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Gaspar N, Hung GY, Strauss SJ, Campbell-Hewson Q, Dela Cruz FS, Glade Bender JL, Koh KN, Whittle SB, Chan GCF, Gerber NU, Palmu S, Morgenstern DA, Longhi A, Baecklund F, Lee JA, Locatelli F, Márquez Vega C, Janeway KA, McCowage G, McCabe MG, Bidadi B, Huang J, McKenzie J, Okpara CE, Bautista F. Lenvatinib Plus Ifosfamide and Etoposide in Children and Young Adults With Relapsed Osteosarcoma: A Phase 2 Randomized Clinical Trial. JAMA Oncol 2024:2824985. [PMID: 39418029 DOI: 10.1001/jamaoncol.2024.4381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
Importance The combination of ifosfamide and etoposide (IE) is commonly used to treat relapsed or refractory osteosarcoma; however, second-line treatment recommendations vary across guidelines. Objective To evaluate whether the addition of lenvatinib to IE (LEN-IE) improves outcomes in children and young adults with relapsed or refractory osteosarcoma. Design, Setting, and Participants The OLIE phase II, open-label, randomized clinical trial was conducted globally across Europe, Asia and the Pacific, and North America. From March 22, 2020, through November 11, 2021, the trial enrolled patients aged 2 to 25 years with high-grade osteosarcoma, measurable or evaluable disease per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1), and 1 to 2 prior lines of systemic treatment. The data analyses were performed between March 22, 2020 (first patient in) and June 22, 2022 (data cutoff for the primary analysis), and September 29, 2023 (end of study final database lock). Interventions The OLIE trial assessed the efficacy and safety of lenvatinib (14 mg/m2 taken orally once daily) combined with up to 5 cycles of ifosfamide (3000 mg/m2 intravenously) and etoposide (100 mg/m2 intravenously) on days 1 to 3 of each cycle vs IE alone at the same doses. Patients randomized to IE could cross over to receive lenvatinib upon disease progression by independent imaging review. Main Outcomes and Measures The primary end point was progression-free survival (PFS) per RECIST 1.1 by independent imaging review. The Kaplan-Meier method was used to estimate the PFS distribution, with a prespecified 1-sided significance threshold of .025 by stratified log-rank test. Secondary end points included PFS rate at 4 months and overall survival. Adverse events were summarized using descriptive statistics. Results A total of 81 patients were enrolled (median [IQR] age, 15.0 [12.0-18.0] years; 46 males [56.8%]), with 40 in the LEN-IE arm and 41 in the IE arm. Median PFS was 6.5 months (95% CI, 5.7-8.2 months) for the LEN-IE arm and 5.5 months (95% CI, 2.9-6.5 months) for the IE arm (hazard ratio [HR], 0.54; 95% CI, 0.27-1.08; 1-sided P = .04). The rate of PFS at 4 months was 76.3% (95% CI, 59.3%-86.9%) in the LEN-IE arm and 66.0% (95% CI, 47.7%-79.2%) in the IE arm. Median overall survival was 11.9 months (95% CI, 10.1 months to not estimable) with LEN-IE and 17.4 months (95% CI, 14.2 months to not estimable) with IE (HR, 1.28; 95% CI, 0.60-2.70; 1-sided nominal P = .75). Grade 3 or higher treatment-related adverse events occurred in 35 of 39 patients (89.7%) in the LEN-IE arm and 31 of 39 patients (79.5%) in the IE arm. Conclusions and Relevance Although LEN-IE did not meet prespecified statistical significance for improved PFS vs IE, this study demonstrates the importance of international collaboration and randomized clinical trials in patients with relapsed or refractory osteosarcoma and may inform future trial design. Trial Registration ClinicalTrials.gov Identifier: NCT04154189.
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Affiliation(s)
- Nathalie Gaspar
- Department of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France
| | - Giun-Yi Hung
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Sandra J Strauss
- London Sarcoma Service, University College London Hospital NHS Trust, London, United Kingdom
| | - Quentin Campbell-Hewson
- The Great North Children's Hospital, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | - Filemon S Dela Cruz
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Julia L Glade Bender
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kyung-Nam Koh
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sarah B Whittle
- Department of Pediatrics, Texas Children's Cancer Center, Baylor College of Medicine, Houston
| | - Godfrey Chi-Fung Chan
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Nicolas U Gerber
- Department of Oncology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Sauli Palmu
- Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and University Hospital, Tampere, Finland
| | - Daniel A Morgenstern
- Division of Haematology/Oncology, Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Alessandra Longhi
- Chemotherapy Service, Istituto Ortopedico Rizzoli, Istituto di Ricovero e Cura a Carattere Scientifico, Bologna, Italy
| | - Fredrik Baecklund
- Paediatric Oncology Unit, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Jun Ah Lee
- Center for Pediatric Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Katherine A Janeway
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts
| | - Geoffrey McCowage
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martin G McCabe
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Behzad Bidadi
- Clinical Research, Merck & Co Inc, Rahway, New Jersey
| | - Jie Huang
- Biostatistics, Eisai Inc, Nutley, New Jersey
| | - Jodi McKenzie
- Oncology Business Group, Eisai Inc, Nutley, New Jersey
| | | | - Francisco Bautista
- Hospital del Niño Jesús, Madrid, Spain
- Now with Princess Maxima Centrum for Pediatric Cancer, Utrecht, the Netherlands
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Boam T, Rogoyski BG, Jawaid W, Losty PD. Do Children With Osteosarcoma Benefit From Pulmonary Metastasectomy?: A Systematic Review of Published Studies and "Real World" Outcomes. Ann Surg 2024; 280:235-240. [PMID: 38375639 DOI: 10.1097/sla.0000000000006239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To critically examine the evidence-base for survival benefit of pulmonary metastasectomy (PM) for osteosarcoma (OS) in the pediatric population. BACKGROUND PM for OS is recommended as the standard of care in both pediatric and adult treatment protocols. Recent results from the "Pulmonary Metastasectomy in Colorectal Cancer" trial demonstrate no survival benefit from PM in colorectal cancer in adults. METHODS A systematic review was undertaken according to "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" guidelines. Medline, Embase, and 2 clinical trial registers were searched for all studies detailing pediatric patients with OS (<18 years) undergoing PM with a comparison cohort group that did not receive PM. RESULTS Eleven studies met inclusion criteria dating from 1984 to 2017. All studies were retrospective and none directly compared PM versus no PM in pediatric patients as its main objective(s). Three-year survival rates ranged from 0% to 54% for PM and 0% to 16% for no PM. No patients receiving PM were usually those with unresectable disease and/or considered to have a poor prognosis. All studies were at high risk of bias and there was marked heterogeneity in the patient selection. CONCLUSIONS There is a weak evidence base (level IV) for a survival benefit of PM for OS in pediatric patients likely due to selection bias of "favorable cases." The included studies many of which detailed outdated treatment protocols were not designed in their reporting to specifically address the questions directly. A randomized controlled trial-while ethically challenging in a pediatric population-incorporating modern OS chemotherapy protocols is needed to crucially address any "survival benefit."
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Affiliation(s)
- Tristan Boam
- Department of Pediatric Surgery, Queens Medical Centre, Nottingham, UK
- Department of Pediatric Surgery, University Hospitals of Leicester, Leicester, UK
| | - Bethan G Rogoyski
- Leicester School of Allied Health Sciences, De Montfort University, Leicester, UK
| | - Wajid Jawaid
- Department of Pediatric Surgery, Oxford University Hospitals, Oxford, UK
| | - Paul D Losty
- Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Pediatric Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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McAloney CA, Makkawi R, Budhathoki Y, Cannon MV, Franz EM, Gross AC, Cam M, Vetter TA, Duhen R, Davies AE, Roberts RD. Host-derived growth factors drive ERK phosphorylation and MCL1 expression to promote osteosarcoma cell survival during metastatic lung colonization. Cell Oncol (Dordr) 2024; 47:259-282. [PMID: 37676378 PMCID: PMC10899530 DOI: 10.1007/s13402-023-00867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE For patients with osteosarcoma, disease-related mortality most often results from lung metastasis-a phenomenon shared with many solid tumors. While established metastatic lesions behave aggressively, very few of the tumor cells that reach the lung will survive. By identifying mechanisms that facilitate survival of disseminated tumor cells, we can develop therapeutic strategies that prevent and treat metastasis. METHODS We analyzed single cell RNA-sequencing (scRNAseq) data from murine metastasis-bearing lungs to interrogate changes in both host and tumor cells during colonization. We used these data to elucidate pathways that become activated in cells that survive dissemination and identify candidate host-derived signals that drive activation. We validated these findings through live cell reporter systems, immunocytochemistry, and fluorescent immunohistochemistry. We then validated the functional relevance of key candidates using pharmacologic inhibition in models of metastatic osteosarcoma. RESULTS Expression patterns suggest that the MAPK pathway is significantly elevated in early and established metastases. MAPK activity correlates with expression of anti-apoptotic genes, especially MCL1. Niche cells produce growth factors that increase ERK phosphorylation and MCL1 expression in tumor cells. Both early and established metastases are vulnerable to MCL1 inhibition, but not MEK inhibition in vivo. Combining MCL1 inhibition with chemotherapy both prevented colonization and eliminated established metastases in murine models of osteosarcoma. CONCLUSION Niche-derived growth factors drive MAPK activity and MCL1 expression in osteosarcoma, promoting metastatic colonization. Although later metastases produce less MCL1, they remain dependent on it. MCL1 is a promising target for clinical trials in both human and canine patients.
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Affiliation(s)
- Camille A McAloney
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Rawan Makkawi
- Knight Cancer Institute's, Cancer Early Detection Advanced Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Yogesh Budhathoki
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH, USA
| | - Matthew V Cannon
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Emily M Franz
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH, USA
| | - Amy C Gross
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Maren Cam
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Tatyana A Vetter
- Center for Gene Therapy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Rebekka Duhen
- Knight Cancer Institute's, Cancer Early Detection Advanced Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Alexander E Davies
- Knight Cancer Institute's, Cancer Early Detection Advanced Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | - Ryan D Roberts
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Division of Pediatric Hematology, Oncology, and BMT, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
- The Ohio State University James Comprehensive Cancer Center, Columbus, OH, USA.
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van Ewijk R, Cleirec M, Herold N, le Deley MC, van Eijkelenburg N, Boudou-Rouquette P, Risbourg S, Strauss SJ, Palmerini E, Boye K, Kager L, Hecker-Nolting S, Marchais A, Gaspar N. A systematic review of recent phase-II trials in refractory or recurrent osteosarcoma: Can we inform future trial design? Cancer Treat Rev 2023; 120:102625. [PMID: 37738712 DOI: 10.1016/j.ctrv.2023.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND/OBJECTIVE To analyze changes in recurrent/refractory osteosarcoma phase II trials over time to inform future trials in this population with poor prognosis. METHODS A systematic review of trials registered on trial registries between 01/01/2017-14/02/2022. Comparison of 98 trials identified between 2003 and 2016. Publication search/analysis for both periods, last update on 01/12/2022. RESULTS Between 2017 and 2022, 71 phase-II trials met our selection criteria (19 osteosarcoma-specific trials, 14 solid tumor trials with and 38 trials without an osteosarcoma-specific stratum). The trial number increased over time: 13.9 versus 7 trials/year (p = 0.06). Monotherapy remained the predominant treatment (62% vs. 62%, p = 1). Targeted therapies were increasingly evaluated (66% vs. 41%, P = 0.001). Heterogeneity persisted in the trial characteristics. The inclusion criteria were measurable disease (75%), evaluable disease (14%), and surgical remission (11%). 82% of the trials included pediatric or adolescent patients. Biomarker-driven trials accounted for 25% of the total trials. The survival endpoint use (rather than response) slightly increased (40% versus 31%), but the study H1/H0 hypotheses remained heterogeneous. Single-arm designs predominated over multiarm trials (n = 7). Available efficacy data on 1361 osteosarcoma patients in 58 trials remained disappointing, even though 21% of these trials were considered positive, predominantly those evaluating multi-targeted kinase inhibitors. CONCLUSION Despite observed changes in trial design and an increased number of trials investigating new therapies, high heterogeneity remained with respect to patient selection, study design, primary endpoints, and statistical hypotheses in recently registered phase II trials for osteosarcoma. Continued optimization of trial design informed by a deeper biological understanding should strengthen the development of new therapies.
