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Meta-Analysis of Genome-Wide Association Studies Identifies Genetic Risk Factors for Stroke in African Americans
Carty, Cara L. , Keene, Keith L. , Cheng, Yu-Ching , Chen, Wei‐Min , Nalls, Mike A., Bis, Joshua C. , Kittner, Steven J. , Rich, Stephen S. , Tajuddin, Salman M. , Zonderman, Alan B. , Evans, Michele K. , Langefeld, Carl D. , Gottesman, Rebecca F., Shahar, Eyal , Woo, Daniel , Yaffe, Kristine , Sale, Michèle M. , Dichgans, Martin , Longstreth, W. T., Mitchell, Braxton D. , Reiner, Alex P. , Worrall, Bradford B. , Fornage, Myriam , Nalls, Mike, Tajuddin, Salman, Reiner, Alexander, Meschia, James F. , Mosley, Thomas H. , Liu, Ching‐Ti , Malik, Rainer , Psaty, Bruce M. , Kooperberg, Charles , Dichgans, Martin , Rich, Stephen S , Mitchell, Braxton D

Stroke | June 18, 2015 | Volume: 46 | Issue: 8 | Pages: 2063-2068

10.1161/strokeaha.115.009044 | PMID 26089329 Get It

Background and Purpose— The majority of genome-wide association studies (GWAS) of stroke have focused on European-ancestry populations; however, none has been conducted in African Americans, despite the disproportionately high burden of stroke in this population. The Consortium of Minority Population Genome-Wide Association Studies of Stroke (COMPASS) was established to identify stroke susceptibility loci in minority populations. Methods— Using METAL, we conducted meta-analyses of GWAS in 14 746 African Americans (1365 ischemic and 1592 total stroke cases) from COMPASS, and tested genetic variants with P <10 −6 for validation in METASTROKE, a consortium of ischemic stroke genetic studies in European-ancestry populations. We also evaluated stroke loci previously identified in European-ancestry populations. Results— The 15q21.3 locus linked with lipid levels and hypertension was associated with total stroke (rs4471613; P =3.9×10 −8 ) in African Americans. Nominal associations ( P <10 −6 ) for total or ischemic stroke were observed for 18 variants in or near genes implicated in cell cycle/mRNA presplicing ( PTPRG , CDC5L ), platelet function ( HPS4 ), blood–brain barrier permeability ( CLDN17 ), immune response ( ELTD1, WDFY4 , and IL1F10-IL1RN ), and histone modification ( HDAC9 ). Two of these loci achieved nominal significance in METASTROKE: 5q35.2 ( P =0.03), and 1p31.1 ( P =0.018). Four of 7 previously reported ischemic stroke loci ( PITX2, HDAC9, CDKN2A/CDKN2B , and ZFHX3 ) were nominally associated ( P <0.05) with stroke in COMPASS. Conclusions— We identified a novel genetic variant associated with total stroke in African Americans and found that ischemic stroke loci identified in European-ancestry populations may also be relevant for African Americans. Our findings support investigation of diverse populations to identify and characterize genetic risk factors, and the importance of shared genetic risk across populations.
Memory, executive, and multidomain subtle cognitive impairment
Toledo, Jon B. , Bjerke, Maria , Rozycki, Martin, Jack, Clifford R. , Weiner, Michael W. , Arnold, Steven E. , Reiman, Eric M. , Davatzikos, Christos , Shaw, Leslie M. , Trojanowski, John Q. , Initiative, For the Alzheimer's Disease Neuroimaging, Weiner, Michael, Aisen, Paul , Weiner, Michael, Petersen, Ronald, Jagust, William, Trojanowki, John Q., Green, Robert C., Saykin, Andrew J., Liu, Enchi , Green, Robert C., Montine, Tom, Petersen, Ronald, Gamst, Anthony, Thomas, Ronald G. , Walter, Sarah , Gessert, Devon, Sather, Tamie, Kornak, John , Felmlee, Joel P. , Schuff, Norbert, Alexander, Gene E. , DeCarli, Charles, Jagust, William, Bandy, Dan, Foster, Norm, Reiman, Eric M., Mathis, Chet, Cairns, Nigel J. , Taylor‐Reinwald, Lisa, Shaw, Les, Korecka, Magdalena , Crawford, Karen , Neu, Scott, Potkin, Steven, Kachaturian, Zaven, Frank, Richard , Molchan, Susan, Quinn, Joseph, Lind, Betty, Dolen, Sara, Schneider, Lon S. , Pawluczyk, Sonia, Spann, Bryan M., Brewer, James, Vanderswag, Helen, Heidebrink, Judith L. , Petersen, Ronald, Johnson, Kris , Doody, Rachelle S., Chowdhury, Munir , Bell, Karen L. , Leon, Sue, Schneider, Stacy, Marson, Daniel , Griffith, Randall, Clark, David, Grossman, Hillel, Mitsis, Effie, Romirowsky, Aliza, deToledo‐Morrell, Leyla, Duara, Ranjan , Varon, Daniel, Roberts, Peggy, Albert, Marilyn, Onyike, Chiadi, Kielb, Stephanie , Glodzik, Lidia , Santi, Susan De , Doraiswamy, P. Murali , Petrella, Jeffrey R. , Coleman, R. Edward, Arnold, Steven E., Karlawish, Jason , Smith, Charles D., Jicha, Gregory A. , Hardy, Peter , Oakley, MaryAnn, Simpson, Donna M., Goldstein, Bonnie S., Martin, Kim, Makino, Kelly M., Ismail, M. Saleem , Brand, Connie, Mulnard, Ruth A., Thai, Gaby , Mc-Adams-Ortiz, Catherine, Mathews, Dana, Quiceno, Mary , King, Richard, Weiner, Myron, Martin-Cook, Kristen, Devous, Michael D. , Cellar, Janet S., Anderson, Heather S., Swerdlow, Russell H. , Apostolova, Liana , Lu, Po H. , Bartzokis, George, Graff‐Radford, Neill R. , Parfitt, Francine, Farlow, Martin R. , Hake, Ann Marie , Matthews, Brandy R., Herring, Scott, Dyck, Christopher H. van , Carson, Richard E. , MacAvoy, Martha G., Chertkow, Howard, Bergman, Howard , Hosein, Chris, Caldwell, Curtis, Hsiung, Ging‐Yuek Robin , Mudge, Benita, Assaly, Michele, Kertesz, Andrew, Rogers, John, Trost, Dick, Bernick, Charles , Munic, Donna, Mesulam, Marek-Marsel, Lipowski, Kristina, Wu, Chuang‐Kuo, Johnson, Nancy , Sadowsky, Carl, Villena, Teresa, Johnson, Kathleen, Reynolds, Brigid, Johnson, Keith A. , Marshall, Gad A. , Frey, Meghan , Yesavage, Jerome A. , Taylor, Joy L. , Lane, Barton , Rosen, Allyson , Tinklenberg, Jared, Sabbagh, Marwan N. , Belden, Christine M. , Jacobson, Sandra A. , Kowall, Neil W. , Budson, Andrew E. , Johnson, Patricia Lynn, Wolday, Saba, Bwayo, Salome K., Lerner, Alan J. , Hudson, Leon, Ogrocki, Paula, Fletcher, Evan, Olichney, John , Kittur, Smita, Borrie, Michael, Lee, T‐Y, Bartha, Dr Rob, Asthana, Sanjay , Carlsson, Cynthia M., Preda, Adrian , Tariot, Pierre N. , Fleisher, Adam , Reeder, Stephanie, Bates, Vernice, Capote, Horacio, Rainka, Michelle, Kataki, Maria , Zimmerman, Earl A. , Celmins, Dzintra, Brown, Alice D., Blank, Karen, Anderson, Karen, Saykin, Andrew J., Santulli, Robert B. , Schwartz, Eben S., Williamson, Jeff D. , Garg, Pradeep , Watkins, Franklin, Ott, Brian R. , Querfurth, Henry, Tremont, Geoffrey , Salloway, Stephen , Malloy, Paul, Correia, Stephen , Rosen, Howard J. , Mintzer, Jacobo , Longmire, Crystal Flynn, Spicer, Kenneth, Rachinsky, Irina, Rogers, John, Kertesz, Andrew, Drost, Dick, Hernando, Raymundo, Sarrael, Antero, Schultz, Susan K. , Ponto, Laura L. Boles , Shim, Hyungsub , Smith, Karen E. , Relkin, Norman , Chaing, Gloria, Raudin, Lisa, Smith, Amanda , Fargher, Kristin, Raj, Balebail Ashok, Chen, Kewei , Initiative, For the Alzheimer's Disease Neuroimaging, Weiner, Michael, Weiner, Michael, Petersen, Ronald, Jagust, William, Toga, Arthur W. , Beckett, Laurel , Green, Robert C., Saykin, Andrew J., Morris, John C. , Green, Robert C., Petersen, Ronald, Donohue, Michael , Harvey, Danielle , Dale, Anders M. , Bernstein, Matt A. , Fox, Nick C. , Thompson, Paul M. , Jagust, William, Koeppe, Robert A. , Foster, Norm, Reiman, Eric M., Mathis, Chet, Lee, Virginia M.‐Y. , Saykin, Andrew J. , Foroud, Tatiana , Shen, Li , Snyder, Peter J. , Kaye, Jeffrey , Lord, Joanne L. , Petersen, Ronald, Villanueva-Meyer, Javier E. , Stern, Yaakov , Honig, Lawrence S. , Ances, Beau M. , Shah, Raj C. , Duara, Ranjan , Varón, Daniel , Rusinek, Henry , Leon, Mony J. de , Arnold, Steven E., Wolk, David A. , López, Oscar L. , Porsteinsson, Anton P. , Womack, Kyle , Diaz‐Arrastia, Ramon , Levey, Allan I. , Lah, James J. , Burns, Jeffrey M. , Silverman, Daniel H.S. , Johnson, Heather K. , Black, Sandra E. , Stefanovic, Bojana , Feldman, Howard , Kertesz, Andrew, Rogers, John, Kerwin, Diana , Martínez, Walter Fabián , Turner, Raymond Scott , Sperling, Reisa Anne , Killiany, Ronald , Norbash, Alexander , Obisesan, Thomas O. , Carmichael, Owen , Johnson, Sterling C. , Carlsson, Cynthia M. , Potkin, Steven G. , Nguyen, Dana R. , Reeder, Stephanie, Scharre, Douglas W. , Pearlson, Godfrey D. , Saykin, Andrew J., Sink, Kaycee M. , Miller, Bruce L. , Finger, Elizabeth C. , Rogers, John, Kertesz, Andrew, Jack, Clifford R , Preda, Adrian , Hsiung, Gink-Yuek , Jicha, Gregory A

