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Chemotherapy and Other Systemic Approaches to Adult Sarcomas. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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102
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Agarwal N, Hansberry DR, Kavi A, Agarwal P, Baisre A, Goldstein IM. Prognostic Differences: Epstein-Barr Virus-Associated Primary Leiomyosarcoma of the Spine Versus Spinal Leiomyosarcoma Metastases. World Neurosurg 2016; 99:484-490. [PMID: 28011357 DOI: 10.1016/j.wneu.2016.12.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/09/2016] [Accepted: 12/10/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The authors studied 6 cases of osseous leiomyosarcoma of the spine. Two of these cases were of immunocompromised human immunodeficiency virus (HIV)-positive patients with Epstein-Barr virus (EBV)-associated primary vertebral leiomyosarcomas. The remaining 4 cases were of patients with leiomyosarcoma metastases to the spine. METHODS Each patient underwent surgical resection of their vertebral mass; however, the patients with the EBV-associated tumors had the best postoperative prognosis. RESULTS The HIV-positive patients have had no further local recurrence, while the other 4 patients had rapid local recurrences requiring multiple surgical interventions. Furthermore, the patients living with HIV have lived longer with fewer leiomyosarcoma-related health complications. CONCLUSIONS These findings suggest that EBV-associated vertebral leiomyosarcoma is of a less aggressive variety than metastatic leiomyosarcoma of the spine.
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Affiliation(s)
- Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ami Kavi
- Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA
| | - Prateek Agarwal
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ada Baisre
- Department of Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ira M Goldstein
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
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Sirichativapee W, Wisanuyotin T, Pattanittum P, Paholpak P, Laupattarakasem P, Srisodaphol W, Tsuchiya H, Laopaiboon M, Kosuwon W, Wiangnon S. Chemotherapy for treating high-grade osteosarcoma in children and young adults. Hippokratia 2016. [DOI: 10.1002/14651858.cd012372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Winai Sirichativapee
- Faculty of Medicine, Khon Kaen University; Orthopedics; 123 Mithraphap rd, Muang District Thailand 40002
| | - Taweechok Wisanuyotin
- Faculty of Medicine, Khon Kaen University; Orthopedics; 123 Mithraphap rd, Muang District Thailand 40002
| | - Porjai Pattanittum
- Khon Kaen University; Department of Biostatistics and Demography, Faculty of Public Health; Mitraparp Road Mueng District Khon Kaen Khon Kaen Thailand 40002
| | - Permsak Paholpak
- Faculty of Medicine, Khon Kaen University; Orthopedics; 123 Mithraphap rd, Muang District Thailand 40002
| | - Pat Laupattarakasem
- Faculty of Medicine, Khon Kaen University; Orthopedics; 123 Mithraphap rd, Muang District Thailand 40002
| | | | - Hiroyuki Tsuchiya
- Graduate School of Medicine, Kanazawa University; Orthopedic Surgery; 13-1 Takara-machi Kanazawa Japan 920-8641
| | - Malinee Laopaiboon
- Khon Kaen University; Department of Epidemiology and Biostatistics, Faculty of Public Health; 123 Mitraparb Road Amphur Muang Khon Kaen Thailand 40002
| | - Weerachai Kosuwon
- Faculty of Medicine, Khon Kaen University; Orthopedics; 123 Mithraphap rd, Muang District Thailand 40002
| | - Surapon Wiangnon
- Faculty of Medicine, Khon Kaen University; Department of Pediatrics; 123 Mithraphap rd, Muang district Thailand 40002
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Bishop MW, Chang YC, Krailo MD, Meyers PA, Provisor AJ, Schwartz CL, Marina NM, Teot LA, Gebhardt MC, Gorlick R, Janeway KA, Chou AJ. Assessing the Prognostic Significance of Histologic Response in Osteosarcoma: A Comparison of Outcomes on CCG-782 and INT0133-A Report From the Children's Oncology Group Bone Tumor Committee. Pediatr Blood Cancer 2016; 63:1737-43. [PMID: 27128693 PMCID: PMC5136499 DOI: 10.1002/pbc.26034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/27/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The prognostic value of histologic response for osteosarcoma may have changed with induction chemotherapy schedules over time. We hypothesized that the increased intensity of induction therapy provided on INT0133 compared to the Children's Cancer Group study CCG-782 would diminish the impact of histologic response on the risk of events after definitive surgery. METHODS Retrospective analysis was performed for patients aged <22 with newly diagnosed nonmetastatic osteosarcoma enrolled on CCG-782 and INT0133. Clinical factors were evaluated for association with response and outcome. Good response was defined as <5% viable tumor at resection. Associations of response, study, and postdefinitive surgery event-free survival (EFS-DS) were determined using Cox proportional hazard models. EFS-DS was estimated by Kaplan-Meier methodology. RESULTS Data were available for 814 patients (206 CCG-782, 608 INT0133). For good responders, 10-year EFS-DS (±SE) was 75.4% ± 7.7% for CCG-782 and 70.8% ± 3.1% for INT0133. For poor responders, 10-year EFS-DS was 39.9% ± 4.9% for CCG-782 and 58.4% ± 3.1% for INT0133. Histologic response predicted outcome across studies (P < 0.0001). Significant interaction between study and histologic response was observed for EFS-DS (P = 0.011). Using proportional hazards regression, INT0133 poor responders had less risk of events compared to CCG-782 poor responders (relative hazard ratio (RHR) = 0.6:1), but good responders on INT0133 had a greater risk of events compared to CCG-782 good responders (RHR = 1.53:1). CONCLUSION We observed an inverse relationship between the predictive value of tumor necrosis and intensity of induction therapy, raising questions about the true prognostic value of histologic response. This highlights the need for novel markers to develop strategies for treatment in future trials.
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Affiliation(s)
- Michael W. Bishop
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Yu-Chen Chang
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Mark D. Krailo
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Paul A. Meyers
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York
| | - Arthur J. Provisor
- Division of Pediatric Hematology-Oncology, Children’s Hospital of Memorial University Medical Center, Savannah, Georgia
| | | | - Neyssa M. Marina
- Department of Pediatric Hematology-Oncology, Lucile Packard Children’s Hospital at Stanford, Palo Alto, California
| | - Lisa A. Teot
- Department of Pathology, Boston Children’s Hospital, Boston, Massachusetts
| | - Mark C. Gebhardt
- Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, Massachusetts
| | - Richard Gorlick
- Division of Pediatric Hematology/Oncology, The Children’s Hospital at Montefiore, Bronx, New York
| | - Katherine A. Janeway
- Department of Pediatric Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Alexander J. Chou
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York
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Lettieri CK, Appel N, Labban N, Lussier DM, Blattman JN, Hingorani P. Progress and opportunities for immune therapeutics in osteosarcoma. Immunotherapy 2016; 8:1233-44. [DOI: 10.2217/imt-2016-0048] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Survival outcomes for osteosarcoma have plateaued since the 1980s, and patients with relapsed or refractory disease have a particularly dismal outcome. Treatment options for these patients are limited primarily due to the paucity of effective therapeutics. Immune therapies such as tumor vaccines and traditional antigen-targeted monoclonal antibodies have had limited success in solid tumors. The recent discovery of novel immune checkpoint blockade strategies and their success in adult cancers has revitalized the use of immunotherapy strategies for the treatment of solid tumors. This paper summarizes existing data supporting the use of immune therapies in osteosarcoma and the progress of this class of drugs in osteosarcoma therapy.
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Affiliation(s)
| | - Nicole Appel
- School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Nicole Labban
- School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA
| | | | - Joseph N Blattman
- School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA
| | - Pooja Hingorani
- Center for Cancer & Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ 85016, USA
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Jia Y, Yuan H, Shan S, Xu G, Yu J, Zhao C, Mou X. Corosolic acid inhibits the proliferation of osteosarcoma cells by inducing apoptosis. Oncol Lett 2016; 12:4187-4194. [PMID: 27895790 DOI: 10.3892/ol.2016.5185] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/25/2016] [Indexed: 11/05/2022] Open
Abstract
Corosolic acid (CRA), a pentacyclic triterpene isolated from medicinal herbs, has been reported to exhibit anticancer properties in several cancers. However, the anticancer activity of CRA in osteosarcoma cells is still unclear. In the present study, the inhibitory effect of CRA in osteosarcoma MG-63 cells was investigated, and the results revealed that CRA significantly inhibited the viability of MG-63 cells in a dose- and time-dependent manner. A typical apoptotic hallmark such as DNA ladder was detected by agarose gel electrophoresis following treatment with CRA. Further experiments demonstrated that CRA induced apoptosis of MG-63 cells by flow cytometry using propidium iodide and annexin V staining. In addition, it was observed that the apoptosis of MG-63 cells induced by CRA was closely associated with activation of caspase-3 and caspase-9, loss of mitochondrial membrane potential, and release of cytochrome c from mitochondria, suggesting that CRA may trigger the activation of the mitochondria-mediated apoptosis pathway. In addition, the inhibition of caspase activity attenuated the CRA-induced apoptosis of MG-63 cells, which further confirmed the role of the mitochondrial pathway in CRA-induced apoptosis. These results indicated that CRA could induce the apoptosis of osteosarcoma cells through activating the mitochondrial pathway, which provides an evidence that CRA may be a useful chemotherapeutic agent for osteosarcoma.
