1
|
Tam YB, Low K, Ps H, Chadha M, Burns J, Wilding CP, Arthur A, Chen TW, Thway K, Sadanandam A, Jones RL, Huang PH. Proteomic features of soft tissue tumours in adolescents and young adults. COMMUNICATIONS MEDICINE 2024; 4:93. [PMID: 38762630 PMCID: PMC11102500 DOI: 10.1038/s43856-024-00522-x] [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: 07/13/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Adolescents and young adult (AYA) patients with soft tissue tumours including sarcomas are an underserved group with disparities in treatment outcomes. METHODS To define the molecular features between AYA and older adult (OA) patients, we analysed the proteomic profiles of a large cohort of soft tissue tumours across 10 histological subtypes (AYA n = 66, OA n = 243), and also analysed publicly available functional genomic data from soft tissue tumour cell lines (AYA n = 5, OA n = 8). RESULTS Biological hallmarks analysis demonstrates that OA tumours are significantly enriched in MYC targets compared to AYA tumours. By comparing the patient-level proteomic data with functional genomic profiles from sarcoma cell lines, we show that the mRNA splicing pathway is an intrinsic vulnerability in cell lines from OA patients and that components of the spliceosome complex are independent prognostic factors for metastasis free survival in AYA patients. CONCLUSIONS Our study highlights the importance of performing age-specific molecular profiling studies to identify risk stratification tools and targeted agents tailored for the clinical management of AYA patients.
Collapse
Affiliation(s)
- Yuen Bun Tam
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Kaan Low
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Hari Ps
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Madhumeeta Chadha
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Jessica Burns
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Christopher P Wilding
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Amani Arthur
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Tom W Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Khin Thway
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Anguraj Sadanandam
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Robin L Jones
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Paul H Huang
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom.
| |
Collapse
|
2
|
Armenian SH, Chao C. Burden of Morbidity and Mortality in Adolescent and Young Adult Cancer Survivors. J Clin Oncol 2024; 42:735-742. [PMID: 37983585 DOI: 10.1200/jco.23.01751] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/29/2023] [Accepted: 09/28/2023] [Indexed: 11/22/2023] Open
Abstract
There are an estimated 650,00 survivors of adolescent and young adult (AYA) cancers in the United States, a number that is expected to markedly increase in the coming decades. The recognition of the potential for some cancer treatments to affect the health of patients for many years after the initial diagnosis has prompted investigators to examine the evolving burden of late morbidity and mortality in AYAs with cancer after treatment completion. Studies in large international cohorts of AYA cancer survivors have now shown that the burden of late effects in survivors treated during the past four decades is substantial, affecting the health and well-being of the survivor, health systems' preparedness to meet their health care needs in the future, and societal economic costs that are largely affected by loss of productivity. We highlight the unique considerations for AYA cancer survivors, identify gaps in knowledge for future research, and provide an overview of emerging efforts to mitigate late effects in these survivors. Ongoing multidisciplinary bench-to-bedside collaborations are critical to understanding the biology of late effects in AYA cancer survivors and to developing personalized interventions to mitigate them. The growing population of AYA cancer survivors makes it imperative that these efforts extend across the cancer care continuum, which will allow survivors to ultimately live to their fullest potential.
Collapse
Affiliation(s)
- Saro H Armenian
- Department of Pediatrics, City of Hope, Duarte, CA
- Division of Outcomes Research, Department of Population Science, City of Hope, Duarte, CA
| | - Chun Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| |
Collapse
|
3
|
Zhang Y, Huang Y, Qin Y, Yang N, Yang P, Li N, Feng Z. Alveolar soft part sarcoma: a clinicopathological and immunohistochemical analysis of 26 cases emphasizing risk factors and prognosis. Diagn Pathol 2024; 19:23. [PMID: 38291475 PMCID: PMC10826116 DOI: 10.1186/s13000-024-01450-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/21/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the clinicopathological features and prognostic indicators of alveolar soft part sarcoma (ASPS). METHODS The characteristics of 26 ASPS patients diagnosed at our hospital between January 2011 and January 2019 were retrospectively analysed. RESULTS The data for 12 male and 14 female patients, with a median age of 27.5 years, were assessed. The clinical symptoms mainly included painless enlarged masses in deep soft tissues. ASPS had a characteristic pathological morphology. Twenty-four patients were positive for TFE3, and TFE3 gene rearrangement was detected in 12 patients. Among the 26 patients who completed follow-up, 14 had metastasis, 1 had local recurrence, and 7 died. Kaplan-Meier survival analysis revealed that prognosis was significantly correlated with sex, tumour size and metastasis (P < 0.05). Multivariate Cox regression analysis revealed that sex and metastasis were independent prognostic risk factors for patients with ASPS (P < 0.05). CONCLUSION ASPS is a rare soft tissue sarcoma of unknown origin that occurs in young people, has a slow but metastatic course, and is associated with a poor 5-year survival rate among patients with metastasis. ASPS has character TFE3 protein and gene expression, and the diagnosis is relatively specific. The diagnosis requires comprehensive analysis of clinical history, histological morphology, and immunohistochemistry.
Collapse
Affiliation(s)
- Yi Zhang
- Department of Pathology, Bengbu Medical College, Anhui, China
| | - Yuchen Huang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Yanzi Qin
- Department of Pathology, Bengbu Medical College, Anhui, China
| | - Ningning Yang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Panpan Yang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Nan Li
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Zhenzhong Feng
- Department of Pathology, Bengbu Medical College, Anhui, China.
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China.
| |
Collapse
|
4
|
Hanssen KM, Fletcher JI, Kamili A. Generation of Orthotopic and Subcutaneous Patient-Derived Xenograft Models from Diverse Clinical Tissue Samples of Pediatric Extracranial Solid Tumors. Methods Mol Biol 2024; 2806:55-74. [PMID: 38676796 DOI: 10.1007/978-1-0716-3858-3_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Realistic and renewable laboratory models that accurately reflect the distinct clinical features of childhood cancers have enormous potential to speed research progress. These models help us to understand disease biology, develop new research methods, advance new therapies to clinical trial, and implement personalized medicine. This chapter describes methods to generate patient-derived xenograft models of neuroblastoma and rhabdomyosarcoma, two tumor types for which children with high-risk disease have abysmal survival outcomes and survivors have lifelong-debilitating effects from treatment. Further, this protocol addresses model development from diverse clinical tumor tissue samples, subcutaneous and orthotopic engraftment, and approaches to avoid model loss.
