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Mitchelson KAJ, O’Connell F, O’Sullivan J, Roche HM. Obesity, Dietary Fats, and Gastrointestinal Cancer Risk-Potential Mechanisms Relating to Lipid Metabolism and Inflammation. Metabolites 2024; 14:42. [PMID: 38248845 PMCID: PMC10821017 DOI: 10.3390/metabo14010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Obesity is a major driving factor in the incidence, progression, and poor treatment response in gastrointestinal cancers. Herein, we conducted a comprehensive analysis of the impact of obesity and its resulting metabolic perturbations across four gastrointestinal cancer types, namely, oesophageal, gastric, liver, and colorectal cancer. Importantly, not all obese phenotypes are equal. Obese adipose tissue heterogeneity depends on the location, structure, cellular profile (including resident immune cell populations), and dietary fatty acid intake. We discuss whether adipose heterogeneity impacts the tumorigenic environment. Dietary fat quality, in particular saturated fatty acids, promotes a hypertrophic, pro-inflammatory adipose profile, in contrast to monounsaturated fatty acids, resulting in a hyperplastic, less inflammatory adipose phenotype. The purpose of this review is to examine the impact of obesity, including dietary fat quality, on adipose tissue biology and oncogenesis, specifically focusing on lipid metabolism and inflammatory mechanisms. This is achieved with a particular focus on gastrointestinal cancers as exemplar models of obesity-associated cancers.
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Affiliation(s)
- Kathleen A. J. Mitchelson
- Nutrigenomics Research Group, UCD Conway Institute, UCD Institute of Food and Health, and School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 H1W8 Dublin, Ireland
| | - Fiona O’Connell
- Department of Surgery, Trinity St. James’s Cancer Institute and Trinity Translational Medicine Institute, St. James’s Hospital and Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Jacintha O’Sullivan
- Department of Surgery, Trinity St. James’s Cancer Institute and Trinity Translational Medicine Institute, St. James’s Hospital and Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Helen M. Roche
- Nutrigenomics Research Group, UCD Conway Institute, UCD Institute of Food and Health, and School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 H1W8 Dublin, Ireland
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Belfast BT9 5DL, UK
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Correlation Study on the Expression of INSR, IRS-1, and PD-L1 in Nonsmall Cell Lung Cancer. JOURNAL OF ONCOLOGY 2022; 2022:5233222. [PMID: 36245982 PMCID: PMC9553505 DOI: 10.1155/2022/5233222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022]
Abstract
Objective To study the expression and correlation of insulin receptor (INSR), insulin receptor substrate-1 (IRS-1), and programmed cell death ligand-1 (PD-L1) in nonsmall cell lung cancer (NSCLC). Methods 45 lung cancer tissues and 30 adjacent normal tissues of NSCLC patients diagnosed in the Second Affiliated Hospital of Shandong First Medical University from June 2019 to August 2020 were selected. The expressions of INSR, IRS-1, and PD-L1 proteins in tumor tissues and adjacent tissues of NSCLC were detected by immunohistochemical staining. Results The expression of INSR and IRS-1 in NSCLC was significantly higher than that in adjacent normal lung tissue (P < 0.05). INSR expression had statistical significance with the degree of pathological differentiation of nonsmall cell carcinoma (P = 0.031), but had no significant association with age, gender, pathological type, TNM stage, and lymph node metastasis status (P > 0.05). There was no significant correlation between IRS-1 positive expression and NSCLC patients' age, gender, pathological typing, degree of differentiation, TNM stage, and lymph node metastasis (P > 0.05). PD-L1 positive expression was correlated with lymph node metastasis of NSCLC (P = 0.028), while there was no significant correlation with gender, age, pathological type, TNM stage, and pathological differentiation degree of NSCLC patients (P > 0.05). Spearman correlation analysis showed that PD-L1 protein expression had a significant positive correlation with IRS-1 protein expression (r = 0.373), but was not correlated with the expression of INSR protein. Conclusion IRS-1 may be involved in the regulation of PD-L1 expression and mediate the occurrence of tumor immune escape, which is expected to become a new target for NSCLC immunotherapy and provide new clinical evidence for immunosuppressive therapy.
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Subventricular zone adult mouse neural stem cells require insulin receptor for self-renewal. Stem Cell Reports 2022; 17:1411-1427. [PMID: 35523180 PMCID: PMC9213826 DOI: 10.1016/j.stemcr.2022.04.007] [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: 08/25/2019] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
The insulin receptor (INSR) is an evolutionarily conserved signaling protein that regulates development and cellular metabolism. INSR signaling promotes neurogenesis in Drosophila; however, a specific role for the INSR in maintaining adult neural stem cells (NSCs) in mammals has not been investigated. We show that conditionally deleting the Insr gene in adult mouse NSCs reduces subventricular zone NSCs by ∼70% accompanied by a corresponding increase in progenitors. Insr deletion also produced hyposmia caused by aberrant olfactory bulb neurogenesis. Interestingly, hippocampal neurogenesis and hippocampal-dependent behaviors were unperturbed. Highly aggressive proneural and mesenchymal glioblastomas had high INSR/insulin-like growth factor (IGF) pathway gene expression, and isolated glioma stem cells had an aberrantly high ratio of INSR:IGF type 1 receptor. Moreover, INSR knockdown inhibited GBM tumorsphere growth. Altogether, these data demonstrate that the INSR is essential for a subset of normal NSCs, as well as for brain tumor stem cell self-renewal. Insulin receptor (INSR) is essential for adult SVZ neural stem cell self-renewal INSR deletion causes hyposmia with increased olfactory bulb neurogenesis Hippocampal stem cells (and associated behaviors) do not require INSR Glioblastomas overexpress INSR pathway components required for tumorsphere growth
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Leitner BP, Siebel S, Akingbesote ND, Zhang X, Perry RJ. Insulin and cancer: a tangled web. Biochem J 2022; 479:583-607. [PMID: 35244142 PMCID: PMC9022985 DOI: 10.1042/bcj20210134] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022]
Abstract
For a century, since the pioneering work of Otto Warburg, the interwoven relationship between metabolism and cancer has been appreciated. More recently, with obesity rates rising in the U.S. and worldwide, epidemiologic evidence has supported a link between obesity and cancer. A substantial body of work seeks to mechanistically unpack the association between obesity, altered metabolism, and cancer. Without question, these relationships are multifactorial and cannot be distilled to a single obesity- and metabolism-altering hormone, substrate, or factor. However, it is important to understand the hormone-specific associations between metabolism and cancer. Here, we review the links between obesity, metabolic dysregulation, insulin, and cancer, with an emphasis on current investigational metabolic adjuncts to standard-of-care cancer treatment.
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Affiliation(s)
- Brooks P. Leitner
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
| | - Stephan Siebel
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Pediatrics, Yale School of Medicine, New Haven, CT, U.S.A
| | - Ngozi D. Akingbesote
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
| | - Xinyi Zhang
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
| | - Rachel J. Perry
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
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Leiter A, Charokopos A, Bailey S, Gallagher EJ, Hirsch FR, LeRoith D, Wisnivesky JP. Assessing the association of diabetes with lung cancer risk. Transl Lung Cancer Res 2021; 10:4200-4208. [PMID: 35004250 PMCID: PMC8674590 DOI: 10.21037/tlcr-21-601] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/27/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Diabetes is a well-established risk factor for many cancers, but its relationship with lung cancer incidence remains unclear. In this study, we aimed to assess if diabetes is independently associated with lung cancer risk and histology subtype among participants in a screening study. METHODS In a retrospective cohort study using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) study, we assessed the association of self-reported diabetes with lung cancer incidence using Poisson regression while adjusting for other established risk factors in the PLCOM2012, a validated lung cancer prediction model. The adjusted association of diabetes and lung cancer cell type was evaluated using nominal regression. Stratified analyses were also conducted according to sex, smoking history, and body mass index categories. RESULTS Overall, 140,395 participants were included in our analysis. Diabetes was not significantly associated with lung cancer incidence [incidence rate ratio (IRR): 1.03, 95% confidence interval (CI): 0.91-1.17]. Similarly, stratified analyses also did not show significant associations between diabetes and lung cancer risk (all P values >0.05). We found no significant difference in the distribution of lung cancer histology in participants with vs. without diabetes (P=0.30). CONCLUSIONS Diabetes was not an independent risk factor for lung cancer in a large cohort of PLCO participants. We did not observe differences in histology according to diabetes status. These results suggest that patients with diabetes do not need more aggressive lung cancer screening. Future research including more detailed metabolic parameters may further elucidate the relationship between metabolic disease and lung cancer risk.
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Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Antonios Charokopos
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stacyann Bailey
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily J. Gallagher
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA;,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fred R. Hirsch
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Derek LeRoith
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan P. Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Jaiswal P, Tripathi V, Nayak A, Kataria S, Lukashevich V, Das A, Parmar HS. A molecular link between diabetes and breast cancer: Therapeutic potential of repurposing incretin-based therapies for breast cancer. Curr Cancer Drug Targets 2021; 21:829-848. [PMID: 34468298 DOI: 10.2174/1568009621666210901101851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022]
Abstract
Female breast cancer recently surpassed lung cancer and became the most commonly diagnosed cancer worldwide. As per the recent data from WHO, breast cancer accounts for one out of every 8 cancer cases diagnosed among an estimated 2.3 million new cancer cases. Breast cancer is the most prevailing cancer type among women causing the highest number of cancer-related mortality. It has been estimated that in 2020, 68,5000 women died due to this disease. Breast cancers have varying degrees of molecular heterogeneity; therefore, they are divided into various molecular clinical sub types. Recent reports suggest that type 2 diabetes (one of the common chronic diseases worldwide) is linked to the higher incidence, accelerated progression, and aggressiveness of different cancers; especially breast cancer. Breast cancer is hormone-dependent in nature and has a cross-talk with metabolism. A number of antidiabetic therapies are known to exert beneficial effects on various types of cancers, including breast cancer. However, only a few reports are available on the role of incretin-based antidiabetic therapies in cancer as a whole and in breast cancer in particular. The present review sheds light on the potential of incretin based therapies on breast cancer and explores the plausible underlying mechanisms. Additionally, we have also discussed the sub types of breast cancer as well as the intricate relationship between diabetes and breast cancer.
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Affiliation(s)
- Pooja Jaiswal
- School of Biotechnology, Devi Ahilya University, Indore-452001. M.P., India
| | - Versha Tripathi
- School of Biotechnology, Devi Ahilya University, Indore-452001. M.P., India
| | - Aakruti Nayak
- School of Biotechnology, Devi Ahilya University, Indore-452001. M.P., India
| | - Shreya Kataria
- School of Biotechnology, Devi Ahilya University, Indore-452001. M.P., India
| | - Vladimir Lukashevich
- Institute of Physiology of the National Academy of Sciences of Belarus, Minsk-220072. Belarus
| | - Apurba Das
- Department of Chemical Sciences, IIT, Indore, Simrol, Indore, M.P., India
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Disrupting Insulin and IGF Receptor Function in Cancer. Int J Mol Sci 2021; 22:ijms22020555. [PMID: 33429867 PMCID: PMC7827299 DOI: 10.3390/ijms22020555] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023] Open
Abstract
The insulin and insulin-like growth factor (IGF) system plays an important role in regulating normal cell proliferation and survival. However, the IGF system is also implicated in many malignancies, including breast cancer. Preclinical studies indicate several IGF blocking approaches, such as monoclonal antibodies and tyrosine kinase inhibitors, have promising therapeutic potential for treating diseases. Uniformly, phase III clinical trials have not shown the benefit of blocking IGF signaling compared to standard of care arms. Clinical and laboratory data argue that targeting Type I IGF receptor (IGF1R) alone may be insufficient to disrupt this pathway as the insulin receptor (IR) may also be a relevant cancer target. Here, we review the well-studied role of the IGF system in regulating malignancies, the limitations on the current strategies of blocking the IGF system in cancer, and the potential future directions for targeting the IGF system.