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Affiliation(s)
- Yong Jia
- Orthopedic Center of Chinese PLA, Urumqi General Hospital of Lanzhou Military Region, Urumqi, Xinjiang 830000, P.R. China
| | - Hua Yuan
- Department of Rehabilitation, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Shouqin Shan
- Department of Rehabilitation, Qingdao First Sanatorium of Jinan Military Region, Qingdao, Shandong 266071, P.R. China
| | - Gang Xu
- Orthopedic Center of Chinese PLA, Urumqi General Hospital of Lanzhou Military Region, Urumqi, Xinjiang 830000, P.R. China
| | - Jie Yu
- Department of Information, Urumqi General Hospital of Lanzhou Military Region, Urumqi, Xinjiang 830000, P.R. China
| | - Chenguang Zhao
- Department of Rehabilitation, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Xiang Mou
- Department of Rehabilitation, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Kleinerman E. Maximum benefit of chemotherapy for osteosarcoma achieved-what are the next steps? Lancet Oncol 2016; 17:1340-1342. [PMID: 27569441 DOI: 10.1016/s1470-2045(16)30270-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/17/2016] [Indexed: 11/30/2022]
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Comparison of MAPIE versus MAP in patients with a poor response to preoperative chemotherapy for newly diagnosed high-grade osteosarcoma (EURAMOS-1): an open-label, international, randomised controlled trial. Lancet Oncol 2016; 17:1396-1408. [PMID: 27569442 PMCID: PMC5052459 DOI: 10.1016/s1470-2045(16)30214-5] [Citation(s) in RCA: 284] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/24/2016] [Accepted: 05/27/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND We designed the EURAMOS-1 trial to investigate whether intensified postoperative chemotherapy for patients whose tumour showed a poor response to preoperative chemotherapy (≥10% viable tumour) improved event-free survival in patients with high-grade osteosarcoma. METHODS EURAMOS-1 was an open-label, international, phase 3 randomised, controlled trial. Consenting patients with newly diagnosed, resectable, high-grade osteosarcoma aged 40 years or younger were eligible for randomisation. Patients were randomly assigned (1:1) to receive either postoperative cisplatin, doxorubicin, and methotrexate (MAP) or MAP plus ifosfamide and etoposide (MAPIE) using concealed permuted blocks with three stratification factors: trial group; location of tumour (proximal femur or proximal humerus vs other limb vs axial skeleton); and presence of metastases (no vs yes or possible). The MAP regimen consisted of cisplatin 120 mg/m2, doxorubicin 37·5 mg/m2 per day on days 1 and 2 (on weeks 1 and 6) followed 3 weeks later by high-dose methotrexate 12 g/m2 over 4 h. The MAPIE regimen consisted of MAP as a base regimen, with the addition of high-dose ifosfamide (14 g/m2) at 2·8 g/m2 per day with equidose mesna uroprotection, followed by etoposide 100 mg/m2 per day over 1 h on days 1-5. The primary outcome measure was event-free survival measured in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00134030. FINDINGS Between April 14, 2005, and June 30, 2011, 2260 patients were registered from 325 sites in 17 countries. 618 patients with poor response were randomly assigned; 310 to receive MAP and 308 to receive MAPIE. Median follow-up was 62·1 months (IQR 46·6-76·6); 62·3 months (IQR 46·9-77·1) for the MAP group and 61·1 months (IQR 46·5-75·3) for the MAPIE group. 307 event-free survival events were reported (153 in the MAP group vs 154 in the MAPIE group). 193 deaths were reported (101 in the MAP group vs 92 in the MAPIE group). Event-free survival did not differ between treatment groups (hazard ratio [HR] 0·98 [95% CI 0·78-1·23]); hazards were non-proportional (p=0·0003). The most common grade 3-4 adverse events were neutropenia (268 [89%] patients in MAP vs 268 [90%] in MAPIE), thrombocytopenia (231 [78% in MAP vs 248 [83%] in MAPIE), and febrile neutropenia without documented infection (149 [50%] in MAP vs 217 [73%] in MAPIE). MAPIE was associated with more frequent grade 4 non-haematological toxicity than MAP (35 [12%] of 301 in the MAP group vs 71 [24%] of 298 in the MAPIE group). Two patients died during postoperative therapy, one from infection (although their absolute neutrophil count was normal), which was definitely related to their MAP treatment (specifically doxorubicin and cisplatin), and one from left ventricular systolic dysfunction, which was probably related to MAPIE treatment (specifically doxorubicin). One suspected unexpected serious adverse reaction was reported in the MAP group: bone marrow infarction due to methotrexate. INTERPRETATION EURAMOS-1 results do not support the addition of ifosfamide and etoposide to postoperative chemotherapy in patients with poorly responding osteosarcoma because its administration was associated with increased toxicity without improving event-free survival. The results define standard of care for this population. New strategies are required to improve outcomes in this setting. FUNDING UK Medical Research Council, National Cancer Institute, European Science Foundation, St Anna Kinderkrebsforschung, Fonds National de la Recherche Scientifique, Fonds voor Wetenschappelijk Onderzoek-Vlaanderen, Parents Organization, Danish Medical Research Council, Academy of Finland, Deutsche Forschungsgemeinschaft, Deutsche Krebshilfe, Federal Ministry of Education and Research, Semmelweis Foundation, ZonMw (Council for Medical Research), Research Council of Norway, Scandinavian Sarcoma Group, Swiss Paediatric Oncology Group, Cancer Research UK, National Institute for Health Research, University College London Hospitals, and Biomedical Research Centre.
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Chui MH, Kandel RA, Wong M, Griffin AM, Bell RS, Blackstein ME, Wunder JS, Dickson BC. Histopathologic Features of Prognostic Significance in High-Grade Osteosarcoma. Arch Pathol Lab Med 2016; 140:1231-1242. [PMID: 27552092 DOI: 10.5858/arpa.2015-0389-oa] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context .- In osteosarcoma treated with neoadjuvant chemotherapy the extent of tumor necrosis on resection is considered an indicator of treatment response, and this has been shown to correlate with survival in most but not all studies. Objective .- To identify additional histologic variables of prognostic significance in high-grade osteosarcoma. Design .- Slides of pretreatment biopsy and primary postneoadjuvant chemotherapy resections from 165 patients with high-grade osteosarcoma were reviewed. Univariate (Kaplan-Meier) and multivariate (Cox regression) analyses were performed to identify clinical and histomorphologic attributes associated with overall survival. Results .- Univariate analyses confirmed the prognostic significance of metastatic status on presentation, primary tumor size, anatomic site, and histologic subtype. Additionally, the identification of lymphovascular invasion, 10% or more residual viable tumor, and 10 or more mitoses per 10 high-powered fields assessed in posttreatment resections were associated with poor survival, retaining significance in multivariate analyses. Based on results from multivariate analysis, we developed a prognostic index incorporating primary tumor size and site, and significant histologic features assessed on resection (ie, lymphovascular invasion status, mitotic rate, and extent of viable tumor). This scoring system segregates patients into 3 risk categories with significant differences in overall survival and retained significance in an independent validation set of 42 cases. Conclusions .- The integration of clinical and microscopic features improves prognostication of patients with osteosarcoma.
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Ren L, Mendoza A, Zhu J, Briggs JW, Halsey C, Hong ES, Burkett SS, Morrow J, Lizardo MM, Osborne T, Li SQ, Luu HH, Meltzer P, Khanna C. Characterization of the metastatic phenotype of a panel of established osteosarcoma cells. Oncotarget 2016; 6:29469-81. [PMID: 26320182 PMCID: PMC4745740 DOI: 10.18632/oncotarget.5177] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/25/2015] [Indexed: 11/25/2022] Open
Abstract
Osteosarcoma (OS) is the most common bone tumor in pediatric patients. Metastasis is a major cause of mortality and morbidity. The rarity of this disease coupled with the challenges of drug development for metastatic cancers have slowed the delivery of improvements in long-term outcomes for these patients. In this study, we collected 18 OS cell lines, confirmed their expression of bone markers and complex karyotypes, and characterized their in vivo tumorgenicity and metastatic potential. Since prior reports included conflicting descriptions of the metastatic and in vivo phenotypes of these models, there was a need for a comparative assessment of metastatic phenotypes using identical procedures in the hands of a single investigative group. We expect that this single characterization will accelerate the study of this metastatic cancer. Using these models we evaluated the expression of six previously reported metastasis-related OS genes. Ezrin was the only gene consistently differentially expressed in all the pairs of high/low metatstatic OS cells. We then used a subtractive gene expression approach of the high and low human metastatic cells to identify novel genes that may be involved in OS metastasis. PHLDA1 (pleckstrin homology-like domain, family A) was identified as one of the genes more highly expressed in the high metastatic compared to low metastatic cells. Knocking down PHLDA1 with siRNA or shRNA resulted in down regulation of the activities of MAPKs (ERK1/2), c-Jun N-terminal kinases (JNK), and p38 mitogen-activated protein kinases (MAPKs). Reducing the expression of PHLDA1 also delayed OS metastasis progression in mouse xenograft models.
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Affiliation(s)
- Ling Ren
- Molecular Oncology Section - Metastasis Biology Group, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Arnulfo Mendoza
- Molecular Oncology Section - Metastasis Biology Group, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Jack Zhu
- Genetic Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Joseph W Briggs
- Molecular Oncology Section - Metastasis Biology Group, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Charles Halsey
- Molecular Pathology Unit, Laboratory of Cancer Biology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Ellen S Hong
- Molecular Oncology Section - Metastasis Biology Group, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Sandra S Burkett
- Comparative Molecular Cytogenetics Core Facility, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - James Morrow
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael M Lizardo
- Molecular Oncology Section - Metastasis Biology Group, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Tanasa Osborne
- National Institute of Environmental Health, Research Triangle Park, North Carolina, USA
| | - Samuel Q Li
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Hue H Luu
- Department of Orthopedic Surgery & Rehabilitation Medicine, University of Chicago, Medicine & Biological Sciences, Chicago, USA
| | - Paul Meltzer
- Genetic Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Chand Khanna
- Molecular Oncology Section - Metastasis Biology Group, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
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van As JW, van den Berg H, van Dalen EC. Platinum-induced hearing loss after treatment for childhood cancer. Cochrane Database Syst Rev 2016; 2016:CD010181. [PMID: 27486906 PMCID: PMC6466671 DOI: 10.1002/14651858.cd010181.pub2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Platinum-based therapy, including cisplatin, carboplatin, oxaliplatin or a combination of these, is used to treat a variety of paediatric malignancies. Unfortunately, one of the most important adverse effects is the occurrence of hearing loss or ototoxicity. There is a wide variation in the reported prevalence of platinum-induced ototoxicity and the associated risk factors. More insight into the prevalence of and risk factors for platinum-induced hearing loss is essential in order to develop less ototoxic treatment protocols for the future treatment of children with cancer and to develop adequate follow-up protocols for childhood cancer survivors treated with platinum-based therapy. OBJECTIVES To evaluate the existing evidence on the association between childhood cancer treatment including platinum analogues and the occurrence of hearing loss. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 8), MEDLINE (PubMed) (1945 to 23 September 2015) and EMBASE (Ovid) (1980 to 23 September 2015). In addition, we searched reference lists of relevant articles and the conference proceedings of the International Society for Paediatric Oncology (2008 to 2014), the American Society of Pediatric Hematology/Oncology (2008 to 2015) and the International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer (2010 to 2015). Experts in the field provided information on additional studies. SELECTION CRITERIA All study designs, except case reports, case series (i.e. a description of non-consecutive participants) and studies including fewer than 100 participants treated with platinum-based therapy who had an ototoxicity assessment, examining the association between childhood cancer treatment including platinum analogues and the occurrence of hearing loss. DATA COLLECTION AND ANALYSIS Two review authors independently performed the study selection. One review author performed data extraction and risk of bias assessment, which was checked by another review author. MAIN RESULTS We identified 13 eligible cohort studies including 2837 participants with a hearing test after treatment with a platinum analogue for different types of childhood cancers. All studies had methodological limitations, with regard to both internal (risk of bias) and external validity. Participants were treated with cisplatin, carboplatin or both, in varying doses. The reported prevalence of hearing loss varied considerably between 0% and 90.1%; none of the studies provided data on tinnitus. Three studies reported a prevalence of 0%, but none of these studies provided a definition for hearing loss and there might be substantial or even complete overlap in included participants between these three studies. When only studies that did provide a definition for hearing loss were included, the prevalence of hearing loss still varied widely between 1.7% and 90.1%. All studies were very heterogeneous with regard to, for example, definitions of hearing loss, used diagnostic tests, participant characteristics, (prior) anti-tumour treatment, other ototoxic drugs and length of follow-up. Therefore, pooling of results was not possible.Only two studies included a control group of people who had not received platinum treatment. In one study, the prevalence of hearing loss was 67.1% (95% confidence interval (CI) 59.3% to 74.1%) in platinum-treated participants, while in the control participants it was 7.4% (95% CI 6.2% to 8.8%). However, hearing loss was detected by screening in survivors treated with platinum analogues and by clinical presentation in control participants. It is uncertain what the effect of this difference in follow-up/diagnostic testing was. In the other study, the prevalence of hearing loss was 20.1% (95% CI 17.4% to 23.2%) in platinum-treated participants and 0.4% (95% CI 0.12% to 1.6%) in control participants. As neither study was a randomized controlled trial or controlled clinical trial, the calculation of a risk ratio was not feasible as it is very likely that both groups differed more than only the platinum treatment.Only two studies evaluated possible risk factors using multivariable analysis. One study identified a significantly higher risk of hearing loss in people treated with cisplatin 400 mg/m(2) plus carboplatin 1700 mg/m(2) as compared to treatment with cisplatin 400 mg/m(2) or less, irrespective of the definition of hearing loss. They also identified a significantly higher risk of hearing loss in people treated with non-anthracycline aminoglycosides antibiotics (using a surrogate marker) as compared to people not treated with them, for three out of four definitions of hearing loss. The other study reported that age at treatment (odds ratio less than 1 for each single-unit increase) and single maximum cisplatin dose (odds ratio greater than 1 for each single-unit increase) were significant predictors for hearing loss, while gender was not. AUTHORS' CONCLUSIONS This systematic review shows that children treated with platinum analogues are at risk for developing hearing loss, but the exact prevalence and risk factors remain unclear. There were no data available for tinnitus. Based on the currently available evidence we can only advise that children treated with platinum analogues are screened for ototoxicity in order to make it possible to diagnose hearing loss early and to take appropriate measures. However, we are unable to give recommendations for specific follow-up protocols including frequency of testing. Counselling regarding the prevention of noise pollution can be considered, such as the use of noise-limiting equipment, avoiding careers with excess noise and ototoxic medication. Before definitive conclusions on the prevalence and associated risk factors of platinum-induced ototoxicity can be made, more high-quality research is needed. Accurate and transparent reporting of findings will make it possible for readers to appraise the results of these studies critically.
