451
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Siu IM, Ruzevick J, Zhao Q, Connis N, Jiao Y, Bettegowda C, Xia X, Burger PC, Hann CL, Gallia GL. Erlotinib inhibits growth of a patient-derived chordoma xenograft. PLoS One 2013; 8:e78895. [PMID: 24260133 PMCID: PMC3829812 DOI: 10.1371/journal.pone.0078895] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 09/17/2013] [Indexed: 11/18/2022] Open
Abstract
Chordomas are rare primary bone tumors that occur along the neuraxis. Primary treatment is surgery, often followed by radiotherapy. Treatment options for patients with recurrence are limited and, notably, there are no FDA approved therapeutic agents. Development of therapeutic options has been limited by the paucity of preclinical model systems. We have established and previously reported the initial characterization of the first patient-derived chordoma xenograft model. In this study, we further characterize this model and demonstrate that it continues to resemble the original patient tumor histologically and immunohistochemically, maintains nuclear expression of brachyury, and is highly concordant with the original patient tumor by whole genome genotyping. Pathway analysis of this xenograft demonstrates activation of epidermal growth factor receptor (EGFR). In vitro studies demonstrate that two small molecule inhibitors of EGFR, erlotinib and gefitinib, inhibit proliferation of the chordoma cell line U-CH 1. We further demonstrate that erlotinib significantly inhibits chordoma growth in vivo. Evaluation of tumors post-treatment reveals that erlotinib reduces phosphorylation of EGFR. This is the first demonstration of antitumor activity in a patient-derived chordoma xenograft model and these findings support further evaluation of EGFR inhibitors in this disease.
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Affiliation(s)
- I-Mei Siu
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jacob Ruzevick
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Qi Zhao
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Ludwig Collaborative Laboratory, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Nick Connis
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yuchen Jiao
- Ludwig Center for Cancer Genetics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Chetan Bettegowda
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Ludwig Center for Cancer Genetics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Xuewei Xia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Neurosurgery, Affiliated Hospital of Gulin Medical College, Guilin, China
| | - Peter C. Burger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Christine L. Hann
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Gary L. Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
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452
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Trucco MM, Awad O, Wilky BA, Goldstein SD, Huang R, Walker RL, Shah P, Katuri V, Gul N, Zhu YJ, McCarthy EF, Paz-Priel I, Meltzer PS, Austin CP, Xia M, Loeb DM. A novel chordoma xenograft allows in vivo drug testing and reveals the importance of NF-κB signaling in chordoma biology. PLoS One 2013; 8:e79950. [PMID: 24223206 PMCID: PMC3819300 DOI: 10.1371/journal.pone.0079950] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 09/27/2013] [Indexed: 01/10/2023] Open
Abstract
Chordoma is a rare primary bone malignancy that arises in the skull base, spine and sacrum and originates from remnants of the notochord. These tumors are typically resistant to conventional chemotherapy, and to date there are no FDA-approved agents to treat chordoma. The lack of in vivo models of chordoma has impeded the development of new therapies for this tumor. Primary tumor from a sacral chordoma was xenografted into NOD/SCID/IL-2R γ-null mice. The xenograft is serially transplantable and was characterized by both gene expression analysis and whole genome SNP genotyping. The NIH Chemical Genomics Center performed high-throughput screening of 2,816 compounds using two established chordoma cell lines, U-CH1 and U-CH2B. The screen yielded several compounds that showed activity and two, sunitinib and bortezomib, were tested in the xenograft. Both agents slowed the growth of the xenograft tumor. Sensitivity to an inhibitor of IκB, as well as inhibition of an NF-κB gene expression signature demonstrated the importance of NF-κB signaling for chordoma growth. This serially transplantable chordoma xenograft is thus a practical model to study chordomas and perform in vivo preclinical drug testing.