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Abstract
Elevated circulating insulin levels are frequently observed in the setting of obesity and early type 2 diabetes, as a result of insensitivity of metabolic tissues to the effects of insulin. Higher levels of circulating insulin have been associated with increased cancer risk and progression in epidemiology studies. Elevated circulating insulin is believed to be a major factor linking obesity, diabetes and cancer. With the development of targeted cancer therapies, insulin signalling has emerged as a mechanism of therapeutic resistance. Although metabolic tissues become insensitive to insulin in the setting of obesity, a number of mechanisms allow cancer cells to maintain their ability to respond to insulin. Significant progress has been made in the past decade in understanding the insulin receptor and its signalling pathways in cancer, and a number of lessons have been learnt from therapeutic failures. These discoveries have led to numerous clinical trials that have aimed to reduce the levels of circulating insulin and to abrogate insulin signalling in cancer cells. With the rising prevalence of obesity and diabetes worldwide, and the realization that hyperinsulinaemia may contribute to therapeutic failures, it is essential to understand how insulin and insulin receptor signalling promote cancer progression.
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Affiliation(s)
- Emily J Gallagher
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Derek LeRoith
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Abstract
The insulin and insulin-like growth factor (IGF) family of proteins are part of a complex network that regulates cell proliferation and survival. While this system is undoubtedly important in prenatal development and postnatal cell growth, members of this family have been implicated in several different cancer types. Increased circulating insulin and IGF ligands have been linked to increased risk of cancer incidence. This observation has led to targeting the IGF system as a therapeutic strategy in a number of cancers. This chapter aims to describe the well-characterized biology of the IGF1R system, outline the rationale for targeting this system in cancer, summarize the clinical data as it stands, and discuss where we can go from here.
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A Cohort Study of Exposure to Antihyperglycemic Therapy and Survival in Patients with Lung Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051747. [PMID: 32156062 PMCID: PMC7084663 DOI: 10.3390/ijerph17051747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/24/2022]
Abstract
We evaluated the effect of antihyperglycemic therapy on the survival of patients with lung cancer (LC). The analysis included patients with LC and concomitant type 2 diabetes. 15,929 patients were classified into five groups: metformin users, insulin users, metformin and insulin users, sulphonylurea users and non-diabetic group. A multivariate analysis showed that exposure to either metformin or to insulin was associated with a lower risk of LC-specific mortality, and this approached statistical significance (HR 0.82, 95% CI 0.72–92 for metformin and HR 0.65, 95% CI 0.44–95 for insulin). When deaths from all causes were considered, only metformin exposure was associated with a significantly lower risk of death (HR 0.82, 95% CI 0.73–0.92). Users of sulphonylurea were at a higher risk of LC-specific and overall mortality (HRs 1.19, 95% CI 0.99–1.43 and 1.22, 95% CI 1.03–1.45). Our study shows a positive effect of metformin on the survival of patients with LC. Moreover, our results show that exposure to insulin was associated with a lower risk of LC-specific mortality, but not with deaths from all causes. The study results suggested that users of sulphonylurea may be at a higher risk of LC-specific and overall mortality.
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Phase I Study of IGF-Methotrexate Conjugate in the Treatment of Advanced Tumors Expressing IGF-1R. Am J Clin Oncol 2019; 42:862-869. [DOI: 10.1097/coc.0000000000000611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Roos JF, Qudsi M, Samara A, Rahim MM, Al-Bayedh SA, Ahmed H. Metformin for lung cancer prevention and improved survival: a novel approach. Eur J Cancer Prev 2019; 28:311-315. [PMID: 29481337 DOI: 10.1097/cej.0000000000000442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus has been associated with increased risk for the development of many types of cancer. Metformin, an oral medication and first-line treatment for type 2 diabetes mellitus, has been suggested to reduce cancer risk and mortality in various types of cancer. This study focuses on assessing metformin association with lung cancer as reported in the literature. Recent studies and reviews investigating metformin effects on lung cancer incidence and patient survival are critically and systematically discussed.
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Affiliation(s)
- Juliana F Roos
- Department of Clinical Pharmacy and Pharmacy Practice, Dubai Pharmacy College
| | - Mariam Qudsi
- Department of Clinical Pharmacy and Pharmacy Practice, Dubai Pharmacy College
| | - Arwa Samara
- Department of Clinical Pharmacy and Pharmacy Practice, Dubai Pharmacy College
| | - Madina M Rahim
- Department of Clinical Pharmacy and Pharmacy Practice, Dubai Pharmacy College
| | - Samar A Al-Bayedh
- Department of Clinical Pharmacy and Pharmacy Practice, Dubai Pharmacy College
| | - Hafez Ahmed
- Department of Biochemistry, Dubai Medical College, Dubai, United Arab Emirates
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Xu J, Bie F, Wang Y, Chen X, Yan T, Du J. Prognostic value of IGF-1R in lung cancer: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2019; 98:e15467. [PMID: 31083179 PMCID: PMC6531258 DOI: 10.1097/md.0000000000015467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/30/2019] [Accepted: 04/08/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Insulin-like growth factor receptor 1 (IGF-1R) is a key player in a wide array of pathological processes, while the prognostic role of IGF-1R in lung cancer remains controversial. METHODS We conducted a meta-analysis to evaluate the prognostic value of IGF-1R in lung cancer. We searched for recent studies on the expression of IGF-1R and extracted prognostic lung cancer data from the articles. RESULTS Eventually, 22 studies with 3859 patients were analyzed in our meta-analysis. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to quantify the ability of IGF-1R to predict survival. The results indicated that IGF-1R positive expression was associated with an unfavorable disease-free survival (DFS) in non-small cell lung cancer (NSCLC) patients on univariate analysis (HR = 1.24, 95% CI: 1.00-1.55, P = .054) and multivariate analysis (HR = 1.49, 95% CI: 1.01-2.21, P = .045), but there was no significant difference in the relationship between IGF-1R positive expression and overall survival (OS) on univariate analysis (HR = 1.04, 95% CI: 0.86-1.25, P = .712) and multivariate analysis (HR = 0.89, 95% CI: 0.57-1.39, P = .602). IGF-1R mRNA expression related to OS was obtained in 2 studies, with the pooled HR being 1.663 (95% CI: 1.071-2.583, P = .024). For IGF-1R expression and small cell lung cancer (SCLC), the conclusion was not statistically significant, with the pooled HR being 1.22 (95% CI: 0.66-2.27, P = .524). CONCLUSIONS Our results indicate that high expression of IGF-1R predicts poor DFS in NSCLC, yet it does not predict poor OS in NSCLC and SCLC. IGF-1R may be a useful predictor of outcomes in patients with NSCLC.
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Affiliation(s)
- Jun Xu
- Department of Thoracic Surgery, Jining No. 1 People's Hospital, Jining, Shandong
| | | | | | | | | | - Jiajun Du
- Institute of Oncology
- Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
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Heckl SM, Wiesener V, Behrens HM, Ulase D, Krüger S, Röcken C. The expression of the insulin receptor in gastric cancer correlates with the HER2 status and may have putative therapeutic implications. Gastric Cancer 2019; 22:1130-1142. [PMID: 30989432 PMCID: PMC6811372 DOI: 10.1007/s10120-019-00964-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 04/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Metabolic reprogramming in gastric cancer (GC) involves not only an alteration of glucose metabolism, but also of insulin receptor (IR) expression. We investigated if (1) GCs express the IR in cancer cells (CC-IR) and vasculature (VIR), (2) IR expression is clinically relevant and may be a novel target of GC treatment. METHODS 467 primary GCs were studied by immunohistochemistry using an IR-specific antibody. CD31-immunostaining ensured the presence of representative intratumoral microvasculature. VIR, and membranous and cytoplasmic CC-IR (mCC-IR, cCC-IR) were evaluated using a modified HistoScore (HScore) and subsequently dichotomized into low or high IR expressions. The IR status was correlated with clinico-pathological patient characteristics, including survival and HER2 status. RESULTS VIR, mCC-IR, and cCC-IR (HScore > 0) were found in 97.0%, 87.6%, and 95.7% of all GCs. After dichotomization of the HScores, 50.7, 48.8, and 50.3% were classified as VIR-high, mCC-IR-high, and cCC-IR-high, respectively. IR was associated with the Laurén phenotype, tumor localization, local tumor growth, vascular invasion, perineural invasion, tumor budding, mucin phenotype, UICC stage, worse survival, and the HER2 status. On multivariate analysis, VIR status was an independent prognosticator of overall (p = 0.010) and tumor-specific (p = 0.006) patient survival. CONCLUSIONS VIR and CC-IR expressions are frequent in GC, biologically significant and even correlate with the HER2 status, opening avenues for novel putative therapeutic interventions in GC.
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Affiliation(s)
- Steffen M Heckl
- Department of Pathology, Christian-Albrechts-University, Arnold-Heller-Str. 3, Haus 14, 24105, Kiel, Germany
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Viva Wiesener
- Department of Pathology, Christian-Albrechts-University, Arnold-Heller-Str. 3, Haus 14, 24105, Kiel, Germany
| | - Hans-Michael Behrens
- Department of Pathology, Christian-Albrechts-University, Arnold-Heller-Str. 3, Haus 14, 24105, Kiel, Germany
| | - Dita Ulase
- Department of Pathology, Riga Stradins University, Riga, Latvia
| | - Sandra Krüger
- Department of Pathology, Christian-Albrechts-University, Arnold-Heller-Str. 3, Haus 14, 24105, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, Christian-Albrechts-University, Arnold-Heller-Str. 3, Haus 14, 24105, Kiel, Germany.
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15
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Heckl SM, Pellinghaus M, Krüger S, Bosselmann C, Wilhelm F, Behrens HM, Schreiber S, Röcken C. Epithelial insulin receptor expression-prognostic relevance in colorectal cancer. Oncotarget 2018; 9:37497-37508. [PMID: 30680065 PMCID: PMC6331016 DOI: 10.18632/oncotarget.26490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/10/2018] [Indexed: 12/15/2022] Open
Abstract
Background Metabolic reprogramming in cancer encompasses the insulin receptor (IR) as a player of energy homeostasis and proliferation. We aimed to characterize vascular (VIR) and epithelial (EIR) IR expression in CRC and correlate it with clinico-pathological parameters and survival. Methods 1580 primary CRCs were explored by immunohistochemistry for evaluation of VIR and EIR. Subgroup analyses included in situ hybridization for IR isoform A (IR-A) and DNA mismatch repair protein immunohistochemistry. Clinico-pathological and survival parameters were studied. Results High VIR was evident in 63.5% of all CRC samples and was associated with T-stage (P = 0.005). EIR was present in 72.2% and was associated with lower T-stages (P = 0.006) and UICC-stages (P < 0.001). EIR negativity was associated with increased metastasis (P = 0.028), nodal spread (P < 0.001), lymphatic invasion (P = 0.008) and a decreased tumor-specific (P = 0.011) and overall survival (P = 0.007; 95%-C.I.: 44.5-84.1). EIR negativity in UICC-stage II was associated with a significantly worse tumor-specific (P = 0.045) and overall (P = 0.043) survival. IR-A was expressed in CRC vessels and cells. Conclusions We demonstrate VIR to be frequent in CRC and characterize EIR negativity as an important prognostic risk factor. The association between EIR negativity and worse survival in UICC-stage II should be prospectively evaluated for an application in therapeutic algorithms.