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Affiliation(s)
- Jorrit W van As
- Princess Máxima Center for Pediatric Oncologyc/o Cochrane Childhood CancerHeidelberglaan 25UtrechtNetherlands3584 CS
| | - Henk van den Berg
- Emma Children's Hospital, Amsterdam UMC, University of AmsterdamDepartment of Paediatric OncologyPO Box 22660AmsterdamNetherlands1100 DD
| | - Elvira C van Dalen
- Princess Máxima Center for Pediatric OncologyHeidelberglaan 25UtrechtNetherlands3584 CS
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Du MD, He KY, Qin G, Chen J, Li JY. Adriamycin resistance-associated prohibitin gene inhibits proliferation of human osteosarcoma MG63 cells by interacting with oncogenes and tumor suppressor genes. Oncol Lett 2016; 12:1994-2000. [PMID: 27602127 DOI: 10.3892/ol.2016.4862] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 02/16/2016] [Indexed: 12/19/2022] Open
Abstract
The resistance of cancer cells to chemotherapeutic agents is a major obstacle for successful chemotherapy, and the mechanism of chemoresistance remains unclear. The present study developed an adriamycin-resistant human osteosarcoma MG-63 sub-line (MG-63/ADR), and identified differentially expressed proteins that may be associated with adriamycin resistance. Two dimensional gel electrophoresis, matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis and a protein identification assay were performed. Western blot analysis was used to examine the prohibitin (PHB) levels in the MG-63/ADR cells. Quantitative polymerase chain reaction was utilized to detect adriamycin resistant-associated genes. Laser-scanning confocal microscope was employed to examine the colocalization of PHB with v-myc avian myelocytomatosis viral oncogene homolog (c-myc), FBJ murine osteosarcoma viral oncogene homolog (c-fos), tumor protein p53 and retinoblastoma 1 (Rb). In addition, the full length of the open reading frame of human PHB was subcloned into a lentiviral vector pLVX-puro. The proliferative rate of MG-63 cells was also investigated. The overall protein expression in MG-63/ADR cells was clearly suppressed. Three notable protein regions, representing high mobility group box 1, Ras homolog gene family, member A, and PHB, were identified to be significantly altered in MG-63/ADR cells when compared with its parental cells. Therefore, PHB modulated the chemoresistance of MG-63/ADR cells by interacting with multiple oncogenes or tumor suppressor genes (c-myc, c-fos, p53 and Rb). In addition, overexpression of PHB decreases the proliferative rate of MG-63 cells. In conclusion, PHB is an adriamycin resistance-associated gene, which may inhibit the proliferation of human osteosarcoma MG-63 cells by interacting with the oncogenes or tumor suppressor genes, c-myc, c-fos, p53 and Rb.
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Affiliation(s)
- Min-Dong Du
- Department of Osteoarthrosis, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning, Guangxi 530023, P.R. China
| | - Kai-Yi He
- Department of Osteoarthrosis, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning, Guangxi 530023, P.R. China
| | - Gang Qin
- Department of Osteoarthrosis, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning, Guangxi 530023, P.R. China
| | - Jin Chen
- Department of Osteoarthrosis, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning, Guangxi 530023, P.R. China
| | - Jin-Yi Li
- Department of Osteoarthrosis, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning, Guangxi 530023, P.R. China
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Zhang C, Zhong W. [Graphic Evolution Witness the Development of Lung Cancer Translational Research]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2016; 19:403-8. [PMID: 27335306 PMCID: PMC6015202 DOI: 10.3779/j.issn.1009-3419.2016.06.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
肺癌从传统化疗到分子靶向,再到如今免疫治疗的转变,转化性研究发挥着无可替代的作用,其中图表演化更是见证一次次重大变迁,从“森林图”到“生存曲线图”,“瀑布图”,“蜘蛛图”再到最近的“时间线区域面积图”,纵向展示了肺癌治疗从群体逐渐向个体深入细化的理念和演进过程。尽管目前最新的免疫治疗炙手可热,但其研究结果并没有达到预期理想,同时传统的治疗手段仍然存在局限性,需要更深入探索。本文将从图表演化角度论述肺癌转化性研究的发展历程,剖析部分失败的外科临床研究,以期对未来肺癌治疗及图表演化有所启发。
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Affiliation(s)
- Chao Zhang
- Department of Surgical Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Wenzhao Zhong
- Department of Surgical Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Gerrand C, Athanasou N, Brennan B, Grimer R, Judson I, Morland B, Peake D, Seddon B, Whelan J. UK guidelines for the management of bone sarcomas. Clin Sarcoma Res 2016; 6:7. [PMID: 27148438 PMCID: PMC4855334 DOI: 10.1186/s13569-016-0047-1] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/09/2016] [Indexed: 01/02/2023] Open
Abstract
This document is an update of the British Sarcoma Group guidelines published in 2010. The aim is to provide a reference standard for the clinical care of patients in the UK with bone sarcomas. Recent recommendations by the European Society of Medical Oncology, The National Comprehensive Cancer Network and The National Institute for Health and Care Excellence have been incorporated, and the literature since 2010 reviewed. The standards represent a consensus amongst British Sarcoma Group members in 2015. It is acknowledged that these guidelines will need further updates as care evolves. The key recommendations are that bone pain or a palpable mass should always lead to further investigation and that patients with clinico-radiological findings suggestive of a primary bone tumour at any site in the skeleton should be referred to a specialist centre and managed by a fully accredited bone sarcoma multidisciplinary team. Treatment recommendations are provided for the major tumour types and for localised, metastatic and recurrent disease. Follow up schedules are suggested.
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Affiliation(s)
- Craig Gerrand
- />Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
| | | | | | - Robert Grimer
- />Royal Orthopaedic Hospital, Birmingham, B31 2AP UK
| | | | - Bruce Morland
- />Birmingham Children’s Hospital, Birmingham, B4 6NH UK
| | - David Peake
- />Queen Elizabeth Hospital, Birmingham, B15 2TH UK
| | | | | | - On behalf of the British Sarcoma Group
- />Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
- />Nuffield Orthopaedic Centre, Oxford, OX3 7LD UK
- />Royal Manchester Children’s Hospital, Manchester, M13 9WL UK
- />Royal Orthopaedic Hospital, Birmingham, B31 2AP UK
- />The Royal Marsden, Sutton, SM2 5PT UK
- />Birmingham Children’s Hospital, Birmingham, B4 6NH UK
- />Queen Elizabeth Hospital, Birmingham, B15 2TH UK
- />University College Hospital, London, NW1 2PG UK
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Meazza C, Scanagatta P. Metastatic osteosarcoma: a challenging multidisciplinary treatment. Expert Rev Anticancer Ther 2016; 16:543-56. [PMID: 26999418 DOI: 10.1586/14737140.2016.1168697] [Citation(s) in RCA: 196] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Osteosarcoma is the most common malignant bone tumor, currently treated with pre-and postoperative chemotherapy in association with the surgical removal of the tumor. About 15-20% of patients have evidence of metastases at diagnosis, mostly in the lungs. Patients with metastatic disease still have a very poor prognosis, with approximately 20-30% of long-term survivors, as compared with 65-70% of patients with localized disease. The optimum management of these patients has not been standardized yet due to several patterns of metastatic disease harboring different prognosis. Complete surgical resection of all sites of disease is mandatory and predictive of survival. Patients with multiple sites of disease not amenable to complete surgery removal should be considered for innovative therapeutic approaches because of poor prognosis.
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Affiliation(s)
- Cristina Meazza
- a Pediatric Oncology Unit , Fondazione IRCCS Istituto Nazionale dei Tumori , Milano , Italy
| | - Paolo Scanagatta
- b Division of Thoracic Surgery , Fondazione IRCCS Istituto Nazionale dei Tumori , Milano , Italy
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Prospective immunotherapies in childhood sarcomas: PD1/PDL1 blockade in combination with tumor vaccines. Pediatr Res 2016; 79:371-7. [PMID: 26595537 DOI: 10.1038/pr.2015.246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/01/2015] [Indexed: 12/21/2022]
Abstract
Progress has slowed substantially in improving survival rates for pediatric sarcomas, particularly in refractory and metastatic disease. Significant progress has been made in the field of tumor vaccines for such malignancies, which target established tumor antigens. While tumor vaccines have demonstrated safety and improved survival rates, they are inadequate in mediating the regression of established tumor masses and metastases. Programmed cell death ligand 1 (PDL1) is a cell-surface protein induced in a number of adult malignancies. By acting on the corresponding T-cell receptor PD1, PDL1 is able to suppress cytotoxic T-cell-mediated tumor responses. Recent therapeutics blocking this interaction have shown promise in various adult cancers by restoring a functional T-cell response and by directing this response toward an activated, rather than regulatory, T-cell phenotype. We shall discuss the current state of tumor vaccines targeting pediatric sarcomas, review PD1-PDL1 interactions and current therapies targeting these interactions in adult malignancies, and discuss recent studies in which tumor vaccines, combined with PDL1 blockades, produced superior tumor regression compared with the vaccine alone. These studies provide a compelling case for investigation of PDL1 expression and its inhibition in pediatric sarcomas, while continuing to utilize tumor vaccines in tandem to achieve superior clinical outcomes.
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Venkatramani R, Murray J, Helman L, Meyer W, Hicks MJ, Krance R, Lau C, Jo E, Chintagumpala M. Risk-Based Therapy for Localized Osteosarcoma. Pediatr Blood Cancer 2016; 63:412-7. [PMID: 26501936 PMCID: PMC6993185 DOI: 10.1002/pbc.25808] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 09/16/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND The outcome of localized osteosarcoma has remained constant over the past 30 years. Histological response to preoperative chemotherapy is the best predictor of outcome. Strategies to alter treatment based on histological response have not resulted in increased survival. PROCEDURE Patients with localized osteosarcoma received preoperative chemotherapy with cisplatin, doxorubicin, and methotrexate. Patients whose tumors had a good histological response (≥90% necrosis) continued with the same treatment postoperatively. Patients with poor histological response (<90% necrosis) received three courses of melphalan 100 mg/m(2) on day -4, cyclophosphamide 2,000 mg/m(2) on days -3, and -2 followed by stem cell infusion. RESULTS Fifty-two patients were enrolled. Median age was 14 years, and 56% of patients were male. The femur was the most common site. Forty patients underwent limb salvage surgery and amputation was performed in six patients. Forty-eight percent of tumors showed good histological response. Forty patients were evaluable for outcome; 18 patients with poor histologic response received high-dose chemotherapy. The 5-year event-free survival (EFS) and overall survival (OS) for patients treated on the high-dose chemotherapy arm were 28% (95% confidence interval [CI], 10-49) and 48% (95% CI, 23-69), respectively. The 5-year EFS and OS for patients treated on the standard chemotherapy arm were 62% (95% CI, 36-80) and 74% (95% CI, 44-90), respectively. All patients who received high-dose chemotherapy developed grade 3 or higher hematological toxicity. There were no treatment-related deaths. CONCLUSIONS Postoperative alkylator intensification with high-dose cyclophosphamide and melphalan in patients with localized osteosarcoma with poor histological response failed to improve survival.