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Affiliation(s)
- Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Morgane Cleirec
- Department of Pediatric Oncology, CHU Nantes, Nantes, France
| | - Nikolas Herold
- Paediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden, and Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Marie-Cécile le Deley
- Unité de Méthodologie et Biostatistiques, Centre Oscar Lambret, Lille, France; Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, U1018 ONCOSTAT, F-94085 Villejuif, France
| | | | - Pascaline Boudou-Rouquette
- Department of Medical Oncology, Cochin Hospital, Cochin Institute, INSERMU1016, Paris Cancer Institute, CARPEM, AP-HP, Paris, France
| | - Séverine Risbourg
- Unité de Méthodologie et Biostatistiques, Centre Oscar Lambret, Lille, France
| | - Sandra J Strauss
- Department of Oncology, University College London Cancer Institute, London, UK
| | - Emanuela Palmerini
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Kjetil Boye
- Department of Oncology, Oslo University Hospital, Norway
| | - Leo Kager
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria; St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | | | - Antonin Marchais
- Department of Oncology for Child and Adolescents, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France; National Institute for Health and Medical Research (INSERM) U1015, BiiOSTeam, Gustave Roussy Institute, Villejuif, France
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescents, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France; National Institute for Health and Medical Research (INSERM) U1015, BiiOSTeam, Gustave Roussy Institute, Villejuif, France.
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5
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Mettmann VL, Baumhoer D, Bielack SS, Blattmann C, Friedel G, von Kalle T, Kager L, Kevric M, Nathrath M, Sorg B, Dürken M, Hecker‐Nolting S. Solitary pulmonary metastases at first recurrence of osteosarcoma: Presentation, treatment, and survival of 219 patients of the Cooperative Osteosarcoma Study Group. Cancer Med 2023; 12:18219-18234. [PMID: 37548393 PMCID: PMC10524021 DOI: 10.1002/cam4.6409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/04/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND To evaluate patient and tumour characteristics, treatment and their impact on survival in patients with a solitary pulmonary metastasis at first relapse of high-grade osteosarcoma. PROCEDURE Two-hundred and nineteen consecutive patients who had achieved a complete surgical remission and then developed a solitary pulmonary metastasis at first recurrence of high-grade osteosarcoma were retrospectively reviewed. RESULTS Two hundred and three (94.9%) of 214 patients achieved a second complete remission. After a median time from initial diagnosis of osteosarcoma to first relapse of 2.3 years (range, 0.3-18.8 years), actuarial post-relapse overall survival after 2 and 5 years was 72.0% and 51.2%. Post-relapse event-free survival was 39.1% and 31.1%. Median follow-up time was 3.2 years (range, 0.1-29.4 years). A longer time until first relapse and diagnosis due to imaging were positive prognostic factors in uni- and multivariate analyses, as were a second complete surgical remission and, in regard to death, the absence of a subsequent relapse. The use of salvage chemotherapy and radiotherapy were not associated with patient outcomes, nor was the surgical approach (thoracoscopy vs. thoracotomy) nor the exploration (uni- vs. bilateral). CONCLUSION Approximately half of the patients who experience a solitary pulmonary relapse at first recurrence of osteosarcoma remain alive 5 years after this first relapse. Only one third will remain disease-free. A complete surgical resection of the lesion is essential for long-term survival while relapse chemotherapy does not seem to improve survival. Innovative therapies are required to improve outcomes.
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Affiliation(s)
- Vanessa L. Mettmann
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)StuttgartGermany
- Medical Faculty HeidelbergHeidelberg UniversityHeidelbergGermany
| | - Daniel Baumhoer
- Bone Tumour Reference Centre, Institute of Medical Genetics and PathologyUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Stefan S. Bielack
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)StuttgartGermany
- Department for Paediatric Haematology and OncologyUniversity's Children's Hospital MuensterMuensterGermany
| | - Claudia Blattmann
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)StuttgartGermany
| | - Godehard Friedel
- Department of Thoracic SurgeryUniversity of Tubingen, Faculty of ScienceTubingenGermany
| | - Thekla von Kalle
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer CentreInstitute of RadiologyStuttgartGermany
| | - Leo Kager
- St. Anna KinderspitalUniversity Hospital for Paediatric and Adolescent Medicine of the Medical University, and St. Anna Children's Cancer Research Institute (CCRI)ViennaAustria
| | - Matthias Kevric
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)StuttgartGermany
| | - Michaela Nathrath
- Department of Paediatrics and Children's Cancer Research Centre, Klinikum rechts der IsarTechnical University of Munich, School of MedicineMunichGermany
- Paediatric Haematology and Oncology, Klinikum KasselKasselGermany
| | - Benjamin Sorg
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)StuttgartGermany
| | - Matthias Dürken
- Department of Paediatric Haematology and OncologyMannheim University HospitalMannheimGermany
| | - Stefanie Hecker‐Nolting
- Klinikum Stuttgart ‐ Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)StuttgartGermany
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Li YA, Chen HY, Hsieh CP, Chen CL, Hung SC, Huang YF. Acute generation of reactive oxygen species that induced by doxycycline pretreatment results in rapid cell death in polyphyllin G-treated osteosarcoma cell lines. ENVIRONMENTAL TOXICOLOGY 2023; 38:1174-1184. [PMID: 36773305 DOI: 10.1002/tox.23757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/21/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Polyphyllin G, a pennogenyl saponin extracted from Paris polyphylla, has been shown to possess antitumor effects. In this study, we demonstrated that doxycycline, an antibiotic medicine, could significantly enhance the sensitivities of osteosarcoma cell lines to polyphyllin G. As the cells were pretreated with doxycycline at non-toxic concentrations and then co-exposed to polyphyllin G, this combination could induce a rapid cell death distinct from apoptosis. The non-apoptotic cell death was characterized by a loss of integrity of plasma membrane without externalization of phosphatidyl serine. Furthermore, this combined treatment resulted in suppression of cell viability and colony-forming ability, and increased the level of γ-H2A.X, a critical marker for DNA damage, in osteosarcoma cell lines. When examining the underlying mechanism, it was revealed combination of polyphyllin G and doxycycline triggered an enhanced generation of reactive oxygen species (ROS), and up-regulated mitochondrial oxidative stress within 0.5 h. Co-administration of the ROS inhibitor NAC reversed the suppressed cell viability and colony-forming ability, and abolished the increased level of γ-H2A.X in the cells with the combined treatment, indicating that the enhanced ROS was involved in the anti-proliferative effect of the combined treatment. Overall, the results demonstrated that doxycycline may function as chemosensitizers by inducing an acute and lethal ROS production to enhance cytotoxic of polyphyllin G in osteosarcoma cell lines, and the combined use of drugs may provide an alternative thinking for the development of new therapeutic agents.
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Affiliation(s)
- Yi-An Li
- Institute of Translational Medicine and New Drug Development, School of Medicine, China Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Orthopaedic Department, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsuan-Ying Chen
- Orthopedics & Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan
| | - Cheng-Pu Hsieh
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Orthopedics & Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan
- Department of Kinesiology, Health and Leisure Studies, Chienkuo Technology University, Changhua, Taiwan
| | - Chiu-Liang Chen
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | - Shih-Chieh Hung
- Drug Development Center, Institute of Translational Medicine and New Drug Development, School of Medicine, China Medical University, Taichung, Taiwan
- Integrative Stem Cell Center, China Medical University Hospital, Taichung, Taiwan
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Fu Huang
- Orthopedics & Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan
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Klosowski M, Haines L, Alfino L, McMellen A, Leibowitz M, Regan D. Naturally occurring canine sarcomas: Bridging the gap from mouse models to human patients through cross-disciplinary research partnerships. Front Oncol 2023; 13:1130215. [PMID: 37035209 PMCID: PMC10076632 DOI: 10.3389/fonc.2023.1130215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
Fueled by support from the National Cancer Institute's "Cancer Moonshot" program, the past few years have witnessed a renewed interest in the canine spontaneous cancer model as an invaluable resource in translational oncology research. Increasingly, there is awareness that pet dogs with cancer provide an accessible bridge to improving the efficiency of cancer drug discovery and clinical therapeutic development. Canine tumors share many biological, genetic, and histologic features with their human tumor counterparts, and most importantly, retain the complexities of naturally occurring drug resistance, metastasis, and tumor-host immune interactions, all of which are difficult to recapitulate in induced or genetically engineered murine tumor models. The utility of canine models has been particularly apparent in sarcoma research, where the increased incidence of sarcomas in dogs as compared to people has facilitated comparative research resulting in treatment advances benefitting both species. Although there is an increasing awareness of the advantages in using spontaneous canine sarcoma models for research, these models remain underutilized, in part due to a lack of more permanent institutional and cross-institutional infrastructure to support partnerships between veterinary and human clinician-scientists. In this review, we provide an updated overview of historical and current applications of spontaneously occurring canine tumor models in sarcoma research, with particular attention to knowledge gaps, limitations, and growth opportunities within these applications. Furthermore, we propose considerations for working within existing veterinary translational and comparative oncology research infrastructures to maximize the benefit of partnerships between veterinary and human biomedical researchers within and across institutions to improve the utility and application of spontaneous canine sarcomas in translational oncology research.
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Affiliation(s)
- Marika Klosowski
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Laurel Haines
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Lauren Alfino
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Alexandra McMellen
- Center for Cancer and Blood Disorders, Children’s Hospital Colorado, Aurora, CO, United States
| | - Michael Leibowitz
- Center for Cancer and Blood Disorders, Children’s Hospital Colorado, Aurora, CO, United States
| | - Daniel Regan
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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8
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Attenuation of Endoplasmic Reticulum Stress Enhances Carvacrol-Induced Apoptosis in Osteosarcoma Cell Lines. Life (Basel) 2023; 13:life13030744. [PMID: 36983900 PMCID: PMC10054369 DOI: 10.3390/life13030744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Carvacrol is a monoterpenoid phenol that has excellent antimicrobial, antiviral, and anti-inflammatory activities. It can also improve wound healing. However, few studies have explored its antitumor effect on osteosarcoma. In this report, we tried to determine the potential efficacy of carvacrol against osteosarcoma cell lines. Our data revealed that carvacrol exposure inhibited the proliferation of osteosarcoma HOS and U-2 OS cells. In addition, carvacrol exposure enhanced the levels of cleaved PARP and caspase 3 and increased annexin V-positive cells, indicating that carvacrol exposure triggers apoptosis in osteosarcoma cell lines. Furthermore, the levels of reactive oxygen species (ROS) were enhanced after carvacrol exposure and cotreatment with NAC, the ROS scavenger, decreased the levels of cleaved PARP and caspase 3, suggesting the involvement of ROS in carvacrol-induced apoptosis. Importantly, we found that carvacrol exposure triggered several protein expressions related to endoplasmic reticulum (ER) stress, including GRP78/Bip, IRE1a, PERK, and CHOP, in HOS and U-2 OS cells, indicating that carvacrol exposure could result in ER stress in these cell lines. Cotreatment with the ER stress inhibitor 4-PBA increased the levels of cleaved PARP and caspase 3 and further suppressed cellular proliferation in carvacrol-exposed osteosarcoma cell lines. Overall, the results indicate that induced ER stress can protect cells from apoptosis, but increased ROS contributes to apoptosis in carvacrol-treated cells. In this report, we first demonstrate the role of ER stress in carvacrol-induced apoptosis and suggest that ER stress could be targeted to enhance the antitumor activity of carvacrol in osteosarcoma cell lines.
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9
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Tippett VL, Tattersall L, Ab Latif NB, Shah KM, Lawson MA, Gartland A. The strategy and clinical relevance of in vitro models of MAP resistance in osteosarcoma: a systematic review. Oncogene 2023; 42:259-277. [PMID: 36434179 PMCID: PMC9859755 DOI: 10.1038/s41388-022-02529-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/27/2022]
Abstract
Over the last 40 years osteosarcoma (OS) survival has stagnated with patients commonly resistant to neoadjuvant MAP chemotherapy involving high dose methotrexate, adriamycin (doxorubicin) and platinum (cisplatin). Due to the rarity of OS, the generation of relevant cell models as tools for drug discovery is paramount to tackling this issue. Four literature databases were systematically searched using pre-determined search terms to identify MAP resistant OS cell lines and patients. Drug exposure strategies used to develop cell models of resistance and the impact of these on the differential expression of resistance associated genes, proteins and non-coding RNAs are reported. A comparison to clinical studies in relation to chemotherapy response, relapse and metastasis was then made. The search retrieved 1891 papers of which 52 were relevant. Commonly, cell lines were derived from Caucasian patients with epithelial or fibroblastic subtypes. The strategy for model development varied with most opting for continuous over pulsed chemotherapy exposure. A diverse resistance level was observed between models (2.2-338 fold) with 63% of models exceeding clinically reported resistance levels which may affect the expression of chemoresistance factors. In vitro p-glycoprotein overexpression is a key resistance mechanism; however, from the available literature to date this does not translate to innate resistance in patients. The selection of models with a lower fold resistance may better reflect the clinical situation. A comparison of standardised strategies in models and variants should be performed to determine their impact on resistance markers. Clinical studies are required to determine the impact of resistance markers identified in vitro in poor responders to MAP treatment, specifically with respect to innate and acquired resistance. A shift from seeking disputed and undruggable mechanisms to clinically relevant resistance mechanisms may identify key resistance markers that can be targeted for patient benefit after a 40-year wait.