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Affiliation(s)
- Steffen M Heckl
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Marie Pellinghaus
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sandra Krüger
- Department of Pathology, Christian-Albrechts-University, Kiel, Germany
| | - Clara Bosselmann
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Franziska Wilhelm
- Department of Pathology, Christian-Albrechts-University, Kiel, Germany
| | | | - Stefan Schreiber
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, Christian-Albrechts-University, Kiel, Germany
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Wang R, Cai Y, Zhang B, Wu Z. A 16-gene expression signature to distinguish stage I from stage II lung squamous carcinoma. Int J Mol Med 2018; 41:1377-1384. [PMID: 29286069 PMCID: PMC5819923 DOI: 10.3892/ijmm.2017.3332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/08/2017] [Indexed: 12/21/2022] Open
Abstract
The present study aimed to perform screening of a gene signature for the discrimination and prognostic prediction of stage I and II lung squamous carcinoma. A microarray meta‑analysis was performed to identify differentially expressed genes (DEGs) between stage I and II lung squamous carcinoma samples in seven microarray datasets collected from the Gene Expression Omnibus database via the MetaQC and MetaDE package in R. The important DEGs were selected according to the betweenness centrality value of the protein‑protein interaction (PPI) network. Support vector machine (SVM) analysis was performed to screen the feature genes for discrimination and prognosis. One independent dataset downloaded from The Cancer Genome Atlas was used to validate the reliability. Pathway enrichment analysis was also performed for the feature genes. A total of 924 DEGs were identified to construct a PPI network consisting of 392 nodes and 686 edges. The top 100 of the 392 nodes were selected as crucial genes to construct an SVM classifier, and a 16‑gene signature (caveolin 1, eukaryotic translation elongation factor 1γ, casein kinase 2α1, tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation η, tyrosine 3‑monooxygenase/tryptophan 5‑monooxygenase activation θ, pleiotrophin, insulin receptor, insulin receptor substrate 1, 3‑phosphoinositide‑dependent protein kinase‑1, specificity protein 1, COP9 signalosome subunit 6, N‑myc downstream regulated gene 1, retinoid X receptor α, heat shock protein 90α A1, karyopherin subunit β1 and erythrocyte membrane protein band 4.1) with high discrimination accuracy was identified. This 16‑gene signature had significant prognostic value, and patients with stage II lung squamous carcinoma exhibited shorter survival rates, compared with those with stage I disease. Seven DEGs of the 16-gene signature were significantly involved in the phosphoinositide 3‑kinase‑Akt signaling pathway. The 16‑gene signature identified in the present study may be useful for stratifying the patients with stage I or II lung squamous carcinoma and predicting prognosis.
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Affiliation(s)
- Rui Wang
- Department of VIP and Geriatrics, Xi'an Gaoxin Hospital, Gaoxin Industrial Development Distinct, Xi'an, Shanxi 710075
| | | | - Baoping Zhang
- Department of Thoracic Surgery, Baoji Central Hospital, Baoji, Shanxi 721008, P.R. China
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17
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Marrone KA, Zhou X, Forde PM, Purtell M, Brahmer JR, Hann CL, Kelly RJ, Coleman B, Gabrielson E, Rosner GL, Ettinger DS. A Randomized Phase II Study of Metformin plus Paclitaxel/Carboplatin/Bevacizumab in Patients with Chemotherapy‐Naïve Advanced or Metastatic Nonsquamous Non‐Small Cell Lung Cancer. Oncologist 2018; 23:859-865. [PMID: 29487223 PMCID: PMC6058336 DOI: 10.1634/theoncologist.2017-0465] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/21/2017] [Indexed: 01/09/2023] Open
Abstract
Retrospective clinical data and laboratory studies point to metformin having a potential role in cancer treatment; however, the efficacy of this drug in cancer treatment therapy has not been validated in prospective trials. In particular, limited data evaluating the effects of metformin in lung cancer has been available. Responding to this need, a prospective phase II clinical trial was conducted, and this article evaluates response rate and progression‐free survival of platinum‐based doublet chemotherapy with or without metformin in chemotherapy‐naïive advanced or metastatic nonsquamous non‐small cell lung cancer. Background. In the absence of a targeted oncogenic driver mutation or high programmed death‐ligand 1 expression, systemic therapy with platinum‐based doublet chemotherapy with or without bevacizumab has been the standard treatment in advanced or metastatic non‐small cell lung cancer (NSCLC). Metformin has been shown to have antitumor effects via a variety of insulin‐dependent and insulin‐independent mechanisms and to be potentially synergistic with chemotherapy. Materials and Methods. This open‐label single‐center phase II study (NCT01578551) enrolled patients with chemotherapy‐naïve advanced or metastatic nonsquamous NSCLC and randomized them (3:1) to receive carboplatin, paclitaxel, and bevacizumab with (Arm A) or without (Arm B) concurrent metformin for four to six cycles followed by maintenance therapy with bevacizumab ± metformin continued until disease progression, intolerable toxicity, or study withdrawal. The primary outcome was 1‐year progression free survival (PFS). Secondary outcomes included overall survival, response to therapy, and toxicity. Results. A total of 25 patients were enrolled from August 2012 to April 2015, of whom 24 received at least one cycle of therapy administration. The study was stopped early due to slow accrual and changes in standard first‐line therapy of advanced NSCLC. The 1‐year PFS on Arm A (n = 18) was 47% (95% confidence interval [CI]: 25%–88%), which exceeded the historical control 1‐year PFS of 15%. Median overall survival of patients treated on Arm A was 15.9 months (95% CI: 8.4–not available [NA]) and 13.9 months (95% CI: 12.7–NA) on Arm B. There were no significant differences in toxicity between the study arms. Conclusion. To the authors' knowledge, this is the first study to show a significant benefit in PFS with the use of metformin in this patient population and is a signal of efficacy for metformin in advanced NSCLC. Implications for Practice. The anticancer effects of metformin continue to be elucidated. To the authors' knowledge, this is the first trial in nondiabetic advanced non‐small cell lung cancer patients to show a significant change in outcome with the addition of metformin to standard first‐line chemotherapy. Well tolerated and widely available, metformin is a drug that should be considered for further study in the lung cancer treatment landscape.
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Affiliation(s)
- Kristen A Marrone
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Xian Zhou
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Patrick M Forde
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Michael Purtell
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Julie R Brahmer
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Christine L Hann
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Ronan J Kelly
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Barbara Coleman
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Edward Gabrielson
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Gary L Rosner
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - David S Ettinger
- Department of Oncology, Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland
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18
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The preoperative HbA1c level is an independent prognostic factor for the postoperative survival after resection of non-small cell lung cancer in elderly patients. Surg Today 2017; 48:517-524. [DOI: 10.1007/s00595-017-1612-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022]
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Jiang J, Ren HY, Geng GJ, Mi YJ, Liu Y, Li N, Yang SY, Shen DY. Oncogenic activity of insulin in the development of non-small cell lung carcinoma. Oncol Lett 2017; 15:447-452. [PMID: 29387228 DOI: 10.3892/ol.2017.7347] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/17/2017] [Indexed: 12/19/2022] Open
Abstract
Insulin is associated with the progression of numerous different types of cancer. However, the association between insulin and non-small cell lung carcinoma (NSCLC) remains unknown. The aim of the present study was to evaluate the role of insulin in the proliferation, migration and drug resistance of NSCLC cells, and to determine whether the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway was involved. NSCLC cells were treated with insulin in the absence or presence of LY294002, an inhibitor of the PI3K/Akt pathway. Following co-incubation with insulin, cell proliferation and drug resistance were measured by MTT; cell migration was examined by wound healing and Transwell assays; and the expression of cyclin A, proliferating cell nuclear antigen (PCNA), p27, matrix metalloproteinase 3 (MMP3), P-gp and proteins involved in the PI3K/Akt pathway were assessed via western blotting. The results of the current study demonstrated that insulin enhanced the proliferation, migration and drug resistance of NSCLC cells. Correspondingly, insulin upregulated the expression of cyclin A, PCNA, MMP3, P-gp and downregulated p27 expression in NSCLC cells. Following treatment with insulin, it was demonstrated that phospho-Akt expression increased in a dose-dependent manner. However, the effects of insulin on NSCLC cells was inhibited by the PI3K/Akt pathway inhibitor LY294002. Therefore, the results of the current study indicate that insulin is associated with the development of NSCLC by activating the PI3K/Akt pathway. This may improve understanding of the mechanism of action of insulin in NSCLC in the future.
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Affiliation(s)
- Jie Jiang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
| | - Hong-Yue Ren
- Department of Pathology, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Guo-Jun Geng
- Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
| | - Yan-Jun Mi
- Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
| | - Yu Liu
- Department of Biobank, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
| | - Ning Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
| | - Shu-Yu Yang
- Department of Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
| | - Dong-Yan Shen
- Department of Biobank, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, P.R. China
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20
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Lončar-Brzak B, Klobučar M, Veliki-Dalić I, Sabol I, Kraljević Pavelić S, Krušlin B, Mravak-Stipetić M. Expression of small leucine-rich extracellular matrix proteoglycans biglycan and lumican reveals oral lichen planus malignant potential. Clin Oral Investig 2017; 22:1071-1082. [PMID: 28779221 DOI: 10.1007/s00784-017-2190-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/21/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to examine molecular alterations on the protein level in lesions of oral lichen planus (OLP), oral squamous cell carcinoma (OSCC) and healthy mucosa. MATERIALS AND METHODS Global protein profiling methods based on liquid chromatography coupled to mass spectrometry (LC-MS) were used, with a special emphasis on evaluation of deregulated extracellular matrix molecules expression, as well as on analyses of IG2F and IGFR2 expression in healthy mucosa, OLP and OSCC tissues by comparative semi-quantitative immunohistochemistry. RESULTS Mass spectrometry-based proteomics profiling of healthy mucosa, OLP and OSCC tissues (and accompanied histologically unaltered tissues, respectively) identified 55 extracellular matrix proteins. Twenty among identified proteins were common to all groups of samples. Expression of small leucine-rich extracellular matrix proteoglycans lumican and biglycan was found both in OSCC and OLP and they were validated by Western blot analysis as putative biomarkers. A significant increase (p < 0.05) of biglycan expression in OLP-AT group was determined in comparison with OLP-T group, while lumican showed significant up-regulation (p < 0.05) in OLP-T and OSCC-T groups vs. adjacent and control tissue groups. Biglycan expression was only determined in OSCC-AT group. Immunohistochemical analysis of IGF2 and IG2FR expression revealed no significant difference among groups of samples. CONCLUSION/CLINICAL RELEVANCE Biglycan and lumican were identified as important pathogenesis biomarkers of OLP that point to its malignant potential.