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Affiliation(s)
- Matteo M. Trucco
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ola Awad
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Breelyn A. Wilky
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Seth D. Goldstein
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ruili Huang
- National Center for Advancing Translational Sciences, NIH, Rockville, Maryland, United States of America
| | - Robert L. Walker
- Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, United States of America
| | - Preeti Shah
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Varalakshmi Katuri
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Naheed Gul
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Yuelin J. Zhu
- Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, United States of America
| | - Edward F. McCarthy
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ido Paz-Priel
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Paul S. Meltzer
- Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, United States of America
| | - Christopher P. Austin
- National Center for Advancing Translational Sciences, NIH, Rockville, Maryland, United States of America
| | - Menghang Xia
- National Center for Advancing Translational Sciences, NIH, Rockville, Maryland, United States of America
| | - David M. Loeb
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
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453
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Chambers KJ, Lin DT, Meier J, Remenschneider A, Herr M, Gray ST. Incidence and survival patterns of cranial chordoma in the United States. Laryngoscope 2013; 124:1097-102. [DOI: 10.1002/lary.24420] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 07/08/2013] [Accepted: 09/05/2013] [Indexed: 11/05/2022]
Affiliation(s)
- Kyle J. Chambers
- Department of Otolaryngology-Head and Neck Surgery; Massachusetts Eye and Ear Infirmary; Boston Massachusetts U.S.A
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Derrick T. Lin
- Department of Otolaryngology-Head and Neck Surgery; Massachusetts Eye and Ear Infirmary; Boston Massachusetts U.S.A
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Josh Meier
- Department of Otolaryngology-Head and Neck Surgery; Massachusetts Eye and Ear Infirmary; Boston Massachusetts U.S.A
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Aaron Remenschneider
- Department of Otolaryngology-Head and Neck Surgery; Massachusetts Eye and Ear Infirmary; Boston Massachusetts U.S.A
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Marc Herr
- Department of Otolaryngology-Head and Neck Surgery; Massachusetts Eye and Ear Infirmary; Boston Massachusetts U.S.A
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Stacey T. Gray
- Department of Otolaryngology-Head and Neck Surgery; Massachusetts Eye and Ear Infirmary; Boston Massachusetts U.S.A
- Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts U.S.A
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454
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Bag AK, Chapman PR. Neuroimaging: Intrinsic Lesions of the Central Skull Base Region. Semin Ultrasound CT MR 2013; 34:412-35. [DOI: 10.1053/j.sult.2013.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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455
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Zhang L, Guo S, Schwab JH, Nielsen GP, Choy E, Ye S, Zhang Z, Mankin H, Hornicek FJ, Duan Z. Tissue microarray immunohistochemical detection of brachyury is not a prognostic indicator in chordoma. PLoS One 2013; 8:e75851. [PMID: 24086644 PMCID: PMC3781148 DOI: 10.1371/journal.pone.0075851] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 08/22/2013] [Indexed: 12/13/2022] Open
Abstract
Brachyury is a marker for notochord-derived tissues and neoplasms, such as chordoma. However, the prognostic relevance of brachyury expression in chordoma is still unknown. The improvement of tissue microarray technology has provided the opportunity to perform analyses of tumor tissues on a large scale in a uniform and consistent manner. This study was designed with the use of tissue microarray to determine the expression of brachyury. Brachyury expression in chordoma tissues from 78 chordoma patients was analyzed by immunohistochemical staining of tissue microarray. The clinicopathologic parameters, including gender, age, location of tumor and metastatic status were evaluated. Fifty-nine of 78 (75.64%) tumors showed nuclear staining for brachyury, and among them, 29 tumors (49.15%) showed 1+ (<30% positive cells) staining, 15 tumors (25.42%) had 2+ (31% to 60% positive cells) staining, and 15 tumors (25.42%) demonstrated 3+ (61% to 100% positive cells) staining. Brachyury nuclear staining was detected more frequently in sacral chordomas than in chordomas of the mobile spine. However, there was no significant relationship between brachyury expression and other clinical variables. By Kaplan-Meier analysis, brachyury expression failed to produce any significant relationship with the overall survival rate. In conclusion, brachyury expression is not a prognostic indicator in chordoma.
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Affiliation(s)
- Linlin Zhang
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Pathology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shang Guo
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Orthopaedics, Shanghai Sixth People’s Hospital affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Joseph H. Schwab
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - G. Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Edwin Choy
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Shunan Ye
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Zhan Zhang
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Pathology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Henry Mankin
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Francis J. Hornicek
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Zhenfeng Duan
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- * E-mail:
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456
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Hattori Y, Tahara S, Ishii Y, Kitamura T, Inomoto C, Osamura RY, Teramoto A, Morita A. A case of prolactinoma with chordoma. Clin Neurol Neurosurg 2013; 115:2537-9. [PMID: 24129004 DOI: 10.1016/j.clineuro.2013.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/07/2013] [Accepted: 09/14/2013] [Indexed: 11/18/2022]
Affiliation(s)
- Yujiro Hattori
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.