Neurology | June 18, 2015 | Volume: 85 | Issue: 2 | Pages: 144-153

10.1212/wnl.0000000000001738 | PMID 26085606 Get It

Global and local ancestry in African‐Americans: Implications for Alzheimer's disease risk
Hohman, Timothy J. , Bailey, Jessica N. Cooke , Reitz, Christiane , Jun, Gyungah , Beecham, Gary W. , Carney, Regina M., Vance, Jeffery M. , Rajbhandary, Ruchita, Lin, Chiao‐Feng , Larson, Eric B., Graff‐Radford, Neill R. , Evans, Denis A., Jager, Philip L. De , Crane, Paul K. , Buxbaum, Joseph D. , Murrell, Jill R. , Raj, Towfique , Ertekin‐Taner, Nilüfer , Baldwin, Clinton T., Green, Robert C. , Barnes, Lisa L. , Cantwell, Laura B., Fallin, M. Daniele , Go, Rodney C.P., Griffith, Patrick , Obisesan, Thomas O. , Lunetta, Kathryn L. , Kamboh, M. Ilyas , Bennett, David A. , Hardy, John , Hendrie, Hugh C. , Hall, Kathleen, Goate, Alison , Lang, Rosalyn, Byrd, Goldie S. , Kukull, Walter A. , Farrer, Lindsay A. , Martin, Eden R. , Pericak‐Vance, Margaret A. , Schellenberg, Gerard D. , Mayeux, Richard , Haines, Jonathan L. , Thornton‐Wells, Tricia A., Carroll, Steven L. , Bennett, David A. , Naj, Adam Christian , Liu, Zhi , Cuccaro, Michael L. , Vardarajan, Badri Narayan , Wang, Weixin , Valladares, Otto , Logue, Mark W. , Manly, Jennifer J. , López, Oscar L. , Foroud, Tatiana , Seto, Mabel , Hardy, John , Goate, Alison M , Barnes, Lisa L