Collapse
Affiliation(s)
- Kimberley M Hanssen
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine & Health, UNSW Sydney, Sydney, NSW, Australia
| | - Jamie I Fletcher
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine & Health, UNSW Sydney, Sydney, NSW, Australia
| | - Alvin Kamili
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia.
- School of Clinical Medicine, Faculty of Medicine & Health, UNSW Sydney, Sydney, NSW, Australia.
| |
Collapse
|
5
|
Soft-tissue sarcoma in adolescents and young adults. Int J Clin Oncol 2023; 28:1-11. [PMID: 35084598 DOI: 10.1007/s10147-022-02119-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/09/2022] [Indexed: 01/11/2023]
Abstract
Soft-tissue sarcoma is a rare cancer that accounts for approximately 1% of all malignant tumors. Although they occur in various age groups, soft-tissue sarcomas account for 8% of all malignant tumors developing in adolescents and young adults, suggesting that they are not rare in this age group. This study aimed to evaluate the clinical and pathological characteristics of soft-tissue sarcoma in adolescents and young adults. According to the Bone and Soft-Tissue Tumor Registry in Japan, myxoid liposarcoma is the most common type of soft-tissue sarcoma found in adolescents and young adults; alveolar soft part sarcoma, extraskeletal Ewing sarcoma, epithelioid sarcoma, clear cell sarcoma and synovial sarcoma occur predominantly in this age group among soft-tissue sarcomas. The analysis based on this registry demonstrated that age was not a prognostic factor for poor survival of soft-tissue sarcoma, although the prognosis in adolescents and young adults was better than that in older patients in the US and Scandinavia. Adolescent and young adult patients with soft-tissue sarcoma have age-specific problems, and a multidisciplinary approach to physical, psychological, and social issues is necessary to improve the management of these young patients both during and after treatment.
Collapse
|
6
|
Yin X, You L, Hu X. Role of Radiation Therapy in Mortality among Adolescents and Young Adults with Lymphoma: Differences According to Cause of Death. Cancers (Basel) 2022; 14:cancers14205067. [PMID: 36291852 PMCID: PMC9599966 DOI: 10.3390/cancers14205067] [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: 09/05/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Despite its efficacy, emerging concerns exist regarding radiation therapy (RT)-associated toxicity in adolescent and young adult (AYA) lymphoma patients. However, the most current research studying the association between RT and outcome is based only on groups of lymphoma patients and is not compared with the general population, which could more accurately reveal the impact of RT on outcomes. This population-based analysis showed that after adjusting for potential confounders, RT administration is associated with a low risk of cause-specific mortality, including death due to the original diagnosis, second malignant neoplasms (SMNs), and noncancer causes, among AYA patients with lymphoma. This analysis may play a guiding role in the design of future lymphoma studies and the formulation of healthcare policies regarding the widespread use of RT, especially for AYA survivors. Abstract Background: Despite its efficacy, emerging concerns exist regarding radiation therapy (RT)-associated toxicity in adolescent and young adult (AYA) lymphoma patients. Few long-term follow-up studies have examined the association between RT and outcomes. Methods: Lymphoma patients aged 15–39 years were identified in the Surveillance, Epidemiology and End Results (SEER) database from 1992 to 2016. Mortality was assessed by comparing those with and without RT using the Fine–Gray competing risk model. Standardized mortality ratios (SMRs) were used to assess the relative risk of death compared with the general U.S. population. Results: In total, 29,686 patients were included; 10,708 (36.07%) received RT. Cause-specific mortality was compared between patients with and without RT while considering other competing events, including death due to index cancer, second malignant neoplasms (SMNs), and noncancer causes. Patients with RT had a lower probability of death and crude 5-year cumulative incidence of death. Moreover, there were significantly lower SMRs in patients with RT than in patients without RT. Differences between the two groups were greatest for mortality due to hematological malignancies and infections. Additionally, in the RT cohort, the SMR for index-cancer-related death was highest in the first year after diagnosis and gradually decreased. Hematological malignancies and infections were the most common specific SMN and noncancer causes of death, respectively. Conclusions: RT did not increase mortality from index cancer, SMNs, or noncancer causes in AYA patients with lymphoid malignancies. The current analysis may serve as a reference for healthcare providers monitoring RT application for AYA lymphoid malignancy survivors.
Collapse
Affiliation(s)
- Xuejiao Yin
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou 310003, China
- Zhejiang Province Key Laboratory of Hematology Oncology Diagnosis and Treatment, Hangzhou 310003, China
| | - Liangshun You
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou 310003, China
- Zhejiang Province Key Laboratory of Hematology Oncology Diagnosis and Treatment, Hangzhou 310003, China
- Correspondence: (L.Y.); (X.H.); Tel./Fax: +86-571-87236702 (L.Y. & X.H.)
| | - Xuelian Hu
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou 310003, China
- Zhejiang Province Key Laboratory of Hematology Oncology Diagnosis and Treatment, Hangzhou 310003, China
- Correspondence: (L.Y.); (X.H.); Tel./Fax: +86-571-87236702 (L.Y. & X.H.)