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457
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Gharavi MH, Wu HH, Toms SA. High fluorodeoxyglucose ((18)F)PET-uptake lymph nodes in a patient with chordoma: Tumor metastasis or sarcoidosis? AMERICAN JOURNAL OF CASE REPORTS 2013; 14:373-5. [PMID: 24086794 PMCID: PMC3783480 DOI: 10.12659/ajcr.889329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 05/17/2013] [Indexed: 02/02/2023]
Abstract
Patient: Male, 48 Final Diagnosis: Chordoma Symptoms: — Medication: — Clinical Procedure: — Specialty: Neurology
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458
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Abdulrauf SI. Decision-making process for the treatment of intracranial chordomas. World Neurosurg 2013; 82:612-3. [PMID: 23924967 DOI: 10.1016/j.wneu.2013.07.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 07/29/2013] [Indexed: 11/18/2022]
Affiliation(s)
- Saleem I Abdulrauf
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
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459
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Srivastava A, Vischioni B, Fiore MR, Vitolo V, Fossati P, Iannalfi A, Tuan JKL, Orecchia R. Quality of life in patients with chordomas/chondrosarcomas during treatment with proton beam therapy. JOURNAL OF RADIATION RESEARCH 2013; 54 Suppl 1:i43-8. [PMID: 23824125 PMCID: PMC3700519 DOI: 10.1093/jrr/rrt057] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Health-related quality of life (HQL) parameters have never been tested in patients having chondromas/chondrosarcomas who are being treated with protons. The aim of this study was to document changes in HQL of chordoma/chondrosarcoma patients treated with proton beam radiotherapy. Treatments commenced in September 2011 at CNAO, and HQL studies were initiated in January 2012 for all patients undergoing treatment. METHODS The validated Italian translation of the EORTC QLQ-C30 version 3.0 was used for HQL evaluation. The HQL assessments were made prior to starting radiation and at completion of treatment. Scoring was as per the EORTC manual. As per standard norms, a difference of >10 points in the mean scores was taken to be clinically meaningful. RESULTS Between January and September 2012, 17 patients diagnosed with chordoma or chondrosarcoma, with a mean ± SD age of 49.5 ± 16.4 years, had completed treatment. The involved sites were skull base (n = 12) and sacral/paraspinal (n = 5). The prescribed dose was 70-74 GyE at 2 GyE per fraction, 5 days/week. When comparing pre- and post-treatment scores, neither a clinically meaningful nor a statistically significant change was documented. CONCLUSIONS During treatment, HQL is not adversely affected by protons, allowing normal life despite the long course of treatment. This is an ongoing study and more long-term assessment will help evaluate the actual impact of proton therapy on HQL for these slow-responding tumours.
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Affiliation(s)
- A Srivastava
- Department of Radiation Oncology, Medanta the Medicity, Sector 38, Gurgaon 122001, Haryana, India.
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460
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Deconde AS, Sanaiha Y, Suh JD, Bhuta S, Bergsneider M, Wang MB. Metastatic disease to the clivus mimicking clival chordomas. J Neurol Surg B Skull Base 2013; 74:292-9. [PMID: 24436927 DOI: 10.1055/s-0033-1348027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 04/15/2013] [Indexed: 12/14/2022] Open
Abstract
Objectives/Hypothesis A comprehensive review of the literature of clival metastases and presentation of two additional cases. Study Design Literature review and report of two cases. Methods A literature review of the MEDLINE database (1950 to January 19, 2013) was performed to identify all cases of patients with metastatic disease to the clivus. Additionally, two novel cases are presented. Results In total, 47 cases were identified in the literature, including the two cases presented in this study. Metastatic disease to the clivus is the initial presenting symptom of the primary malignancy in 36% (13/36) of the cases. When there was a history of malignancy, the median interval of time to clival metastases was 24 months (range 1 to 172 months). Clinical symptoms manifested often as cranial neuropathies, with at least abducens palsies as the initial presenting symptom in 61.9% (26/42) of patients. Tumor pathology was diverse, but several pathologies were seen more commonly: prostate carcinoma (18.1%, 9/47), hepatocellular carcinoma (10.6%, 5/47), and thyroid follicular carcinoma (8.5%, 4/47). Conclusion Although clival metastases are extremely rare, they are an important part of the differential of clival masses as they can be the presenting symptom of distant malignancy. Level of Evidence 4.