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Affiliation(s)
- Victoria L Tippett
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Luke Tattersall
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Norain B Ab Latif
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
- Universiti Kuala Lumpur Royal College of Medicine Perak, No. 3 Jalan Greentown, 30450, Ipoh, Perak, Malaysia
| | - Karan M Shah
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Michelle A Lawson
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Alison Gartland
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK.
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10
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The Role of a Multidisciplinary Team in the Diagnosis and Treatment of Bone and Soft Tissue Sarcomas: A Single-Center Experience. J Pers Med 2022; 12:jpm12122079. [PMID: 36556299 PMCID: PMC9782466 DOI: 10.3390/jpm12122079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Bone and soft tissue sarcomas with complex and varied clinical, imaging, and pathological characteristics cannot be diagnosed and treated by a single discipline, as each discipline has some limitations. This study aimed to explore the role of a multidisciplinary team (MDT) in the diagnosis and treatment of bone and soft tissue sarcomas over the past four consecutive years. The subjects were 269 patients discussed during MDT meetings at a Bone and Soft Tissue Sarcomas Center in South China. The diagnosis, relapse diagnosis, unplanned resection, management of pulmonary nodules, and treatment of refractory and advanced tumors were compared to similar data provided in the literature to (i) determine whether the MDT significantly affected the diagnosis and treatment of bone and soft tissue sarcomas, and (ii) explore trends in the types of patients with bone and soft tissue sarcomas and treatment decision-making since the establishment of the MDT. Results revealed that the MDT significantly improved preoperative diagnostic accuracy for patients with bone and soft tissue sarcomas; the accuracy of diagnosis and relapse diagnosis by the MDT reached 95.42% and 100%, respectively. After an MDT discussion, the positive pathology rate for extended resection after unplanned resection was 81.2%. The overall accuracy of the MDT in determining the nature of pulmonary nodules was 87.1-91.9%. For patients presenting with pulmonary nodules in osteosarcoma, no statistically significant difference in survival was shown between cases discussed by the MDT and those without an MDT discussion (p = 0.5751). Collectively, the MDT can play a positive role in accurate preoperative diagnosis, relapse diagnosis, the decision to extend resection after an unplanned resection, and the diagnostic accuracy of pulmonary nodules.
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11
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Hingorani P, Krailo M, Buxton A, Hutson P, Sondel PM, Diccianni M, Yu A, Morris CD, Womer RB, Crompton B, Randall RL, Teot LA, DuBois SG, Janeway KA, Gorlick RG, Isakoff MS. Phase 2 study of anti-disialoganglioside antibody, dinutuximab, in combination with GM-CSF in patients with recurrent osteosarcoma: A report from the Children's Oncology Group. Eur J Cancer 2022; 172:264-275. [PMID: 35809374 PMCID: PMC9631806 DOI: 10.1016/j.ejca.2022.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Novel effective therapies are urgently needed in recurrent osteosarcoma. GD2 is expressed in human osteosarcoma tumours and cell lines. This study evaluated the disease control rate (DCR) in patients with recurrent osteosarcoma treated with the anti-GD2 antibody dinutuximab plus cytokine therapy as compared to historical outcomes. METHODS AOST1421 was a single-arm Phase 2 study for patients with recurrent pulmonary osteosarcoma in complete surgical remission. Patients received up to five cycles of dinutuximab (70 mg/m2/cycle) with granulocyte-macrophage colony-stimulating factor (GM-CSF). Two different dinutuximab infusion schedules were studied: 35 mg/m2/day over 20 h (2 days) and 17.5 mg/m2/day over 10 h (4 days). Primary end point was DCR, defined as a proportion of patients event free at 12 months from enrolment. The historical benchmark was 12-month DCR of 20% (95% CI 10-34%). Dinutuximab would be considered effective if ≥ 16/39 patients remained event free. Secondary objectives included toxicity evaluation and pharmacokinetics. RESULTS Thirty-nine eligible patients were included in the outcome analysis. Dinutuximab did not demonstrate evidence of efficacy as 11/39 patients remained event free for a DCR of 28.2% (95% CI 15-44.9%). One of 136 administered therapy cycles met criteria for unacceptable toxicity when a patient experienced sudden death of unknown cause. Other ≥ Grade 3 toxicities included pain, diarrhoea, hypoxia, and hypotension. Pharmacokinetic parameters were similar in the two schedules. CONCLUSIONS The combination of dinutuximab with GM-CSF did not significantly improve DCR in recurrent osteosarcoma. Dinutuximab toxicity and pharmacokinetics in adolescent and young adult osteosarcoma patients were similar to younger patients. Other strategies for targeting GD2 in osteosarcoma are being developed.
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Affiliation(s)
| | - Mark Krailo
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Paul Hutson
- UW School of Pharmacy, University of Wisconsin, Madison, WI, USA
| | - Paul M Sondel
- Pediatrics, Human Oncology and Genetics, University of Wisconsin, Madison, WI, USA
| | | | - Alice Yu
- University of California, San Diego, CA, USA
| | - Carol D Morris
- Johns Hopkins University/ Sidney Kimmel Cancer Center, Baltimore, MD, USA
| | - Richard B Womer
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Crompton
- Dana-Farber/ Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - R Lor Randall
- University of California Davis Comprehensive Cancer Center, San Diego, CA, USA
| | - Lisa A Teot
- Dana-Farber/ Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Steven G DuBois
- Dana-Farber/ Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Katherine A Janeway
- Dana-Farber/ Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
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12
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Zhang Y, Gong R, Liu Y, Sun X, Liang J, Zhou Y, Wang Y, Yu W, Wang Y, Tang L, He A, Shen Z, Yao Y, Hu H, Liu X, Zhang J. Ailanthone Inhibits Proliferation, Migration and Invasion of Osteosarcoma Cells by Downregulating the Serine Biosynthetic Pathway. Front Oncol 2022; 12:842406. [PMID: 35186770 PMCID: PMC8850634 DOI: 10.3389/fonc.2022.842406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Osteosarcoma (OS) is the most common primary bone sarcoma, chemoresistance becomes an obstacle to its treatment. Metabolic reprogramming is a hallmark of malignancy, targeting the metabolic pathways might provide a reasonable therapeutic strategy for OS. Here we demonstrated that Ailanthone (AIL), a major component of the Chinese medicine Ailanthus altissima, significantly suppressed OS cell growth in vitro and in vivo. Furthermore, AIL dose-dependently inhibited cell migration and invasion, induced cell cycle arrest and apoptosis in OS cells. Combined transcriptomics, proteomics and metabolomics analyses revealed that AIL induced widespread changes in metabolic programs in OS cells, while the serine biosynthetic pathway (SSP) was the most significantly altered pathway. qRT-PCR and Western blot assay confirmed that the transcript and protein levels of the SSP genes (PHGDH, PSAT1 and PSPH) were downregulated dose-dependently by AIL. In addition, we found out that many downstream pathways of the SSP including the one-carbon pool by folate, purine metabolism, pyrimidine metabolism, DNA replication and sphingolipid metabolism were downregulated after AIL treatment. In the revere test, PHGDH overexpression but not exogenous serine supplementation clearly attenuated the effects of AIL on OS cells. Taken together, AIL exerts antitumor effects on OS through mediating metabolic reprogramming, at least in part, by suppressing the SSP. Our findings suggest that AIL could emerge as a potential therapeutic strategy in OS.
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Affiliation(s)
- Yawen Zhang
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Runze Gong
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yong Liu
- School of Artificial Intelligence, Guangxi University for Nationalities, Nanning, China
| | - Xipeng Sun
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jinrong Liang
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yan Zhou
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yaling Wang
- Department of Oncology, The Eighth People's Hospital of Shanghai, Shanghai, China
| | - Wenxi Yu
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yonggang Wang
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lina Tang
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Aina He
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zan Shen
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yang Yao
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Haiyan Hu
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xin Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianjun Zhang
- Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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13
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Menendez N, Epelman M, Shao L, Douglas D, Meyers AB. Pediatric Osteosarcoma: Pearls and Pitfalls. Semin Ultrasound CT MR 2022; 43:97-114. [PMID: 35164914 DOI: 10.1053/j.sult.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Osteosarcoma is a malignant bone tumor most commonly presenting in children. It has a bimodal distribution with a peak incidence occurring during the ages of 10-14 years old and in adults greater than age 65. The first peak of osteosarcoma correlates with the increased proliferation of bone during the pubertal growth period. Osteosarcoma most frequently presents with localized bone pain, swelling, and an antalgic gait. The patient may attribute symptoms to trauma or strenuous exercise, causing the patient to be managed conservatively. In these cases, the pain persists and eventually leads to further evaluation. The most common type of osteosarcoma is the conventional high-grade osteosarcoma. For conventional osteosarcoma, the diagnosis is typically made or strongly suggested based upon the initial radiographic appearance. Other types of osteosarcomas include low grade central, telangiectatic, small-cell, surface and intracortical. Consequently, it is important for radiologists to be aware of these subtypes and the imaging features that differentiate them from other etiologies to prevent a delay in treatment.
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Affiliation(s)
- Nelson Menendez
- University of Central Florida College of Medicine, Orlando, FL; Department of Radiology, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Monica Epelman
- University of Central Florida College of Medicine, Orlando, FL; Department of Radiology, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Lei Shao
- University of Central Florida College of Medicine, Orlando, FL; Department of Pathology and Lab Medicine, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Dorothea Douglas
- University of Central Florida College of Medicine, Orlando, FL; Department of Pediatrics, Nemours Children's Health System/Nemours Children's Hospital, Orlando, FL
| | - Arthur B Meyers
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Dept. of Radiology, Cincinnati, OH.
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14
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Regan DP, Chow L, Das S, Haines L, Palmer E, Kurihara JN, Coy JW, Mathias A, Thamm DH, Gustafson DL, Dow SW. Losartan Blocks Osteosarcoma-Elicited Monocyte Recruitment, and Combined With the Kinase Inhibitor Toceranib, Exerts Significant Clinical Benefit in Canine Metastatic Osteosarcoma. Clin Cancer Res 2021; 28:662-676. [PMID: 34580111 DOI: 10.1158/1078-0432.ccr-21-2105] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/16/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE There is increasing recognition that progress in immuno-oncology could be accelerated by evaluating immune-based therapies in dogs with spontaneous cancers. Osteosarcoma (OS) is one tumor for which limited clinical benefit has been observed with the use of immune checkpoint inhibitors. We previously reported the angiotensin receptor blocker losartan suppressed metastasis in preclinical mouse models through blockade of CCL2-CCR2 monocyte recruitment. Here we leverage dogs with spontaneous OS to determine losartan's safety and pharmacokinetics associated with monocyte pharmacodynamic endpoints, and assess its antitumor activity, in combination with the kinase inhibitor toceranib. PATIENTS AND METHODS CCL2 expression, monocyte infiltration, and monocyte recruitment by human and canine OS tumors and cell lines were assessed by gene expression, ELISA, and transwell migration assays. Safety and efficacy of losartan-toceranib therapy were evaluated in 28 dogs with lung metastatic OS. Losartan PK and monocyte PD responses were assessed in three dose cohorts of dogs by chemotaxis, plasma CCL2, and multiplex cytokine assays, and RNA-seq of losartan-treated human peripheral blood mononuclear cells. RESULTS Human and canine OS cells secrete CCL2 and elicit monocyte migration, which is inhibited by losartan. Losartan PK/PD studies in dogs revealed that a 10-fold-higher dose than typical antihypertensive dosing was required for blockade of monocyte migration. Treatment with high-dose losartan and toceranib was well-tolerated and induced a clinical benefit rate of 50% in dogs with lung metastases. CONCLUSIONS Losartan inhibits the CCL2-CCR2 axis, and in combination with toceranib, exerts significant biological activity in dogs with metastatic osteosarcoma, supporting evaluation of this drug combination in patients with pediatric osteosarcoma.