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Affiliation(s)
- Rajkumar Venkatramani
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Cancer Center, Texas Children’s Hospital, Houston, Texas;,Correspondence to: Rajkumar Venkatramani, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Cancer Center, Texas Children’s Hospital,6701 Fannin St., Suite 1510, Houston, TX 77030.
| | | | - Lee Helman
- National Institutes of Health Clinical Center, Pediatric Oncology Branch, Bethesda, Maryland
| | - William Meyer
- Department of Pediatrics, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - M. John Hicks
- Department of Pathology and Immunology and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Robert Krance
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Cancer Center, Texas Children’s Hospital, Houston, Texas
| | - Ching Lau
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Cancer Center, Texas Children’s Hospital, Houston, Texas
| | - Eunji Jo
- Biostatistics and Informatics Shared Resource, The Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Murali Chintagumpala
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Cancer Center, Texas Children’s Hospital, Houston, Texas
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Quartuccio N, Byun BH, Alongi P, Caobelli F, Kong CB, Lim SM, Cistaro A. Assessment of response to treatment in paediatric bone sarcomas by means of PET imaging. Clin Transl Imaging 2016. [DOI: 10.1007/s40336-015-0160-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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119
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Prognosticating metastatic osteosarcoma treated with uniform chemotherapy protocol without high dose methotrexate and delayed metastasectomy: a single center experience of 102 patients. Clin Transl Oncol 2016; 18:937-44. [DOI: 10.1007/s12094-015-1467-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
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120
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Harwood JL, Alexander JH, Mayerson JL, Scharschmidt TJ. Targeted Chemotherapy in Bone and Soft-Tissue Sarcoma. Orthop Clin North Am 2015; 46:587-608. [PMID: 26410647 DOI: 10.1016/j.ocl.2015.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Historically surgical intervention has been the mainstay of therapy for bone and soft-tissue sarcomas, augmented with adjuvant radiation for local control. Although cytotoxic chemotherapy revolutionized the treatment of many sarcomas, classic treatment regimens are fraught with side effects while outcomes have plateaued. However, since the approval of imatinib in 2002, research into targeted chemotherapy has increased exponentially. With targeted therapies comes the potential for decreased side effects and more potent, personalized treatment options. This article reviews the evolution of medical knowledge regarding sarcoma, the basic science of sarcomatogenesis, and the major targets and pathways now being studied.
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Affiliation(s)
- Jared L Harwood
- Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 West 10 Avenue, Columbus, OH 43210, USA
| | - John H Alexander
- Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 West 10 Avenue, Columbus, OH 43210, USA
| | - Joel L Mayerson
- Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 West 10 Avenue, Columbus, OH 43210, USA.
| | - Thomas J Scharschmidt
- Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 West 10 Avenue, Columbus, OH 43210, USA
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Nataraj V, Batra A, Rastogi S, Khan SA, Sharma MC, Vishnubhatla S, Bakhshi S. Developing a prognostic model for patients with localized osteosarcoma treated with uniform chemotherapy protocol without high dose methotrexate: A single-center experience of 237 patients. J Surg Oncol 2015; 112:662-8. [DOI: 10.1002/jso.24045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 09/04/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Vijayamurugan Nataraj
- Department of Medical Oncology; New Delhi
- Dr. B.R.A. Institute Rotary Cancer Hospital; New Delhi
- All India Institute of Medical Sciences; New Delhi
| | - Atul Batra
- Department of Medical Oncology; New Delhi
- Dr. B.R.A. Institute Rotary Cancer Hospital; New Delhi
- All India Institute of Medical Sciences; New Delhi
| | - Shishir Rastogi
- All India Institute of Medical Sciences; New Delhi
- Department of Orthopedics; New Delhi
| | - Shah Alam Khan
- All India Institute of Medical Sciences; New Delhi
- Department of Orthopedics; New Delhi
| | - Mehar Chand Sharma
- All India Institute of Medical Sciences; New Delhi
- Department of Pathology; New Delhi
| | - Sreenivas Vishnubhatla
- All India Institute of Medical Sciences; New Delhi
- Department of Biostatistics; New Delhi
| | - Sameer Bakhshi
- Department of Medical Oncology; New Delhi
- Dr. B.R.A. Institute Rotary Cancer Hospital; New Delhi
- All India Institute of Medical Sciences; New Delhi
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Shkalim-Zemer V, Ash S, Toledano H, Kollender Y, Issakov J, Yaniv I, Cohen IJ. Highly effective reduced toxicity dose-intensive pilot protocol for non-metastatic limb osteogenic sarcoma (SCOS 89). Cancer Chemother Pharmacol 2015; 76:909-16. [DOI: 10.1007/s00280-015-2865-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 09/02/2015] [Indexed: 11/30/2022]
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123
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Isakoff MS, Bielack SS, Meltzer P, Gorlick R. Osteosarcoma: Current Treatment and a Collaborative Pathway to Success. J Clin Oncol 2015; 33:3029-35. [PMID: 26304877 DOI: 10.1200/jco.2014.59.4895] [Citation(s) in RCA: 1001] [Impact Index Per Article: 111.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Osteosarcoma is the bone tumor that most commonly affects children, adolescents, and young adults. Before 1970, treatment primarily included surgical resection. However, the introduction of chemotherapy led to a dramatic improvement in prognosis for patients with localized osteosarcoma; long-term survival rates of less than 20% improved to 65% to 70% after the advent of multiagent chemotherapy regimens. Controversy concerning the ideal combination of chemotherapy agents ensued throughout the last quarter of the 20th century because of conflicting and often nonrandomized data. However, large cooperative group studies and international collaboration have demonstrated that the most effective regimens include the combination of high-dose methotrexate, doxorubicin, and cisplatin (MAP). The introduction of biologic agents such as muramyl tripeptide and the use of additional cytotoxic chemotherapy such as ifosfamide have not definitively improved the survival of patients with osteosarcoma. Collaborative efforts to increase understanding of the biology of osteosarcoma and the use of preclinical models to test novel agents will be critical to identify the path toward improving outcomes for patients. Once promising agents are identified, an international infrastructure exists for clinical trials. Herein, biologic, preclinical, and clinical trial efforts will be described along with future international collaborative strategies to improve outcomes for patients who develop this challenging tumor.
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Affiliation(s)
- Michael S Isakoff
- Michael S. Isakoff, Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, CT; Stefan S. Bielack, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany; Paul Meltzer, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD; and Richard Gorlick, The Children's Hospital of Montefiore; Bronx, NY
| | - Stefan S Bielack
- Michael S. Isakoff, Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, CT; Stefan S. Bielack, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany; Paul Meltzer, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD; and Richard Gorlick, The Children's Hospital of Montefiore; Bronx, NY
| | - Paul Meltzer
- Michael S. Isakoff, Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, CT; Stefan S. Bielack, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany; Paul Meltzer, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD; and Richard Gorlick, The Children's Hospital of Montefiore; Bronx, NY
| | - Richard Gorlick
- Michael S. Isakoff, Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, CT; Stefan S. Bielack, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany; Paul Meltzer, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD; and Richard Gorlick, The Children's Hospital of Montefiore; Bronx, NY.
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Delebinski CI, Georgi S, Kleinsimon S, Twardziok M, Kopp B, Melzig MF, Seifert G. Analysis of proliferation and apoptotic induction by 20 steroid glycosides in 143B osteosarcoma cells in vitro. Cell Prolif 2015; 48:600-10. [PMID: 26300346 DOI: 10.1111/cpr.12208] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/04/2015] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Osteosarcoma is the most common type of malignant bone tumour in children and adolescents; it has poor prognosis, is highly metastatic and is resistant to current therapeutic approaches. In this study, different herbal extracts used in phytotherapy have been screened after searching innovative natural anti-cancer components. MATERIALS AND METHODS Twenty steroid glycosides were examined for accordance to their potential of inhibiting cell proliferation and inducing apoptosis in the osteosarcoma cell line 143B. Cell proliferation was examined using a CASY counter. Effects of cardiac glycosides on induction of apoptosis were evaluated by Annexin V-APC and flow cytometry, caspase activity assay and measurement of mitochondrial membrane potential. RESULTS The study revealed that various steroid glycosides suppress cell proliferation in a concentration-dependent manner. Further investigations indicated apoptotic induction by 17 of the 20 tested cardenolides and bufadienolides. Bufadienolide proscillaridin A, arenobufagin, and cardenolides evomonoside, convallatoxol and ouabain waged strongest apoptotic induction, associated with breakdown of mitochondrial membrane potential and activation of caspases -8 and -9. In contrast, the bufadienolide resibufogenin and cardenolide uzarin had no effect on proliferation inhibition, apoptotic induction or change in mitochondrial membrane potential. CONCLUSION These results indicate that bufadienolides proscillaridin A and arenobufagin and cardenolide evomonoside, or related natural compounds might be promising new starting points for development of novel anti-cancer agents for treatment of osteosarcoma.