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Affiliation(s)
- Adam S Deconde
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Yas Sanaiha
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jeffrey D Suh
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Sunita Bhuta
- Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Marvin Bergsneider
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Marilene B Wang
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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461
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Long C, Jiang L, Wei F, Ma C, Zhou H, Yang S, Liu X, Liu Z. Integrated miRNA-mRNA analysis revealing the potential roles of miRNAs in chordomas. PLoS One 2013; 8:e66676. [PMID: 23826111 PMCID: PMC3691184 DOI: 10.1371/journal.pone.0066676] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 05/09/2013] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Emerging evidence suggests that microRNAs (miRNAs) are crucially involved in tumorigenesis and that paired expression profiles of miRNAs and mRNAs can be used to identify functional miRNA-target relationships with high precision. However, no studies have applied integrated analysis to miRNA and mRNA profiles in chordomas. The purpose of this study was to provide insights into the pathogenesis of chordomas by using this integrated analysis method. METHODS Differentially expressed miRNAs and mRNAs of chordomas (n = 3) and notochord tissues (n = 3) were analyzed by using microarrays with hierarchical clustering analysis. Subsequently, the target genes of the differentially expressed miRNAs were predicted and overlapped with the differentially expressed mRNAs. Then, GO and pathway analyses were performed for the intersecting genes. RESULTS The microarray analysis indicated that 33 miRNAs and 2,791 mRNAs were significantly dysregulated between the two groups. Among the 2,791 mRNAs, 911 overlapped with putative miRNA target genes. A pathway analysis showed that the MAPK pathway was consistently enriched in the chordoma tissue and that miR-149-3p, miR-663a, miR-1908, miR-2861 and miR-3185 likely play important roles in the regulation of MAPK pathways. Furthermore, the Notch signaling pathway and the loss of the calcification or ossification capacity of the notochord may also be involved in chordoma pathogenesis. CONCLUSION This study provides an integrated dataset of the miRNA and mRNA profiles in chordomas, and the results demonstrate that not only the MAPK pathway and its related miRNAs but also the Notch pathway may be involved in chordoma development. The occurrence of chordoma may be associated with dysfunctional calcification or ossification of the notochord.
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Affiliation(s)
- Cheng Long
- Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China
| | - Liang Jiang
- Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China
| | - Feng Wei
- Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China
| | - Chuan Ma
- Spine Tumor Center, Peking University Third Hospital, Haidian, Beijing, China
| | - Hua Zhou
- Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China
| | - Shaomin Yang
- Pathology Department, Peking University Health Science Centre, Haidian, Beijing, China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital, Haidian, Beijing, China
- * E-mail:
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462
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463
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Iorgulescu JB, Laufer I, Hameed M, Boland P, Yamada Y, Lis E, Bilsky M. Benign Notochordal Cell Tumors of the Spine. Neurosurgery 2013; 73:411-6. [DOI: 10.1227/01.neu.0000431476.94783.c6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Notochord-related lesions of the spinal column include benign notochordal cell tumors (BNCTs), ecchordosis physaliphora, both generally considered benign lesions, and chordomas, which represent malignant tumors. The histological similarity of these lesions to the notochord and each other and their strong predilection to the axial skeleton have led to the hypothesis that these lesions represent a continuum of malignant transformation from notochordal remnants, BNCTs, and finally chordomas.
OBJECTIVE:
To present a cohort of biopsy-proven BNCTs with a description of radiographic features, histology, and follow-up to help elucidate the optimal management of these lesions.
METHODS:
A retrospective chart review identified 13 patients with notochordal rest lesions confirmed by histology. Histologic inclusion criteria included notochordal features without evidence of septation, myxoid matrix, nuclear atypia, or mitotic figures. Tumors exhibiting evidence of cortical expansion or destruction were excluded. The natural history and histological and radiographic features were examined.
RESULTS:
Sixteen spinal lesions from 8 patients met the diagnostic criteria for BNCTs, identified on imaging after the patient presented with back pain. Radiographically, all lesions were hypointense on T1-weighted magnetic resonance imaging sequences and hyperintense on T2-weighted and short T1 inversion recovery. The median radiographic follow-up was 21.6 months (range, 8.5-71.2 months). None of the lesions exhibited radiographic or symptomatic progression.