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Affiliation(s)
- Daniel P Regan
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado. .,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Lyndah Chow
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Sunetra Das
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Laurel Haines
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Eric Palmer
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Jade N Kurihara
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Jonathan W Coy
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Alissa Mathias
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Daniel L Gustafson
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Steven W Dow
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado. .,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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15
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Liu Y, Raina DB, Sebastian S, Nagesh H, Isaksson H, Engellau J, Lidgren L, Tägil M. Sustained and controlled delivery of doxorubicin from an in-situ setting biphasic hydroxyapatite carrier for local treatment of a highly proliferative human osteosarcoma. Acta Biomater 2021; 131:555-571. [PMID: 34271171 DOI: 10.1016/j.actbio.2021.07.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
Doxorubicin (DOX) is a cornerstone drug in the treatment of osteosarcoma. However, achieving sufficient concentration in the tumor tissue after systemic administration with few side effects has been a challenge. Even with the most advanced nanotechnology approaches, less than 5% of the total administered drug gets delivered to the target site. Alternatives to increase the local concentration of DOX within the tumor using improved drug delivery methods are needed. In this study, we evaluate a clinically approved calcium sulfate/hydroxyapatite (CaS/HA) carrier, both in-vitro and in-vivo, for local, sustained and controlled delivery of DOX to improve osteosarcoma treatment. In-vitro drug release studies indicated that nearly 28% and 36% of the loaded drug was released over a period of 4-weeks at physiological pH (7.4) and acidic pH (5), respectively. About 63% of the drug had been released after 4-weeks in-vivo. The efficacy of the released drug from the CaS/HA material was verified on two human osteosarcoma cell lines MG-63 and 143B. It was demonstrated that the released drug fractions functioned the same way as the free drug without impacting its efficacy. Finally, the carrier system with DOX was assessed using two clinically relevant human osteosarcoma xenograft models. Compared to no treatment or the clinical standard of care with systemic DOX administration, the delivery of DOX using a CaS/HA biomaterial could significantly hinder tumor progression by inhibiting angiogenesis and cell proliferation. Our results indicate that a clinically approved CaS/HA biomaterial containing cytostatics could potentially be used for the local treatment of osteosarcoma. STATEMENT OF SIGNIFICANCE: The triad of doxorubicin (DOX), methotrexate and cisplatin has routinely been used for the treatment of osteosarcoma. These drugs dramatically improved the prognosis, but 45-55% of the patients respond poorly to the treatment with low 5-year survival. In the present study, we repurpose the cornerstone drug DOX by embedding it in a calcium sulfate/hydroxyapatite (CaS/HA) biomaterial, ensuring a spatio-temporal drug release and a hypothetically higher and longer lasting intra-tumoral concentration of DOX. This delivery system could dramatically hinder the progression of a highly aggressive osteosarcoma compared to systemic administration, by inhibiting angiogenesis and cell proliferation. Our data show an efficient method for supplementary osteosarcoma treatment with possible rapid translational potential due to clinically approved constituents.
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16
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Gaspar N, Campbell-Hewson Q, Huang J, Okpara CE, Bautista F. OLIE, ITCC-082: a Phase II trial of lenvatinib plus ifosfamide and etoposide in relapsed/refractory osteosarcoma. Future Oncol 2021; 17:4249-4261. [PMID: 34382412 DOI: 10.2217/fon-2021-0743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
While survival rates for patients with relapsed/refractory osteosarcoma are low, kinase inhibitors have shown efficacy in its treatment. The multikinase inhibitor lenvatinib, plus ifosfamide and etoposide, showed antitumor activity in a Phase II study in patients with relapsed/refractory osteosarcoma. This Phase II randomized controlled trial (OLIE) will assess whether the combination of lenvatinib + ifosfamide + etoposide is superior to ifosfamide + etoposide alone in children, adolescents and young adults with relapsed/refractory osteosarcoma. The primary end point is progression-free survival; secondary and exploratory end points include, but are not limited to, overall survival, objective response rate, safety and tolerability, pharmacokinetic characterization of lenvatinib in the combination treatment, quality of life and quantification of baseline unresectable lesions that are converted to resectable.
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Affiliation(s)
- Nathalie Gaspar
- Department of Childhood & Adolescent Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Jie Huang
- Biostatistics, Eisai Inc., Woodcliff Lake, NJ 07677, USA
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17
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Tang RZ, Li ZZ, Hu D, Kanwal F, Yuan CB, Mustaqeem M, Batool AI, Rehman MFU. Sanjie Yiliu Formula Inhibits Colorectal Cancer Growth by Suppression of Proliferation and Induction of Apoptosis. ACS OMEGA 2021; 6:7761-7770. [PMID: 33778287 PMCID: PMC7992181 DOI: 10.1021/acsomega.0c05565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 05/04/2023]
Abstract
Colorectal cancer (CRC) is one of the most common malignancies worldwide. As current therapies toward CRC, including chemotherapy and radiotherapy, pose limitations, such as multidrug resistance (MDR) as well as the intrinsic and potential cytotoxic effects, necessitating to find more effective treatment options with fewer side effects, traditional Chinese medicine (TCM) has an advantage in complementary therapies. In the present study, 3-(4,5-dimethylthiozol-2-yl)-2,5-diphenyltetrazolium bromide (MTT assays), trypan blue staining, colony formation, 4,6-diamidino-2-phenylindole dihydrochloride (DAPI) staining, cell cycle determination, and Annexin V-FITC/PI staining were used to examine the efficacy of Sanjie Yiliu Formula (SJYLF) against CRC proliferation and to investigate its underlying molecular mechanisms through protein expression of various proapoptotic factors by quantitative polymerase chain reaction (q-PCR) and Western blotting. This four-herb-TCM SJYLF can be suggested as one of the decoctions clinically effective in late-stage cancer treatment. Our results suggest that SJYLF robustly decreased the viability of only CRC cell lines (HCT-8, SW-480, HT-29, and DLD-1) and not the normal human kidney cells (HK-2). Moreover, SJYLF significantly suppressed proliferation and induced apoptosis in HCT-8 and downregulated cyclin D1, CDK4, and BCL-2, while Bax expression was upregulated at both mRNA and protein expression levels.
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Affiliation(s)
- Rong Zhu Tang
- Department
of Gastroenterology, Seventh People’s
Hospital of Shanghai University of Traditional Chinese Medicine, NO.358, Datong Road, Pudong New
Area, Shanghai 200137, P. R. China
| | - Zhang Zhi Li
- Department
of Hematology, Taihe Hospital Affiliated
to the Hubei University of Medicine, Shiyan, China
| | - Dan Hu
- Department
of Neurology, The Central Hospital of Xiaogan, Xiaogan, Hubei 432100, P. R. China
| | - Fariha Kanwal
- Med-X
Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 201620, P. R.
China
| | - Cheng Bin Yuan
- Department
of Critical Care Medicine, Shanghai General
Hospital, Shanghai 200080, P. R. China
- School
of Medicine, Shanghai Jiao Tong University, Shanghai 200025, P. R. China
| | - Muhammad Mustaqeem
- Department
of Chemistry, University of Sargodha, Sub-Campus Bhakkar, Bhakkar 30000, Pakistan
| | - Aima Iram Batool
- Department
of Zoology, University of Sargodha, Sargodha 40100, Pakistan
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Huybrechts S, Le Teuff G, Tauziède-Espariat A, Rossoni C, Chivet A, Indersie É, Varlet P, Puget S, Abbas R, Ayrault O, Guerrini-Rousseau L, Grill J, Valteau-Couanet D, Dufour C. Prognostic Clinical and Biologic Features for Overall Survival after Relapse in Childhood Medulloblastoma. Cancers (Basel) 2020; 13:cancers13010053. [PMID: 33375523 PMCID: PMC7795432 DOI: 10.3390/cancers13010053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Despite progress in the biology and upfront treatment of childhood medulloblastoma, relapse is almost universally fatal. No standardized treatment has so far been established for these patients. By determining which characteristics are prognostic after relapse, treatment strategies may be optimized for each of these children. We demonstrated that molecular subgroup at diagnosis is a relevant prognostic factor of outcome after relapse. Moreover, we showed that time to relapse and the use of salvage radiotherapy at relapse might have a potential impact on post-relapse survival. Our data suggest that ongoing efforts toward a better understanding of the biology, timing and type of relapse would be important to understand the determinants of tumor behavior at relapse. This could help us address more specific questions on the best surveillance strategies after completion of the treatment and the introduction of risk-stratified second-line treatment strategies. Abstract Given the very poor prognosis for children with recurrent medulloblastoma, we aimed to identify prognostic factors for survival post-relapse in children with childhood medulloblastoma. We retrospectively collected clinico-biological data at diagnosis and main clinical characteristics at relapse of children newly diagnosed with a medulloblastoma between 2007 and 2017 at Gustave Roussy and Necker Hospital. At a median follow-up of 6.6 years (range, 0.4–12.3 years), relapse occurred in 48 out 155 patients (31%). The median time from diagnosis to relapse was 14.3 months (range, 1.2–87.2 months). Relapse was local in 9, metastatic in 22 and combined (local and metastatic) in 17 patients. Second-line treatment consisted of chemotherapy in 31 cases, radiotherapy in 9, SHH-inhibitor in four and no treatment in the remaining four. The 1-year overall survival rate post-relapse was 44.8% (CI 95%, 31.5% to 59.0%). While molecular subgrouping at diagnosis was significantly associated with survival post-relapse, the use of radiotherapy at relapse and time to first relapse (>12 months) might also have a potential impact on post-relapse survival.
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Affiliation(s)
- Sophie Huybrechts
- Service National d’Oncologie et Hématologie Pédiatrique, Centre Hospitalier de Luxembourg, L-1210 Luxembourg City, Luxembourg;
| | - Gwénaël Le Teuff
- Department of Biostatistics, Gustave Roussy Cancer Center, Paris-Saclay University, 94800 Villejuif, France; (G.L.T.); (C.R.); (R.A.)
| | - Arnault Tauziède-Espariat
- Department of Neuropathology, Sainte Anne Hospital, Rene Descartes University, 75014 Paris, France; (A.T.-E.); (P.V.)
| | - Caroline Rossoni
- Department of Biostatistics, Gustave Roussy Cancer Center, Paris-Saclay University, 94800 Villejuif, France; (G.L.T.); (C.R.); (R.A.)
| | - Anaïs Chivet
- Department of Pediatric Neurosurgery, Necker Hospital, Paris Descartes University, 75015 Paris, France; (A.C.); (S.P.)
| | - Émilie Indersie
- Institut Curie, PSL Research University, CNRS UMR, INSERM, 91400 Orsay, France; (É.I.); (O.A.)
- Paris Sud University, Paris-Saclay University, CNRS UMR 3347, INSERM U1021, 91400 Orsay, France
| | - Pascale Varlet
- Department of Neuropathology, Sainte Anne Hospital, Rene Descartes University, 75014 Paris, France; (A.T.-E.); (P.V.)
| | - Stéphanie Puget
- Department of Pediatric Neurosurgery, Necker Hospital, Paris Descartes University, 75015 Paris, France; (A.C.); (S.P.)
| | - Rachid Abbas
- Department of Biostatistics, Gustave Roussy Cancer Center, Paris-Saclay University, 94800 Villejuif, France; (G.L.T.); (C.R.); (R.A.)
| | - Olivier Ayrault
- Institut Curie, PSL Research University, CNRS UMR, INSERM, 91400 Orsay, France; (É.I.); (O.A.)
- Paris Sud University, Paris-Saclay University, CNRS UMR 3347, INSERM U1021, 91400 Orsay, France
| | - Léa Guerrini-Rousseau
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, 94800 Villejuif, France; (L.G.-R.); (J.G.); (D.V.-C.)
- INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, 94800 Villejuif, France
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, 94800 Villejuif, France; (L.G.-R.); (J.G.); (D.V.-C.)
- INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, 94800 Villejuif, France
| | - Dominique Valteau-Couanet
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, 94800 Villejuif, France; (L.G.-R.); (J.G.); (D.V.-C.)
| | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, 94800 Villejuif, France; (L.G.-R.); (J.G.); (D.V.-C.)
- INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, 94800 Villejuif, France
- Correspondence: ; Tel.: +33-1-42114247
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Pushpam D, Garg V, Ganguly S, Biswas B. Management of Refractory Pediatric Sarcoma: Current Challenges and Future Prospects. Onco Targets Ther 2020; 13:5093-5112. [PMID: 32606731 PMCID: PMC7293381 DOI: 10.2147/ott.s193363] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/12/2020] [Indexed: 12/11/2022] Open
Abstract
Paediatric sarcomas are a heterogeneous group of disorders constituting bone sarcoma and various soft tissue sarcomas. Almost one-third of these presents with metastasis at baseline and another one-third recur after initial curative treatment. There is a huge unmet need in this cohort in terms of curative options and/or prolongation of survival. In this review, we have discussed the current treatment options, challenges and future strategies of managing relapsed/refractory paediatric sarcomas. Upfront risk-adapted treatment with multidisciplinary management remains the main strategy to prevent future recurrence or relapse of the disease. In the case of limited local and/or systemic relapse or late relapse, initial multimodality management can be administered. In treatment-refractory cases or where cure is not feasible, the treatment options are limited to novel therapeutics, immunotherapeutic approach, targeted therapies, and metronomic therapies. A better understanding of disease biology, mechanism of treatment refractoriness, identifications of driver mutation, the discovery of novel targeted therapies, cellular vaccine and adapted therapies should be explored in relapsed/refractory cases. Close national and international collaboration for translation research is needed to fulfil the unmet need.