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Affiliation(s)
- C I Delebinski
- Department of Paediatric Oncology/Haematology, Otto-Heubner-Centre for Paediatric and Adolescent Medicine (OHC), Charité, Universitaetsmedizin Berlin, Berlin, 13353, Germany
| | - S Georgi
- FU Berlin, Institute for Pharmacy, Berlin, 14195, Germany
| | - S Kleinsimon
- Department of Paediatric Oncology/Haematology, Otto-Heubner-Centre for Paediatric and Adolescent Medicine (OHC), Charité, Universitaetsmedizin Berlin, Berlin, 13353, Germany
| | - M Twardziok
- Department of Paediatric Oncology/Haematology, Otto-Heubner-Centre for Paediatric and Adolescent Medicine (OHC), Charité, Universitaetsmedizin Berlin, Berlin, 13353, Germany
| | - B Kopp
- Department of Pharmacognosy, University of Vienna, Vienna, A-1090, Austria
| | - M F Melzig
- FU Berlin, Institute for Pharmacy, Berlin, 14195, Germany
| | - G Seifert
- Department of Paediatric Oncology/Haematology, Otto-Heubner-Centre for Paediatric and Adolescent Medicine (OHC), Charité, Universitaetsmedizin Berlin, Berlin, 13353, Germany
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O'Kane GM, Cadoo KA, Walsh EM, Emerson R, Dervan P, O'Keane C, Hurson B, O'Toole G, Dudeney S, Kavanagh E, Eustace S, Carney DN. Perioperative chemotherapy in the treatment of osteosarcoma: a 26-year single institution review. Clin Sarcoma Res 2015; 5:17. [PMID: 26175892 PMCID: PMC4501053 DOI: 10.1186/s13569-015-0032-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 06/30/2015] [Indexed: 11/26/2022] Open
Abstract
Background Chemotherapy in the multimodality treatment of osteosarcoma has improved survival. Reported outcomes on adult patients are limited. Poor necrosis rates post neoadjuvant chemotherapy (NAC) is considered an adverse prognostic factor and attempts have been made to improve survival in this group. Patients and methods Adult and young adult patients diagnosed with osteosarcoma between January 1986 and August 2012 were retrospectively reviewed. Patients identified were stratified according to stage (localised or metastatic) and age (≤40 and >40 years). Event free survival (EFS) and overall survival (OS) outcomes were determined. In patients with localised disease ≤40 years, survival was assessed according to necrosis rates post NAC (<90 and ≥90%). NAC consisted of two cycles of methotrexate alternating with doxorubicin/cisplatin (MAP) followed by definitive surgery. Those with ≥90% tumour necrosis continued on MAP. Patients with <90% necrosis received ifosfamide and etoposide (IE) post operatively. Results A total of 108 patients were reviewed and 97 were included. Median age was 23 years (range 16–75) and 70% of patients were male. Five year EFS and OS across all groups was 57% and 63% respectively. Of the patients with localised disease (N = 81), 5-year overall survival (OS), with a median follow up of 7 years (2–26) was 70% (p < 0.0001). Patients aged 16–40 (N = 68) with localised osteosarcoma had a significantly improved 5-year OS (74%) compared to those >40 years (N = 13) (42%) (p = 0.004). Of the 68 patients with localised osteosarcoma ≤40 years, 62 were evaluated according to necrosis rates post MAP. In 33 patients who achieved ≥90% necrosis and continued MAP, 5-year OS was 82%. In 29 patients who had <90% tumour necrosis and received adjuvant IE, 5-year OS was 68% (p = 0.15). Multivariate analysis confirmed age and stage as prognostic factors but not poor necrosis rates in our treated population. Conclusions Long-term survival outcomes in a predominantly adult Irish population are similar to large reported trials. Age and stage at diagnosis are prognostic. Postoperative ifosfamide/etoposide alone in patients with poor necrosis rates is a feasible regimen, but its role in the adjuvant setting remains uncertain. Electronic supplementary material The online version of this article (doi:10.1186/s13569-015-0032-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G M O'Kane
- Department of Medical Oncology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - K A Cadoo
- Gynaecologic Medical Oncology Service, Memorial Sloan-Kettering Cancer Centre, 300 East 66th Street, New York, NY 10065 USA
| | - E M Walsh
- Department of Medical Oncology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - R Emerson
- Department of Medical Oncology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - P Dervan
- Department of Histopathology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - C O'Keane
- Department of Histopathology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - B Hurson
- Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
| | - G O'Toole
- Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
| | - S Dudeney
- Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
| | - E Kavanagh
- Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - S Eustace
- Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - D N Carney
- Department of Medical Oncology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
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Smith TJ, Bohlke K, Lyman GH, Carson KR, Crawford J, Cross SJ, Goldberg JM, Khatcheressian JL, Leighl NB, Perkins CL, Somlo G, Wade JL, Wozniak AJ, Armitage JO. Recommendations for the Use of WBC Growth Factors: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2015; 33:3199-212. [PMID: 26169616 DOI: 10.1200/jco.2015.62.3488] [Citation(s) in RCA: 565] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To update the 2006 American Society of Clinical Oncology guideline on the use of hematopoietic colony-stimulating factors (CSFs). METHODS The American Society of Clinical Oncology convened an Update Committee and conducted a systematic review of randomized clinical trials, meta-analyses, and systematic reviews from October 2005 through September 2014. Guideline recommendations were based on the review of the evidence by the Update Committee. RESULTS Changes to previous recommendations include the addition of tbo-filgrastim and filgrastim-sndz, moderation of the recommendation regarding routine use of CSFs in older patients with diffuse aggressive lymphoma, and addition of recommendations against routine dose-dense chemotherapy in lymphoma and in favor of high-dose-intensity chemotherapy in urothelial cancer. The Update Committee did not address recommendations regarding use of CSFs in acute myeloid leukemia or myelodysplastic syndromes in adults. RECOMMENDATIONS Prophylactic use of CSFs to reduce the risk of febrile neutropenia is warranted when the risk of febrile neutropenia is approximately 20% or higher and no other equally effective and safe regimen that does not require CSFs is available. Primary prophylaxis is recommended for the prevention of febrile neutropenia in patients who are at high risk on the basis of age, medical history, disease characteristics, and myelotoxicity of the chemotherapy regimen. Dose-dense regimens that require CSFs should only be used within an appropriately designed clinical trial or if supported by convincing efficacy data. Current recommendations for the management of patients exposed to lethal doses of total-body radiotherapy, but not doses high enough to lead to certain death as a result of injury to other organs, include the prompt administration of CSFs.
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Affiliation(s)
- Thomas J Smith
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Kari Bohlke
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Gary H Lyman
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Kenneth R Carson
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Jeffrey Crawford
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Scott J Cross
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - John M Goldberg
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - James L Khatcheressian
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Natasha B Leighl
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Cheryl L Perkins
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - George Somlo
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - James L Wade
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - Antoinette J Wozniak
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
| | - James O Armitage
- Thomas J. Smith, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Kari Bohlke, American Society of Clinical Oncology, Alexandria; Scott J. Cross, Virginia Oncology Associates, Norfolk; James L. Khatcheressian, Virginia Cancer Institute, Richmond, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kenneth R. Carson, Washington University, St Louis, MO; Jeffrey Crawford, Duke Medicine, Durham, NC; John M. Goldberg, University of Miami Miller School of Medicine, Miami, FL; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Cheryl L. Perkins, patient representative, Dallas, TX; George Somlo, City of Hope National Medical Center, Duarte, CA; James L. Wade, Cancer Care Specialists of Central Illinois, Decatur, IL; Antoinette J. Wozniak, Karmanos Cancer Institute, Detroit, MI; and James O. Armitage, University of Nebraska Medical Center, Omaha, NE
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Kubo T, Shimose S, Fujimori J, Furuta T, Ochi M. Quantitative (201)thallium scintigraphy for prediction of histological response to neoadjuvant chemotherapy in osteosarcoma; systematic review and meta-analysis. Surg Oncol 2015; 24:194-9. [PMID: 26092710 DOI: 10.1016/j.suronc.2015.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/17/2014] [Accepted: 06/08/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE The histological assessment of tumor necrosis of the excised lesion after neoadjuvant chemotherapy is the most important prognostic factor for patients with osteosarcoma, but more early prognostic factors are needed for the adjustment of adjuvant treatment regimen. The objective of this systematic review is to provide an up-to-date and unprecedented summary of the value of (201)thallium ((201)Tl) scintigraphy for the preoperative evaluation of the chemotherapy response of osteosarcoma. METHODS Studies evaluating (201)Tl scintigraphy for the preoperative evaluation of the chemotherapy response of osteosarcoma were systematically searched for in MEDLINE, EMBASE, and Web of Science. Pooled sensitivity and specificity for each study were calculated into 2 × 2 contingency tables. The DerSimonian-Laird random-effects method was used for determining the pooled diagnostic odds ratio and the area under curve (AUC) of the summary receiver operating characteristic (SROC) curve. RESULTS A total of six studies with 139 patients who fulfilled all of the inclusion criteria were considered for the meta-analysis. The pooled sensitivity and specificity were 0.93 (95% CI, 0.83-0.98) and 0.63 (95% CI, 0.52-0.74), respectively. A significant difference was found between the good and poor responders in the diagnostic odds ratio. The SROC curve showed that the AUC was 0.840, indicating excellent diagnostic accuracy. There was no statistically significant heterogeneity among the six studies. CONCLUSIONS The alteration ratio derived from (201)Tl scintigraphy was useful for evaluating the histological response of patients to neoadjuvant chemotherapy in osteosarcoma.
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Affiliation(s)
- Tadahiko Kubo
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
| | - Shoji Shimose
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Jun Fujimori
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Taisuke Furuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Hattinger CM, Fanelli M, Tavanti E, Vella S, Ferrari S, Picci P, Serra M. Advances in emerging drugs for osteosarcoma. Expert Opin Emerg Drugs 2015; 20:495-514. [PMID: 26021401 DOI: 10.1517/14728214.2015.1051965] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Osteosarcoma (OS), the most common primary malignant bone tumor, is currently treated with pre- and postoperative chemotherapy in association with the surgical removal of the tumor. Conventional treatments allow to cure about 60 - 65% of patients with primary tumors and only 20 - 25% of patients with recurrent disease. New treatment approaches and drugs are therefore highly warranted to improve prognosis. AREAS COVERED This review focuses on the therapeutic approaches that are under development or clinical evaluation in OS. Information was obtained from different and continuously updated data bases, as well as from literature searches, in which particular relevance was given to reports and reviews on new targeted therapies under clinical investigation in high-grade OS. EXPERT OPINION OS is a heterogeneous tumor, with a great variability in treatment response between patients. It is therefore unlikely that a single therapeutic tool will be uniformly successful for all OS patients. This claims for the validation of new treatment approaches together with biologic/(pharmaco)genetic markers, which may select the most appropriate subgroup of patients for each treatment approach. Since some promising novel agents and treatment strategies are currently tested in Phase I/II/III clinical trials, we may hope that new therapies with superior efficacy and safety profiles will be identified in the next few years.
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Faisham WI, Mat Saad AZ, Alsaigh LN, Nor Azman MZ, Kamarul Imran M, Biswal BM, Bhavaraju VMK, Salzihan MS, Hasnan J, Ezane AM, Ariffin N, Norsarwany M, Ziyadi MG, Wan Azman WS, Halim AS, Zulmi W. Prognostic factors and survival rate of osteosarcoma: A single-institution study. Asia Pac J Clin Oncol 2015; 13:e104-e110. [PMID: 25870979 DOI: 10.1111/ajco.12346] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Wan Ismail Faisham
- Department of Orthopaedics; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Arman Zaharil Mat Saad
- Reconstructive Sciences Unit; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Laith N Alsaigh
- Department of Orthopaedics; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Mat Z Nor Azman
- Department of Orthopaedics; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Musa Kamarul Imran
- Department of Community Medicine; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Biswa M Biswal
- Department of Radiation Therapy and Oncology; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Venkata MK Bhavaraju
- Department of Radiation Therapy and Oncology; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Md Salleh Salzihan
- Department of Pathology; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Jaafar Hasnan
- Department of Pathology; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Aziz M Ezane
- Department of Radiology; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Nasir Ariffin
- Department of Pediatric (Oncology); Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Mohamad Norsarwany
- Department of Pediatric (Oncology); Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Mohamad G Ziyadi
- Cardiothoracic Unit; School of Medical Sciences; Health Campus; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Wan Sulaiman Wan Azman
- Reconstructive Sciences Unit; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Ahmad Sukari Halim
- Reconstructive Sciences Unit; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
| | - Wan Zulmi
- Department of Orthopaedics; Universiti Sains Malaysia; Kubang Kerian Kelantan Malaysia
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Hagleitner MM, Coenen MJH, Gelderblom H, Makkinje RR, Vos HI, de Bont ESJM, van der Graaf WTA, Schreuder HWB, Flucke U, van Leeuwen FN, Hoogerbrugge PM, Guchelaar HJ, te Loo DMWM. A First Step toward Personalized Medicine in Osteosarcoma: Pharmacogenetics as Predictive Marker of Outcome after Chemotherapy-Based Treatment. Clin Cancer Res 2015; 21:3436-41. [PMID: 25829401 DOI: 10.1158/1078-0432.ccr-14-2638] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 03/17/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Overall survival in patients with osteosarcoma is only 60%. Poor response to chemotherapy is the dominant risk factor for poor survival. Pharmacogenetic research can offer possibilities to optimize treatment and improve outcome. We applied a pathway-based approach to evaluate the cumulative effect of genes involved in the metabolism of cisplatin and doxorubicin in relationship to clinical outcome. EXPERIMENTAL DESIGN We included 126 patients with osteosarcoma. To comprehensively assess common genetic variation in the 54 genes selected, linkage disequilibrium (LD; r(2) = 0.8)-based tag-single nucleotide polymorphisms (SNP) strategy was used. A final set of 384 SNPs was typed using Illumina Beadarray platform. SNPs significantly associated with 5-year progression-free survival (PFS) were replicated in another 64 patients with osteosarcoma. RESULTS We identified five variants in FasL, MSH2, ABCC5, CASP3, and CYP3A4 that were associated with 5-year PFS. Risk stratification based on the combined effects of the risk alleles showed a significant improvement of 5-year PFS. Patients that carried no or only one risk allele had a 5-year PFS of 100% compared with a 5-year PFS of 84.4% for carriers of two or three risk alleles, 66.7% PFS if a patient carried four to five alleles, and a 5-year PFS of 41.8% for patients with >5 risk alleles (P < 0.001). CONCLUSIONS We identified several genes that showed association with PFS in patients with osteosarcoma. These pharmacogenetic risk factors might be useful to predict treatment outcome and to stratify patients immediately after diagnosis and offer the possibility to improve treatment and outcome.