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Affiliation(s)
- Božana Lončar-Brzak
- School of Dental Medicine, Department of Oral Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Klobučar
- Department of Biotechnology and Centre for High-throughput technologies, University of Rijeka, Radmile Matejčić 2, 51000, Rijeka, Croatia
| | - Irena Veliki-Dalić
- Department of Pathology, Clinical Hospital for Tumours, Clinical Hospital Centre Sisters of Mercy, Zagreb, Croatia
| | - Ivan Sabol
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Sandra Kraljević Pavelić
- Department of Biotechnology and Centre for High-throughput technologies, University of Rijeka, Radmile Matejčić 2, 51000, Rijeka, Croatia.
| | - Božo Krušlin
- School of Medicine, Department of Pathology, Clinical Hospital Centre Sisters of Mercy, University of Zagreb, Zagreb, Croatia
| | - Marinka Mravak-Stipetić
- School of Dental Medicine, Department of Oral Medicine, University of Zagreb, Zagreb, Croatia
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21
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Humar M, Kern I, Vlacic G, Hadzic V, Cufer T. Insulin-like Growth Factor 1 Receptor Expression in Advanced Non-small-cell Lung Cancer and its Impact on Overall Survival. Radiol Oncol 2017; 51:195-202. [PMID: 28740455 PMCID: PMC5514660 DOI: 10.1515/raon-2017-0020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 11/08/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The insulin-like growth factor 1 receptor (IGF1R) expression has been addressed as a potential prognostic marker in non-small-cell lung cancer (NSCLC) in various studies; however, the associations between IGF1R expression and prognosis of advanced NSCLC patients is still controversial. The aim of our observational, cohort study was to evaluate the expression of IGF1R in advanced NSCLC and its prognostic role. A subgroup analysis was performed to address the influence of pre-existing type 2 diabetes mellitus (T2DM) status on IGF1R expression and overall survival (OS). PATIENTS AND METHODS IGF1R expression was evaluated in 167 consecutive advanced NSCLC patients (stage IIIB and IV), diagnosed and treated at one university institution, between 2005 and 2010. All patients received at least one line of standard cytotoxic therapy and 18 of them had pre-existing T2DM. IGF1R expression was determined by immunohistochemical (IHC) staining, with score ≥ 1+ considered as positive. Information on baseline characteristics, as well as patients' follow-up data, were obtained from the hospital registry. Associations of IGF1R expression with clinical characteristics and overall survival were compared. RESULTS IGF1R expression was positive in 79.6% of patients, significantly more often in squamous-cell carcinoma (SCC) compared to non-squamous-cell (NSCC) histology (88.7% vs. 74.3%; P = 0.03). IGF1R positivity did not correlate with T2DM status or with other clinical features (sex, smoking status, performance status). Median OS was similar between IGF1R positive and IGF1R negative group (10.2 vs. 8.5 months, P = 0.168) and between patients with or without T2DM (8.7 vs. 9.8 months, P = 0.575). Neither IGF1R expression nor T2DM were significant predictors of OS. CONCLUSIONS IGF1R or T2DM status were not significantly prognostic in described above collective of advanced NSCLC treated with at least one line of chemotherapy. In addition, no association between T2DM status and IGF1R expression was found. Further studies on IGF1R expression and its prognostic as well as therapeutic consequences in a larger collective of advanced NSCLC patients, with or without T2DM, are needed.
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Affiliation(s)
- Mojca Humar
- General hospital of Nova Gorica, Ulica padlih borcev 13a, 5290 Šempeter Pri Gorici, Slovenia
| | | | | | - Vedran Hadzic
- Faculty of Sport, University of Ljubljana, Slovenia, Ljubljana, Slovenia
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22
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Vigneri R, Goldfine ID, Frittitta L. Insulin, insulin receptors, and cancer. J Endocrinol Invest 2016; 39:1365-1376. [PMID: 27368923 DOI: 10.1007/s40618-016-0508-7] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 06/23/2016] [Indexed: 12/13/2022]
Abstract
Insulin is a major regulator of cell metabolism but, in addition, is also a growth factor. Insulin effects in target cells are mediated by the insulin receptor (IR), a transmembrane protein with enzymatic (tyrosine kinase) activity. The insulin receptor, however, is represented by a heterogeneous family of proteins, including two different IR isoforms and also hybrid receptors resulting from the IR hemireceptor combination with a hemireceptor of the cognate IGF-1 receptor. These different receptors may bind insulin and its analogs with different affinity and produce different biologic effects. Since many years, it is known that many cancer cells require insulin for optimal in vitro growth. Recent data indicate that: (1) insulin stimulates growth mainly via its own receptor and not the IGF-1 receptor; (2) in many cancer cells, the IR is overexpressed and the A isoform, which has a predominant mitogenic effect, is more represented than the B isoform. These characteristics provide a selective growth advantage to malignant cells when exposed to insulin. For this reason, all conditions of hyperinsulinemia, both endogenous (prediabetes, metabolic syndrome, obesity, type 2 diabetes before pancreas exhaustion and polycystic ovary syndrome) and exogenous (type 1 diabetes) will increase the risk of cancer. Cancer-related mortality is also increased in patients exposed to hyperinsulinemia but other factors, related to the different diseases, may also contribute. The complexity of the diseases associated with hyperinsulinemia and their therapies does not allow a precise evaluation of the cancer-promoting effect of hyperinsulinemia, but its detrimental effect on cancer incidence and mortality is well documented.
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Affiliation(s)
- R Vigneri
- Endocrinology, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122, Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
- Humanitas, Catania Cancer Center, Catania, Italy.
- CNR, Institute of Bioimages and Biostructures, Catania, Italy.
| | - I D Goldfine
- University of California, San Francisco, CA, USA
| | - L Frittitta
- Endocrinology, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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23
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The tobacco-specific carcinogen-operated calcium channel promotes lung tumorigenesis via IGF2 exocytosis in lung epithelial cells. Nat Commun 2016; 7:12961. [PMID: 27666821 PMCID: PMC5052689 DOI: 10.1038/ncomms12961] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/19/2016] [Indexed: 12/20/2022] Open
Abstract
Nicotinic acetylcholine receptors (nAChRs) binding to the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) induces Ca2+ signalling, a mechanism that is implicated in various human cancers. In this study, we investigated the role of NNK-mediated Ca2+ signalling in lung cancer formation. We show significant overexpression of insulin-like growth factors (IGFs) in association with IGF-1R activation in human preneoplastic lung lesions in smokers. NNK induces voltage-dependent calcium channel (VDCC)-intervened calcium influx in airway epithelial cells, resulting in a rapid IGF2 secretion via the regulated pathway and thus IGF-1R activation. Silencing nAChR, α1 subunit of L-type VDCC, or various vesicular trafficking curators, including synaptotagmins and Rabs, or blockade of nAChR/VDCC-mediated Ca2+ influx significantly suppresses NNK-induced IGF2 exocytosis, transformation and tumorigenesis of lung epithelial cells. Publicly available database reveals inverse correlation between use of calcium channel blockers and lung cancer diagnosis. Our data indicate that NNK disrupts the regulated pathway of IGF2 exocytosis and promotes lung tumorigenesis. The binding of tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) to nicotinic acetylcholine receptors (nAChRs) induces calcium signalling. Here the authors show that NKK-induced calcium influx in airway epithelial cells triggers IGF2 secretion and tumourigenesis.
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24
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Arrieta O, Varela-Santoyo E, Soto-Perez-de-Celis E, Sánchez-Reyes R, De la Torre-Vallejo M, Muñiz-Hernández S, Cardona AF. Metformin use and its effect on survival in diabetic patients with advanced non-small cell lung cancer. BMC Cancer 2016; 16:633. [PMID: 27519177 PMCID: PMC4983059 DOI: 10.1186/s12885-016-2658-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 08/01/2016] [Indexed: 12/29/2022] Open
Abstract
Background Previous population-based studies have demonstrated an association between metformin use and improved survival among diabetic patients with cancer. We sought to analyze the effects of diabetes and its treatment in terms of the survival of patients with lung cancer. Methods Overall, 1106 patients with non-small cell lung cancer (94.3 % with stage IV disease) were included. The outcomes were compared between the patients with (n = 186) and without diabetes (n = 920). The characteristics associated with antidiabetic treatment and proper glycemic control (defined as a mean plasma glucose <130 mg/dL) were examined at diagnosis. The overall survivals (OSs) of the different patient populations were analyzed using Kaplan-Meier curves, and a multivariate Cox proportional hazard model was used to determine the influences of the patient and tumor characteristics on survival. Results The OS for the entire population was 18.3 months (95 % CI 16.1-20.4). There was no difference in the OSs of the diabetic and non-diabetic patients (18.5 vs 16.4 months, p = 0.62). The diabetic patients taking metformin exhibited a superior OS than did those on other antidiabetic treatments (25.6 vs 13.2 months, p = 0.017). Those with proper glycemic control had a better OS than did those without proper glycemic control and the non-diabetics (40.5 vs 13.2 and 18.5 months, respectively, p < 0.001). Both the use of metformin (HR 0.53, p < 0.0001 and HR 0.57, p = 0.017, respectively) and proper glycemic control (HR 0.49, p < 0.0001 and HR 0.40, p = 0.002, respectively) were significant protective factors in all and only diabetic patients, respectively. Conclusions The diabetic patients with proper glycemic control exhibited a better OS than did those without proper glycemic control and even exhibited a better OS than did the patients without diabetes mellitus. Metformin use was independently associated with a better OS. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2658-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oscar Arrieta
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
| | - Edgar Varela-Santoyo
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Enrique Soto-Perez-de-Celis
- Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Roberto Sánchez-Reyes
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Martha De la Torre-Vallejo
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Saé Muñiz-Hernández
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Andrés F Cardona
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
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25
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Cao H, Dong W, Qu X, Shen H, Xu J, Zhu L, Liu Q, Du J. Metformin Enhances the Therapy Effects of Anti-IGF-1R mAb Figitumumab to NSCLC. Sci Rep 2016; 6:31072. [PMID: 27488947 PMCID: PMC4973270 DOI: 10.1038/srep31072] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 07/14/2016] [Indexed: 12/31/2022] Open
Abstract
The insulin-like growth factor (IGF) signaling system plays a critical role in tumorigenesis, highlighting the potential of targeting IGF-1R as an anti-cancer therapy. Although multiple anti-IGF-1R monoclonal antibody (mAb) drugs have been developed, challenges remain in the validation of the therapeutic effects and understanding the molecular mechanism of these mAbs. Herein, we conducted a study to validate the effect of Figitumumab (CP), an anti-IGF-1R mAb, in a panel of non-small cell lung cancer (NSCLC) cell lines. We found all tested cell lines were sensitive to CP, and CP could block IGF-1R and the downstream PI3K/AKT pathway activation. Unexpectedly, we found CP could activate ERK signaling pathway in IGF-1R kinase independent manner, which we further verified was mainly mediated by β-arrestin2. We also investigated the anti-tumor effect of metformin alone as well as its combination with CP to target NSCLC. Metformin could target IGF-1R signaling pathway by attenuating PI3K/AKT and MEK/ERK signaling pathways and down-regulating IGF-1R. Finally, we found that combining metformin with CP could further induce IGF-1R down-regulation and was more effective to target NSCLC cells. Our data suggests the combining of metformin with CP has additive therapeutic value against NSCLC.
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Affiliation(s)
- Hongxin Cao
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China.,Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong University, Shandong University, Jinan, P.R. China
| | - Wei Dong
- Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
| | - Xiao Qu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
| | - Hongchang Shen
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
| | - Jun Xu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
| | - Linhai Zhu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
| | - Qi Liu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
| | - Jiajun Du
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China.,Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, P.R. China
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26
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Activation of insulin-like growth factor 1 receptor in patients with non-small cell lung cancer. Oncotarget 2016; 6:16746-56. [PMID: 25944691 PMCID: PMC4599304 DOI: 10.18632/oncotarget.3796] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 03/20/2015] [Indexed: 11/25/2022] Open
Abstract
According to previous reports demonstrating the implication of insulin-like growth factor receptor (IGF-1R) signaling in non-small cell lung cancer (NSCLC), in this study, the potential prognostic values of IGF-1R expression/activation were analyzed. The expression and activation of IGF-1R were evaluated in two tissue microarray (TMA) sets from NSCLC patients (N = 352 for TMA I, and N = 353 for TMA II). Alterations in IGF-1R protein or mRNA expression in NSCLC patients were evaluated using publicly available data from The Cancer Genome Atlas (TCGA). We found that membranous and cytoplasmic IGF-1R expressions were significantly associated with squamous cell carcinoma (SCC) in both of the TMAs. Analysis of the TCGA data revealed increased mRNA levels in NSCLC patients, which was significantly associated with reductions in overall survival (OS) (median survival 26.51 vs. 47.77 months, P = 0.017) and disease-free survival (median survival 17.44 vs. 37.65 months, P = 0.045) only in NSCLC patients with adenocarcinoma (ADC). These data suggest that IGF-1R is activated in patients with NSCLC, particularly those with SCC. IGF-1R mRNA expression is a potential prognostic factor in patients with NSCLC, especially those with ADC. Further studies are warranted to investigate the prognostic value of IGF-1R in NSCLC patients.