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Affiliation(s)
| | - Vikas Garg
- Department of Medical Oncology, AIIMS, New Delhi, India
| | - Sandip Ganguly
- Department of Medical Oncology, Tata Medical Center, Kolkata, India
| | - Bivas Biswas
- Department of Medical Oncology, Tata Medical Center, Kolkata, India
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Meazza C, Bastoni S, Scanagatta P. What is the best clinical approach to recurrent/refractory osteosarcoma? Expert Rev Anticancer Ther 2020; 20:415-428. [PMID: 32379504 DOI: 10.1080/14737140.2020.1760848] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Osteosarcoma is the most common malignant bone tumor. It is currently treated with pre-and postoperative chemotherapy, associated with surgical resection of the tumor.Area covered: Relapses occur in about one in three patients presenting with localized disease, and three in four of those with metastases at diagnosis. Relapsing disease carries a very poor prognosis, with 5-year survival rates ranging between 13% and 40%.Expert opinion: Patients with unilateral lung involvement or solitary lung metastases and a recurrence-free interval (RFI) longer than 24 months have a better prognosis, and could be managed with surgical resection and close observation. Complete surgical resection of all sites of disease remains essential to survival: patients unable to achieve complete remission have a catastrophic overall survival rate. The role of second-line chemotherapy is not at all clear, and no controlled studies are available on this topic. It is worth considering for patients unable to achieve complete surgical remission, and those with multiple metastases and/or a RFI <24 months. Given their dismal prognosis, patients with multiple sites of disease not amenable to complete surgical resection should also be considered for innovative therapeutic approaches.
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Affiliation(s)
- Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Stefano Bastoni
- Center for Oncological Orthopedic Surgery, ASST Azienda Ospedaliera Istituto G Pini-CTO, Milano, Italy
| | - Paolo Scanagatta
- Thoracic Surgery Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Yu XJ, Guo XZ, Li C, Chong Y, Song TN, Pang JF, Shao M. SIRT1-ZEB1-positive feedback promotes epithelial-mesenchymal transition process and metastasis of osteosarcoma. J Cell Biochem 2018; 120:3727-3735. [PMID: 30304565 DOI: 10.1002/jcb.27653] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/16/2018] [Indexed: 12/25/2022]
Abstract
Osteosarcoma is the most common malignant bone cancer that mainly affects children and young adults. Recently, the NAD+ -dependent deacetylase, sirtuin 1 (SIRT1), has been reported to play a key role in the development of malignant tumors. The study aimed to investigate the role of SIRT1 in osteosarcoma and explore its underlying oncogenic mechanisms. The prognostic value of SIRT1 in osteosarcoma was assessed through detection of SIRT1 expression based on osteosarcoma biopsy tissue. Then, to further investigate the effect of SIRT1 in osteosarcoma, osteosarcoma cells were treated with small interfering RNA SIRT1 and overexpressed SIRT1 to detect the cell migration, invasion, and epithelial-mesenchymal transition (EMT). The levels of SIRT1 expression were significantly higher in osteosarcoma tissues than those in adjacent normal tissues, and the SIRT1 protein level may be coupled with metastatic and poor prognosis risk in patients with osteosarcoma. Moreover, SIRT1 silencing inhibited the migration as well as invasion ability of osteosarcoma cells in vitro, and SIRT1 upregulation reversed those effects. Finally, we found that SIRT1-ZEB1-positive feedback enhanced the EMT process and metastasis of osteosarcoma. Altogether, the results of the current study revealed that high levels of SIRT1 might be a biomarker for a high metastatic rate in patients with osteosarcoma, which suggested that inhibition of SIRT1 might be promising for the therapeutics of osteosarcoma.
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Affiliation(s)
- Xiao-Jun Yu
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xin-Zhen Guo
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chao Li
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yang Chong
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tie-Nan Song
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jian-Feng Pang
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ming Shao
- Division of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Abstract
The aim of the present study was to evaluate the efficiency and side effects of mifamurtide in childhood osteosarcoma (OS). In total, 477 doses of 2 mg/m intravenous (IV) mifamurtide, along with paracetamol as a premedication, were given to 15 patients with primary nonmetastatic OS after complete surgical resection and to 3 patients with progressive OS. The most common side effects encountered in the patients were chills and fever (17/18). These reactions were observed in 4 patients during the administration of each dose, in a single patient during the last administration, and in the remaining 12 patients during the first or initial 2 administrations. Headache, myalgia, and arthralgia were observed in 2 patients during each infusion. Headache was observed in 1 patient with additional hearing loss during the first 2 infusions. One patient had back pain occuring within the first infusion. Of the 15 patients with primary nonmetastatic OS and treated with the addition of mifamurtide to chemotherapy, 13 showed a complete remission, and 2 patients were still under treatment with a complete remission. Of 3 patients with progressive disease, 2 died while the disease progressed further in the third case over a 51-month period. The 3-year overall survival and event-free survival distributions were 87.5% (mean follow-up time, 46.12; 95% confidence interval, 37.79-52.45 mo) and 75.6% (mean follow-up time, 31.30; 95% confidence interval, 26.54-36.06 mo), respectively. We consider that mifamurtide therapy is a safe and well-tolerated agent in childhood OS.
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23
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TIPE1 suppresses osteosarcoma tumor growth by regulating macrophage infiltration. Clin Transl Oncol 2018; 21:334-341. [PMID: 30062520 DOI: 10.1007/s12094-018-1927-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 07/16/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Osteosarcoma is the most common primary malignancy of the bone, and macrophages play a promotional role during osteosarcoma development and progression. TIPE1 is known to function as a tumor suppressor in diverse cancers by inducing cell arrest and apoptosis. However, the biological function of TIPE1 in osteosarcoma is still unclear. PURPOSE The purpose of this study was to investigate the expression and function of TIPE1 in osteosarcoma. METHODS In the present study, TIPE1 expression in osteosarcoma cancer cells was determined by qPCR and western blotting. A subcutaneous tumor model was established to investigate the potential anti-tumor activity of TIPE1 in osteosarcoma. Further, flow cytometry, western blotting, immunofluorescence staining, and ELISA were performed to clarify the underlying mechanism by which TIPE1 regulates growth of osteosarcoma. RESULTS Our results suggest that TIPE1 is downregulated in osteosarcoma cancer cells, and ectopic expression TIPE1 significantly inhibited osteosarcoma tumor growth in vivo. Furthermore, TIPE1 inhibits the infiltration of macrophages in osteosarcoma tumor by suppressing MCP-1 expression in osteosarcoma cells. Further in vivo study revealed that inhibition of MCP-1/CCR2 axis by Bindarit blocked the inhibitory effect of TIPE1 on osteosarcoma growth. CONCLUSION Collectively, our results demonstrate the anti-tumor role of TIPE1 in osteosarcoma and reveal a novel therapy target for osteosarcoma.
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24
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Abraham JA, Kenneally B, Amer K, Geller DS. Can Navigation-assisted Surgery Help Achieve Negative Margins in Resection of Pelvic and Sacral Tumors? Clin Orthop Relat Res 2018; 476. [PMID: 29529631 PMCID: PMC6260048 DOI: 10.1007/s11999.0000000000000064] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Navigation-assisted resection has been proposed as a useful adjunct to resection of malignant tumors in difficult anatomic sites such as the pelvis and sacrum where it is difficult to achieve tumor-free margins. Most of these studies are case reports or small case series, but these reports have been extremely promising. Very few reports, however, have documented benefits of navigation-assisted resection in series of pelvic and sacral primary tumors. Because this technology may add time and expense to the surgical procedure, it is important to determine whether navigation provides any such benefits or simply adds cost and time to an already complex procedure. QUESTIONS/PURPOSES (1) What proportion of pelvic and sacral bone sarcoma resections utilizing a computer-assisted resection technique achieves negative margins? (2) What are the oncologic outcomes associated with computer-assisted resection of pelvic and sacral bone sarcomas? (3) What complications are associated with navigation-assisted resection? METHODS Between 2009 and 2015 we performed 24 navigation-assisted resections of primary tumors of the pelvis or sacrum. Of those, four were lost to followup after the 2-year postoperative visit. In one patient, however, there was a failure of navigation as a result of inadequate imaging, so nonnavigated resection was performed; the remaining 23 were accounted for and were studied here at a mean of 27 months after surgery (range, 12-52 months). During this period, we performed navigation-assisted resections in all patients presenting with a pelvis or sacral tumor; there was no selection process. No patients were treated for primary tumors in these locations without navigation during this time with the exception of the single patient in whom the navigation system failed. We retrospectively evaluated the records of these 23 patients and evaluated the margin status of these resections. We calculated the proportion of patients with local recurrence, development of metastases, and overall survival at an average 27-month followup (range, 12-52 months). We queried a longitudinally maintained surgical database for any complications and noted which, if any, could have been directly related to the use of the navigation-assisted technique. RESULTS In our series, 21 of 23 patients had a negative margin resection. In all patients the bone margin was negative, but two with sacral resections had positive soft tissue margins. Six of 23 patients experienced local recurrence within the study period. Three patients died during the study period. Seventeen patients demonstrated no evidence of disease at last recorded followup. We noted three intraoperative complications: one dural tear, one iliac vein laceration, and one bladder injury. Eight patients out of 23 had wound complications resulting in operative débridement. Two patients in the series developed transient postoperative femoral nerve palsy, which we believe were caused by stretch of the femoral nerve secondary to the placement of the reference array in the pubic ramus. CONCLUSIONS Navigation-assisted resection of pelvic and sacral tumors resulted in a high likelihood of negative margin resection in this series, and we observed relatively few complications related specifically to the navigation. We have no comparison group without navigation, and future studies should indeed compare navigated with nonnavigated resection approaches in these anatomic locations. We did identify a potential navigation-related complication of femoral nerve palsy in this series and suggest careful placement and observation of the reference array during the operative procedure to lessen the likelihood of this previously unreported complication. We suggest it is worthwhile to consider the use of navigation-assisted surgery in resection of tumors of the pelvis and sacrum, but further study will be needed to determine its precise impact, if any, on local recurrence and other oncologic outcomes. LEVEL OF EVIDENCE Level IV, therapeutic study.
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25
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Wang S, Li H, Ye C, Lin P, Li B, Zhang W, Sun L, Wang Z, Xue D, Teng W, Zhou X, Lin N, Ye Z. Valproic Acid Combined with Zoledronate Enhance γδ T Cell-Mediated Cytotoxicity against Osteosarcoma Cells via the Accumulation of Mevalonate Pathway Intermediates. Front Immunol 2018. [PMID: 29535738 PMCID: PMC5835048 DOI: 10.3389/fimmu.2018.00377] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The long-term survival of osteosarcoma has remained unchanged in the last several decades. Immunotherapy is proved to be a promising therapeutic strategy against osteosarcoma, especially for those with metastasis. Our previous study explored the sensibilization of zoledronate (ZOL) in γδ T cell-mediated cytotoxicity against osteosarcoma, but we have not yet elucidated the specific mechanism. Besides, high concentration is required to achieve these effects, whereas plasma ZOL concentration declines rapidly in the circulation. Valproic acid (VPA), a histone deacetylase inhibitor commonly used as the antiepileptic drug, has attracted much attention due to its synergistic antitumor efficacy with chemotherapy or immunotherapy. Here, we demonstrated that VPA combined with ZOL revealed the synergistic effect in enhancing antitumor efficacy of γδ T cells against osteosarcoma cells. This enhancement was mainly TCR-mediated and largely dependent on granule exocytose pathway. Of note, our findings indicated that ZOL sensitized osteosarcoma cells to γδ T cells by increasing the accumulation of the mevalonate pathway intermediates, which could be facilitated by VPA. We also found that this combination had similar effects on primary osteosarcoma cells. All the results suggested that VPA combined with ZOL could reduce the dose required to achieve a significant antitumor effect of γδ T cells, promoting it to be a novel therapy against osteosarcoma.