| |
Collapse
|
7
|
Castle JT, Levy BE, Rodeberg DA. Abdominal Tumors. Surg Clin North Am 2022; 102:715-737. [DOI: 10.1016/j.suc.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
8
|
Liu H, Zhang H, Zhang C, Liao Z, Li T, Yang T, Zhang G, Yang J. Pan-Soft Tissue Sarcoma Analysis of the Incidence, Survival, and Metastasis: A Population-Based Study Focusing on Distant Metastasis and Lymph Node Metastasis. Front Oncol 2022; 12:890040. [PMID: 35875111 PMCID: PMC9303001 DOI: 10.3389/fonc.2022.890040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background The rarity and complexity of soft tissue sarcoma (STS) make it a challenge to determine the incidence, survival, and metastasis rates. In addition, the clinicopathological risk factors for lymph node metastasis have rarely been reported. Methods Data on patients diagnosed with STS in the SEER database from 2000 to 2018 were extracted by SEER*Stat 8.3.9.1, and the incidence trend was calculated by Joinpoint 4.9 software. The KM method was used to calculate the survival curve, and the log-rank method was used to compare differences in the survival curves. The clinicopathological risk factors for lymph node metastasis were screened by logistic regression. Results Among the 35987 patients, 4299 patients (11.9%) had distant metastasis. The overall lymph node metastasis rate was 6.02%, which included patients suffering from both lymph node and distant metastasis. Considering that some lymph node metastases might be accompanying events of distant metastasis, the rate of only lymph node metastasis in STS patients decreased to 3.42% after excluding patients with distant metastasis. Patients with only lymph node metastases (N1/2M0) had a significantly worse prognosis than those without metastases (N0M0) but a better prognosis than those with only distant metastases (N0M1) (p<0.0001). In the multivariate logistic analysis, STS patients with larger tumors located in the head and neck, viscera, retroperitoneum, and certain specific pathological subtypes (compared with the liposarcoma), such as undifferentiated pleomorphic sarcoma, rhabdomyosarcoma, endometrial stromal sarcoma, gastrointestinal stromal tumor, synovial sarcoma, and angiosarcoma, had a higher risk of lymph node metastasis. Conclusions Lymph node metastasis is rare in STS, and the metastasis rate is significantly different among the different pathological types. Tumor size, location, and pathological subtype are significantly associated with the risk of lymph node metastasis. The overall survival of patients with lymph node metastasis is better than that of patients with distant metastasis, which suggests a more precise prognosis evaluation should be performed in these AJCC stage IV STS patients.
Collapse
Affiliation(s)
- Haotian Liu
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hongliang Zhang
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Orthopedic Surgery Department, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Chao Zhang
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zhichao Liao
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Ting Li
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Tielong Yang
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Gengpu Zhang
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jilong Yang
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- *Correspondence: Jilong Yang,
| |
Collapse
|
9
|
Xi Y, Liu J, Shen G. Low expression of IGFBP4 and TAGLN accelerate the poor overall survival of osteosarcoma. Sci Rep 2022; 12:9298. [PMID: 35665757 PMCID: PMC9166812 DOI: 10.1038/s41598-022-13163-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/20/2022] [Indexed: 11/09/2022] Open
Abstract
Osteosarcoma is a common malignant bone tumor characterized by the production of osteoid stroma by the tumor. However, effect of IGFBP4 and TAGLN on the survival of osteosarcoma is unclear. The GEO database was used to identify the differentially expressed genes (DEGs) between control samples and osteosarcoma. Genes for biological process (BP), cellular composition (CC), and molecular function (MF) were examined using DAVID, Metascape, and GSEA. GSE14359 and GSE36001 were downloaded in the GEO database. GEO2R was used to find DEGs between control samples and osteosarcoma. The cytoHubb also found the hub genes of IGFBP4 and TAGLN. The Kaplan–Meier method was used to analyze overall survival. A total of 134 patients with osteosarcoma were enrolled in this study. The RNA levels of IGFBP4 and TAGLN were evaluated by RT-qPCR. The correlation between IGFBP4 and TAGLN expression and their associations with clinical indicators were analyzed using Spearman's rho test and Pearson's Chi-squared test. Univariate and multivariate Cox regression analyses were used to determine the potential prognostic factors. And the animal model was used to verify the role of hub genes on the osteosarcoma by the RT-qPCR and immunofluorescence. Support Vector Machine (SVM) was performed to construct the correlation among the expression of IGFBP4, TAGLN, and osteosarcoma. Through bioinformatics, IGFBP4 and TAGLN were identified as the hub genes of osteosarcoma. And osteosarcoma patients with high expression levels of IGFBP4 (HR = 0.56, P = 0.013) and TAGLN (HR = 0.52, P = 0.012) had better overall survival times than those with low expression levels. The results showed that pathologic grade (P = 0.017), tumor metastasis (P < 0.001), and enneking stage (P < 0.001) were significantly correlated with IGFBP4. Also, pathologic grade (P = 0.002), tumor metastasis (P < 0.001), and enneking stage (P < 0.001) were significantly related to the TAGLN. Spearman’s correlation coefficient displayed that IGFBP4 were significantly correlated with the tumor metastasis (ρ = − 0.843, P < 0.001), enneking stage (ρ = − 0.500, P < 0.001), and TAGLN (ρ = 0.821, P < 0.001). IGFBP4 (HR = 0.252, 95% CI 0.122–0.517, P < 0.001) and TAGLN (HR = 0.155, 95% CI 0.089–0.269, P < 0.001) were significantly associated with overall survival. Based on the qPCR and immunofluorescence, IGFBP4 and TAGLN were down-regulated in the osteosarcoma tissue than the control group. And the SVM presented that there exists strong relationship among the expression of IGFBP4, TAGLN, and osteosarcoma. IGFBP4 and TAGLN may be attractive molecular targets for osteosarcoma, opening a new avenue for research into the disease.
Collapse
Affiliation(s)
- Yue Xi
- Department of Orthopaedics, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, 1279 Sanmen Road, Hongkou District, Shanghai, 200011, China
| | - Jianlin Liu
- Department of Orthopaedics, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, 1279 Sanmen Road, Hongkou District, Shanghai, 200011, China
| | - Gufeng Shen
- Department of Orthopaedics, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, 1279 Sanmen Road, Hongkou District, Shanghai, 200011, China.
| |
Collapse
|
10
|
Tang J, Wang J, Pan X. A Web-Based Prediction Model for Overall Survival of Elderly Patients With Malignant Bone Tumors: A Population-Based Study. Front Public Health 2022; 9:812395. [PMID: 35087789 PMCID: PMC8787310 DOI: 10.3389/fpubh.2021.812395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/13/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Malignant bone tumors (MBT) are one of the causes of death in elderly patients. The purpose of our study is to establish a nomogram to predict the overall survival (OS) of elderly patients with MBT. Methods: The clinicopathological data of all elderly patients with MBT from 2004 to 2018 were downloaded from the SEER database. They were randomly assigned to the training set (70%) and validation set (30%). Univariate and multivariate Cox regression analysis was used to identify independent risk factors for elderly patients with MBT. A nomogram was built based on these risk factors to predict the 1-, 3-, and 5-year OS of elderly patients with MBT. Then, used the consistency index (C-index), calibration curve, and the area under the receiver operating curve (AUC) to evaluate the accuracy and discrimination of the prediction model was. Decision curve analysis (DCA) was used to assess the clinical potential application value of the nomogram. Based on the scores on the nomogram, patients were divided into high- and low-risk groups. The Kaplan-Meier (K-M) curve was used to test the difference in survival between the two patients. Results: A total of 1,641 patients were included, and they were randomly assigned to the training set (N = 1,156) and the validation set (N = 485). The univariate and multivariate analysis of the training set suggested that age, sex, race, primary site, histologic type, grade, stage, M stage, surgery, and tumor size were independent risk factors for elderly patients with MBT. The C-index of the training set and the validation set were 0.779 [0.759–0.799] and 0.801 [0.772–0.830], respectively. The AUC of the training and validation sets also showed similar results. The calibration curves of the training and validation sets indicated that the observed and predicted values were highly consistent. DCA suggested that the nomogram had potential clinical value compared with traditional TNM staging. Conclusion: We had established a new nomogram to predict the 1-, 3-, 5-year OS of elderly patients with MBT. This predictive model can help doctors and patients develop treatment plans and follow-up strategies.
