
pubmed: 29205363 doi: 10.1002/jso.24912
Shiozaki, H. et al. Prognosis of gastric adenocarcinoma patients with various burdens of peritoneal metastases. J. Surg. Oncol. 113, 29–35 (2016).
pubmed: 26603684 doi: 10.1002/jso.24087
Chen, C. et al. Efficacy and safety of immune checkpoint inhibitors in advanced gastric or gastroesophageal junction cancer: a systematic review and meta-analysis. Oncoimmunology 8, e1581547 (2019).
pubmed: 31069144 pmcid: 6492970 doi: 10.1080/2162402X.2019.1581547
Taieb, J. et al. Evolution of checkpoint inhibitors for the treatment of metastatic gastric cancers: current status and future perspectives. Cancer Treat. Rev. 66, 104–113 (2018).
pubmed: 29730461 doi: 10.1016/j.ctrv.2018.04.004
Bartley, A. N. et al. HER2 testing and clinical decision making in gastroesophageal adenocarcinoma: guideline from the College of American Pathologists, American Society for Clinical Pathology, and the American Society of Clinical Oncology. J. Clin. Oncol. 35, 446–464 (2017).
pubmed: 28129524 doi: 10.1200/JCO.2016.69.4836
Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature 513, 202–209 (2014).
doi: 10.1038/nature13480
Wang, R. et al. Multiplex profiling of peritoneal metastases from gastric adenocarcinoma identified novel targets and molecular subtypes that predict treatment response. Gut 69, 18–31 (2020).
pubmed: 31171626 doi: 10.1136/gutjnl-2018-318070
Tirosh, I. et al. Dissecting the multicellular ecosystem of metastatic melanoma by single-cell RNA-seq. Science 352, 189–196 (2016).
pubmed: 27124452 pmcid: 4944528 doi: 10.1126/science.aad0501
Han, X. et al. Construction of a human cell landscape at single-cell level. Nature 581, 303–309 (2020).
pubmed: 32214235 doi: 10.1038/s41586-020-2157-4
Buttner, M., Miao, Z., Wolf, F. A., Teichmann, S. A. & Theis, F. J. A test metric for assessing single-cell RNA-seq batch correction. Nat. Methods 16, 43–49 (2019).
pubmed: 30573817 doi: 10.1038/s41592-018-0254-1
McInnes, L., Healy, J., Melville, J. UMAP: uniform manifold approximation and projection for dimension reduction. Preprint at https://arxiv.org/abs/1802.03426 (2018).
Smillie, C. S. et al. Intra- and inter-cellular rewiring of the human colon during ulcerative colitis. Cell 178, 714–730.e22 (2019).
pubmed: 31348891 pmcid: 6662628 doi: 10.1016/j.cell.2019.06.029
Butler, A., Hoffman, P., Smibert, P., Papalexi, E. & Satija, R. Integrating single-cell transcriptomic data across different conditions, technologies, and species. Nat. Biotechnol. 36, 411–420 (2018).
pubmed: 29608179 pmcid: 6700744 doi: 10.1038/nbt.4096
Cao, J. et al. The single-cell transcriptional landscape of mammalian organogenesis. Nature 566, 496–502 (2019).
pubmed: 30787437 pmcid: 6434952 doi: 10.1038/s41586-019-0969-x
Kiselev, V. Y. et al. SC3: consensus clustering of single-cell RNA-seq data. Nat. Methods 14, 483–486 (2017).
pubmed: 28346451 pmcid: 5410170 doi: 10.1038/nmeth.4236
Puram, S. V. et al. Single-cell transcriptomic analysis of primary and metastatic tumor ecosystems in head and neck cancer. Cell 171, 1611–1624.e24 (2017).
pubmed: 29198524 pmcid: 5878932 doi: 10.1016/j.cell.2017.10.044
Patel, A. P. et al. Single-cell RNA-seq highlights intratumoral heterogeneity in primary glioblastoma. Science 344, 1396–1401 (2014).
pubmed: 24925914 pmcid: 4123637 doi: 10.1126/science.1254257
Jerby-Arnon, L. et al. A cancer cell program promotes T cell exclusion and resistance to checkpoint blockade. Cell 175, 984–997.e24 (2018).
pubmed: 30388455 pmcid: 6410377 doi: 10.1016/j.cell.2018.09.006
Stevens, C. E. & Leblond, C. P. Renewal of the mucous cells in the gastric mucosa of the rat. Anat. Rec. 115, 231–245 (1953).
pubmed: 13031133 doi: 10.1002/ar.1091150206
Karam, S. M. A focus on parietal cells as a renewing cell population. World J. Gastroenterol. 16, 538–546 (2010).
pubmed: 20128020 pmcid: 2816264 doi: 10.3748/wjg.v16.i5.538
Merzel, J. & Leblond, C. P. Origin and renewal of goblet cells in the epithelium of the mouse small intestine. Am. J. Anat. 124, 281–305 (1969).
pubmed: 5773907 doi: 10.1002/aja.1001240303