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Affiliation(s)
- Shengdong Wang
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Hengyuan Li
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Chenyi Ye
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Peng Lin
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Binghao Li
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Wei Zhang
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Lingling Sun
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Zhan Wang
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Deting Xue
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Wangsiyuan Teng
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Xingzhi Zhou
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Nong Lin
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Zhaoming Ye
- Department of Orthopedics, Centre for Orthopedic Research, Second Affiliated Hospital, School of Medicine, Orthopedics Research Institute, Zhejiang University, Hangzhou, China
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Oertel S, Blattmann C, Rieken S, Jensen A, Combs SE, Huber PE, Bischof M, Kulozik A, Debus J, Schulz-Ertner D. Radiotherapy in the Treatment of Primary Osteosarcoma – a Single Center Experience. TUMORI JOURNAL 2018; 96:582-8. [DOI: 10.1177/030089161009600411] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To analyze our experiences concerning radiation treatment in patients with osteosarcoma. Materials and methods Since 1981, 40 patients with osteosarcoma have undergone radiotherapy in Heidelberg; 3 of them were immediately lost to follow-up. Twenty patients with metastases were treated palliatively and 17 patients were treated with a curative intent. Results Interestingly, 14 of the 17 patients treated with a curative intent were referred to our clinic during the last 8 years, whereas the number of patients referred for palliation decreased. The mean dose applied for palliation was 47 Gy (range, 26 Gy to >70 GyE), for cure was 59 Gy (range, 45 Gy to >70 GyE). Local control until death could be achieved in 15 of the 20 palliatively treated patients, with a mean survival of 7 months after radiation. Five patients experienced local failure with symptom recurrence, and 3 of them had received doses >60 Gy. At last follow-up, 3 of the 17 curatively treated patients had experienced local recurrence. Median follow-up was 32 months (range, 3-144). Estimated 5-year overall survival and local control rates were 38% and 68%, respectively. Local disease-free survival was shorter in patients treated for recurrent, inoperable or incompletely resected tumors and doses below 60 Gy. Conclusions With adequate doses, long-term local control is possible even in inoperable or incompletely resected tumors. Improvements of systemic therapy and modern radiation techniques have begun to bring the possibly curative role of radiation treatment back to the fore. However, in disseminated tumors, even doses beyond 60 Gy do not guarantee local control, suggesting an extremely low radiosensitivity of certain kinds of osteosarcoma.
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Affiliation(s)
| | - Claudia Blattmann
- Department of Pediatric Oncology,
University Clinic Heidelberg, Frankfurt, Germany
| | | | | | | | - Peter E Huber
- Department of Radiooncology,
Frankfurt, Germany
- German Cancer Research Center,
Radiooncology, Heidelberg, Frankfurt, Germany
| | | | - Andreas Kulozik
- Department of Pediatric Oncology,
University Clinic Heidelberg, Frankfurt, Germany
| | | | - Daniela Schulz-Ertner
- Department of Radiooncology,
Frankfurt, Germany
- Markus-Krankenhaus, Frankfurt,
Germany
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27
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Zhou Y, Zhang W, Tang F, Luo Y, Min L, Zhang W, Shi R, Duan H, Tu C. A case report of apatinib in treating osteosarcoma with pulmonary metastases. Medicine (Baltimore) 2017; 96:e6578. [PMID: 28403086 PMCID: PMC5403083 DOI: 10.1097/md.0000000000006578] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Osteosarcoma is the most common malignant bone tumor in children and adolescents. Pulmonary metastases lead to a significantly increased risk of death. Apatinib, a new potent oral small-molecule tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor 2 (VEGFR-2), shows survival benefits in treating advanced or metastatic gastric adenocarcinoma, non-squamous non-small cell lung cancer and metastatic breast cancer. However, its efficacy in metastatic osteosarcoma has not been reported yet. PATIENT CONCERNS Herein, we presented a 50-year-old man patient who visited hospital due to local bone pain in the left leg. DIAGNOSES He was initially diagnosed with osteoblastic osteosarcoma. INTERVENTIONS The patient suffered repeated resection surgeries but developed multiple lung metastases. Positive staining for CD31, CD34, and VEGFR-2 were detected in the tumor section. As he refused to receive chemotherapy due to concerns regarding the chemotherapy toxicities and sorafenib due to high cost, apatinib was given at a dose of 500 mg daily. OUTCOMES Eleven months following apatinib administration, the patient achieved a partial response according to the RECIST 1.1 standard. No severe toxicity or drug-related side effect was observed during the treatment. LESSONS Therefore, apatinib could be a new option for the treatment of metastatic osteosarcoma. Clinical trials are required to further confirm the efficacy and safety of apatinib in treating pulmonary metastases from osteosarcoma.
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Affiliation(s)
| | - Wengeng Zhang
- Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Yi Luo
- Department of Orthopedics
| | - Li Min
- Department of Orthopedics
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Kuo C, Kent PM, Logan AD, Tamulonis KB, Dalton KL, Batus M, Fernandez K, Mcfall RE. Docetaxel, bevacizumab, and gemcitabine for very high risk sarcomas in adolescents and young adults: A single-center experience. Pediatr Blood Cancer 2017; 64. [PMID: 28221727 DOI: 10.1002/pbc.26265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) patients with very high risk sarcomas have poor outcomes and are in need of novel therapies. PROCEDURE From January 2005 to February 2016, we retrospectively identified all AYA patients with relapsed or metastatic high-grade sarcomas, who were treated with at least one cycle of docetaxel (T), bevacizumab (A), and gemcitabine (G) (TAG ; T = 100 mg/m2 Day 8, A = 15 mg/kg Day 1, G = 1,000 mg/m2 Days 1 and 8). RESULTS Fourteen patients, median age of 20 (15-30), received a total of 80 cycles of TAG, and were followed for a median of 83 months. Diagnosis included osteosarcoma (OST; 8), Ewing sarcoma (3), and soft tissue sarcoma (3). Five of 14 patients achieved clinical remission (CR), 3 had partial responses (PR), 3 had stable disease (SD), and 3 had progressive disease (PD). The median progression-free survival and overall survival were 7 and 19 months, respectively. The objective response rate (CR + PR) and tumor control rate (CR + PR + SD) were 57% and 79%, respectively, with two patients alive after 5 years; toxicities included thrombocytopenia, neutropenia, and capillary leak syndrome. CONCLUSIONS Our study builds on previous studies utilizing TAG in adult leiomyosarcoma (LMS) by focusing on AYA, non-LMS sarcomas, especially OST. Our experience suggests that TAG is well tolerated and has activity in very high risk sarcomas in AYA.
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Affiliation(s)
- Christopher Kuo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois
| | - Paul M Kent
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois
| | - Antonio D Logan
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois
| | - Karen B Tamulonis
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois
| | - Kristen L Dalton
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marta Batus
- Division of Medical Oncology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Karen Fernandez
- Division of Hematology/Oncology, Department of Pediatrics, University of Illinois College of Medicine, Peoria, Illinois
| | - Rebecca E Mcfall
- Division of Hematology/Oncology, Department of Pediatrics, Advocate Christ Medical Center, Oak Lawn, Illinois
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Fujiwara T, Oda M, Yoshida A, Ogura K, Chuman H, Kusumoto M, Kawai A. Atypical manifestation of lung metastasis 17 years after initial diagnosis of low-grade central osteosarcoma. J Orthop Sci 2017; 22:357-361. [PMID: 26755392 DOI: 10.1016/j.jos.2015.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 07/27/2015] [Accepted: 08/15/2015] [Indexed: 02/09/2023]
Affiliation(s)
- Tomohiro Fujiwara
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Mai Oda
- Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Koichi Ogura
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Hirokazu Chuman
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Masahiko Kusumoto
- Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
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Liu W, Liu SY, He YB, Huang RL, Deng SY, Ni GX, Yu B. MiR-451 suppresses proliferation, migration and promotes apoptosis of the human osteosarcoma by targeting macrophage migration inhibitory factor. Biomed Pharmacother 2017; 87:621-627. [PMID: 28086136 DOI: 10.1016/j.biopha.2016.12.121] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/27/2016] [Indexed: 02/05/2023] Open
Abstract
Previous studies have shown that MiR-451 plays an important role in human osteosarcoma carcinogenesis, but the underlying mechanism by which MiR-451 affects the osteosarcoma has not been fully understood. This study intends to uncover the mechanism by which MiR-451 functions as a tumor suppressor. The expression of MiR-451 in osteosarcoma tissues and osteosarcoma cell lines was monitored by real-time PCR. The proliferation ability was examined by MTT and cell cycle assay. The migration and apoptosis of cells were monitored by migration assay and flow cytometry, respectively. Moreover, the angiogenesis of HUVEC cells transfected with MiR-451 mimics was examined by tube formation assay. The effect of MiR-451 on MIF was determined by luciferase assays and Western blot assay. The results showed that MiR-451 expression level was significantly reduced in the osteosarcoma compared with normal bone tissues. Overexpression of MiR-451 significantly attenuated the proliferation and migration, and induced the apoptosis of osteosarcoma cells. Furthermore, the angiogenesis of HUVEC cells transfected with MiR-451 mimics was assayed and the decreased angiogenic ability was detected compared to the controls. Finally, we demonstrated that MiR-451 overexpression inhibited the malignant behavior of osteosarcoma by downregulating MIF. These findings suggest that MiR-451 may act as a tumor suppressor in osteosarcoma. MiR-451 inhibited cell proliferation, migration and angiogenesis and promoted apoptosis of human osteosarcoma cells, at least partially, by inhibiting the expression of MIF. MiR-451/MIF may be a novel therapeutic target in treatment of osteosarcoma.
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Affiliation(s)
- Wei Liu
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou 510515, China; Department of Orthopedics, The People's Hospital of Gaoming District of Foshan City, Guangdong 528500, China
| | - Sheng-Yao Liu
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou 510515, China
| | - Yong-Bin He
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou 510515, China
| | - Rui-Liang Huang
- Department of Orthopedics, The People's Hospital of Gaoming District of Foshan City, Guangdong 528500, China
| | - Song-Yun Deng
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou 510515, China
| | - Guo-Xin Ni
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou 510515, China; Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China.
| | - Bin Yu
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou 510515, China.
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31
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Song L, Duan P, Gan Y, Li P, Zhao C, Xu J, Zhang Z, Zhou Q. Silencing LPAATβ inhibits tumor growth of cisplatin-resistant human osteosarcoma in vivo and in vitro. Int J Oncol 2016; 50:535-544. [DOI: 10.3892/ijo.2016.3820] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 12/06/2016] [Indexed: 11/06/2022] Open
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32
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Wang B, Xu M, Zheng K, Yu X. Effect of Unplanned Therapy on the Prognosis of Patients with Extremity Osteosarcoma. Sci Rep 2016; 6:38783. [PMID: 27929143 PMCID: PMC5143937 DOI: 10.1038/srep38783] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 11/14/2016] [Indexed: 11/23/2022] Open
Abstract
Unplanned therapy for extremity osteosarcoma can result in erroneous surgical procedures and lack of neoadjuvant chemotherapy before the first operation. Our aim was to compare the prognosis between patients with extremity osteosarcoma who received unplanned therapy and those who received standard treatment. This was a retrospective review of patients with extremity osteosarcoma who received appropriate surgical treatment and neoadjuvant chemotherapy (n = 79) and those who received unplanned therapy (n = 24) between June 2000 and October 2014. Survival rate, local recurrence rate and metastasis rate were compared between the two groups. We found that patients who had unplanned therapy had a higher local recurrence rate (41.7% vs. 21.5%; P = 0.049) and a shorter mean time for recurrence (8.90 vs. 14.59 months; P = 0.018). There was no significant difference between groups in the 5-year survival rate (56.3% vs.67.8%; P = 0.356), metastasis rate (45.8% vs. 30.4%; P = 0.125) and mean time to metastasis (23.18 vs.18.24 months; P = 0.396). Our findings suggest that unplanned therapy for extremity osteosarcoma can result in failure of local control. The use of supplementary interventions after unplanned therapy, such as neoadjuvant chemotherapy and limb salvage surgery, may explain the similar survival and metastasis rates between patients receiving unplanned therapy and those receiving standard treatment.
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Affiliation(s)
- Bing Wang
- Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan, P.R.China
| | - Ming Xu
- Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan, P.R.China
| | - Kai Zheng
- Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan, P.R.China
| | - Xiuchun Yu
- Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan, P.R.China
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Abstract
Osteosarcoma (OS) is the most common primary malignancy of bone and patients with metastatic disease or recurrences continue to have very poor outcomes. Unfortunately, little prognostic improvement has been generated from the last 20 years of research and a new perspective is warranted. OS is extremely heterogeneous in both its origins and manifestations. Although multiple associations have been made between the development of osteosarcoma and race, gender, age, various genomic alterations, and exposure situations among others, the etiology remains unclear and controversial. Noninvasive diagnostic methods include serum markers like alkaline phosphatase and a growing variety of imaging techniques including X-ray, computed tomography, magnetic resonance imaging, and positron emission as well as combinations thereof. Still, biopsy and microscopic examination are required to confirm the diagnosis and carry additional prognostic implications such as subtype classification and histological response to neoadjuvant chemotherapy. The current standard of care combines surgical and chemotherapeutic techniques, with a multitude of experimental biologics and small molecules currently in development and some in clinical trial phases. In this review, in addition to summarizing the current understanding of OS etiology, diagnostic methods, and the current standard of care, our group describes various experimental therapeutics and provides evidence to encourage a potential paradigm shift toward the introduction of immunomodulation, which may offer a more comprehensive approach to battling cancer pleomorphism.