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Affiliation(s)
- Melanie M Hagleitner
- Department of Pediatric Hematology and Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans Gelderblom
- Department of Clinical Oncology, Leiden University Medical Center, the Netherlands
| | - Remco R Makkinje
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanneke I Vos
- Department of Pediatric Hematology and Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eveline S J M de Bont
- Department of Pediatric Hematology and Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - H W Bart Schreuder
- Department of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Uta Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frank N van Leeuwen
- Department of Pediatric Hematology and Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter M Hoogerbrugge
- Department of Pediatric Hematology and Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, the Netherlands
| | - Dunja M W M te Loo
- Department of Pediatric Hematology and Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
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Bone sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 25 Suppl 3:iii113-23. [PMID: 25210081 DOI: 10.1093/annonc/mdu256] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Fenger JM, London CA, Kisseberth WC. Canine osteosarcoma: a naturally occurring disease to inform pediatric oncology. ILAR J 2015; 55:69-85. [PMID: 24936031 DOI: 10.1093/ilar/ilu009] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Osteosarcoma (OSA) is the most common form of malignant bone cancer in children and dogs, although the disease occurs in dogs approximately 10 times more frequently than in people. Multidrug chemotherapy and aggressive surgical techniques have improved survival; however, new therapies for OSA are critical, as little improvement in survival times has been achieved in either dogs or people over the past 15 years, even with significant efforts directed at the incorporation of novel therapeutic approaches. Both clinical and molecular evidence suggests that human and canine OSA share many key features, including tumor location, presence of microscopic metastatic disease at diagnosis, development of chemotherapy-resistant metastases, and altered expression/activation of several proteins (e.g. Met, ezrin, phosphatase and tensin homolog, signal transducer and activator of transcription 3), and p53 mutations, among others. Additionally, canine and pediatric OSA exhibit overlapping transcriptional profiles and shared DNA copy number aberrations, supporting the notion that these diseases are similar at the molecular level. This review will discuss the similarities between pediatric and canine OSA with regard to histology, biologic behavior, and molecular genetic alterations that indicate canine OSA is a relevant, spontaneous, large animal model of the pediatric disease and outline how the study of naturally occurring OSA in dogs will offer additional insights into the biology and future treatment of this disease in both children and dogs.
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Kubo T, Shimose S, Fujimori J, Furuta T, Arihiro K, Ochi M. Does expression of glucose transporter protein-1 relate to prognosis and angiogenesis in osteosarcoma? Clin Orthop Relat Res 2015; 473:305-10. [PMID: 25193692 PMCID: PMC4390948 DOI: 10.1007/s11999-014-3910-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 08/19/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND The survival of patients who present with nonmetastatic extremity osteosarcoma has dramatically improved, but there are some patients who do not respond to chemotherapy. The ability to identify patients with a poorer prognosis might allow us to target different therapy for these patients. Glucose transporter protein-1 (Glut-1), one of the key factors in glucose metabolism, has been reported to be an independent prognostic factor in various tumors. However, little is known about the role of the Glut-1 pathway in osteosarcoma. QUESTIONS/PURPOSES We asked (1) if Glut-1 expression is a prognostic marker for survival in patients with osteosarcoma, and (2) if there is a relationship between Glut-1 expression and tumor angiogenesis. PATIENTS AND METHODS Thirty-seven patients with resectable high-grade osteosarcomas treated between 1982 and 2007 were reviewed retrospectively. Patients were excluded if representative biopsy material and followup data were not available. The expression of Glut-1 and the number of CD34-positive microvessels for angiogenic activity were measured immunohistochemically. The median followup was 6 years 6 months (range, 11-211 months). Survival analyses were evaluated using the Kaplan-Meier method and the Cox proportional hazards model. The association between Glut-1 expression and microvessel density was analyzed using Student's t-test and chi-square test. For 12 (32.4%) of 37 patients with osteosarcoma, the expression of Glut-1 was positive, with four patients (10.8%) showing strong expression of Glut-1 protein. RESULTS The expression of Glut-1 correlated with a shorter disease-free survival period (relative risk, 20.13; 95% CI, 1.77-229.3; p=0.0016). The microvessel density mean value of positive Glut-1 expression (mean±SD, 26.5±19.4) was lower than that of negative expression (mean±SD, 46.4±35.3; Student's t-test, p=0.038). When more than 50 was defined as a high microvessel density, positive expression of Glut-1 was significantly associated with low microvessel density (chi-square test, p=0.049). CONCLUSIONS These findings indicate that Glut-1 is a potential predictor of survival in patients with osteosarcoma and that glucose metabolism may be negatively associated with angiogenesis. If substantiated in larger numbers of patients, these findings might stimulate the development of novel treatments for patients with a poorer prognosis. LEVEL OF EVIDENCE Level III, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Tadahiko Kubo
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan,
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Reddy KIA, Wafa H, Gaston CL, Grimer RJ, Abudu AT, Jeys LM, Carter SR, Tillman RM. Does amputation offer any survival benefit over limb salvage in osteosarcoma patients with poor chemonecrosis and close margins? Bone Joint J 2015; 97-B:115-20. [DOI: 10.1302/0301-620x.97b1.33924] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A poor response to chemotherapy (≤ 90% necrosis) for osteosarcomas leads to poorer survival and an increased risk of local recurrence, particularly if there is a close margin of excision. We evaluated whether amputation confers any survival benefit over limb salvage surgery (LSS) with narrow margins in patients who respond poorly to chemotherapy. We only analysed patients with an osteosarcoma of the limb, a poor response to chemotherapy and close margins on LSS (marginal/intralesional) or primary amputation: 360 patients (36 LSS (intralesional margins), 197 LSS (marginal margins) and 127 amputations) were included. Local recurrence developed in 13 (36%) following LSS with intralesional margins, and 39 (20%) following LSS with marginal margins. There was no local recurrence in patients who underwent amputation. The five-year survival for all patients was 41% (95% confidence interval (CI) 35 to 46), but for those treated by LSS with marginal margins was 46.2% (95% CI 38 to 53), 36.3% (95% CI 27 to 45) for those treated by amputation, and 28% (95 CI 14 to 44) for those treated by LSS with intralesional margins. Patients who had LSS and then developed local recurrence as a first event had the same survival as those who had primary amputation without local recurrence. Prophylactic adjuvant radiotherapy was used in 40 patients but had no discernible effect in preventing local recurrence. Although amputation offered better local control, it conferred no clear survival benefit over LSS with marginal margins in these patients with a poor overall prognosis. Cite this article: Bone Joint J 2015;97-B:115–20.
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Affiliation(s)
- K. I. A Reddy
- Vanderbilt Orthopaedic Institute, 1215
21st Avenue South, Medical Center East, S Tower, Suite
4200, Nashville, Tennessee
37232-8774, USA
| | - H. Wafa
- Glasgow Royal Infirmary, 84, Castle
Street, Glasgow, G4 0SF, UK
| | - C. L. Gaston
- Royal Orthopaedic Hospital, Bristol
Road South, Northfield, Birmingham, B31
2AP, UK
| | - R. J. Grimer
- Royal Orthopaedic Hospital, Bristol
Road South, Northfield, Birmingham, B31
2AP, UK
| | - A. T. Abudu
- Royal Orthopaedic Hospital, Bristol
Road South, Northfield, Birmingham, B31
2AP, UK
| | - L. M. Jeys
- Royal Orthopaedic Hospital, Bristol
Road South, Northfield, Birmingham, B31
2AP, UK
| | - S. R. Carter
- Royal Orthopaedic Hospital, Bristol
Road South, Northfield, Birmingham, B31
2AP, UK
| | - R. M. Tillman
- Royal Orthopaedic Hospital, Bristol
Road South, Northfield, Birmingham, B31
2AP, UK
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135
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Choeyprasert W, Pakakasama S, Sirachainan N, Songdej D, Chuansumrit A, Anurathapan U, Hongeng S, Nartthanarung A. Comparative Outcome of Thai Pediatric Osteosarcoma Treated with Two Protocols: the Role of High-Dose Methotrexate (HDMTX) in a Single Institute Experience. Asian Pac J Cancer Prev 2014; 15:9823-9. [DOI: 10.7314/apjcp.2014.15.22.9823] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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136
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Wang J, Li G. Mechanisms of methotrexate resistance in osteosarcoma cell lines and strategies for overcoming this resistance. Oncol Lett 2014; 9:940-944. [PMID: 25621072 PMCID: PMC4301490 DOI: 10.3892/ol.2014.2773] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 09/26/2014] [Indexed: 01/20/2023] Open
Abstract
The aim of the present study was to investigate the underlying mechanisms of methotrexate (MTX) resistance in the human osteosarcoma cell line, Saos-2/MTX4.4, and to evaluate various methods of overcoming the resistance to this chemotherapeutic agent. MMT assays were performed to determine the resistance of the primary (Saos-2) and resistant (Saos-2/MTX4.4) cell lines to MTX, cisplatin [cis-diamminedichloroplatinum II (DDP)], ifosfamide (IFO), Adriamycin (ADM), epirubicin (EPI) and theprubicin (THP). The Saos-2/MTX4.4 cells exhibited a low resistance to IFO, ADM, EPI and THP; however, no resistance to DDP was identified. Overall, the Saos-2/MTX4.4 cells exhibited a greater resistance to all the chemotherapeutic agents investigated compared with the Saos-2 cells. Rhodamine 123 (R123) fluorescence was measured in the Saos-2/MTX4.4 and Saos-2 cells 30 and 60 min after the addition of R123, and R123 plus verapamil (VER). VER administration increased the intracellular accumulation of R123. In addition, reverse transcription-quantitative polymerase chain reaction was performed to determine the mRNA expression levels of multidrug resistance gene 1 (MDR1) in the two cell lines. Although the Saos-2/MTX4.4 cells were more resistant to the chemotherapeutic agents than the Saos-2 cells, no significant difference was identified between the relative mRNA expression levels of MDR1 in the Saos-2/MTX4.4 and Saos-2 cells (0.4350±0.0354 vs. 0.3886±0.0456; P>0.05).