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Ball MW, Bezerra SM, Chaux A, Faraj SF, Gonzalez-Roibon N, Munari E, Sharma R, Bivalacqua TJ, Netto GJ, Burnett AL. Overexpression of Insulin-like Growth Factor-1 Receptor Is Associated With Penile Cancer Progression. Urology 2016; 92:51-6. [PMID: 26905033 DOI: 10.1016/j.urology.2016.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 02/02/2016] [Accepted: 02/04/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To evaluate insulin-like growth factor-1 receptor (IGF1R) expression in penile cancer and its association with oncologic outcomes. METHODS Tissue microarrays were constructed from 53 patients treated at our institution. Expression of IGF1R was evaluated using a Her2-like scoring system. Overexpression was defined as 1+ or greater membranous staining. Association of IGF1R expression with pathologic features was assessed with comparative statistics, and association with local recurrence, progression to nodal or distance metastases, or death was assessed with Kaplan-Meier survival analysis and Cox proportional hazard regression models. RESULTS Overall, IGF1R overexpression was seen in 33 (62%) cases. With a median follow-up of 27.8 months, IGF1R overexpression was associated with inferior progression-free survival (PFS) (P = .003). In a multivariable model controlling for grade, T stage, perineural invasion, and lymphovascular invasion, IGF1R expression was independently associated with disease progression (hazard ratio 2.3, 95% confidence interval 1.1-5.1, P = .03. Comparing patients without IGF1R overexpression to those with overexpression, 5-year PFS was 94.1% vs 45.8%. CONCLUSION IGF1R overexpression was associated with inferior PFS in penile cancer. Drugs that target IGF1R and downstream messengers may have a therapeutic benefit in patients that exhibit IGF1R overexpression.
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Affiliation(s)
- Mark W Ball
- The James Buchanan Brady Urological Institute & Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Stephania M Bezerra
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alcides Chaux
- Norte University, Office of Scientific Research, Asunción, Paraguay
| | - Sheila F Faraj
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nilda Gonzalez-Roibon
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Enrico Munari
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rajni Sharma
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Trinity J Bivalacqua
- The James Buchanan Brady Urological Institute & Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - George J Netto
- The James Buchanan Brady Urological Institute & Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Arthur L Burnett
- The James Buchanan Brady Urological Institute & Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD
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Tian RH, Zhang YG, Wu Z, Liu X, Yang JW, Ji HL. Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysis. Clin Transl Oncol 2015; 18:641-9. [PMID: 26459254 DOI: 10.1007/s12094-015-1412-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/18/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Anti-cancer effect of metformin on different kinds of lung cancer has been studied frequently. However, the association between metformin and the prognosis of lung cancer in type 2 diabetes patients is still controversial. METHODS An electronic search was conducted using PubMed/Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity examined by I (2) statistics. RESULTS Six studies involving 2350 patients were included in the current meta-analysis. In all, the pooled HR of overall survival (OS) was 0.90 (95 % CI 0.84-0.96; P = 0.003). Sub-group analysis showed that when stratified by region the HR of OS was 0.52 (95 % CI 0.31-0.87; P = 0.012) and 0.86 (95 % CI 0.67-1.11, P = 0.361) for Asian and Western countries. When stratified by study design, the HR of OS was 0.78 (95 % CI 0.52-1.15, P = 0.206) and 0.82 (95 % CI 0.59-1.16, P = 0.264) for cohort and medical data-based studies. When stratified by lung cancer subtype, HR of OS was 0.52 (95 % CI 0.31-0.87; P = 0.012), 1.06 (95 % CI 0.51-2.19; P = 0.878) and 0.82 (95 % CI 0.59-1.16; P = 0.264) for SCLS, NSCLC and non-divided subtypes, respectively. CONCLUSION Metformin use may associate with a good prognosis in lung cancer patients with type 2 diabetes but the effect was modest. However, it could achieve benefits in a selective sub-group of lung cancer patients especially in SCLC patients from Asian. Further studies are warranted to confirm this efficacy.
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Affiliation(s)
- R-H Tian
- Department of Respiratory, Affiliated Haian People's Hospital of Nantong University, 17 Cheng Zhong Ba Middle Road, Haian, 226600, Jiangsu, People's Republic of China
| | - Y-G Zhang
- Department of Respiratory, Shouguang People's Hospital, Shouguang, 262700, Shandong, People's Republic of China
| | - Z Wu
- Department of Respiratory, Affiliated Haian People's Hospital of Nantong University, 17 Cheng Zhong Ba Middle Road, Haian, 226600, Jiangsu, People's Republic of China.
| | - X Liu
- Department of Respiratory, Affiliated Haian People's Hospital of Nantong University, 17 Cheng Zhong Ba Middle Road, Haian, 226600, Jiangsu, People's Republic of China.
| | - J-W Yang
- Department of Respiratory, Affiliated Haian People's Hospital of Nantong University, 17 Cheng Zhong Ba Middle Road, Haian, 226600, Jiangsu, People's Republic of China
| | - H-L Ji
- Department of Medical Affairs, Affiliated Haian People's Hospital of Nantong University, Haian, 226600, Jiangsu, People's Republic of China
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Frisch CM, Zimmermann K, Zilleßen P, Pfeifer A, Racké K, Mayer P. Non-small cell lung cancer cell survival crucially depends on functional insulin receptors. Endocr Relat Cancer 2015; 22:609-21. [PMID: 26113601 DOI: 10.1530/erc-14-0581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2015] [Indexed: 12/19/2022]
Abstract
Insulin plays an important role as a growth factor and its contribution to tumor proliferation is intensely discussed. It acts via the cognate insulin receptor (IR) but can also activate the IGF1 receptor (IGF1R). Apart from increasing proliferation, insulin might have additional effects in lung cancer. Therefore, we investigated insulin action and effects of IR knockdown (KD) in three (NCI-H292, NCI-H226 and NCI-H460) independent non-small cell lung cancer (NSCLC) cell lines. All lung cancer lines studied were found to express IR, albeit with marked differences in the ratio of the two variants IR-A and IR-B. Insulin activated the classical signaling pathway with IR autophosphorylation and Akt phosphorylation. Moreover, activation of MAPK was observed in H292 cells, accompanied by enhanced proliferation. Lentiviral shRNA IR KD caused strong decrease in survival of all three lines, indicating that the effects of insulin in lung cancer go beyond enhancing proliferation. Unspecific effects were ruled out by employing further shRNAs and different insulin-responsive cells (human pre-adipocytes) for comparison. Caspase assays demonstrated that IR KD strongly induced apoptosis in these lung cancer cells, providing the physiological basis of the rapid cell loss. In search for the underlying mechanism, we analyzed alterations in the gene expression profile in response to IR KD. A strong induction of certain cytokines (e.g. IL20 and tumour necrosis factor) became obvious and it turned out that these cytokines trigger apoptosis in the NSCLC cells tested. This indicates a novel role of IR in tumor cell survival via suppression of pro-apoptotic cytokines.
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Affiliation(s)
- Carolin Maria Frisch
- Institute of Pharmacology and ToxicologyUniversity of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, GermanyFederal Institute for Drugs and Medical Devices (BfArM)Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Katrin Zimmermann
- Institute of Pharmacology and ToxicologyUniversity of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, GermanyFederal Institute for Drugs and Medical Devices (BfArM)Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Pia Zilleßen
- Institute of Pharmacology and ToxicologyUniversity of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, GermanyFederal Institute for Drugs and Medical Devices (BfArM)Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Alexander Pfeifer
- Institute of Pharmacology and ToxicologyUniversity of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, GermanyFederal Institute for Drugs and Medical Devices (BfArM)Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Kurt Racké
- Institute of Pharmacology and ToxicologyUniversity of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, GermanyFederal Institute for Drugs and Medical Devices (BfArM)Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Peter Mayer
- Institute of Pharmacology and ToxicologyUniversity of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, GermanyFederal Institute for Drugs and Medical Devices (BfArM)Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
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Lodhia KA, Tienchaiananda P, Haluska P. Understanding the Key to Targeting the IGF Axis in Cancer: A Biomarker Assessment. Front Oncol 2015. [PMID: 26217584 PMCID: PMC4495315 DOI: 10.3389/fonc.2015.00142] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Type 1 insulin like growth factor receptor (IGF-1R) targeted therapies showed compelling pre-clinical evidence; however, to date, this has failed to translate into patient benefit in Phase 2/3 trials in unselected patients. This was further complicated by the toxicity, including hyperglycemia, which largely results from the overlap between IGF and insulin signaling systems and associated feedback mechanisms. This has halted the clinical development of inhibitors targeting IGF signaling, which has limited the availability of biopsy samples for correlative studies to understand biomarkers of response. Indeed, a major factor contributing to lack of clinical benefit of IGF targeting agents has been difficulty in identifying patients with tumors driven by IGF signaling due to the lack of predictive biomarkers. In this review, we will describe the IGF system, rationale for targeting IGF signaling, the potential liabilities of targeting strategies, and potential biomarkers that may improve success.
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Affiliation(s)
| | | | - Paul Haluska
- Department of Oncology, Mayo Clinic , Rochester, MN , USA
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31
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Min HY, Yun HJ, Lee JS, Lee HJ, Cho J, Jang HJ, Park SH, Liu D, Oh SH, Lee JJ, Wistuba II, Lee HY. Targeting the insulin-like growth factor receptor and Src signaling network for the treatment of non-small cell lung cancer. Mol Cancer 2015; 14:113. [PMID: 26041671 PMCID: PMC4453276 DOI: 10.1186/s12943-015-0392-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/21/2015] [Indexed: 01/10/2023] Open
Abstract
Background Therapeutic interventions in the insulin-like growth factor receptor (IGF-1R) pathway were expected to provide clinical benefits; however, IGF-1R tyrosine kinase inhibitors (TKIs) have shown limited antitumor efficacy, and the mechanisms conveying resistance to these agents remain elusive. Methods The expression and activation of the IGF-1R and Src were assessed via the analysis of a publicly available dataset, as well as immunohistochemistry, Western blotting, RT-PCR, and in vitro kinase assays. The efficacy of IGF-1R TKIs alone or in combination with Src inhibitors was analyzed using MTT assays, colony formation assays, flow cytometric analysis, and xenograft tumor models. Results The co-activation of IGF-1R and Src was observed in multiple human NSCLC cell lines as well as in a tissue microarray (n = 353). The IGF-1R and Src proteins mutually phosphorylate on their autophosphorylation sites. In high-pSrc-expressing NSCLC cells, linsitinib treatment initially inactivated the IGF-1R pathway but led a Src-dependent reactivation of downstream effectors. In low-pSrc-expressing NSCLC cells, linsitinib treatment decreased the turnover of the IGF-1R and Src proteins, ultimately amplifying the reciprocal co-activation of IGF-1R and Src. Co-targeting IGF-1R and Src significantly suppressed the proliferation and tumor growth of both high-pSrc-expressing and low-pSrc-expressing NSCLC cells in vitro and in vivo and the growth of patient-derived tissues in vivo. Conclusions Reciprocal activation between Src and IGF-1R occurs in NSCLC. Src causes IGF-1R TKI resistance by acting as a key downstream modulator of the cross-talk between multiple membrane receptors. Targeting Src is a clinically applicable strategy to overcome resistance to IGF-1R TKIs. Electronic supplementary material The online version of this article (doi:10.1186/s12943-015-0392-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye-Young Min
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
| | - Hye Jeong Yun
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
| | - Ji-Sun Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
| | - Hyo-Jong Lee
- College of Pharmacy, Inje University, Gimhae, Gyungnam, 621-749, Republic of Korea.
| | - Jaebeom Cho
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
| | - Hyun-Ji Jang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
| | - Shin-Hyung Park
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
| | - Diane Liu
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Cener, Houston, TX, USA.
| | - Seung-Hyun Oh
- College of Pharmacy, Gachon University, Incheon, 406-840, Republic of Korea.
| | - J Jack Lee
- Department of Biostatistics, The University of Texas M. D. Anderson Cancer Cener, Houston, TX, USA.
| | - Ignacio I Wistuba
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Cener, Houston, TX, USA. .,Department of Pathology, The University of Texas M. D. Anderson Cancer Cener, Houston, TX, USA.
| | - Ho-Young Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 151-742, Republic of Korea.