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Affiliation(s)
- Brock A Lindsey
- Department of Orthopaedics, West Virginia University, Morgantown, WV, USA.
| | - Justin E Markel
- Department of Orthopaedics, West Virginia University, Morgantown, WV, USA
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Koirala P, Roth ME, Gill J, Chinai JM, Ewart MR, Piperdi S, Geller DS, Hoang BH, Fatakhova YV, Ghorpade M, Zang X, Gorlick R. HHLA2, a member of the B7 family, is expressed in human osteosarcoma and is associated with metastases and worse survival. Sci Rep 2016; 6:31154. [PMID: 27531281 PMCID: PMC4987662 DOI: 10.1038/srep31154] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/11/2016] [Indexed: 12/02/2022] Open
Abstract
Over the past four decades there have been minimal improvements in outcomes for patients with osteosarcoma. New targets and novel therapies are needed to improve outcomes for these patients. We sought to evaluate the prevalence and clinical significance of the newest immune checkpoint, HHLA2, in osteosarcoma. HHLA2 protein expression was evaluated in primary tumor specimens and metastatic disease using an osteosarcoma tumor microarray (TMA) (n = 62). The association of HHLA2 with the presence of tumor infiltrating lymphocytes (TILs) and five-year-event-free-survival were examined. HHLA2 was expressed in 68% of osteosarcoma tumors. HHLA2 was expressed in almost all metastatic disease specimens and was more prevalent than in primary specimens without known metastases (93% vs 53%, p = 0.02). TILs were present in 75% of all osteosarcoma specimens. Patients whose tumors were ≥25% or ≥50% HHLA2 positive had significantly worse five-year event-free-survival (33% vs 64%, p = 0.03 and 14% vs 59%, p = 0.02). Overall, we have shown that HHLA2 is expressed in the majority of osteosarcoma tumors and its expression is associated with metastatic disease and poorer survival. Along with previously reported findings that HHLA2 is a T cell co-inhibitor, these results suggest that HHLA2 may be a novel immunosuppressive mechanism within the osteosarcoma tumor microenvironment.
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Affiliation(s)
- Pratistha Koirala
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michael E Roth
- Division of Pediatric Hematology, Oncology, Marrow &Blood Cell Transplantation, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jonathan Gill
- Division of Pediatric Hematology, Oncology, Marrow &Blood Cell Transplantation, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jordan M Chinai
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michelle R Ewart
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sajida Piperdi
- Division of Pediatric Hematology, Oncology, Marrow &Blood Cell Transplantation, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David S Geller
- Division of Pediatric Hematology, Oncology, Marrow &Blood Cell Transplantation, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Bang H Hoang
- Department of Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Maya Ghorpade
- Division of Pediatric Hematology, Oncology, Marrow &Blood Cell Transplantation, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xingxing Zang
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard Gorlick
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA.,Division of Pediatric Hematology, Oncology, Marrow &Blood Cell Transplantation, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
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Immune infiltration and PD-L1 expression in the tumor microenvironment are prognostic in osteosarcoma. Sci Rep 2016; 6:30093. [PMID: 27456063 PMCID: PMC4960483 DOI: 10.1038/srep30093] [Citation(s) in RCA: 195] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/10/2016] [Indexed: 12/11/2022] Open
Abstract
Osteosarcoma patient survival has remained stagnant for 30 years. Novel therapeutic approaches are needed to improve outcomes. We examined the expression of Programmed Death Ligand 1 (PD-L1) and defined the tumor immune microenvironment to assess the prognostic utility in osteosarcoma. PD-L1 expression in osteosarcoma was examined in two patient cohorts using immunohistochemistry (IHC) (n = 48, n = 59) and expression was validated using quantitative real time PCR (n = 21) and western blotting (n = 9). IHC was used to determine the presence of tumor infiltrating lymphocytes and antigen-presenting cells (APCs) in the tumor. Expression of PD-L1 was correlated with immune cell infiltration and event-free-survival (EFS). The 25% of primary osteosarcoma tumors that express PD-L1 were more likely to contain cells that express PD-1 than PD-L1 negative tumors (91.7% vs 47.2%, p = 0.002). Expression of PD-L1 was significantly associated with the presence of T cells, dendritic cells, and natural killer cells. Although all immune cell types examined were present in osteosarcoma samples, only infiltration by dendritic cells (28.3% vs. 83.9%, p = 0.001) and macrophages (45.5% vs. 84.4%, p = 0.031) were associated with worse five-year-EFS. PD-L1 expression was significantly associated with poorer five-year-EFS (25.0%. vs. 69.4%, p = 0.014). Further studies in osteosarcoma are needed to determine if targeting the PD-L1:PD-1 axis improves survival.
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Lagmay JP, Krailo MD, Dang H, Kim A, Hawkins DS, Beaty O, Widemann BC, Zwerdling T, Bomgaars L, Langevin AM, Grier HE, Weigel B, Blaney SM, Gorlick R, Janeway KA. Outcome of Patients With Recurrent Osteosarcoma Enrolled in Seven Phase II Trials Through Children's Cancer Group, Pediatric Oncology Group, and Children's Oncology Group: Learning From the Past to Move Forward. J Clin Oncol 2016; 34:3031-8. [PMID: 27400942 DOI: 10.1200/jco.2015.65.5381] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The use of radiographic response as the primary end point in phase II osteosarcoma trials may limit optimal detection of treatment response because of the calcified tumor matrix. We performed this study to determine if time to progression could be used as an end point for subsequent studies. PATIENTS AND METHODS We performed a retrospective analysis of outcome for patients with recurrent/refractory osteosarcoma enrolled in one of seven phase II trials conducted by the Children's Oncology Group and predecessor groups from 1997 to 2007. All trials used RECIST or WHO radiographic response criteria and the primary end point of response rate. The following potential prognostic factors-age, trial, number of prior chemotherapy regimens, sex, and race/ethnicity-were evaluated for their impact on event-free survival (EFS). We used data from a phase II study (AOST0221) of patients with osteosarcoma who were given inhaled granulocyte-macrophage colony-stimulating factor with first pulmonary recurrence who had an EFS as well as biologic end point to determine the historical disease control rate for patients with fully resected disease. RESULTS In each included trial, the drugs tested were determined to be inactive on the basis of radiographic response rates. The EFS for 96 patients with osteosarcoma and measurable disease was 12% at 4 months (95% CI, 6% to 19%). There was no significant difference in EFS across trials according to number of prior treatment regimens or patient age, sex, and ethnicity. The 12-month EFS for the 42 evaluable patients enrolled in AOST0221 was 20% (95% CI, 10% to 34%). CONCLUSION The EFS was uniformly poor for children with recurrent/refractory osteosarcoma in these single-arm phase II trials. We have now constructed baseline EFS outcomes that can be used as a comparison for future phase II trials for recurrent osteosarcoma.
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Affiliation(s)
- Joanne P Lagmay
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY.
| | - Mark D Krailo
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Ha Dang
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - AeRang Kim
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Douglas S Hawkins
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Orren Beaty
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Brigitte C Widemann
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Theodore Zwerdling
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Lisa Bomgaars
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Anne-Marie Langevin
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Holcombe E Grier
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Brenda Weigel
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Susan M Blaney
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Richard Gorlick
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
| | - Katherine A Janeway
- Joanne P. Lagmay, Shands Hospital for Children, University of Florida, Gainesville, FL; Mark D. Krailo and Ha Dang, University of Southern California, Los Angeles; and Children's Oncology Group, Monrovia; Theodore Zwerdling, Jonathan Jaques Children's Cancer Center, Miller Children's and Women's Hospital, Long Beach, CA; AeRang Kim, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; Douglas S. Hawkins, Seattle Children's Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; Orren Beaty III, Zeiss Children's Cancer Center, Mission Hospitals, Asheville, NC; Brigitte C. Widemann, National Institutes of Health Clinical Center, Bethesda, MD; Lisa Bomgaars and Susan M. Blaney, Baylor College of Medicine/Texas Children's Cancer Center, Houston; Anne-Marie Langevin, University of Texas Health Science Center at San Antonio, San Antonio, TX; Holcombe E. Grier and Katherine A. Janeway, Dana-Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Center, Boston, MA; Brenda Weigel, University of Minnesota, Minneapolis, MN; and Richard Gorlick, The Albert Einstein College of Medicine of Yeshiva University, The Children's Hospital at Montefiore, New York, NY
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Jackson TM, Bittman M, Granowetter L. Pediatric Malignant Bone Tumors: A Review and Update on Current Challenges, and Emerging Drug Targets. Curr Probl Pediatr Adolesc Health Care 2016; 46:213-228. [PMID: 27265835 DOI: 10.1016/j.cppeds.2016.04.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT) are the most common malignant bone tumors in children and adolescents. While significant improvements in survival have been seen in other pediatric malignancies the treatment and prognosis for pediatric bone tumors has remained unchanged for the past 3 decades. This review and update of pediatric malignant bone tumors will provide a general overview of osteosarcoma and the Ewing sarcoma family of tumors, discuss bone tumor genomics, current challenges, and emerging drug targets.
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Affiliation(s)
- Twana M Jackson
- Division of Pediatric Hematology Oncology, NYU Langone Medical Center, New York, NY.
| | - Mark Bittman
- Department of Radiology, NYU Langone Medical Center, New York, NY
| | - Linda Granowetter
- Division of Pediatric Hematology Oncology, NYU Langone Medical Center, New York, NY
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Increased cathepsin D protein expression is a biomarker for osteosarcomas, pulmonary metastases and other bone malignancies. Oncotarget 2016. [PMID: 26203049 PMCID: PMC4599286 DOI: 10.18632/oncotarget.4140] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cancer proteomics provide a powerful approach to identify biomarkers for personalized medicine. Particularly, biomarkers for early detection, prognosis and therapeutic intervention of bone cancers, especially osteosarcomas, are missing. Initially, we compared two-dimensional gel electrophoresis (2-DE)-based protein expression pattern between cell lines of fetal osteoblasts, osteosarcoma and pulmonary metastasis derived from osteosarcoma. Two independent statistical analyses by means of PDQuest® and SameSpot® software revealed a common set of 34 differentially expressed protein spots (p < 0.05). 17 Proteins were identified by mass spectrometry and subjected to Ingenuity Pathway Analysis resulting in one high-ranked network associated with Gene Expression, Cell Death and Cell-To-Cell Signaling and Interaction. Ran/TC4-binding protein (RANBP1) and Cathepsin D (CTSD) were further validated by Western Blot in cell lines while the latter one showed higher expression differences also in cytospins and in clinical samples using tissue microarrays comprising osteosarcomas, metastases, other bone malignancies, and control tissues. The results show that protein expression patterns distinguish fetal osteoblasts from osteosarcomas, pulmonary metastases, and other bone diseases with relevant sensitivities between 55.56% and 100% at ≥87.50% specificity. Particularly, CTSD was validated in clinical material and could thus serve as a new biomarker for bone malignancies and potentially guide individualized treatment regimes.
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Abstract
PURPOSE The purpose of this study was to analyze the prognostic factors that influence postrelapse survival (PRS) in children and adolescents with initial localized high-grade osteosarcoma. METHODS/PATIENTS This is a retrospective evaluation of patients aged 21 years and below with nonmetastatic high-grade osteosarcoma treated at our institution from 1985 to 2011 who developed recurrent disease after achievement of an initial complete response (CR). PRS and postrelapse event-free survival (PREFS) analyses were performed using the Kaplan-Meier method and log-rank test. Multivariate Cox regression analysis was used to determine which variables were independently prognostic. RESULTS Thirty-one patients were included. Median age at primary diagnosis was 13.7 years (range, 1.9 to 21.0 y). Median time to first relapse was 16 months (range, 3 to 36 mo). Fourteen patients achieved a second CR (CR2) after surgery±chemotherapy treatment. The 5-year PRS and PREFS were both 26% (95% confidence interval, 14%-49%), with a median follow-up of 99 months (range, 27 to 271 mo). Multivariate analysis showed that achievement of CR2 (P<0.001) and histologic response to first-line treatment (P=0.02) were significantly associated with PRS, whereas time to first relapse did not retain univariate significance. CONCLUSIONS Achievement of CR2 and histologic response to preoperative first-line treatment are independent survival prognostic factors in osteosarcoma recurrence.