Blanpain, C., Horsley, V. & Fuchs, E. Epithelial stem cells: turning over new leaves. Cell 128, 445–458 (2007).
pubmed: 17289566 pmcid: 2408375 doi: 10.1016/j.cell.2007.01.014
Coker, E. A. et al. canSAR: update to the cancer translational research and drug discovery knowledgebase. Nucleic Acids Res. 47, D917–D922 (2019).
pubmed: 30496479 doi: 10.1093/nar/gky1129
Kim, H. K. et al. A gene expression signature of acquired chemoresistance to cisplatin and fluorouracil combination chemotherapy in gastric cancer patients. PLoS ONE 6, e16694 (2011).
pubmed: 21364753 pmcid: 3041770 doi: 10.1371/journal.pone.0016694
Ooi, C. H. et al. Oncogenic pathway combinations predict clinical prognosis in gastric cancer. PLoS Genet. 5, e1000676 (2009).
pubmed: 19798449 pmcid: 2748685 doi: 10.1371/journal.pgen.1000676
Cristescu, R. et al. Molecular analysis of gastric cancer identifies subtypes associated with distinct clinical outcomes. Nat. Med. 21, 449–456 (2015).
pubmed: 25894828 doi: 10.1038/nm.3850
Mizrak Kaya, D. et al. Advanced gastric adenocarcinoma: optimizing therapy options. Expert Rev. Clin. Pharmacol. 10, 263–271 (2017).
pubmed: 28094573
Dagogo-Jack, I. & Shaw, A. T. Tumour heterogeneity and resistance to cancer therapies. Nat. Rev. Clin. Oncol. 15, 81–94 (2018).
pubmed: 29115304 doi: 10.1038/nrclinonc.2017.166
Hudler, P. Challenges of deciphering gastric cancer heterogeneity. World J. Gastroenterol. 21, 10510–10527 (2015).
pubmed: 26457012 pmcid: 4588074 doi: 10.3748/wjg.v21.i37.10510
Gullo, I., Carneiro, F., Oliveira, C. & Almeida, G. M. Heterogeneity in gastric cancer: from pure morphology to molecular classifications. Pathobiology 85, 50–63 (2018).
pubmed: 28618420 doi: 10.1159/000473881
Oh, S. C. et al. Clinical and genomic landscape of gastric cancer with a mesenchymal phenotype. Nat. Commun. 9, 1777 (2018).
pubmed: 29725014 pmcid: 5934392 doi: 10.1038/s41467-018-04179-8
Merlo, L. M., Pepper, J. W., Reid, B. J. & Maley, C. C. Cancer as an evolutionary and ecological process. Nat. Rev. Cancer 6, 924–935 (2006).
pubmed: 17109012 doi: 10.1038/nrc2013
Michor, F. & Polyak, K. The origins and implications of intratumor heterogeneity. Cancer Prev. Res. (Phila.) 3, 1361–1364 (2010).
doi: 10.1158/1940-6207.CAPR-10-0234
Barros, R., Freund, J. N., David, L. & Almeida, R. Gastric intestinal metaplasia revisited: function and regulation of CDX2. Trends Mol. Med. 18, 555–563 (2012).
pubmed: 22871898 doi: 10.1016/j.molmed.2012.07.006
Moghimi-Dehkordi, B., Safaee, A. & Zali, M. R. Comparison of colorectal and gastric cancer: survival and prognostic factors. Saudi J. Gastroenterol. 15, 18–23 (2009).
pubmed: 19568550 pmcid: 2702946 doi: 10.4103/1319-3767.43284
Qiu, M. Z. et al. Clinicopathological characteristics and prognostic analysis of Lauren classification in gastric adenocarcinoma in China. J. Transl. Med. 11, 58 (2013).
pubmed: 23497313 pmcid: 3600019 doi: 10.1186/1479-5876-11-58
Petrelli, F. et al. Prognostic value of diffuse versus intestinal histotype in patients with gastric cancer: a systematic review and meta-analysis. J. Gastrointest. Oncol. 8, 148–163 (2017).
pubmed: 28280619 pmcid: 5334055 doi: 10.21037/jgo.2017.01.10
Petitprez, F. et al. B cells are associated with survival and immunotherapy response in sarcoma. Nature 577, 556–560 (2020).
pubmed: 31942077 doi: 10.1038/s41586-019-1906-8
Cabrita, R. et al. Tertiary lymphoid structures improve immunotherapy and survival in melanoma. Nature 577, 561–565 (2020).
pubmed: 31942071 doi: 10.1038/s41586-019-1914-8
Helmink, B. A. et al. B cells and tertiary lymphoid structures promote immunotherapy response. Nature 577, 549–555 (2020).
pubmed: 31942075 pmcid: 8762581 doi: 10.1038/s41586-019-1922-8
Najafi, M. et al. Macrophage polarity in cancer: a review. J. Cell. Biochem. 120, 2756–2765 (2019).
pubmed: 30270458 doi: 10.1002/jcb.27646
Kaneda, M. M. et al. PI3Kγ is a molecular switch that controls immune suppression. Nature 539, 437–442 (2016).
pubmed: 27642729 pmcid: 5479689 doi: 10.1038/nature19834