Collapse
Affiliation(s)
- Jie Tang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenyang Medical College, Shenyang, China
| | - JinKui Wang
- Department of Orthopedics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiudan Pan
- Department of Biostatistics and Epidemiology, School of Public Health, Shenyang Medical College, Shenyang, China
| |
Collapse
|
11
|
Yang P, Zhang L, Hou X. Incidence of suicide among adolescent and young adult cancer patients: a population-based study. Cancer Cell Int 2021; 21:540. [PMID: 34663328 PMCID: PMC8522157 DOI: 10.1186/s12935-021-02225-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/23/2021] [Indexed: 11/14/2022] Open
Abstract
Background As the survival rates of cancer patients continue to increase, most cancer patients now die of non-cancer causes. Several studies have been showing elevated suicide rates among patients with cancer. However, no large-scale study has thoroughly assessed the risk of suicide among adolescent and young adult (AYA) patients with cancer. This study was conducted to characterize suicide mortality among AYA patients in the US and identify risk factors associated with a higher risk of suicide. Methods Patients aged 15–39 years were residents of the US served by the Surveillance, Epidemiology, and End Results (SEER) program, who were diagnosed with cancers from 1973 to 2015. Results We report that 981 of the 572,500 AYA patients with cancer committed suicide, for an age-, sex-, and race-adjusted suicide rate of 17.68/100,000 person-years. The rate of suicide was 14.33/100,000 person-years in the corresponding general population, giving a standardized mortality ratio (SMR) of 1.234 [95% confidence interval (CI) 1.159–1.313]. Higher suicide rates were associated with male sex, white race, unmarried state, distant tumor stage, and single primary tumor. AYA patients with otorhinolaryngologic, gonad, stomach, soft tissue, and nasopharyngeal cancer were at the greatest risk of suicide compared with those with other types of cancer. In older patients (≥ 40 years), the risk was highest in those with lung, stomach, oral cavity and pharynx, larynx, and bone malignancies. SMRs were highest in the first 5 years after diagnosis for most types of cancer. Conclusion AYA patients with cancer in the US have over 20% higher the incidence of suicide of the general population, and most suicides occurred in the first 5 years following diagnosis. Suicide rates vary among patients with cancers of different anatomic sites. Further examination of the psychological experience of these young patients with cancer, particularly that of those with certain types of cancer, is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-021-02225-y.
Collapse
Affiliation(s)
- Pengcheng Yang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, 430022, China
| | - Lei Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, 430022, China.
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, 430022, China.
| |
Collapse
|
12
|
Ryder-Burbidge C, Diaz RL, Barr RD, Gupta S, Nathan PC, McKillop SJ, Fidler-Benaoudia MM. The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review. Cancers (Basel) 2021; 13:cancers13194870. [PMID: 34638350 PMCID: PMC8508204 DOI: 10.3390/cancers13194870] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/18/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary It is unclear what the risk of negative health outcomes is after cancer during adolescence and young adulthood. We conducted a review to understand the risk of second cancers, chronic conditions, and death in adolescent and young adult (AYA) cancer survivors and found factors that increase the risk. In total, 652 studies were identified, of which 106 were included in the review: 23 for second cancers, 34 for chronic conditions, and 54 for deaths. The number of included studies increased over time, from four studies in 2010 to 17 in 2020. The studies found that AYA cancer survivors are at an increased risk of second cancers, chronic conditions, and deaths. In particular, the following factors increased risk: radiation exposure for second cancers; younger attained age and earlier calendar period of diagnosis for chronic conditions; and non-Hispanic Black or Hispanic, low socioeconomic status, and earlier calendar period of diagnosis for deaths. Abstract Risk factors associated with late effects in survivors of adolescent and young adult (AYA) cancer are poorly understood. We conducted a systematic scoping review to identify cohort studies published in English from 2010–2020 that included: (1) cancer survivors who were AYAs (age 15–39 years) at diagnosis and (2) outcomes of subsequent malignant neoplasms (SMNs), chronic conditions, and/or late mortality (>5 years postdiagnosis). There were 652 abstracts identified and, ultimately, 106 unique studies were included, of which 23, 34, and 54 studies related to the risk of SMNs, chronic conditions, and mortality, respectively. Studies investigating late effects among survivors of any primary cancer reported that AYA cancer survivors were at higher risk of SMN, chronic conditions, and all-cause mortality compared to controls. There was an indication that the following factors increased risk: radiation exposure (n = 3) for SMNs; younger attained age (n = 4) and earlier calendar period of diagnosis (n = 3) for chronic conditions; and non-Hispanic Black or Hispanic (n = 5), low socioeconomic status (n = 3), and earlier calendar period of diagnosis (n = 4) for late mortality. More studies including the full AYA age spectrum, treatment data, and results stratified by age, sex, and cancer type are needed to advance knowledge about late effects in AYA cancer survivors.
Collapse
Affiliation(s)
- Charlotte Ryder-Burbidge
- Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Department of Cancer Epidemiology and Prevention Research, 5th Floor, BOX ACB, 2210-2 St. SW, Calgary, AB T2S 3C3, Canada; (C.R.-B.); (R.L.D.)
| | - Ruth L. Diaz
- Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Department of Cancer Epidemiology and Prevention Research, 5th Floor, BOX ACB, 2210-2 St. SW, Calgary, AB T2S 3C3, Canada; (C.R.-B.); (R.L.D.)
| | - Ronald D. Barr
- Health Sciences Centre 3A, Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada;
| | - Sumit Gupta
- Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; (S.G.); (P.C.N.)
| | - Paul C. Nathan
- Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; (S.G.); (P.C.N.)
| | - Sarah J. McKillop
- Department of Pediatrics, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Avenue, Edmonton, AL T6G 1C9, Canada;
| | - Miranda M. Fidler-Benaoudia
- Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Department of Cancer Epidemiology and Prevention Research, 5th Floor, BOX ACB, 2210-2 St. SW, Calgary, AB T2S 3C3, Canada; (C.R.-B.); (R.L.D.)