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Affiliation(s)
- Jianjun Wang
- Department of Oncology, Henan University Huaihe Hospital, Kaifeng, Henan 475001, P.R. China
| | - Guojun Li
- Department of Orthopedics, Henan University Huaihe Hospital, Kaifeng, Henan 475001, P.R. China
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137
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Whelan JS, Bielack SS, Marina N, Smeland S, Jovic G, Hook JM, Krailo M, Anninga J, Butterfass-Bahloul T, Böhling T, Calaminus G, Capra M, Deffenbaugh C, Dhooge C, Eriksson M, Flanagan AM, Gelderblom H, Goorin A, Gorlick R, Gosheger G, Grimer RJ, Hall KS, Helmke K, Hogendoorn PCW, Jundt G, Kager L, Kuehne T, Lau CC, Letson GD, Meyer J, Meyers PA, Morris C, Mottl H, Nadel H, Nagarajan R, Randall RL, Schomberg P, Schwarz R, Teot LA, Sydes MR, Bernstein M. EURAMOS-1, an international randomised study for osteosarcoma: results from pre-randomisation treatment. Ann Oncol 2014; 26:407-14. [PMID: 25421877 PMCID: PMC4304379 DOI: 10.1093/annonc/mdu526] [Citation(s) in RCA: 193] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Four international study groups undertook a large study in resectable osteosarcoma, which included two randomised controlled trials, to determine the effect on survival of changing post-operative chemotherapy based on histological response. PATIENTS AND METHODS Patients with resectable osteosarcoma aged ≤40 years were treated with the MAP regimen, comprising pre-operatively of two 5-week cycles of cisplatin 120 mg/m(2), doxorubicin 75 mg/m(2), methotrexate 12 g/m(2) × 2 (MAP) and post-operatively two further cycles of MAP and two cycles of just MA. Patients were randomised after surgery. Those with ≥10% viable tumour in the resected specimen received MAP or MAP with ifosfamide and etoposide. Those with <10% viable tumour were allocated to MAP or MAP followed by pegylated interferon. Longitudinal evaluation of quality of life was undertaken. RESULTS Recruitment was completed to the largest osteosarcoma study to date in 75 months. Commencing March 2005, 2260 patients were registered from 326 centres across 17 countries. About 1334 of 2260 registered patients (59%) were randomised. Pre-operative chemotherapy was completed according to protocol in 94%. Grade 3-4 neutropenia affected 83% of cycles and 59% were complicated by infection. There were three (0.13%) deaths related to pre-operative chemotherapy. At definitive surgery, 50% of patients had at least 90% necrosis in the resected specimen. CONCLUSIONS New models of collaboration are required to successfully conduct trials to improve outcomes of patients with rare cancers; EURAMOS-1 demonstrates achievability. Considerable regulatory, financial and operational challenges must be overcome to develop similar studies in the future. The trial is registered as NCT00134030 and ISRCTN 67613327.
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Affiliation(s)
- J S Whelan
- Department of Oncology, University College Hospital, London, UK
| | - S S Bielack
- Cooperative Osteosarcoma Study Group (COSS), Klinikum Stuttgart - Olgahospital, Stuttgart, Germany
| | - N Marina
- Stanford University Medical Center, Pediatric Hematology/Oncology, Palo Alto, USA
| | - S Smeland
- Division of Cancer, Surgery and Transplantation, and Scandinavian Sarcoma Group, Oslo University Hospital, Oslo Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - G Jovic
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - J M Hook
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - M Krailo
- Children's Oncology Group, Arcadia, USA
| | - J Anninga
- Department of Pediatrics and Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - T Böhling
- University of Helsinki and HUSLAB, Helsinki, Finland
| | - G Calaminus
- University Hospital of Muenster, Muenster, Germany
| | - M Capra
- Our Lady's Children's Hospital, Dublin, Ireland
| | - C Deffenbaugh
- Lucile Salter Packard Childrens Hospital Stanford, Palo Alto, USA
| | - C Dhooge
- University Hospital Ghent, Gent, Belgium
| | - M Eriksson
- Skane University Hospital, Lund University, Lund, Sweden
| | - A M Flanagan
- Royal National Orthopaedic Hospital, Stanmore Cancer Institute, University College London, London, UK
| | - H Gelderblom
- Department of Pediatrics and Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - A Goorin
- Dana-Farber Cancer Institute, Boston
| | - R Gorlick
- Section of Pediatric Hematology/Oncology, Montefiore Medical Center, Bronx, USA
| | - G Gosheger
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, Muenster, Germany
| | - R J Grimer
- Royal Orthopaedic Hospital, Birmingham, UK
| | - K S Hall
- Department of Oncology, Oslo University Hospital, Norwegian Radium Hospital, Scandinavian Sarcoma Group, Oslo, Norway
| | - K Helmke
- Department of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P C W Hogendoorn
- Department of Pediatrics and Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - G Jundt
- Bone Tumor Reference Center at the Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - L Kager
- St Anna Children's Hospital, Vienna, Austria
| | - T Kuehne
- University Children's Hospital Basel, Basel, Switzerland
| | - C C Lau
- Texas Children's Cancer Centre, Baylor College of Medicine, Houston
| | - G D Letson
- H. Lee Moffit Cancer Centre & Research Institute, Tampa
| | - J Meyer
- Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia
| | - P A Meyers
- Memorial Sloan-Kettering Cancer Center, New?York
| | - C Morris
- Memorial Sloan-Kettering Cancer Center, New?York Orthopedic Surgery, Johns Hopkins, Baltimore, USA
| | - H Mottl
- Department of Pediatric Hematology Oncology, University Hospital, Prague, Czech Republic
| | - H Nadel
- British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada
| | - R Nagarajan
- Cincinnati Children's Hospital Medical Center, Cincinnati
| | - R L Randall
- Primary Children's Hospital and Huntsman Cancer Institute, University of Utah, Salt Lake City
| | | | - R Schwarz
- Department of Radiation Oncology, Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L A Teot
- Department of Pathology, Boston Children's Hospital, Boston, USA
| | - M R Sydes
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - M Bernstein
- IWK Health Center, Dalhousie University, Halifax, Canada
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138
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Guan G, Zhang Y, Lu Y, Liu L, Shi D, Wen Y, Yang L, Ma Q, Liu T, Zhu X, Qiu X, Zhou Y. The HIF-1α/CXCR4 pathway supports hypoxia-induced metastasis of human osteosarcoma cells. Cancer Lett 2014; 357:254-264. [PMID: 25444927 DOI: 10.1016/j.canlet.2014.11.034] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 11/13/2014] [Accepted: 11/14/2014] [Indexed: 12/11/2022]
Abstract
HIF-1α mediates hypoxia-induced expression of the chemokine receptor CXCR4 and contributes to metastasis in many different cancers. We have previously shown that hypoxia promotes migration of human osteosarcoma cells by activating the HIF-1α/CXCR4 pathway. Here, immunohistochemical analysis showed that unlike control osteochondroma samples, osteosarcoma specimens were characterized by elevated expression levels of HIF-1α and CXCR4. Moreover, we found that hypoxia-induced invasiveness was more pronounced in high metastatic potential F5M2 osteosarcoma cells than in low metastatic potential F4 cells, and that this induction was sensitive to treatment with the CXCR4 antagonist AMD3100 and the HIF-1α inhibitor KC7F2. Interestingly, hypoxia-induced CXCR4 expression persisted after cultured osteosarcoma cells were returned to normoxic conditions. These observations were confirmed by experiments in a mouse model of osteosarcoma lung metastasis showing that hypoxia stimulation of pulmonary metastasis was greater in F5M2 than in F4 cells, and was sensitive to treatment with AMD3100. Our study provides further evidence of the contributions of hypoxia and the HIF-1α/CXCR4 pathway to the progression of osteosarcoma, and suggests that this axis might be efficiently leveraged in the development of novel osteosarcoma therapeutics.
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Affiliation(s)
- Guofeng Guan
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Yinglong Zhang
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Yao Lu
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Lijuan Liu
- State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Doufei Shi
- Department of Geriatrics, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong 256603, China
| | - Yanhua Wen
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Lianjia Yang
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Qiong Ma
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Tao Liu
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China
| | - Xiaodong Zhu
- Department of Microsurgery, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong 256603, China.
| | - Xiuchun Qiu
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China.
| | - Yong Zhou
- Orthopaedic Oncology Institute, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, China.
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Brosa M, García del Muro X, Mora J, Villacampa A, Pozo-Rubio T, Cubells L, Montoto C. Orphan drugs revisited: cost–effectiveness analysis of the addition of mifamurtide to the conventional treatment of osteosarcoma. Expert Rev Pharmacoecon Outcomes Res 2014; 15:331-40. [DOI: 10.1586/14737167.2015.972378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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140
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Kim SH, Shin KH, Seok SO, Cho YJ, Noh JK, Suh JS, Yang WI. Secondary malignant neoplasms after osteosarcoma: early onset and cumulative alkylating agent dose dependency. Ann Surg Oncol 2014; 22:859-65. [PMID: 25192682 DOI: 10.1245/s10434-014-4070-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To analyze the impacts of chemotherapeutic agent exposures on the development of secondary malignant neoplasms (SMP) after osteosarcoma. METHODS Of 132 patients who had been treated for high-grade extremity osteosarcoma from September 1992 to September 2008, 90 survivors were retrospectively reviewed. Fifty-eight of the survivors received a doublet of doxorubicin (ADR) and cisplatin (DDP), and 32 received a triplet of ADR, DDP, and ifosfamide (Ifos). On the basis of the dose distributions in the study cohort, the association between SMN and the cumulative dose of each agent was evaluated. RESULTS After a mean of 13.1 years of follow-up, six SMNs were noted, three in each regimen. There were no SMNs among 42 patients who died of osteosarcoma. In Kaplan-Meier estimates, the triplet regimen group showed a higher cumulative incidence and shorter latency for SMNs than the doublet group (log rank P = 0.032). Fifteen years' cumulative incidence of SMNs in the triplet and doublet regimen group was 9.4 and 3.8%, respectively. In the independent t test, the mean latency to SMN in the triplet group (3.7 ± 1.3 years) was shorter than that in the double group (13.1 ± 2.8 years) (P = 0.017). In Cox regression, the alkylating agent score (AAS) [hazard ratio (HR) = 2.459, P = 0.015] and DDP (HR = 1.779, P = 0.046) showed a significant relationship with SMNs, whereas ADR (HR = 0.896, P = 0.664) and Ifos (HR = 3.694, P = 0.119) did not. AAS was also significant after adjusting for ADR and DDP (HR = 3.319, P = 0.020). CONCLUSIONS High cumulative AAS is an independent risk factor for SMN and its early-onset development after osteosarcoma.
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Affiliation(s)
- Seung Hyun Kim
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
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Xing D, Qasem SA, Owusu K, Zhang K, Siegal GP, Wei S. Changing prognostic factors in osteosarcoma: analysis of 381 cases from two institutions. Hum Pathol 2014; 45:1688-96. [DOI: 10.1016/j.humpath.2014.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/07/2014] [Accepted: 04/09/2014] [Indexed: 02/05/2023]
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142
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Mullen JT, Hornicek FJ, Harmon DC, Raskin KA, Chen YL, Szymonifka J, Yeap BY, Choy E, DeLaney TF, Nielsen GP. Prognostic significance of treatment-induced pathologic necrosis in extremity and truncal soft tissue sarcoma after neoadjuvant chemoradiotherapy. Cancer 2014; 120:3676-82. [PMID: 25081640 DOI: 10.1002/cncr.28945] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 05/26/2014] [Accepted: 06/30/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Histologic response to chemotherapy has been shown to be an independent prognostic factor in patients with osteosarcoma and Ewing sarcoma. However, in patients with soft tissue sarcoma (STS), the prognostic impact of histologic response to chemotherapy is less clear. In the current study, the authors sought to determine the prognostic significance of treatment-induced pathologic necrosis in patients receiving neoadjuvant chemoradiotherapy for STS. METHODS Between 1989 and 2011, a total of 113 patients with grade 2 or 3 (graded according to the National Cancer Institute grading system using 3 tiers) extremity or truncal STS were identified who received neoadjuvant interdigitated chemoradiotherapy according to protocol followed by surgery. The extent of tumor necrosis in the resected specimens was quantified and correlated with outcome. RESULTS The median tumor necrosis rate was 90%, and 103 patients (91%) received all 3 cycles of planned neoadjuvant chemotherapy. The likelihood of achieving ≥95% necrosis was not related to the number of preoperative cycles of chemotherapy received but was found to be related to tumor histology (62% for malignant fibrous histiocytoma vs 0% for synovial sarcoma [P<.001]; 56% for myxoid liposarcoma vs 0% for synovial sarcoma [P = .002]). At a median follow-up of 6 years, there were no statistically significant differences noted in the 5-year local control, disease-specific survival, and overall survival rates for patients with ≥95% necrosis (50 patients; 44%) and <95% necrosis (63 patients; 56%), even when stratifying by histology. CONCLUSIONS In a homogeneous population of patients with high-grade extremity and truncal STS who were treated with neoadjuvant chemoradiotherapy, the extent of pathologic tumor necrosis did not correlate with outcome.