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Koh YW, Yoon DH, Suh C, Cha HJ, Huh J. Insulin-like growth factor-1 receptor is associated with better prognosis in classical Hodgkin's lymphoma: Correlation with MET expression. Int J Exp Pathol 2015; 96:232-9. [PMID: 25916750 DOI: 10.1111/iep.12128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 03/06/2015] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to examine the prognostic significance of insulin-like growth factor-1 receptor (IGF-1R) expression alone and in relation to the expression of the MET- receptor and the MET-homologous receptor RON, in classical Hodgkin's lymphoma (cHL). Tumour samples from patients with cHL (n = 202; median age 37.5 years) were analysed retrospectively for IGF-R1, MET or RON expression by immunohistochemistry using tissue microarrays. The median follow-up time was 3.7 years (range, 0.1-20 years). Twenty-nine patients (14.3%) expressed IGF-1R protein in Hodgkin/Reed-Sternberg (HRS) cells, which was associated with a better overall survival (OS) (P = 0.036). IGF-1R expression was closely associated with MET receptor expression and low level of lactate dehydrogenase. In patients with cHL receiving doxorubicin, bleomycin, vinblastine and dacarbazine, those expressing IGF-1R showed a trend towards better OS and event-free survival than IGF-1R-negative patients (P = 0.129 and P = 0.115 respectively), but statistical significance was not reached. This study suggests that IGF-1R expression could be associated with better clinical outcome in cHL but is significantly associated with the expression of MET receptor.
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Affiliation(s)
- Young Wha Koh
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hee Jeong Cha
- Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Lin JJ, Gallagher EJ, Sigel K, Mhango G, Galsky MD, Smith CB, LeRoith D, Wisnivesky JP. Survival of patients with stage IV lung cancer with diabetes treated with metformin. Am J Respir Crit Care Med 2015; 191:448-54. [PMID: 25522257 DOI: 10.1164/rccm.201407-1395oc] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Prior studies have shown an anticancer effect of metformin in patients with breast and colorectal cancer. It is unclear, however, whether metformin has a mortality benefit in lung cancer. OBJECTIVES To compare overall survival of patients with diabetes with stage IV non-small cell lung cancer (NSCLC) taking metformin versus those not on metformin. METHODS Using data from the Surveillance, Epidemiology, and End Results registry linked to Medicare claims, we identified 750 patients with diabetes 65-80 years of age diagnosed with stage IV NSCLC between 2007 and 2009. We used propensity score methods to assess the association of metformin use with overall survival while controlling for potential confounders. MEASUREMENTS AND MAIN RESULTS Overall, 61% of patients were on metformin at the time of lung cancer diagnosis. Median survival in the metformin group was 5 months, compared with 3 months in patients not treated with metformin (P < 0.001). Propensity score analyses showed that metformin use was associated with a statistically significant improvement in survival (hazard ratio, 0.80; 95% confidence interval, 0.71-0.89), after controlling for sociodemographics, diabetes severity, other diabetes medications, cancer characteristics, and treatment. CONCLUSIONS Metformin is associated with improved survival among patients with diabetes with stage IV NSCLC, suggesting a potential anticancer effect. Further research should evaluate plausible biologic mechanisms and test the effect of metformin in prospective clinical trials.
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Kothari A, Hulbert ML, Cottrell CE, Nguyen TT. Aggressive congenital juvenile myelomonocytic leukemia associated with somatic KRAS p.G13D mutation and concurrent germline IGF1R duplication. Leuk Lymphoma 2014; 56:1175-8. [PMID: 25110823 DOI: 10.3109/10428194.2014.953152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Alok Kothari
- Division of Pediatric Hematology-Oncology, Department of Pediatrics
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Zhao S, Qiu Z, He J, Li L, Li W. Insulin-like growth factor receptor 1 (IGF1R) expression and survival in non-small cell lung cancer patients: a meta-analysis. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:6694-6704. [PMID: 25400749 PMCID: PMC4230063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 09/13/2014] [Indexed: 06/04/2023]
Abstract
The insulin-like growth factor receptor-1 (IGF1R) plays an important role in cancer progression. Previous studies have been controversial with respect to the associations between IGF1R expression and non small cell lung cancer (NSCLC) prognosis. Thus, we performed a meta-analysis to investigate the prognostic value of IGF1R expression in NSCLC patients and the relationship between the expression of IGF1R and clinical characteristics. Two independent reviewers searched PubMed, Embase, Ovid Medline and CNKI to identify eligible studies. Overall survival (OS), disease free survival (DFS) and clinicopathological characteristics were collected from included studies. Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (95% CI) were calculated to estimate the effect. 17 studies comprising 3,294 patients were included in this meta-analysis. The results showed IGF1R positive expression was associated with an unfavorable DFS in NSCLC patients on univariate analysis (HR = 1.26, 95% CI: 1.09-1.46, P = 0.002) and multivariate analysis (HR = 1.49, 95% CI: 1.01-2.20, p = 0.045), but the relationship between IGF1R expression and OS have no significant difference on univariate analysis (HR = 0.91, 95% CI: 0.82-1.01, P = 0.157) and multivariate analysis (HR = 0.79, 95% CI: 0.45-1.41, P = 0.427). Ever smoking and smaller tumor size (T1 or T2) were associated with IGF1R positive expression: pooled OR 1.45 (1.13-1.85) and pooled OR 0.61 (0.60-0.95). Our results suggested IGF1R positive expression as an unfavorable factor for DFS in NSCLC patients, and IGF1R expression was associated with smoking status and tumor size.
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Affiliation(s)
- Shuang Zhao
- Department of Respiratory Medicine, West China Hospital, Sichuan UniversityChengdu 610041, P. R. China
| | - Zhixin Qiu
- Department of Respiratory Medicine, West China Hospital, Sichuan UniversityChengdu 610041, P. R. China
| | - Jinlan He
- Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan UniversityChengdu 610041, China
| | - Lei Li
- Department of Respiratory Medicine, West China Hospital, Sichuan UniversityChengdu 610041, P. R. China
| | - Weimin Li
- Department of Respiratory Medicine, West China Hospital, Sichuan UniversityChengdu 610041, P. R. China
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Dilli UD, Yildırim M, Suren D, Alikanoglu A, Kaya V, Goktas S, Yildiz M, Sezer C, Gunduz S. Lack of any Prognostic Role of Insulin-Like Growth Factor-1 Receptor in Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev 2014; 15:5753-7. [DOI: 10.7314/apjcp.2014.15.14.5753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lkhagvadorj S, Oh SS, Lee MR, Jung JH, Chung HC, Cha SK, Eom M. Insulin receptor expression in clear cell renal cell carcinoma and its relation to prognosis. Yonsei Med J 2014; 55:861-70. [PMID: 24954312 PMCID: PMC4075388 DOI: 10.3349/ymj.2014.55.4.861] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Both insulin and insulin-like growth factor (IGF)-1 signaling are key regulators of energy metabolism, cellular growth, proliferation, and survival. The IGF-1 receptor (IGF-1R) is overexpressed in most types of human cancers including renal cell carcinoma (RCC) with poor prognosis. Insulin receptor (IR) shares downstream effectors with IGF-1R; however, the expression and function of IR in the tumorigenesis of renal cancer remains elusive. Therefore, we examined the expression of IR and its prognostic significance in clear cell RCC (CCRCC). MATERIALS AND METHODS Immunohistochemical staining for IR was performed on 126 formalin-fixed paraffin-embedded CCRCC tissue samples. Eight of these cases were utilized for western blot analysis. The results were compared with various clinico-pathologic parameters of CCRCC and patient survival. RESULTS IR was expressed in the nuclei of CCRCC tumor cells in 109 cases (87.9%). Higher IR expression was significantly correlated with the presence of cystic change, lower Fuhrman nuclear grade, lower pathologic T stage, and lower TNM stage, although it wasn't significantly related to diabetes status and patient survival. Western blot analyses supported the results of the immunohistochemistry studies. CONCLUSION IR expression in CCRCC may be associated with favorable prognostic factors.
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Affiliation(s)
- Sayamaa Lkhagvadorj
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Soo Oh
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi-Ra Lee
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun Chul Chung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung-Kuy Cha
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea. ; Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Minseob Eom
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Xie HY, Xing CY, Wei BJ, Xu X, Wu J, Chen LM, Cao GQ, Chen H, Chen KJ, Yin SY, Wu LM, Zhou L, Zheng SS. Association of IGF1R polymorphisms with the development of HBV-related hepatocellular carcinoma. ACTA ACUST UNITED AC 2014; 84:264-70. [PMID: 24758241 DOI: 10.1111/tan.12360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/04/2014] [Accepted: 03/25/2014] [Indexed: 02/05/2023]
Affiliation(s)
- H.-Y. Xie
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - C.-Y. Xing
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - B.-J. Wei
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - X. Xu
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - J. Wu
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - L.-M. Chen
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - G.-Q. Cao
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - H. Chen
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - K.-J. Chen
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - S.-Y. Yin
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - L.-M. Wu
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - L. Zhou
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
| | - S.-S. Zheng
- Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health. Key Laboratory of Organ Transplantation, Collaborative innovation center for Diagnosis treatment of infectious diseases; Zhejiang University School of Medicine; Hangzhou China
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Mountzios G, Aivazi D, Kostopoulos I, Kourea HP, Kouvatseas G, Timotheadou E, Zebekakis P, Efstratiou I, Gogas H, Vamvouka C, Chrisafi S, Stofas A, Pentheroudakis G, Koutras A, Galani E, Bafaloukos D, Fountzilas G. Differential expression of the insulin-like growth factor receptor among early breast cancer subtypes. PLoS One 2014; 9:e91407. [PMID: 24637962 PMCID: PMC3956672 DOI: 10.1371/journal.pone.0091407] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 02/11/2014] [Indexed: 12/24/2022] Open
Abstract
Introduction We sought to determine the level of protein expression of the critical components of the insulin-like growth factor receptor (IGFR) pathway and to evaluate their prognostic significance across the different early breast cancer subtypes. Patients and Methods Archival tumor tissue from 1,021 women with early, node positive breast cancer, who were prospectively evaluated within two randomized clinical trials, was used to construct tissue microarrays that were stained for hormone receptors (HR), Ki67, HER2, epidermal growth factor receptor (EGFR) and cytokeratins 5/6, to classify tumors into five immunophenotypical subgroups. Immunohistochemical (IHC) expression of IGF1R-alpha and beta subunits, IGF2R and IGF-binding protein 2 (IGFBP2) was assessed using the immunoreactive score (IRS). Repeated internal cross-validation was performed to examine the statistical validity of the cut off points for all biomarkers. Results After a median follow-up time of 105.4 months, overall 370 women (36.2%) had relapsed and 270 (26.4%) had died. Tumors expressing IGF1R-alpha above the median IRS were significantly more frequently HR positive (luminal A+B+HER2), as compared to HER2-enriched and triple negative ones (p<0.001 for both comparisons). IGF2R was overexpressed significantly more frequently in HR negative tumors (p = 0.001) and had an inverse correlation with all other biomarkers. Patients with luminal A and B tumors with high IGF1R-alpha and negative EGFR expression (N = 190) had significantly higher 4-year survival rates, as compared to the rest (log-rank p = 0.046), as did patients with luminal A and B tumors with high IGF1R-alpha and low IGF2R expression, as compared to the rest (N = 91), (log-rank p = 0.035). After adjustment for significant variables, patients in the latter group had a relative 45% reduction in the risk of death, as compared to the rest (p = 0.035). Conclusion Aberrant expression of components of the IGF1R pathway is associated with better clinical outcomes in women with luminal A and B, node positive, early breast cancer.