- Departments of Oncology and Community Health Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
- Correspondence:
| |
Collapse
|
13
|
Jiménez JA, Apfelbaum AA, Hawkins AG, Svoboda LK, Kumar A, Ruiz RO, Garcia AX, Haarer E, Nwosu ZC, Bradin J, Purohit T, Chen D, Cierpicki T, Grembecka J, Lyssiotis CA, Lawlor ER. EWS-FLI1 and Menin Converge to Regulate ATF4 Activity in Ewing Sarcoma. Mol Cancer Res 2021; 19:1182-1195. [PMID: 33741715 PMCID: PMC8462528 DOI: 10.1158/1541-7786.mcr-20-0679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/15/2021] [Accepted: 03/11/2021] [Indexed: 11/16/2022]
Abstract
Ewing sarcomas are driven by EWS-ETS fusions, most commonly EWS-FLI1, which promotes widespread metabolic reprogramming, including activation of serine biosynthesis. We previously reported that serine biosynthesis is also activated in Ewing sarcoma by the scaffolding protein menin through as yet undefined mechanisms. Here, we investigated whether EWS-FLI1 and/or menin orchestrate serine biosynthesis via modulation of ATF4, a stress-response gene that acts as a master transcriptional regulator of serine biosynthesis in other tumors. Our results show that in Ewing sarcoma, ATF4 levels are high and that ATF4 modulates transcription of core serine synthesis pathway (SSP) genes. Inhibition of either EWS-FLI1 or menin leads to loss of ATF4, and this is associated with diminished expression of SSP transcripts and proteins. We identified and validated an EWS-FLI1 binding site at the ATF4 promoter, indicating that the fusion can directly activate ATF4 transcription. In contrast, our results suggest that menin-dependent regulation of ATF4 is mediated by transcriptional and post-transcriptional mechanisms. Importantly, our data also reveal that the downregulation of SSP genes that occurs in the context of EWS-FLI1 or menin loss is indicative of broader inhibition of ATF4-dependent transcription. Moreover, we find that menin inhibition similarly leads to loss of ATF4 and the ATF4-dependent transcriptional signature in MLL-rearranged B-cell acute lymphoblastic leukemia, extending our findings to another cancer in which menin serves an oncogenic role. IMPLICATIONS: These studies provide new insights into metabolic reprogramming in Ewing sarcoma and also uncover a previously undescribed role for menin in the regulation of ATF4.
Collapse
Affiliation(s)
- Jennifer A Jiménez
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - April A Apfelbaum
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Pediatrics, University of Washington, Seattle, Washington
- Seattle Children's Research Institute, Seattle, Washington
| | - Allegra G Hawkins
- New York Genome Center, New York, New York
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, New York
| | | | - Abhijay Kumar
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Ramon Ocadiz Ruiz
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Alessandra X Garcia
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Elena Haarer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Zeribe C Nwosu
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Joshua Bradin
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Trupta Purohit
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Dong Chen
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Tomasz Cierpicki
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jolanta Grembecka
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Costas A Lyssiotis
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Elizabeth R Lawlor
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan.
- Department of Pediatrics, University of Washington, Seattle, Washington
- Seattle Children's Research Institute, Seattle, Washington
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| |
Collapse
|
14
|
Lo AC, Chen B, Samuel V, Savage KJ, Freeman C, Goddard K. Late effects in survivors treated for lymphoma as adolescents and young adults: a population-based analysis. J Cancer Surviv 2021; 15:837-846. [PMID: 33453004 DOI: 10.1007/s11764-020-00976-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The study objective is to describe and quantify the incidence of treatment-induced late effects in AYA lymphoma patients. METHODS Consecutive patients diagnosed with Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) at 15-24 years of age were identified. All patients in British Columbia who received radiation therapy (RT) from 1974 to 2014 with ≥ 5-year survival post-RT were included. Late effects' analyses included only survivors who received RT to the relevant anatomical site(s) and/or relevant chemotherapy, and were reported as cumulative incidence (CI) ± standard error. RESULTS Three hundred and five patients were identified (74% HL). Median age of diagnosis was 21 years. Median follow-up was 19.1 years for secondary malignancy and 7.2 years for other endpoints. Hypothyroidism was the most prevalent late effect, with a CI of 22.4 ± 2.8% and 35.1 ± 4% at 5 and 10 years, respectively. CI of in-field secondary malignancy was 0.4 ± 0.4% at 10 years and 2.8 ± 1.2% at 20 years. CI of symptomatic pulmonary toxicity was 4.6 ± 1.5% and 6.8 ± 2.0% at 5 and 10 years, respectively, and was higher in patients receiving multiple RT courses (p = 0.009). Esophageal complications occurred at a CI of 1.4 ± 0.8% at 5 years and 2.2 ± 1.1% at 10 years. CI of xerostomia/dental decay was 2.6 ± 1.3% at 5 years and 4.9 ± 2.1% at 10 years. CI of cardiac disease was at 2.3 ± 0.9% at 5 years and 4.4 ± 1.5% at 10 years. CI of infertility was 6.5 ± 1.6% at 5 years and 9.4 ± 2.1% at 10 years. CONCLUSION Survivors of AYA lymphoma have a high incidence and diverse presentation of late effects. IMPLICATIONS FOR CANCER SURVIVORS AYA lymphoma survivors should be educated about their risks of late effects and offered screening and follow-up when appropriate.
Collapse
Affiliation(s)
- Andrea C Lo
- Department of Radiation Oncology, British Columbia (BC) Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada.