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Affiliation(s)
- John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
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143
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Choeyprasert W, Natesirinilkul R, Charoenkwan P, Sittipreechacharn S. Carboplatin and doxorubicin in treatment of pediatric osteosarcoma: a 9-year single institute experience in the Northern Region of Thailand. Asian Pac J Cancer Prev 2014; 14:1101-6. [PMID: 23621194 DOI: 10.7314/apjcp.2013.14.2.1101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. OBJECTIVE To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. METHOD A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. RESULTS Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were 20.2±7.7% and 47.1±9.5% respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis (28.1±13%, 63.1±12.3%, respectively, p=0.202). On univariate analysis, age at diagnosis and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. CONCLUSIONS In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.
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Affiliation(s)
- Worawut Choeyprasert
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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YANG ZHI, ZHANG MING, XU KE, LIU LIN, HOU WEIKUN, CAI YUANZHEN, XU PENG, YAO JIANFENG. Knockdown of YAP1 inhibits the proliferation of osteosarcoma cells in vitro and in vivo. Oncol Rep 2014; 32:1265-72. [DOI: 10.3892/or.2014.3305] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 05/23/2014] [Indexed: 11/06/2022] Open
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145
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Roncuzzi L, Pancotti F, Baldini N. Involvement of HIF-1α activation in the doxorubicin resistance of human osteosarcoma cells. Oncol Rep 2014; 32:389-94. [PMID: 24840054 DOI: 10.3892/or.2014.3181] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 02/03/2014] [Indexed: 11/05/2022] Open
Abstract
Osteosarcoma is the most common primary bone cancer in children and adolescents. Despite aggressive treatment regimens, survival outcomes remain unsatisfactory, particularly in patients with metastatic and/or recurrent disease. Unfortunately, treatment failure is commonly due to the development of chemoresistance, for which the underlying molecular mechanisms remain unclear. The aim of the present study was to investigate the role of hypoxia-inducible factor 1α (HIF‑1α) and its signalling pathways as mediators of drug-resistance in human osteosarcoma. Toward this aim, we established two osteosarcoma cell lines selected for resistance to doxorubicin, a drug of choice in the treatment of this tumour. Our results showed that the multidrug resistance (MDR) phenotype was also mediated by HIF-1α, the most important regulator of cell adaptation to hypoxia. Our data showed that this transcription factor promoted the outward transport of intracellular doxorubicin by activating the P-glycoprotein (P-gp) expression in osteosarcoma cells maintained in normoxic conditions. In addition, it hindered doxorubicin-induced apoptosis by regulating the expression of c-Myc and p21. Finally, we observed that the doxorubicin-resistant cells maintained for 2 months of continuous culture in a drug-free medium, lost their drug-resistance and this effect was associated with the absence of HIF-1α expression. The emerging role of HIF-1α in osteosarcoma biology indicates its use as a valuable therapeutic target.
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Affiliation(s)
- Laura Roncuzzi
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine, Istituto Ortopedico Rizzoli, I-40136 Bologna, Italy
| | - Fabia Pancotti
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine, Istituto Ortopedico Rizzoli, I-40136 Bologna, Italy
| | - Nicola Baldini
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine, Istituto Ortopedico Rizzoli, I-40136 Bologna, Italy
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Shen JK, Cote GM, Choy E, Yang P, Harmon D, Schwab J, Nielsen GP, Chebib I, Ferrone S, Wang X, Wang Y, Mankin H, Hornicek FJ, Duan Z. Programmed cell death ligand 1 expression in osteosarcoma. Cancer Immunol Res 2014; 2:690-698. [PMID: 24866169 DOI: 10.1158/2326-6066.cir-13-0224] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Programmed cell death ligand 1 (PDL1, also known as B7H1) is a cell-surface protein that suppresses the cytotoxic CD8(+) T-cell-mediated immune response. PDL1 expression and its clinical relevance in sarcomas are not well understood. Therefore, we sought to measure RNA expression levels for PDL1 in 38 clinically annotated osteosarcoma tumor samples and aimed to determine if PDL1 expression correlates with clinical features and tumor-infiltrating lymphocytes (TIL). Quantitative real-time RT-PCR for PDL1 was optimized in 18 cell lines, of which 5 were osteosarcoma derived. qRT-PCR results were validated via flow cytometry and immunohistochemistry (IHC) in select cell lines. Total RNA was isolated from 38 human osteosarcoma samples for qRT-PCR analysis. Clinical data were sorted, and significance was determined by the Student t test. TILs were examined in patient samples by tissue microarray hematoxylin-eosin staining. We confirmed the constitutive PDL1 mRNA expression in cell lines by qRT-PCR, flow cytometry, and IHC. Across human osteosarcoma samples, PDL1 mRNA gene expression ranged over 4 log (>5,000-fold difference). Relative expression levels were evaluated against clinical factors such as age/gender, metastasis, recurrence, chemotherapy, percentage of necrosis, and survival; no significant associations were identified. The presence of TILs was associated with high PDL1 expression (R(2) = 0.37; P = 0.01). In summary, we developed an RNA-based assay to determine PDL1 expression levels, and we show, for the first time, that high levels of PDL1 are expressed in a subset of osteosarcoma, and PDL1 expression is positively correlated with TILs. Multiple agents targeting PD1/PDL1 are in clinical development, and this may be a novel immunotherapeutic strategy for osteosarcoma clinical trials.
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Affiliation(s)
- Jacson K Shen
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, United States
| | - Gregory M Cote
- Division of Hematology and Oncology, Massachusetts General Hospital, Boston, United States
| | - Edwin Choy
- Division of Hematology and Oncology, Massachusetts General Hospital, Boston, United States
| | - Pei Yang
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, United States
| | - David Harmon
- Division of Hematology and Oncology, Massachusetts General Hospital, Boston, United States
| | - Joseph Schwab
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, United States
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Boston, United States
| | - Ivan Chebib
- Department of Pathology, Massachusetts General Hospital, Boston, United States
| | - Soldano Ferrone
- Monoclonal Antibody and Immunotherapy Laboratory, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Xinhui Wang
- Monoclonal Antibody and Immunotherapy Laboratory, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Yangyang Wang
- Monoclonal Antibody and Immunotherapy Laboratory, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Henry Mankin
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, United States
| | - Francis J Hornicek
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, United States
| | - Zhenfeng Duan
- Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, United States
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147
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Kushnir I, Kolander Y, Bickels J, Gortzak Y, Flusser G, Issakov J, Merimsky O. Is it important to maintain high-dose intensity chemotherapy in the treatment of adults with osteosarcoma? Med Oncol 2014; 31:936. [DOI: 10.1007/s12032-014-0936-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
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148
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Analysis of Chemotherapy Dosage and Dosage Intensity and Survival Outcomes of High-Grade Osteosarcoma Patients Younger Than 40 Years. Clin Ther 2014; 36:567-78. [DOI: 10.1016/j.clinthera.2014.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 01/27/2014] [Accepted: 02/18/2014] [Indexed: 11/20/2022]
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149
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Hansen AR, Hughes BG, Paul S, Steadman P, Sommerville S, Dickinson IC, Walpole ET, Thomson DB, Mar Fan HG, Joubert WL. Single institution retrospective review of perioperative chemotherapy in adult and adolescent patients with operable osteosarcoma. Asia Pac J Clin Oncol 2014; 12:e222-8. [PMID: 24571381 DOI: 10.1111/ajco.12167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2013] [Indexed: 11/29/2022]
Abstract
AIMS Perioperative chemotherapy has improved the prognosis for patients with operable osteosarcoma. The literature is conflicting about which regimen is optimal. The aim of this study was to evaluate the survival outcomes of two cohorts of patients with operable osteosarcoma treated with different perioperative chemotherapy regimens. METHODS This was a retrospective review of patients diagnosed with operable osteosarcoma treated at the Princess Alexandra Hospital from 1986 to 2009. The standard perioperative chemotherapy regimen changed from the modified T10 Rosen protocol to cisplatin/doxorubicin in 1997. Using the Kaplan-Meier method, overall survival (OS) and disease-free survival (DFS) curves were generated for the cisplatin/doxorubicin and the modified T10 Rosen cohorts. RESULTS Seventy-one patients were identified of whom 63 had potentially curable disease. Of these, 24 received the modified T10 Rosen regimen and 39 received cisplatin/doxorubicin. There was a non-significant trend toward better OS and DFS in the patients who received the modified T10 Rosen protocol. CONCLUSION The trend toward poorer survival in the cisplatin/doxorubicin cohort, in combination with current evidence, has prompted our institution to change its practice.
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Affiliation(s)
- Aaron R Hansen
- Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia
| | - Brett Gm Hughes
- Cancer Care Services, The Royal Brisbane and Women's Hospital, Queensland, Australia
| | - Sanjoy Paul
- Queensland Clinical Trials and Biostatistics Centre, School of Population Health, The University of Queensland, Princess Alexandra Hospital, Queensland, Australia
| | - Peter Steadman
- Department of Orthopaedics, Princess Alexandra Hospital, Queensland, Australia
| | - Scott Sommerville
- Department of Orthopaedics, Princess Alexandra Hospital, Queensland, Australia
| | - Ian C Dickinson
- Department of Orthopaedics, Princess Alexandra Hospital, Queensland, Australia
| | - Euan T Walpole
- Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia
| | - Damien B Thomson
- Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia
| | - Helen G Mar Fan
- Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia.,University of Queensland School of Medicine, Brisbane, Queensland, Australia
| | - Warren L Joubert
- Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia
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150
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Trps1 is associated with the multidrug resistance of osteosarcoma by regulating MDR1 gene expression. FEBS Lett 2014; 588:801-10. [PMID: 24491996 DOI: 10.1016/j.febslet.2014.01.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 01/07/2014] [Accepted: 01/19/2014] [Indexed: 11/17/2022]
Abstract
Multidrug resistance (MDR) is a significant clinical problem in the chemotherapy of osteosarcoma and has been linked to the cellular expression of several multidrug-efflux transporters such as MDR1/P-gp. Our inhibition of the transcription factor Trps1 led to repression of MDR1/P-gp while its overexpression resulted in upregulation of MDR1/P-gp. Flow cytometric analysis suggested Trps1 increased the release of several anti-cancer drugs, thus decreasing their accumulation. Immunohistochemical analysis of clinical samples indicated that the expression of Trps1 directly correlated with MDR1/P-gp. Trps1 inhibited TGFbeta-1 and directly bound to the MDR1 promoter. Our data demonstrate a role for Trps1 in the regulation of MDR1 expression in osteosarcoma.
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