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Affiliation(s)
- Giannis Mountzios
- Department of Medical Oncology, 251 Airforce General Hospital, Athens, Greece
- * E-mail:
| | - Dimitra Aivazi
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Ioannis Kostopoulos
- Department of Pathology, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Helen P. Kourea
- Department of Pathology, University Hospital of Patras, Rion, Greece
| | | | - Eleni Timotheadou
- Department of Medical Oncology, “Papageorgiou” Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Pantelis Zebekakis
- 1 Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | | | - Helen Gogas
- First Department of Medicine, “Laiko” General Hospital, University of Athens, Medical School, Athens, Greece
| | | | - Sofia Chrisafi
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Anastasios Stofas
- Pathology Department National & Kapodistrian University of Athens, Athens, Greece
| | | | - Angelos Koutras
- Division of Oncology, Department of Medicine, University Hospital, University of Patras Medical School, Patras, Greece
| | - Eleni Galani
- Second Department of Medical Oncology, “Metropolitan” Hospital, Piraeus, Greece
| | | | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
- Department of Medical Oncology, “Papageorgiou” Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
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Jiang L, Zhu W, Streicher K, Morehouse C, Brohawn P, Ge X, Dong Z, Yin X, Zhu G, Gu Y, Ranade K, Higgs BW, Yao Y, Huang J. Increased IR-A/IR-B ratio in non-small cell lung cancers associates with lower epithelial-mesenchymal transition signature and longer survival in squamous cell lung carcinoma. BMC Cancer 2014; 14:131. [PMID: 24571613 PMCID: PMC3974050 DOI: 10.1186/1471-2407-14-131] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 02/12/2014] [Indexed: 02/06/2023] Open
Abstract
Background To evaluate the insulin receptor isoform mRNA expression status in non-small cell lung cancer (NSCLC) patients. Methods RNA-seq data from 614 NSCLC [355 adenocarcinomas (LUAD) and 259 squamous cell carcinomas (LUSC)] and 92 normal lung specimens were obtained from The Cancer Genome Atlas (TCGA) to evaluate the mRNA expression of insulin receptor isoform A (IR-A) and insulin receptor isoform B (IR-B). The differential expression status of the insulin receptor isoforms in NSCLC patients was confirmed using qRT-PCR assays with lung cancer cDNA arrays and primary tumor samples. Results The mRNA expression levels of IR-B were significantly lower in some NSCLC samples compared to normal lung specimens, including both LUAD and LUSC. Notably, no IR-B transcripts were detected - only the IR-A isoform was expressed in 11% of NSCLC patients. This decrease in IR-B expression contributed to an elevated IR-A/IR-B ratio, which was also associated with lower epithelial-mesenchymal transition gene signatures in NSCLC and longer patient survival under standard of care in LUSC. In addition to NSCLC, RNA-seq data from TCGA revealed a similar increase in IR-A/IR-B ratio in many other cancer types, with high prevalence in acute myeloid leukemia, glioblastoma multiforme, and brain lower grade glioma. Conclusions Our results indicate a common reduction of the mRNA expression level of IR-B and an increased IR-A/IR-B mRNA ratio in NSCLC and other tumor types. The relationship of altered IR-A/IR-B ratios with cancer progression and patient survival should be prospectively explored in future studies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Yihong Yao
- MedImmune Inc,, LLC, One MedImmune Way, 20878 Gaithersburg, MD, USA.
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Pajares MJ, Agorreta J, Salvo E, Behrens C, Wistuba II, Montuenga LM, Pio R, Rouzaut A. TGFBI expression is an independent predictor of survival in adjuvant-treated lung squamous cell carcinoma patients. Br J Cancer 2014; 110:1545-51. [PMID: 24481402 PMCID: PMC3960613 DOI: 10.1038/bjc.2014.33] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/23/2013] [Accepted: 01/08/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Transforming growth factor β-induced protein (TGFBI) is a secreted protein that mediates cell anchoring to the extracellular matrix. This protein is downregulated in lung cancer, and when overexpressed, contributes to apoptotic cell death. Using a small series of stage IV non-small cell lung cancer (NSCLC) patients, we previously suggested the usefulness of TGFBI as a prognostic and predictive factor in chemotherapy-treated late-stage NSCLC. In order to validate and extend these results, we broaden the analysis and studied TGFBI expression in a large series of samples obtained from stage I-IV NSCLC patients. METHODS TGFBI expression was assessed by immunohistochemistry in 364 completely resected primary NSCLC samples: 242 adenocarcinomas (ADCs) and 122 squamous cell carcinomas (SCCs). Kaplan-Meier curves, log-rank tests and the Cox proportional hazards model were used to analyse the association between TGFBI expression and survival. RESULTS High TGFBI levels were associated with longer overall survival (OS, P<0.001) and progression-free survival (PFS, P<0.001) in SCC patients who received adjuvant platinium-based chemotherapy. Moreover, multivariate analysis demonstrated that high TGFBI expression is an independent predictor of better survival in patients (OS: P=0.030 and PFS: P=0.026). CONCLUSIONS TGFBI may be useful for the identification of a subset of NSCLC who may benefit from adjuvant therapy.
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Affiliation(s)
- M J Pajares
- 1] Division of Oncology, Center for Applied Medical Research, University of Navarra, 31080 Pamplona, Spain [2] Department of Histology and Pathology, University of Navarra, 31080 Pamplona, Spain
| | - J Agorreta
- 1] Division of Oncology, Center for Applied Medical Research, University of Navarra, 31080 Pamplona, Spain [2] Department of Histology and Pathology, University of Navarra, 31080 Pamplona, Spain
| | - E Salvo
- 1] Division of Oncology, Center for Applied Medical Research, University of Navarra, 31080 Pamplona, Spain [2] Department of Biochemistry and Genetics, University of Navarra, 31080 Pamplona, Spain
| | - C Behrens
- Department of Pathology and Thoracic/Head and Neck Medical Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - I I Wistuba
- Department of Pathology and Thoracic/Head and Neck Medical Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - L M Montuenga
- 1] Division of Oncology, Center for Applied Medical Research, University of Navarra, 31080 Pamplona, Spain [2] Department of Biochemistry and Genetics, University of Navarra, 31080 Pamplona, Spain
| | - R Pio
- 1] Department of Biochemistry and Genetics, University of Navarra, 31080 Pamplona, Spain [2] Department of Pathology and Thoracic/Head and Neck Medical Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - A Rouzaut
- 1] Department of Biochemistry and Genetics, University of Navarra, 31080 Pamplona, Spain [2] Department of Pathology and Thoracic/Head and Neck Medical Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA
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Kim JS, Kim ES, Liu D, Lee JJ, Solis L, Behrens C, Lippman SM, Hong WK, Wistuba II, Lee HY. Prognostic implications of tumoral expression of insulin like growth factors 1 and 2 in patients with non-small-cell lung cancer. Clin Lung Cancer 2014; 15:213-21. [PMID: 24485233 DOI: 10.1016/j.cllc.2013.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/15/2013] [Accepted: 12/23/2013] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The currently available systemic therapies for non-small-cell lung cancer (NSCLC) have limited efficacy. Previous studies indicated an association of elevated insulinlike growth factor (IGF)-1 receptor (IGF-1R) and insulin receptor expression levels with poor survival in patients with NSCLC. To better understand the molecular biomarkers involved in the IGF signaling pathway in NSCLC, the expression levels of IGF-1 and IGF-2 are characterized and evaluated for their association with IGF-1R and phosphorylated IGF-1R (pIGF-1R) expression in NSCLC. MATERIALS AND METHODS A total of 352 patients who underwent NSCLC resection with curative intent were studied. The expression patterns of the IGF-1, IGF-2, IGF-1R, and pIGF-1R proteins were assessed immunohistochemically using tissue microarrays. RESULTS The IGF-1 expression was higher in patients with adenocarcinoma (ADC) than in those with squamous cell carcinoma (SCC), whereas the IGF-2 score was higher in patients with SCC than those with ADC. Likewise, the IGF-1 score was higher in patients with mutated epidermal growth factor receptor (mtEGFR) than in those with wild type EGFR (wtEGFR), whereas the IGF-2 score was higher in patients with wtEGFR than in those with mtEGFR. Patients with low levels of IGF-1 expression had longer overall survival (OS) than those with high IGF-1 expression, and subgroup analyses found a significant difference in OS only in patients with ADC. CONCLUSION The overexpression of IGF-1 predicts poor survival among patients with NSCLC, especially those with ADC. These results might serve as a future guide for clinical trials involving IGF-1R-targeting agents.
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Affiliation(s)
- Jin-Soo Kim
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX; Deparment of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Edward S Kim
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Diane Liu
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Jack Lee
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Luisa Solis
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carmen Behrens
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Scott M Lippman
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Waun Ki Hong
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ignacio I Wistuba
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ho-Young Lee
- Department of Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX; College of Pharmacy, Seoul National University, Seoul, South Korea.
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Gold KA, Kim ES, Liu DD, Yuan P, Behrens C, Solis LM, Kadara H, Rice DC, Wistuba II, Swisher SG, Hofstetter WL, Lee JJ, Hong WK. Prediction of survival in resected non-small cell lung cancer using a protein expression-based risk model: implications for personalized chemoprevention and therapy. Clin Cancer Res 2013; 20:1946-54. [PMID: 24366692 DOI: 10.1158/1078-0432.ccr-13-1959] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Patients with resected non-small cell lung cancer (NSCLC) are at risk for recurrence of disease, but we do not have tools to predict which patients are at highest risk. We set out to create a risk model incorporating both clinical data and biomarkers. EXPERIMENTAL DESIGN We assembled a comprehensive database with archival tissues and clinical follow-up from patients with NSCLC resected between 2002 and 2005. Twenty-one proteins identified from our preclinical studies as related to lung carcinogenesis were investigated, including pathways related to metabolism, DNA repair, inflammation, and growth factors. Expression of proteins was quantified using immunohistochemistry. Immunohistochemistry was chosen because it is widely available and can be performed on formalin-fixed paraffin-embedded specimens. Cox models were fitted to estimate effects of clinical factors and biomarkers on recurrence-free survival (RFS) and overall survival (OS). RESULTS A total of 370 patients are included in our analysis. With median follow-up of 5.3 years, median OS is 6.4 years. A total of 209 cases with recurrence or death were observed. Multicovariate risk models for RFS and OS were developed including relevant biomarkers, age, and stage. Increased expression of phospho-adenosine monophosphate-activated protein kinase (pAMPK), phospho-mTOR (pmTOR), epithelial cell adhesion molecule (EpCAM), and calcium/calmodulin-dependent serine protein kinase were significant (P < 0.05) predictors for favorable RFS; insulin receptor, chemokine (C-X-C motif) receptor 2 (CXCR2), and insulin-like growth factor-1 receptor predicted for unfavorable RFS. Significant (P < 0.05) predictors for favorable OS include pAMPK, pmTOR, and EpCAM; CXCR2 and flap structure-specific endonuclease-1 predicted unfavorable OS. CONCLUSION We have developed a comprehensive risk model predictive for recurrence in our large retrospective database, which is one of the largest reported series of resected NSCLC.