Alzheimer's & Dementia | June 16, 2015 | Volume: 12 | Issue: 3 | Pages: 233-243

10.1016/j.jalz.2015.02.012 | PMID 26092349 Get It

AbstractIntroductionAfrican‐American (AA) individuals have a higher risk for late‐onset Alzheimer's disease (LOAD) than Americans of primarily European ancestry (EA). Recently, the largest genome‐wide association study in AAs to date confirmed that six of the Alzheimer's disease (AD)‐related genetic variants originally discovered in EA cohorts are also risk variants in AA; however, the risk attributable to many of the loci (e.g., APOE, ABCA7) differed substantially from previous studies in EA. There likely are risk variants of higher frequency in AAs that have not been discovered.MethodsWe performed a comprehensive analysis of genetically determined local and global ancestry in AAs with regard to LOAD status.ResultsCompared to controls, LOAD cases showed higher levels of African ancestry, both globally and at several LOAD relevant loci, which explained risk for AD beyond global differences.DiscussionExploratory post hoc analyses highlight regions with greatest differences in ancestry as potential candidate regions for future genetic analyses.
Inflammation negatively regulates FOXP3 and regulatory T-cell function via DBC1
Gao, Yayi , Tang, Jiayou , Li, Qiang , Nie, Jia , Lin, Fang , Wu, Qingsi, Chen, Zuojia , Gao, Zhimei, Fan, Huimin , Tsun, Andy , Shen, Jijia, Chen, Guihua , Liu, Zhongmin , Olsen, Nancy J. , Zheng, Song Guo , Li, Bin , Chen, Weiqian , Lou, Zhenkun

Proceedings of the National Academy of Sciences | June 10, 2015 | Volume: 112 | Issue: 25 | Pages: No page available

10.1073/pnas.1421463112 | PMID 26060310 Get It

Significance Treg cells suppress excessive and aberrant immune responses. Impaired function or homeostasis of Treg cells would induce severe autoimmune and inflammatory diseases. Forkhead box P3 (FOXP3), as a master regulator of Treg cells, forms a large complex with other binding factors to modulate Treg-cell function subtly in pathological and physiological conditions. We identified that Deleted in breast cancer 1 (DBC1) is an essential subunit of the FOXP3 complex in human CD4 + Treg cells. Our results show that the inflammatory cytokines TNF-α or IL-6 trigger FOXP3 degradation, whereas downregulation of DBC1 expression prevents FOXP3 degradation and maintains Treg-cell function under inflammatory stimuli in vitro and in vivo. These findings unveil a previously unidentified pathway for therapeutically modulating FOXP3 + Treg-cell stability under inflammation.
Age and Sex Differences in Long‐Term Outcomes Following Implantable Cardioverter‐Defibrillator Placement in Contemporary Clinical Practice: Findings From the Cardiovascular Research Network
Masoudi, Frederick A. , Go, Alan S. , Magid, David J. , Gurwitz, Jerry H. , Liu, Taylor I. , Smith, David H. , Reifler, Liza M. , Glenn, Karen A., Fiocchi, Frances, Gupta, Nigel, Peterson, Pamela N., Schuger, Claudio , Vidaillet, Humberto, Hammill, Stephen C., Greenlee, Robert T. , Cassidy‐Bushrow, Andrea E. , Liu, Taylor , Reynolds, Kristi , Goldberg, Robert Joel , Peterson, Pamela N.