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Ben Chen
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Vanessa Samuel
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kerry J Savage
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre of Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
- Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada
| | - Ciara Freeman
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre of Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
- Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada
| | - Karen Goddard
- Department of Radiation Oncology, British Columbia (BC) Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
15
|
To YH, Orme L, Lewin J. The Role of Systemic Therapies in the Management of Bone Sarcoma. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
16
|
Wen C, Wang H, Wang H, Mo H, Zhong W, Tang J, Lu Y, Zhou W, Tan A, Liu Y, Xie W. A three-gene signature based on tumour microenvironment predicts overall survival of osteosarcoma in adolescents and young adults. Aging (Albany NY) 2020; 13:619-645. [PMID: 33281116 PMCID: PMC7835013 DOI: 10.18632/aging.202170] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023]
Abstract
Evidences shows that immune and stroma related genes in the tumour microenvironment (TME) play a key regulator in the prognosis of Osteosarcomas (OSs). The purpose of this study was to develop a TME-related risk model for assessing the prognosis of OSs. 82 OSs cases aged ≤25 years from TARGET were divided into two groups according to the immune/stromal scores that were analyzed by the Estimate algorithm. The differentially expressed genes (DEGs) between the two groups were analyzed and 122 DEGs were revealed. Finally, three genes (COCH, MYOM2 and PDE1B) with the minimum AIC value were derived from 122 DEGs by multivariate cox analysis. The three-gene risk model (3-GRM) could distinguish patients with high risk from the training (TARGET) and validation (GSE21257) cohort. Furthermore, a nomogram model included 3-GRM score and clinical features were developed, with the AUC values in predicting 1, 3 and 5-year survival were 0.971, 0.853 and 0.818, respectively. In addition, in the high 3-GRM score group, the enrichment degrees of infiltrating immune cells were significantly lower and immune-related pathways were markedly suppressed. In summary, this model may be used as a marker to predict survival for OSs patients in adolescent and young adults.
Collapse
Affiliation(s)
- Chunkai Wen
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China.,Graduate School of Guangxi Medical University, Nanning 530021, China
| | - Hongxue Wang
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Han Wang
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Hao Mo
- Department of Bone and Soft Tissue Tumor Surgery, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Wuning Zhong
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Jing Tang
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Yongkui Lu
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Wenxian Zhou
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Aihua Tan
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Yan Liu
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| | - Weimin Xie
- Department of Breast, Bone and Soft Tissue Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, China
| |
Collapse
|
17
|
Rhee DS, Rodeberg DA, Baertschiger RM, Aldrink JH, Lautz TB, Grant C, Meyers RL, Tracy ET, Christison-Lagay ER, Glick RD, Mattei P, Dasgupta R. Update on pediatric rhabdomyosarcoma: A report from the APSA Cancer Committee. J Pediatr Surg 2020; 55:1987-1995. [PMID: 32674846 DOI: 10.1016/j.jpedsurg.2020.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/31/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND/PURPOSE Rhabdomyosarcoma is the most common soft tissue sarcoma in children and young adults and requires multimodality treatment. The purpose of this review is to present an update on risk stratification as well as surgical and medical management strategies in pediatric rhabdomyosarcoma. METHODS A comprehensive review of the current literature on pediatric rhabdomyosarcoma, including the most recent Children's Oncology Group studies and several international collaboratives, was performed by the authors and key findings were summarized in the manuscript. RESULTS FOXO1 fusion status is a stronger prognostic factor than histology and is now used for risk stratification in treatment protocols. For assessment of regional nodal involvement, FDG-PET-CT shows poor sensitivity and specificity to detect histologically confirmed nodal metastasis. Thus, surgical assessment of regional lymph nodes is required for rhabdomyosarcoma of the extremities or trunk as well as paratesticular rhabdomyosarcoma in patients ≥10 years of age, although adherence to surgical guidelines remains poor. Hemiscrotectomy performed for scrotal violation in paratesticular rhabdomyosarcoma has not shown an improvement in event free survival and is not recommended. CONCLUSIONS Surgical and medical treatment strategies for rhabdomyosarcoma in children continue to evolve. This review provides current evidence-based treatment standards with an emphasis on surgical care. TYPE OF STUDY Review. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Daniel S Rhee
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - David A Rodeberg
- Division of Pediatric Surgery, Department of Surgery, East Carolina University, Greenville, NC
| | - Reto M Baertschiger
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Timothy B Lautz
- Division of Pediatric Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL
| | - Christa Grant
- Division of Pediatric Surgery, Penn State Children's Hospital, Hershey, PA
| | - Rebecka L Meyers
- Division of Pediatric Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT
| | - Elisabeth T Tracy
- Division of Pediatric Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Emily R Christison-Lagay
- Division of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, Yale New Haven Children's Hospital, New Haven, CT
| | - Richard D Glick
- Division of Pediatric Surgery, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center, New Hyde Park, NY
| | - Peter Mattei
- Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | |
Collapse
|
18
|
Kirkham AA, Pituskin E, Neil-Sztramko SE. Age-dependent increased odds of cardiovascular risk factors in cancer survivors: Canadian Longitudinal Study on Aging cohort. Curr Oncol 2020; 27:e368-e376. [PMID: 32905332 PMCID: PMC7467781 DOI: 10.3747/co.27.6117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background This study compared the odds of self-reported and objectively measured cardiovascular (cv) risk factors in a sample of Canadian cancer survivors and individuals without cancer. Methods A nationally representative sample of 45- to 85-year-old cancer survivors (n = 6288) in the Canadian Longitudinal Study on Aging were compared with individuals without cancer (n = 44,051). Results The most prevalent risk factors in cancer survivors were all self-reported or easily measured in clinic: overweight or obesity (68.0%), former smoking (62.9%), fewer than 5 daily servings of fruits and vegetables (59.8%), hypertension (43.7%), and high waist circumference (47.0%). After adjustment for sex and education, the odds ratios of several cv risk factors varied by age in cancer survivors and the non-cancer controls. At ages 50 and 60, cancer survivors have increased odds of overweight or obesity, former smoking, hypertension, high waist circumference and truncal fat, diabetes, lung disease, and heart rate greater than 80 bpm compared with non-cancer controls. At age 70, odds did not differ for many risk factors; at age 80, no differences were evident. Without modification by age, low physical activity was more prevalent in cancer survivors (odds ratio: 1.27; 95% confidence interval: 1.17 to 1.39). There were no differences in the odds of cv risk factors measured by specialized equipment, including electrocardiography, carotid ultrasonography, spirometry, and dual-energy X-ray absorptiometry. Conclusions The odds of several easy-to-assess cv disease risk factors are higher among middle-aged, but not older, cancer survivors relative to the general Canadian population. Initial assessment of cv risk for middle-aged adults in the survivorship setting could be quickly and inexpensively performed using self-reported and easily measured metrics.