CONCLUSION:
Although limited by short follow-up, our series confirms that these lesions may be safely observed without evidence of malignant transformation, which emphasizes the importance of distinction of BNCT from chordoma at diagnosis and the possibility of close follow-up for these lesions instead of aggressive treatment indicated in patients with chordomas.
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Affiliation(s)
- J. Bryan Iorgulescu
- Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ilya Laufer
- Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York
| | - Meera Hameed
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Patrick Boland
- Department of Orthopedic Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Yoshiya Yamada
- Department of Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Eric Lis
- Department of Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Mark Bilsky
- Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Spine Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York
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464
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Elefante A, Caranci F, Del Basso De Caro ML, Peca C, Guadagno E, Severino R, Mariniello G, Maiuri F. Paravertebral high cervical chordoma. A case report. Neuroradiol J 2013; 26:227-32. [PMID: 23859247 DOI: 10.1177/197140091302600214] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/13/2013] [Indexed: 11/17/2022] Open
Abstract
Spinal chordomas are more often located on the midline and are associated with marked destruction of the vertebral bodies. We report a rare case of large cervical (C2-C3) right lateral paravertebral chordoma extending into the spinal canal through a very enlarged intervertebral foramen. The tumor was initially diagnosed as a mucous adenocarcinoma on a percutaneous needle biopsy. However, the neuroradiological features, including the well-defined tumor margins, the regular and sclerosing lytic bone changes with regular enlargement of the intervertebral C2-C3 foramen, were in favor of a more slowly growing lesion, such as schwannoma or neurofibroma. At surgery a well-demarcated capsulated tumor involving the nerve root was partially resected. Histology was in favor of a low-grade chordoma (Ki-67/MIB-1<1%). Postoperative proton beam therapy was also performed. The differential neuroradiological diagnosis is discussed.
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Affiliation(s)
- A Elefante
- Advanced Biomedical Sciences, Section of Neuroradiology, Federico II University, Naples, Italy.
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465
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466
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Neurological surgery: The influence of physical and mental demands on humans performing complex operations. J Clin Neurosci 2013; 20:342-8. [DOI: 10.1016/j.jocn.2012.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 09/05/2012] [Indexed: 11/21/2022]
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467
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Affiliation(s)
| | - Alfredo Conti
- Department of Neurosurgery, University of Messina, Messina, Italy
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468
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Szuhai K, Hogendoorn PCW. 'The chicken or the egg?' dilemma strikes back for the controlling mechanism in chordoma(#). J Pathol 2013; 228:261-5. [PMID: 22952146 DOI: 10.1002/path.4102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Chordoma is a rare malignant tumour of bone showing notochordal differentiation with characteristic expression of the transcription factor brachyury (T). Next to giving insight into its differentiation spectrum, the expression of T can be used as an adjunct diagnostic tool. The expression of brachyury in chordoma is necessary to maintain cell proliferation in chordoma cell lines, indicating that in chordoma it might be a master regulator of oncogenesis. Identification and mapping of the full gene regulatory network in a recent work in The Journal of Pathology by Nelson and colleagues not only shed light on involved pathways but also indicated pathways for targeted therapy, including brachyury itself.