Journal of the American Heart Association | June 3, 2015 | Volume: 4 | Issue: 6 | Pages: No page available

10.1161/jaha.115.002005 | PMID 26037083 Get It

Background Patient sex and age may influence rates of death after receiving an implantable cardioverter‐defibrillator for primary prevention. Differences in outcomes other than mortality and whether these differences vary by heart failure symptoms, etiology, and left ventricular ejection fraction are not well characterized. Methods and Results We studied 2954 patients with left ventricular ejection fraction ≤0.35 undergoing first‐time implantable cardioverter‐defibrillator for primary prevention within the Cardiovascular Research Network; 769 patients (26%) were women, and 2827 (62%) were aged >65 years. In a median follow‐up of 2.4 years, outcome rates per 1000 patient‐years were 109 for death, 438 for hospitalization, and 111 for heart failure hospitalizations. Procedure‐related complications occurred in 8.36%. In multivariable models, women had significantly lower risks of death (hazard ratio 0.67, 95% CI 0.56 to 0.80) and heart failure hospitalization (hazard ratio 0.82, 95% CI 0.68 to 0.98) and higher risks for complications (hazard ratio 1.38, 95% CI 1.01 to 1.90) than men; patients aged >65 years had higher risks of death (hazard ratio 1.55, 95% CI 1.30 to 1.86) and heart failure hospitalization (hazard ratio 1.25, 95% CI 1.05 to 1.49) than younger patients. Age and sex differences were generally consistent in strata according to symptoms, etiology, and severity of left ventricular systolic dysfunction, except the higher risk of complications in women, which differed by New York Heart Association classification ( P =0.03 for sex–New York Heart Association interaction), and the risk of heart failure hospitalization in older patients, which differed by etiology of heart failure ( P =0.05 for age–etiology interaction). Conclusions The burden of adverse outcomes after receipt of an implantable cardioverter‐defibrillator for primary prevention is substantial and varies according to patient age and sex. These differences in outcome generally do not vary according to baseline heart failure characteristics.
Low density lipoprotein receptor related protein 1 and 6 gene variants and ischaemic stroke risk
Harriott, Andrea M. , Rayaprolu, Sruti , Soto‐Ortolaza, Alexandra I., Diehl, Nancy N. , Kanekiyo, Takahisa , Bu, Guojun , Malik, Rayaz A. , Ross, Owen A. , Soto‐Beasley, Alexandra I. , Heckman, Michael G. , Liu, Chin‐Chi , Cole, John W. , Meschia, James F. , Ross, Owen A , Bu, Guojun , Beasley, Alexandra I

European Journal of Neurology | May 29, 2015 | Volume: 22 | Issue: 8 | Pages: 1235-1241

10.1111/ene.12735 | PMID 26031789 Get It

Background and purposeLow density lipoprotein receptor related proteins (LRPs) 1 and 6 have been implicated in cerebral ischaemia. In addition, genetic variation in LRP1 and LRP6 has been linked with various factors that are related to risk of ischaemic stroke. The aim of this study was to examine the association of LRP1 and LRP6 gene variants with risk of ischaemic stroke as part of the Ischemic Stroke Genetics Study (ISGS).MethodsA Caucasian series (434 stroke patients, 319 controls) and an African American series (161 stroke patients, 116 controls) were included. Fourteen LRP6 variants and three LRP1 variants were genotyped and assessed for association with ischaemic stroke.ResultsIn the Caucasian series, significant associations with ischaemic stroke were observed for LRP6 rs2075241 [odds ratio (OR) 0.42, P = 0.023], rs2302685 (OR 0.44, P = 0.049), rs7975614 (OR 0.07, P = 0.017), rs10492120 (OR 0.62, P = 0.036) and rs10743980 (OR 0.66, P = 0.037). Risk of ischaemic stroke was significantly lower for carriers of any of these five protective LRP6 variants (24.0% of subjects) compared to non‐carriers (OR 0.57, P = 0.003). The protective association for LRP6 rs2075241 was observed at a similar magnitude across ischaemic stroke subtypes, whilst the effects of rs23022685, rs10492120 and rs10743980 were most apparent for cardioembolic and large vessel stroke. In the African American series, LRP1 rs11172113 was associated with an increased risk of stroke (OR 1.89, P = 0.006).ConclusionsThe results of our preliminary study provide evidence that LRP6 and LRP1 variants may be associated with risk of ischaemic stroke. Validation in larger studies is warranted.
Retraction: N, S co-doped graphene quantum dots from a single source precursor used for photodynamic cancer therapy under two-photon excitation
Liu, Xifeng , Xia, Jianfei , Bi, Sai , Xia, Yanzhi, Gui, Rijun , Jin, Hui , Wang, Zonghua , Zhang, Feifei , Yang, Min Jae , Xia, Yanzhi