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40
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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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Huang YJ, He AN, Sun YJ, Shen Z, Min DL, Yao Y. Continuous-infusion ifosfamide and doxorubicin combination as second-line chemotherapy for recurrent or refractory osteosarcoma patients in China: a retrospective study. Asian Pac J Cancer Prev 2016; 16:2391-5. [PMID: 25824770 DOI: 10.7314/apjcp.2015.16.6.2391] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this retrospective study was to evaluate the feasibility and efficacy of response to continuous-infusion ifosfamide and doxorubicin combination as second-line chemotherapy for patients with recurrent or refractory osteosarcoma. MATERIALS AND METHODS Eighteen recurrent or refractory osteosarcoma patients who were treated with continuous-infusion ifosfamide and doxorubicin combination between May 1999 and April 2011 were included in the analysis. Ifosfamide at 12 g/m2 was administered by intravenous continuous infusion over 3 days, and doxorubicin 60 mg/m2 was administered as an intravenous bolus injection on day 1. The combination therapy was repeated every 3 weeks. Treatment was continued until evidence of disease progression or unacceptable toxicity. RESULTS The patients (ages 7-53 years) received a total of 42 cycles of chemotherapy (median: 2 courses; range: 2-5 courses). The overall response rate was 0% and the disease control rate was 22.3%, with four patients having stable disease. The median time to progression and overall survival time were 2 months (range: 2-5 months) and 9 months (range: 3-29 months), respectively. Major severe toxicities were leucopenia 7 (38.9%), nausea and vomiting 3 (16.7%) and alopecia 9 (50%). There were no treatment-related deaths. CONCLUSIONS In our experience, continuous-infusion ifosfamide and doxorubicin combination therapy at this dosage and schedule was found to be well tolerated and moderate effective, which could be considered as salvage therapy for patients with recurrent or refractory osteosarcoma. Further assessment is necessary to confirm the safety and efficacy of this treatment.
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Affiliation(s)
- Yu-Jing Huang
- Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China E-mail :
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42
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Abstract
Osteosarcoma is the most common primary bone malignancy in children. Treatment has evolved to include systemic chemotherapy and local control surgery. Although survival improved initially in a drastic fashion with this approach, recent decades have seen little to no further gains in this area. Limb salvage surgery evolved with effective chemotherapy and advances in imaging, and continues to improve in the recent era. This article serves as a review of survival in high-grade osteosarcoma: prognostic factors, advances in chemotherapy and surgery, late effects of chemotherapy and surgery in survivors, and future directions.
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p53 overexpression increases chemosensitivity in multidrug-resistant osteosarcoma cell lines. Cancer Chemother Pharmacol 2015; 77:349-56. [PMID: 26698867 DOI: 10.1007/s00280-015-2944-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 12/11/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Multidrug resistance (MDR) is a major obstacle to the successful treatment of osteosarcoma with chemotherapy. Effectiveness of cancer therapy correlates with the ability to induce a p53-dependent apoptotic response. p53 is a tumor suppressor gene that is mutated in 22 % of osteosarcomas. While impaired p53 has been implicated in the oncogenesis of osteosarcoma, it is unclear whether overexpression of wild-type p53 can increase chemosensitivity in MDR osteosarcoma cells. METHODS We transfected a plasmid encoding the wild-type p53 gene to MDR osteosarcoma cell lines, which have different p53 statuses, U-2OSR2 with wild-type p53 (Wt-p53) and KHOSR2 with mutant p53 (Mt-p53), and determined the effect of p53 overexpression on chemosensitivities. RESULTS Both of the U-2OSR2 and KHOSR2 cell lines displayed similar trends in p53-induced drug sensitivities. However, it seems that the impact of p53 overexpression is different based on the differential intrinsic p53 status in these cell lines. In the KHOSR2 cell line (Mt-p53), overexpression of p53 up-regulates the expression of pro-apoptotic protein p21 and Bax, while in the U-2OSR2 cell line (Wt-p53), overexpression of p53 down-regulates IGF-1r expression significantly. CONCLUSIONS These results demonstrated that transfection of wild-type p53 increases chemosensitivity either through inhibiting IGF-1r or through increasing the expression of pro-apoptotic proteins p21 and Bax in human MDR osteosarcoma cell lines.
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Yang X, Zhou W, Liu S. SPAG9 controls the cell motility, invasion and angiogenesis of human osteosarcoma cells. Exp Ther Med 2015; 11:637-644. [PMID: 26893659 DOI: 10.3892/etm.2015.2932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
Abstract
Sperm-associated antigen 9 (SPAG9) is an oncoprotein involved in the progression of various human malignancies; however, its role in osteosarcoma (OS) remains poorly evaluated. The present study used Matrigel™ cell migration and invasion assays, tube formation assay, Cell Counting kit-8, quantitative polymerase chain reaction, western blotting, and enzyme-linked immunosorbent assay to investigate the role of SPAG9 in OS cell motility, invasion and angiogenesis. The results of the present study demonstrated that SPAG9 expression was upregulated in OS tissues, as compared with adjacent normal tissues, and knockdown of SPAG9 in an OS cell line inhibited cell motility and invasion via inactivation of metalloproteinase (MMP)-2 and MMP-9. Furthermore, the present study demonstrated that silencing of SPAG9 in OS cells inhibited tube formation, the proliferation of human umbilical vascular endothelial cells, and suppressed vascular endothelial growth factor (VEGF) expression and secretion, contributing to a reduction in angiogenesis. The results of the present study indicated that SPAG9 may be an important regulator in OS and may be involved in metastasis. Therefore SPAG9 may be a promising target for the treatment of metastatic OS.
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Affiliation(s)
- Xiaorong Yang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Wenlai Zhou
- Department of Joints, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi, Hubei 445000, P.R. China
| | - Shiqing Liu
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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Silencing of Eag1 Gene Inhibits Osteosarcoma Proliferation and Migration by Targeting STAT3-VEGF Pathway. BIOMED RESEARCH INTERNATIONAL 2015; 2015:617316. [PMID: 26783521 PMCID: PMC4689893 DOI: 10.1155/2015/617316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/03/2015] [Indexed: 11/29/2022]
Abstract
So far, the role of Ether à go-go 1 (Eag1) potassium channels in migration and invasion progression of cancers remains elusive. In the present study, the effects of Eag1 knockdown on osteosarcoma cell proliferation, growth, and apoptosis were examined. Then, we evaluated the effects of Eag1 silencing on osteosarcoma cell migration and invasion. In addition, we detected the expression of vascular endothelial growth factor (VEGF) and signal transducer and activator of transcription 3 (STAT3) in osteosarcoma cell treated with Eag1 small interfering RNAs (siRNAs). Finally, STAT3 siRNA was employed to determine the influence of downregulation of STAT3 on cell proliferation and migration. The results showed that knockdown of Eag1 significantly suppressed osteosarcoma cell proliferation and osteosarcoma xenografts growth. However, Eag1 silencing had little effect on cell apoptosis. Additionally, osteosarcoma cell adhesion, migration, and invasion were also potently attenuated. Notably, the expression levels of VEGF decreased evidently upon Eag1 siRNAs treatment, paralleled with reductions in the expression levels of STAT3. Moreover, a similar pattern was observed in osteosarcoma cell proliferation and migration suppression between STAT3 siRNA and Eag1 siRNAs groups. Our data indicated that Eag1 promotes osteosarcoma proliferation and migration, at least in part, by targeting STAT3-VEGF pathway.
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46
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Polo-like kinase 3 inhibits osteosarcoma cell proliferation and tumorigenesis via cooperative interaction with p21. Mol Med Rep 2015; 12:6789-96. [DOI: 10.3892/mmr.2015.4304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 07/10/2015] [Indexed: 11/05/2022] Open
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Iwata S, Yonemoto T, Iizasa T, Niibe Y, Kamoda H, Ishii T. Oligo-Recurrence of Osteosarcoma Patients: Treatment Strategies for Pulmonary Metastases. Ann Surg Oncol 2015; 22 Suppl 3:S1332-8. [DOI: 10.1245/s10434-015-4682-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Indexed: 11/18/2022]
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Kabnurkar R, Agrawal A, Rekhi B, Purandare N, Shah S, Rangarajan V. Unusual sites of metastatic recurrence of osteosarcoma detected on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med 2015; 30:171-3. [PMID: 25829742 PMCID: PMC4379683 DOI: 10.4103/0972-3919.152986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Osteosarcoma (OS) is the most common nonhematolymphoid primary bone malignancy characterized by osteoid or new bone formation. Lungs and bones are the most common sites of metastases. We report a case where unusual sites of the soft tissue recurrence from OS were detected on restaging fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan done post 6 years of disease free interval.
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Affiliation(s)
- Rasika Kabnurkar
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Bharat Rekhi
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Daw NC, Chou AJ, Jaffe N, Rao BN, Billups CA, Rodriguez-Galindo C, Meyers PA, Huh WW. Recurrent osteosarcoma with a single pulmonary metastasis: a multi-institutional review. Br J Cancer 2014; 112:278-82. [PMID: 25422914 PMCID: PMC4453448 DOI: 10.1038/bjc.2014.585] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/27/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Late relapse and solitary lesion are positive prognostic factors in recurrent osteosarcoma. METHODS We reviewed the records of 39 patients treated at three major centres for recurrent osteosarcoma with a single pulmonary metastasis more than 1 year after diagnosis. We analysed their outcomes with respect to clinical factors and treatment with chemotherapy. RESULTS Median age at diagnosis was 14.6 years. Relapse occurred at a median of 2.5 years (range, 1.2-8.2 years) after initial diagnosis. At relapse, all patients were treated by metastasectomy; 12 (31%) patients also received chemotherapy. There was no difference in time to recurrence or nodule size between the patients who received or did not receive chemotherapy at relapse. Sixteen patients had no subsequent recurrence, 13 of whom survive without evidence of disease. The 5-year and 10-year estimates of post-relapse event-free survival (PREFS) were 33.0±7.5% and 33.0±9.6%, respectively, and of post-relapse survival (PRS) 56.8±8.6% and 53.0±11.0%, respectively. There was a trend for nodules <1.5 cm to correlate positively with PREFS (P=0.070) but not PRS (P=0.49). Chemotherapy at first relapse was not associated with PREFS or PRS. CONCLUSION Approximately half of the patients with recurrent osteosarcoma presenting as a single pulmonary metastasis more than 1 year after diagnosis were long-term survivors. Metastasectomy was the primary treatment; chemotherapy did not add benefit.
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Affiliation(s)
- N C Daw
- Division of Paediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A J Chou
- Department of Paediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - N Jaffe
- Division of Paediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - B N Rao
- 1] Department of Surgery, St Jude Children's Research Hospital, Memphis, TN 38105, USA [2] Department of Surgery, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - C A Billups
- Department of Biostatistics, St Jude Children's Research Hospital and the University of Tennessee, Memphis, TN 38105, USA
| | - C Rodriguez-Galindo
- 1] Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105, USA [2] Department of Paediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - P A Meyers
- Department of Paediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - W W Huh
- Division of Paediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Sakamoto Y, Yokouchi M, Nagano S, Shimada H, Nakamura S, Setoguchi T, Kawamura I, Ishidou Y, Tanimoto A, Komiya S. Metastasis of osteosarcoma to the trapezius muscle: a case report. World J Surg Oncol 2014; 12:176. [PMID: 24893571 PMCID: PMC4050446 DOI: 10.1186/1477-7819-12-176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/16/2014] [Indexed: 11/28/2022] Open
Abstract
Metastasis of a primary osteosarcoma to the muscles is extremely rare. As there have been few reported cases, the necessity of surgical treatment for such metastatic lesions remains controversial. We present the case of a primary osteosarcoma with development of a solitary metastasis to the trapezius muscle during chemotherapy for pulmonary metastasis. The patient was a 51-year-old man diagnosed with osteosarcoma of the right tibia. After undergoing chemotherapy and femoral amputation, he developed pulmonary metastasis. Chemotherapy was reinitiated, however, after approximately 1 year a palpable tumor was identified in the patient’s right shoulder. This tumor grew and was associated with pain in the right shoulder. It was surgically removed 3 years after the re-initiation of chemotherapy. The pathological diagnosis was osteosarcoma with metastasis to the trapezius muscle. Although the patient died of respiratory failure due to pulmonary metastasis 14 months after resection of the metastatic lesion in the trapezius muscle, no new extrapulmonary metastasis was observed after the resection.
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Affiliation(s)
| | - Masahiro Yokouchi
- Department of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
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