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Affiliation(s)
- Karoly Szuhai
- Department of Molecular Cell Biology, Leiden University Medical Center, Einthovenweg 20, 2330 RC, Leiden, The Netherlands
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Brisby H, Papadimitriou N, Brantsing C, Bergh P, Lindahl A, Barreto Henriksson H. The presence of local mesenchymal progenitor cells in human degenerated intervertebral discs and possibilities to influence these in vitro: a descriptive study in humans. Stem Cells Dev 2012; 22:804-14. [PMID: 23025667 DOI: 10.1089/scd.2012.0179] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Low back pain is common and degenerated discs (DDs) are believed to be a major cause. In non-degenerated intervertebral discs (IVDs) presence of stem/progenitor cells was recently reported in different mammals (rabbit, rat, pig). Understanding processes of disc degeneration and regenerative mechanisms within DDs is important. The aim of the study was to examine the presence of local stem/progenitor cells in human DDs and if these cell populations could respond to paracrine stimulation in vitro. Tissue biopsies from the IVD region (L3-S1) were collected from 15 patients, age 34-69 years, undergoing surgery (spinal fusion) and mesenchymal stem cells (MSCs) (iliac crest) from 2 donors. Non-DD cells were collected from 1 donor (scoliosis) and chordoma tissue was obtained from (positive control, stem cell markers) 2 donors. The IVD biopsies were investigated for gene and protein expression of: OCT3/4, CD105, CD90, STRO-1, and NOTCH1. DD cell cultures (pellet mass) were performed with conditioned media from MSCs and non-degenerated IVD cells. Pellets were investigated after 7, 14, 28 days for the same stem cell markers as above. Gene expression of OCT3/4 and STRO-1 was detected in 13/15 patient samples, CD105 in 14/15 samples, and CD90 and NOTCH1 were detected 15/15 samples. Immunohistochemistry analysis supported findings on the protein level, in cells sparsely distributed in DDs tissues. DDs cell cultures displayed more undifferentiated appearance with increased expression of CD105, CD90, STRO-1, OCT3/4, NOTCH1, and JAGGED1, which was observed when cultured in conditioned cell culture media from MSCs compared to cell cultures cultured with conditioned media from non-DD cells. Expression of OCT3/4 (multipotency marker) and NOTCH1 (regulator of cell fate), MSC-markers, CD105, CD90, and STRO-1, indicate that primitive cell populations are present within DDs. Furthermore, the possibility to influence cells from DDs by paracrine signaling /soluble factors from MSCs and from nondegenerated IVD cells was observed in vitro indicating that repair processes within human DDs may be stimulated.
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Affiliation(s)
- Helena Brisby
- Department of Orthopaedics, Institute of Clinical Sciences, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
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Jahangiri A, Jian B, Miller L, El-Sayed IH, Aghi MK. Skull base chordomas: clinical features, prognostic factors, and therapeutics. Neurosurg Clin N Am 2012; 24:79-88. [PMID: 23174359 DOI: 10.1016/j.nec.2012.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Chordomas of the skull base are one of the rarest intracranial malignancies that arise from ectopic remnants of embryonal notochod. The proximity of many chordomas to neurovascular structures makes gross total resection difficult, and the tendency for recurrence leads to the routine use of adjuvant postoperative radiation. Several surgical approaches are used ranging from extensive craniotomies to minimally invasive endonasal endoscopic approaches. In this review, the histopathology and epidemiology, imaging characteristics, surgical approaches, adjuvant therapies, prognostic factors, and molecular biology of chordomas are described.
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Affiliation(s)
- Arman Jahangiri
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
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Bydon M, Papadimitriou K, Witham T, Wolinsky JP, Bydon A, Sciubba D, Gokaslan Z. Novel therapeutic targets in chordoma. Expert Opin Ther Targets 2012; 16:1139-43. [PMID: 22860993 DOI: 10.1517/14728222.2012.714772] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Chordomas are malignant bone tumors arising from notochordal remnants. They most commonly occur at the sacrum, skull base, and spine. The gold standard treatment for these tumors is a combination of en-bloc resection and radiation therapy. AREAS COVERED Recent genomic studies have identified duplication of the gene brachyury as a major susceptibility mutation in familial chordomas. Studies on sporadic chordomas have identified several tumor markers, using microRNAs and Comparative Genome Hybridization. In this article, we highlight current advances in research on the molecular characterization of chordomas. EXPERT OPINION Scientific advances have allowed for the identification of numerous tumor markers involved in chordoma pathogenesis. In the future, chordoma cell lines will be produced that silence or over-express these tumor markers. As we increase our understanding of the mechanism of chordoma tumor proliferation, we can expect the development of targeted drug therapies.
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Affiliation(s)
- Mohamad Bydon
- The Johns Hopkins Hospital, Department of Neurological Surgery, 600 N Wolfe St, Meyer 7-109, Baltimore, MD 21287, USA.
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Chin BM, Orlandi RR, Wiggins RH. Evaluation of the sellar and parasellar regions. Magn Reson Imaging Clin N Am 2012; 20:515-43. [PMID: 22877954 DOI: 10.1016/j.mric.2012.05.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The article reviews the anatomy and imaging evaluation of the sellar and parasellar regions. Both common and uncommon sellar and suprasellar masses are reviewed, focusing on a systematic approach to analysis and when appropriate, differential creation.
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Affiliation(s)
- Brian M Chin
- Department of Radiology, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA.
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