Collapse
Affiliation(s)
- A A Kirkham
- Current: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON; former: Department of Biomedical Engineering, University of Alberta, Edmonton, AB
| | - E Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, AB
| | | |
Collapse
|
19
|
Armenian SH, Xu L, Cannavale KL, Wong FL, Bhatia S, Chao C. Cause-specific mortality in survivors of adolescent and young adult cancer. Cancer 2020; 126:2305-2316. [PMID: 32129881 DOI: 10.1002/cncr.32775] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/04/2019] [Accepted: 12/08/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Few studies have adequately addressed long-term survival (>20 years from diagnosis) among survivors of adolescent and young adult (AYA) cancers. METHODS In this retrospective, population-based cohort study in a US integrated health care system, the authors examined cause-specific mortality in 2-year survivors of AYA cancers (patients aged 15-39 years who were diagnosed between 1990 and 2012; N = 10,574) matched (by age, sex, and calendar year) to individuals without cancer (N = 136,683) to determine whether mortality rates changed over time. Incidence rate ratios (IRRs) for mortality were estimated using multivariable Poisson regression. A multivariable Cox model was used to examine predictors of cause-specific mortality among AYA cancer survivors. RESULTS Through December 31, 2014, 1352 deaths were observed among AYA cancer survivors, yielding an overall survival rate of 78.5% at 25 years after diagnosis. Overall, AYA cancer survivors were at 10.4-fold increased risk for death (95% CI, 9.7-fold to 11.2-fold increased risk for death) compared with the matched noncancer cohort, and this risk remained elevated at >20 years after diagnosis (IRR, 2.9; 95% CI, 2.0-4.3). The absolute excess risk for death from any cause was 12.7 per 1000 person-years (95% CI, 11.9-13.4 per 1000 person-years). Starting at 15 years after diagnosis, the incidence of second cancer-related mortality exceeded the rate of recurrence-related mortality, and similar trends were observed for deaths from other health-related conditions. The 8-year cumulative incidence of mortality declined over time (before 2000, 12.6%; 2000-2006, 10.1%; after 2006, 7.3%; P < .001), largely because of declines in recurrence-related mortality. Age, sex, race/ethnicity, cancer stage at diagnosis, and cancer treatment predicted cause-specific mortality. CONCLUSIONS The current data highlight the need for specialized, long-term follow-up care for AYA cancer survivors.
Collapse
Affiliation(s)
- Saro H Armenian
- Department of Population Sciences, City of Hope, Duarte, California
| | - Lanfang Xu
- MedHealth Statistical Consulting Inc, Solon, Ohio
| | - Kimberly L Cannavale
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - F Lennie Wong
- Department of Population Sciences, City of Hope, Duarte, California
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Chun Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| |
Collapse
|
20
|
Challenges of Clinical Management of Adolescent and Young Adults With Bone and Soft Tissue Sarcoma. ACTA ACUST UNITED AC 2019; 24:301-306. [PMID: 30480574 DOI: 10.1097/ppo.0000000000000337] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Clinical management of adolescents and young adults with bone and soft tissue sarcomas is quite challenging, mainly because of different chemotherapy approaches adopted by pediatric and adult oncologists and tumor-associated factors related to this peculiar age group. Overcoming these barriers is essential for adolescent and young adult patients, whose survival and long-term physical effects are worse than their pediatric counterparts. Nowadays, constant efforts from international collaborations between pediatric and adult oncologists of sarcoma groups have optioned in converging toward a common therapeutic strategy, while improving quality of treatment, as well as research advances dedicated to this at-risk age group of patients with sarcomas.
Collapse
|
21
|
A Quality Improvement Approach to Increase Exercise Assessment in Survivors of Childhood Leukemia. Pediatr Qual Saf 2019; 4:e198. [PMID: 31572899 PMCID: PMC6708644 DOI: 10.1097/pq9.0000000000000198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/24/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction: Survivors of childhood cancer are at increased risk of treatment-related cardiovascular disease, the severity of which is impacted by the level of regular exercise. Exercise assessments (EAs) are not a routine component of follow-up care. Methods: We incorporated a quantitative EA tool into the clinic triage during follow-up visits for survivors of acute lymphoblastic leukemia. The nursing staff was surveyed on the use of the EA tool to gauge understanding and level of comfort with addressing patient questions. Results: Over 27 months, the percentage of off-therapy acute lymphoblastic leukemia patients with documented EA increased from 0% to 80%. We noted degradation in EA completions in the last 6 months of the project, which we attributed to project nursing staff transition and failure to maintain education. Interventions that improved the percentage of completed EA included the incorporation the assessment tool into the electronic medical record and weekly reminders of scheduled eligible patients. A nurse incentive plan did not impact project success. Survey results revealed that the nursing staff were comfortable with the EA and did not view the new process as hurting patient flow. Conclusion: Implementation of an EA tool into routine clinic follow-up was successful. We met the project goal of assessing greater than 50% of the follow-up patients. This work will serve as the foundation for the next phase of the project, which will be to provide education on the importance of exercise and earlier intervention when a sedentary lifestyle is identified.
Collapse
|
22
|
Livingston JA. Improving Outcomes for Adolescents and Young Adults With Sarcoma: A Focus on Cancer Care Delivery. J Oncol Pract 2019; 15:253-254. [DOI: 10.1200/jop.19.00170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
|
23
|
Spraker-Perlman HL, Barkauskas DA, Krailo MD, Meyers PA, Schwartz CL, Doski J, Gorlick R, Janeway KA, Isakoff MS. Factors influencing survival after recurrence in osteosarcoma: A report from the Children's Oncology Group. Pediatr Blood Cancer 2019; 66:e27444. [PMID: 30255612 PMCID: PMC6249072 DOI: 10.1002/pbc.27444] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/20/2018] [Accepted: 08/06/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite drastic improvement in overall survival for pediatric patients with cancer, those with osteosarcoma have stable rates of survival since the 1980s. This project evaluates the effect of several variables on survival after first recurrence in patients with osteosarcoma. METHODS Data from three prospective North American cooperative group trials for newly diagnosed osteosarcoma are included: INT-0133, POG-9754, and AOST0121. The analytic population for this study is all enrolled patients with first event-free survival (EFS) event of relapse. The primary outcome measure for this retrospective analysis was survival after recurrence (SAR). RESULTS The analytic population consisted of N = 431 patients. SAR was statistically significantly associated with age at enrollment (<10 years, P = 0.027), presence of metastatic disease at diagnosis (localized, P < 0.0001), site of relapse (combination lung + bone, unfavorable, P = 0.005), and time to first relapse (2+ years, favorable, P < 0.0001) in multivariate analysis. Ethnicity, primary site of tumor, race, and sex were not significantly related to SAR. CONCLUSIONS Prolonged SAR in patients with relapsed osteosarcoma is associated with age, extent of disease at diagnosis, site of and time to relapse. Adolescent and young adult patients with osteosarcoma have shorter SAR than younger patients, consistent with studies showing decreased overall survival in this group. Although patients with primary metastatic disease have shorter SAR, there is a subset of patients who relapse greater than 2 years from initial diagnosis that will become survivors. Histological response was significantly associated with time to relapse, but was not predictive of SAR.