Kalluri, R. The biology and function of fibroblasts in cancer. Nat. Rev. Cancer 16, 582–598 (2016).
pubmed: 27550820 doi: 10.1038/nrc.2016.73
Calon, A. et al. Stromal gene expression defines poor-prognosis subtypes in colorectal cancer. Nat. Genet. 47, 320–329 (2015).
pubmed: 25706628 doi: 10.1038/ng.3225
Fiori, M. E. et al. Cancer-associated fibroblasts as abettors of tumor progression at the crossroads of EMT and therapy resistance. Mol. Cancer 18, 70 (2019).
pubmed: 30927908 pmcid: 6441236 doi: 10.1186/s12943-019-0994-2
Amin, M. B. et al. AJCC Cancer Staging Manual 8th edn (Springer, 2017).
Amin, M. B. et al. The Eighth Edition AJCC Cancer staging manual: continuing to build a bridge from a population-based to a more ‘personalized’ approach to cancer staging. CA Cancer J. Clin. 67, 93–99 (2017).
pubmed: 28094848 doi: 10.3322/caac.21388
Niu, B. et al. MSIsensor: microsatellite instability detection using paired tumor-normal sequence data. Bioinformatics 30, 1015–1016 (2014).
pubmed: 24371154 doi: 10.1093/bioinformatics/btt755
Savas, P. et al. Single-cell profiling of breast cancer T cells reveals a tissue-resident memory subset associated with improved prognosis. Nat. Med. 24, 986–993 (2018).
pubmed: 29942092 doi: 10.1038/s41591-018-0078-7
Galili, T. dendextend: an R package for visualizing, adjusting and comparing trees of hierarchical clustering. Bioinformatics 31, 3718–3720 (2015).
pubmed: 26209431 pmcid: 4817050 doi: 10.1093/bioinformatics/btv428
Zhang, L. et al. Lineage tracking reveals dynamic relationships of T cells in colorectal cancer. Nature 564, 268–272 (2018).
pubmed: 30479382 doi: 10.1038/s41586-018-0694-x
Lambrechts, D. et al. Phenotype molding of stromal cells in the lung tumor microenvironment. Nat. Med. 24, 1277–1289 (2018).
pubmed: 29988129 doi: 10.1038/s41591-018-0096-5
Sade-Feldman, M. et al. Defining T cell states associated with response to checkpoint immunotherapy in melanoma. Cell 175, 998–1013.e20 (2018).
pubmed: 30388456 pmcid: 6641984 doi: 10.1016/j.cell.2018.10.038
Nilsen, G. et al. Copynumber: efficient algorithms for single- and multi-track copy number segmentation. BMC Genomics 13, 591 (2012).
pubmed: 23442169 pmcid: 3582591 doi: 10.1186/1471-2164-13-591
Cillo, A. R. et al. Immune landscape of viral- and carcinogen-driven head and neck cancer. Immunity 52, 183–199.e9 (2020).
pubmed: 31924475 pmcid: 7201194 doi: 10.1016/j.immuni.2019.11.014
Azizi, E. et al. Single-cell map of diverse immune phenotypes in the breast tumor microenvironment. Cell 174, 1293–1308.e6 (2018).
pubmed: 29961579 pmcid: 6348010 doi: 10.1016/j.cell.2018.05.060
van Dijk, D. et al. Recovering gene interactions from single-cell data using data diffusion. Cell 174, 716–729.e27 (2018).
pubmed: 29961576 pmcid: 6771278 doi: 10.1016/j.cell.2018.05.061
Hicks, S. C., Townes, F. W., Teng, M. & Irizarry, R. A. Missing data and technical variability in single-cell RNA-sequencing experiments. Biostatistics 19, 562–578 (2018).
pubmed: 29121214 doi: 10.1093/biostatistics/kxx053
Hanzelmann, S., Castelo, R. & Guinney, J. GSVA: gene set variation analysis for microarray and RNA-seq data. BMC Bioinforma. 14, 7 (2013).
doi: 10.1186/1471-2105-14-7
Cline, M. S. et al. Integration of biological networks and gene expression data using Cytoscape. Nat. Protoc. 2, 2366–2382 (2007).
pubmed: 17947979 pmcid: 3685583 doi: 10.1038/nprot.2007.324
Harrell, F. E. Jr., Lee, K. L. & Mark, D. B. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat. Med. 15, 361–387 (1996).
pubmed: 8668867 doi: 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4
Peng, F. et al. Differential expression analysis at the individual level reveals a lncRNA prognostic signature for lung adenocarcinoma. Mol. Cancer 16, 98 (2017).
pubmed: 28587642 pmcid: 5461634 doi: 10.1186/s12943-017-0666-z
Lau, S. K. et al. Three-gene prognostic classifier for early-stage non small-cell lung cancer. J. Clin. Oncol. 25, 5562–5569 (2007).
pubmed: 18065728 doi: 10.1200/JCO.2007.12.0352
Kang, J., D’Andrea, A. D. & Kozono, D. A DNA repair pathway–focused score for prediction of outcomes in ovarian cancer treated with platinum-based chemotherapy. J. Natl Cancer Inst. 104, 670–681 (2012).