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Affiliation(s)
- Kathryn A Gold
- Authors' Affiliations: Departments of Thoracic/Head and Neck Medical Oncology, Biostatistics, Pathology, and Thoracic and Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Levine Cancer Center; Philips Digital Pathology; and Department of Pathology, University of San Francisco Xavier de Chuquisaca Sucre-Bolivia, San Francisco, California
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IGF-1R and Bmi-1 expressions in lung adenocarcinoma and their clinicopathologic and prognostic significance. Tumour Biol 2013; 35:739-45. [PMID: 23990442 DOI: 10.1007/s13277-013-1100-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 08/08/2013] [Indexed: 12/31/2022] Open
Abstract
IGF-1R and Bmi-1 play a critical role in cancer growth and survival. We explored the correlation between IGF-1R and Bmi-1, as well as their relationship with clinicopathological parameters and their impacts on outcomes in patients with lung adenocarcinoma resected. Tumors from 178 surgical lung adenocarcinoma patients were evaluated for IGF-1R and Bmi-1 expression by means of immunohistochemistry. The clinicopathological implications of these molecules were analyzed statistically. There was a significant correlation between the expression of IGF-1R and Bmi-1 (p = 0.011). The 5-year survival rate of patients with Bmi-1 positive was only 31.2%, but patients with Bmi-1 negative had a survival rate of 50.7% (p = 0.004). The pattern of survival curves showed that Bmi-1 was a significant prognostic factor of poor overall survival in lung adenocarcinoma patients. However, there was no obvious correlation between IGF-1R expression and patient survival. The results of multivariate Cox analysis revealed that the pathological stages and Bmi-1 expression were independent prognostic factors. Therefore, Bmi-1 may be a good biomarker to predict the prognosis of patients with completely resected lung adenocarcinoma.
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Westley RL, May FEB. A twenty-first century cancer epidemic caused by obesity: the involvement of insulin, diabetes, and insulin-like growth factors. Int J Endocrinol 2013; 2013:632461. [PMID: 23983688 PMCID: PMC3747439 DOI: 10.1155/2013/632461] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 03/25/2013] [Indexed: 02/08/2023] Open
Abstract
Obesity has reached epidemic proportions in the developed world. The progression from obesity to diabetes mellitus type 2, via metabolic syndrome, is recognised, and the significant associated increase in the risk of major human cancers acknowledged. We review the molecular basis of the involvement of morbidly high concentrations of endogenous or therapeutic insulin and of insulin-like growth factors in the progression from obesity to diabetes and finally to cancer. Epidemiological and biochemical studies establish the role of insulin and hyperinsulinaemia in cancer risk and progression. Insulin-like growth factors, IGF-1 and IGF-2, secreted by visceral or mammary adipose tissue have significant paracrine and endocrine effects. These effects can be exacerbated by increased steroid hormone production. Structural studies elucidate how each of the three ligands, insulin, IGF-1, and IGF-2, interacts differently with isoforms A and B of the insulin receptor and with type I IGF receptor and explain how these protagonists contribute to diabetes-associated cancer. The above should inform appropriate treatment of cancers that arise in obese individuals and in those with diabetes mellitus type 2. Novel drugs that target the insulin and insulin-like growth factor signal transduction pathways are in clinical trial and should be effective if appropriate biomarker-informed patient stratification is implemented.
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Affiliation(s)
- Rosalyne L. Westley
- Northern Institute for Cancer Research, Faculty of Medical Sciences, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Felicity E. B. May
- Northern Institute for Cancer Research, Faculty of Medical Sciences, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
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Wu PF, Huang WC, Yang JCH, Lu YS, Shih JY, Wu SG, Lin CH, Cheng AL. Phosphorylated insulin-like growth factor-1 receptor (pIGF1R) is a poor prognostic factor in brain metastases from lung adenocarcinomas. J Neurooncol 2013; 115:61-70. [PMID: 23817810 DOI: 10.1007/s11060-013-1194-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/23/2013] [Indexed: 12/14/2022]
Abstract
A greater understanding of brain metastases is imperative for developing novel therapeutic strategies. Our previous study showed that insulin-like growth factor (IGF) signaling pathway was activated in brain-tropic cancer cells. In this study, we investigated the clinical relevance of activated (phosphorylated) IGF-1 receptor (pIGF1R) expression in brain metastases originating from lung adenocarcinomas. All pathologically confirmed brain metastases from lung adenocarcinomas, with available archived specimens from January 1998 to December 2009 at National Taiwan University Hospital, were assessed immunohistochemically for pIGF1R expression using H-score criteria. A median H-score was used as a cutoff point to define high or low pIGF1R expression. The mutation status in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) was examined using direct sequencing. The prognostic significance of pIGF1R expression, its correlations with clinicopathological characteristics, and EGFR status were evaluated. In the 86 cases, high membranous/cytoplasmic pIGF1R expression in brain metastases correlated with a shorter median survival (10.8 vs 27.8 mo, P = 0.003). This correlation was more significant in patients with EGFR mutations [hazard ratio (HR) 2.38, 95 % confidence interval (CI) 1.19-4.77 for EGFR mutations; HR 1.99, 95 % CI 0.95-4.15 for EGFR wild type] and remained statistically significant in multivariate analysis after adjusting for the effects of other potential prognostic factors, including the graded prognostic assessment score, solitary brain metastasis, extracranial metastatic status, EGFR mutations, and treatment using EGFR tyrosine kinase inhibitors. Although we also identified nuclear pIGF1R expression, this result was prognostically non-significant. Our study results showed that high membranous/cytoplasmic pIGF1R expression in brain metastases was a poor prognostic factor, more significantly in patients with EGFR mutations than in those with wild-type EGFRs.
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Affiliation(s)
- Pei-Fang Wu
- National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei, 100, Taiwan
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Abstract
The growing epidemic of obesity has resulted in a large increase in multiple related diseases. Recent evidence has strengthened the proposed synergistic relationship between obesity-related insulin resistance (IR) and/or diabetes mellitus (DM) and cancer. Within the past year, many studies have examined this relationship. Although the precise mechanisms and pathways are uncertain, it is becoming clear that hyperinsulinemia and possibly sustained hyperglycemia are important regulators of not only the development of cancer but also of treatment outcome. Further, clinical decision-making regarding the treatment of choice for DM will likely be impacted as we learn more about the non-metabolic effects of the available hyperglycemic agents. In our review, we endeavored to synthesize the recent literature and provide a concise view of the journey from macro-level clinical associations to specific mechanistic relationships being elucidated in cell lines and animal models.
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Affiliation(s)
- Etan Orgel
- Jonathan Jaques Children’s Cancer Center, Keck School of Medicine, University of Southern California, Miller Children’s Hospital, 2801 Atlantic Avenue, Long Beach, CA 90806, 562-933-8600 phone
| | - Steven D. Mittelman
- Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd., MS #93, Los Angeles, CA 90027, 323-361-7653 phone
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Xu C, Xie D, Yu SC, Yang XJ, He LR, Yang J, Ping YF, Wang B, Yang L, Xu SL, Cui W, Wang QL, Fu WJ, Liu Q, Qian C, Cui YH, Rich JN, Kung HF, Zhang X, Bian XW. β-Catenin/POU5F1/SOX2 transcription factor complex mediates IGF-I receptor signaling and predicts poor prognosis in lung adenocarcinoma. Cancer Res 2013; 73:3181-9. [PMID: 23539445 DOI: 10.1158/0008-5472.can-12-4403] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer stem-like cells (CSLC) are crucial in tumor initiation and progression; however, the underlying mechanism for the self-renewal of cancer cells remains undefined. In the study, immunohistochemical analysis of specimens freshly excised from patients with lung adenocarcinoma showed that high expression of insulin-like growth factor I receptor (IGF-IR) in lung adenocarcinoma cells was positively correlated with the expressions of cancer stem cell markers CD133 and aldehyde dehydrogenase 1 family member A1 (ALDH1A1). IGF-IR activation enhanced POU class 5 homeobox 1 (POU5F1) expression on human lung adenocarcinoma stem-like cells (LACSLC) through PI3K/AKT/GSK3β/β-catenin cascade. POU5F1 could form a novel complex with β-catenin and SOX2 to bind Nanog promoter for transcription to maintain self-renewal of LACSLCs, which was dependent on the functional IGF-IR. Genetic and pharmacologic inhibition of IGF-IR abrogated LACSLC capabilities for self-renewal and tumorigenicity in vitro. In an in vivo xenograft tumor model, knockdown of either IGF-IR or POU5F1 impeded tumorigenic potentials of LACSLCs. By analyzing pathologic specimens excised from 200 patients with lung adenocarcinoma, we found that colocalization of highly expressed IGF-IR with β-catenin and POU5F1 predicted poor prognosis. Taken together, we show that IGF-IR-mediated POU5F1 expression to form a complex with β-catenin and SOX2 is crucial for the self-renewal and oncogenic potentials of LACSLCs, and the integrative clinical detection of the expressions of IGF-IR, β-catenin, and POU5F1 is indicatory for predicting prognosis in the patients of lung adenocarcinoma.
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Affiliation(s)
- Chuan Xu
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, and Key Laboratory of Tumor Immunopathology, Ministry of Education of China, Chongqing, China
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Xue H, Zhou S, Lu W, Zhao Z. [The targets research of non-small cell lung cancer targeted therapy]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2013; 16:107-13. [PMID: 23425904 PMCID: PMC6000387 DOI: 10.3779/j.issn.1009-3419.2013.02.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Hongsheng Xue
- Department of Thoracic Surgery, Zhongshan Hospital, Dalian University, Dalian 116001, China
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Djiogue S, Nwabo Kamdje AH, Vecchio L, Kipanyula MJ, Farahna M, Aldebasi Y, Seke Etet PF. Insulin resistance and cancer: the role of insulin and IGFs. Endocr Relat Cancer 2013. [PMID: 23207292 DOI: 10.1530/erc-12-0324] [Citation(s) in RCA: 189] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Insulin, IGF1, and IGF2 are the most studied insulin-like peptides (ILPs). These are evolutionary conserved factors well known as key regulators of energy metabolism and growth, with crucial roles in insulin resistance-related metabolic disorders such as obesity, diseases like type 2 diabetes mellitus, as well as associated immune deregulations. A growing body of evidence suggests that insulin and IGF1 receptors mediate their effects on regulating cell proliferation, differentiation, apoptosis, glucose transport, and energy metabolism by signaling downstream through insulin receptor substrate molecules and thus play a pivotal role in cell fate determination. Despite the emerging evidence from epidemiological studies on the possible relationship between insulin resistance and cancer, our understanding on the cellular and molecular mechanisms that might account for this relationship remains incompletely understood. The involvement of IGFs in carcinogenesis is attributed to their role in linking high energy intake, increased cell proliferation, and suppression of apoptosis to cancer risks, which has been proposed as the key mechanism bridging insulin resistance and cancer. The present review summarizes and discusses evidence highlighting recent advances in our understanding on the role of ILPs as the link between insulin resistance and cancer and between immune deregulation and cancer in obesity, as well as those areas where there remains a paucity of data. It is anticipated that issues discussed in this paper will also recover new therapeutic targets that can assist in diagnostic screening and novel approaches to controlling tumor development.
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Affiliation(s)
- Sefirin Djiogue
- Department of Animal Biology and Physiology, University of Yaoundé 1, PO Box 812, Yaoundé, Cameroon
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