Chemical Communications | May 26, 2015 | Volume: 51 | Issue: 49 | Pages: 10066-10066

10.1039/c5cc90244d | PMID 26008806 Get It

Retraction of ‘N, S co-doped graphene quantum dots from a single source precursor used for photodynamic cancer therapy under two-photon excitation’ by Rijun Gui et al. , Chem. Commun ., DOI: 10.1039/C4CC09280E.
Sequence analysis of EBV immune evasion gene BNLF2a in EBV associated tumors and healthy individuals from nasopharyngeal carcinoma endemic and non‐endemic regions of China
Wang, Xiaofeng , Shu, Jun, Zhao, Zhenzhen , Sun, Zhifu , Liu, Song , Luo, Bing , Sun, Zhifu

Journal of Medical Virology | May 8, 2015 | Volume: 87 | Issue: 11 | Pages: 1946-1952

10.1002/jmv.24254 | PMID 25959517 Get It

BNLF2a is an Epstein‐Barr virus (EBV) immune evasion gene. Its protein is located in the endoplasmic reticulum (ER) membrane, and can inhibit the antigen transporting function of TAP, thereby perturbing the immune response to EBV in lytic and prelatent phase. In order to explore whether the polymorphism of BNLF2a gene has a role in different types of EBV associated tumors, we conducted complete sequencing of the gene BNLF2a in 408 cases of EBV positive tumors (76 lymphomas, 45 gastric carcinomas, and 85 nasopharyngeal carcinomas in northern China and 27 lymphomas, 30 gastric carcinomas, and 57 nasopharyngeal carcinomas in southern China) and throat washings from healthy individuals (39 in northern China and 49 in southern China). Two main variant types of BNLF2a were identified. Type BNLF2a‐A, which was similar to B95‐8, was dominant in all sub‐populations (66.7–100%) in this study. Type BNLF2a‐B was characterized by the mutations at position 8 and 40. The variation patterns of BNLF2a were significantly different between samples from northern and southern China ( P < 0.05), and between the tumors and healthy donor samples from the northern China ( P < 0.0167). Type BNLF2a‐B was more frequent in healthy donors of northern China (33.3%), and the proportion of this type was higher in the northern than in the southern NPCs. These data demonstrate that the BNLF2a gene is highly conserved, and its polymorphism is geographically restricted. Type BNLF2a‐B is more prevalent in northern China and may be less tumor transformative. J. Med. Virol. 87:1946–1952, 2015 . © 2015 Wiley Periodicals, Inc.
Abstract PD3-3: Impact of neoadjuvant chemotherapy on the clonal composition of breast cancer
Barrett, Michael T. , McLaughlin, Sarah A., Moreno‐Aspitia, Alvaro , Moyer, Ann M. , Northfelt, Donald W. , Gray, Richard J. , Barman, Poulami , Vedell, Peter T. , Dockter, Travis , Jones, Katie, Felten, Sara J., Conners, Amy Lynn , Eckel‐Passow, Jeanette E. , Sicotte, Hughes, Yu, Jia , Visscher, Daniel W., Wieben, Eric D. , Schultz, Cloann G. , Liu, Minetta C. , Wang, Liewei , Weinshilboum, R., Goetz, Matthew P. , Kalari, Krishna R. , Suman, Vera J. , Sinnwell, Jason P. , Mahoney, Douglas W. , Tang, Xiaojia , Thompson, Kevin J. , Hart, Steven N. , Ingle, James N. , Boughey, Judy C.