pubmed: 22505474 pmcid: 3341307 doi: 10.1093/jnci/djs177
Newman, A. M. et al. Robust enumeration of cell subsets from tissue expression profiles. Nat. Methods 12, 453–457 (2015).
pubmed: 25822800 pmcid: 4739640 doi: 10.1038/nmeth.3337
Becht, E. et al. Estimating the population abundance of tissue-infiltrating immune and stromal cell populations using gene expression. Genome Biol. 17, 218 (2016).
pubmed: 27765066 pmcid: 5073889 doi: 10.1186/s13059-016-1070-5
Cibulskis, K. et al. Sensitive detection of somatic point mutations in impure and heterogeneous cancer samples. Nat. Biotechnol. 31, 213–219 (2013).
pubmed: 23396013 pmcid: 3833702 doi: 10.1038/nbt.2514
Liu, J. et al. An integrated TCGA pan-cancer clinical data resource to drive high-quality survival outcome analytics. Cell 173, 400–416.e11 (2018).
pubmed: 29625055 pmcid: 6066282 doi: 10.1016/j.cell.2018.02.052
Lei, Z. et al. Identification of molecular subtypes of gastric cancer with different responses to PI3-kinase inhibitors and 5-fluorouracil. Gastroenterology 145, 554–565 (2013).
pubmed: 23684942 doi: 10.1053/j.gastro.2013.05.010
Yoon, S. J. et al. Deconvolution of diffuse gastric cancer and the suppression of CD34 on the BALB/c nude mice model. BMC Cancer 20, 314 (2020).
pubmed: 32293340 pmcid: 7160933 doi: 10.1186/s12885-020-06814-4
Irizarry, R. A. et al. Summaries of Affymetrix GeneChip probe level data. Nucleic Acids Res. 31, e15 (2003).
pubmed: 12582260 pmcid: 150247 doi: 10.1093/nar/gng015

Auteurs

Ruiping Wang (R)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Minghao Dang (M)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Kazuto Harada (K)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.

Guangchun Han (G)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Fang Wang (F)

Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Melissa Pool Pizzi (M)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Meina Zhao (M)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Ghia Tatlonghari (G)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Shaojun Zhang (S)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Dapeng Hao (D)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Yang Lu (Y)

Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Shuangtao Zhao (S)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Brian D Badgwell (BD)

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Mariela Blum Murphy (M)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Namita Shanbhag (N)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Jeannelyn S Estrella (JS)

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Sinchita Roy-Chowdhuri (S)

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Ahmed Adel Fouad Abdelhakeem (AAF)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Yuanxin Wang (Y)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Guang Peng (G)

Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Samir Hanash (S)

Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

George A Calin (GA)

Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Xingzhi Song (X)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Yanshuo Chu (Y)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Jianhua Zhang (J)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Mingyao Li (M)

Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Ken Chen (K)

Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Alexander J Lazar (AJ)

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Andrew Futreal (A)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Shumei Song (S)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Jaffer A Ajani (JA)

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jajani@mdanderson.org.

Linghua Wang (L)

Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. LWang22@mdanderson.org.
UTHealth Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. LWang22@mdanderson.org.

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