Cancer Research | May 4, 2015 | Volume: 75 | Issue: 9_Supplement | Pages: PD3-3-PD3-3

10.1158/1538-7445.sabcs14-pd3-3 Get It

Abstract Background Cancer genomic investigations have identified recurrent genomic aberrations critical for cancer initiation, progression, and metastases. However, these investigations are typically performed in isolation, and the effects of treatment on the clonal selection of tumor cells are mostly unknown. We hypothesized that molecular profiling of residual tumors after neoadjuvant chemotherapy (NAC) would identify new drug targets/pathways in patients at high risk for disease recurrence. To better identify clonal populations of resistant breast cancer cells, we utilized DNA content-based flow sorting of nuclei to identify and isolate clonal populations for aCGH and next generation sequencing (NGS) both before and after NAC. Methods The Breast Cancer Genome Guided Therapy Study (BEAUTY) (NCT 02022202) is a prospective study of patients with high-risk breast cancer treated with neoadjuvant 12 weekly paclitaxel (T) +/- trastuzumab followed by 4 cycles of anthracycline based chemotherapy. Tumor tissue from baseline, residual disease from surgery, distant metastases, and patient derived xenografts (PDX) are obtained for cell sorting by DNA ploidy, aCGH, RNA and exome sequencing. Results: 140 patients have been enrolled, 104 have completed surgery and 30 unique PDX have been established corresponding to 26 patients prior to chemotherapy and 4 from residual disease at surgery. Baseline exome and RNA sequencing is complete in 140. Currently, genomic analyses of flow sorted matched baseline, surgical, PDX, and distant disease samples are available in 6 patients. Substantial genomic variation was observed in the surgical sample compared to the primary tumor including gain of oncogenic drivers (EGFR) and loss of negative regulators (ATG5) (Table). The PDX recapitulated these events with excellent fidelity compared to the corresponding human tumor. In patients with TNBC, RNA seq obained from matched samples demonstrated changes in immune related pathways. Evaluation of drug targets/pathways identified in the resistant tumors are ongoing using the PDX and sequencing of the remaining matched baseline/surgical disease will be reported. Clonal changes occurring over time in patients with residual disease or disease recurrence after NACTumor SubtypeResidual Cancer BurdenDisease StatusClonal Aberration Changes (baseline and post NAC)TNBC (AR subtype)3Contralateral lymph node recurrence at 150 days2p25.2 - p25.1 amplicon lost at recurrence; 6p21.32 -p21.31 amplicon lost at recurrenceTNBC (BL 1)3Bone/liver/lymph node recurrence at 135 days5q11.2 amplicon gained at surgery; 12p13.33 - p13.2 amplicon gained at surgeryTNBC (BL 1)3Disease-free at day 1506q21 amplicon lost at sugeryTNBC (BL 2)0Brain recurrence at 390 daysChr 2 chromothripsis at surgeryLuminal B3Progression during chemotherapy7p12.1 - p11.2 amplicon gained at surgeryLuminal HER23Disease-free at day 3609q33.2 amplicon lost at surgery; 15q13.1 - q13.3 amplicon lost at surgery; 15q22.2 - q24.1 amplicon lost at surgery Conclusions: We observed substantial evolutionary changes in residual breast tumors remaining after NAC. Our findings suggest that a comprehensive assessment of the mutational landscape that has evolved during NAC can inform drug development in high risk breast cancer patients. Citation Format: Matthew P Goetz, Michael T Barrett, Krishna R Kalari, Vera J Suman, Sarah A McLaughlin, Alvaro Moreno-Aspitia, Ann M Moyer, Donald W Northfelt, Richard J Gray, Jason Sinnwell, Douglas Mahoney, Poulami Barman, Peter Vedell, Xiaojia Tang, Kevin Thompson, Travis Dockter, Katie Jones, Sara J Felten, Amy Conners, Jeanette Eckel-Passow, Hughes Sicotte, Steven N Hart, Jia Yu, Daniel W Visscher, Eric D Wieben, Cloann Schultz, Minetta C Liu, James N Ingle, Liewei Wang, Richard W Weinshilboum, Judy C Boughey. Impact of neoadjuvant chemotherapy on the clonal composition of breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr PD3-3.