Collapse
Affiliation(s)
| | - Donald A. Barkauskas
- Children’s Oncology Group, Monrovia, CA,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Mark D. Krailo
- Children’s Oncology Group, Monrovia, CA,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Paul A. Meyers
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Cindy L. Schwartz
- Department of Pediatric Hematology-Oncology, Children’s Hospital of Wisconsin, Milwaukee, WI
| | - John Doski
- Department of Surgery/Pediatric Surgery Division, University of Texas Health Science Center, San Rosa Children’s Hospital, San Antonio, TX
| | - Richard Gorlick
- Division of Pediatrics, University of Texas MD Anderson Cancer Center
| | - Katherine A. Janeway
- Department of Pediatric Hematology-Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Michael S. Isakoff
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, CT
| |
Collapse
|
24
|
Rhabdomyosarcoma and Extraosseous Ewing Sarcoma. CHILDREN-BASEL 2018; 5:children5120165. [PMID: 30544742 PMCID: PMC6306718 DOI: 10.3390/children5120165] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 12/27/2022]
Abstract
Rhabdomyosarcoma (RMS) is a malignant tumor that represents the most common form of pediatric soft tissue sarcoma. It arises from mesenchymal origin and forms part of the group of small round blue cell tumors of childhood. It has a constant annual incidence of 4.5 cases per 1,000,000 children. The known histological diagnosis of the two major subtypes (embryonal and alveolar) has been recently enhanced by tumor biological markers and molecular differentiation diagnostic tools that have improved not only the updated classification based on risk stratification, but also the treatment approach based on the clinical group. Ewing sarcoma (ES) is a round cell tumor, highly malignant and poorly differentiated that is currently the second most common malignant bone tumor in children. In rare instances, it develops from an extraskeletal origin, classified as extraosseous Ewing sarcoma (EES). We provide an updated, evidence-based and comprehensive review of the molecular diagnosis, clinical and diagnostic approach and a multidisciplinary medical and surgical management according to the latest standard of care for the treatment of pediatric RMS and EES.
Collapse
|
25
|
Avila JC, Livingston JA, Rodriguez AM, Kirchhoff AC, Kuo YF, Kaul S. Disparities in Adolescent and Young Adult Sarcoma Survival: Analyses of the Texas Cancer Registry and the National SEER Data. J Adolesc Young Adult Oncol 2018; 7:681-687. [PMID: 30096005 DOI: 10.1089/jayao.2018.0034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Examine disparities in survival for adolescents and young adults (AYAs) diagnosed with bone and soft tissue sarcomas in Texas compared with national estimates. METHODS AYAs with sarcomas diagnosed between 1995 and 2012 at ages 15-39 years were identified from the Texas Cancer Registry (TCR) and Surveillance, Epidemiology, and End Results (SEER) program. Patient demographic, treatment, and clinical characteristics were compared between TCR and SEER using chi-squared tests. Five-year survival was computed using the Kaplan-Meier method. Cox proportional hazards (CPH) models evaluated the factors associated with the risk of mortality between and within the two datasets. RESULTS Sarcoma patients in TCR were more likely to be Hispanic, uninsured, diagnosed at late stage, and have lower rates of surgery as the first line of treatment than those in SEER. In Texas, 5-year survival was 68.7% versus 72.2% in SEER (p < 0.001). However, after including surgery in our fully adjusted CPH model, survival differences between the two datasets were no longer observed. In these models, males, and those living in nonmetropolitan areas were more likely to die than their counterparts in both datasets. In TCR, those who lived in the U.S. and Mexico border had higher mortality. In SEER, Hispanics and non-Hispanic blacks had higher mortality. CONCLUSION The adjusted AYA sarcoma survival in Texas was similar to that of SEER, but patients in Texas were more likely to be uninsured and have lower surgery rates. Those living in the U.S. and Mexico border in Texas faced lower survival. These results are important for delineating effective care for this high-risk patient group.
Collapse
Affiliation(s)
- Jaqueline C Avila
- 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
| | - J Andrew Livingston
- 2 Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Ana M Rodriguez
- 3 Department of Obstetrics and Gynecology, University of Texas Medical Branch , Galveston, Texas
| | - Anne C Kirchhoff
- 4 Department of Pediatric Hematology/Oncology and Huntsman Cancer Institute, University of Utah , Salt Lake City, Utah
| | - Yong-Fang Kuo
- 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
| | - Sapna Kaul
- 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas
| |
Collapse
|
26
|
Jensen MV, Rugbjerg K, de Fine Licht S, Johansen C, Schmiegelow K, Andersen KK, Winther JF. Endocrine Late Effects in Survivors of Cancer in Adolescence and Young Adulthood: A Danish Population-Based Cohort Study. JAMA Netw Open 2018; 1:e180349. [PMID: 30646084 PMCID: PMC6324403 DOI: 10.1001/jamanetworkopen.2018.0349] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE As survival rates from cancer have improved dramatically over the last decades, there is a need to explore the long-term consequences. Adolescents and young adults with cancer are at risk for several therapy-related late effects; however, these have not been studied extensively. OBJECTIVE To investigate the lifetime risks of endocrine late effects of cancer and cancer treatment in adolescent and young adult cancer survivors. DESIGN, SETTING, AND PARTICIPANTS This Danish, nationwide, population-based cohort study was conducted from January 1, 1976, through December 31, 2009, and included follow-up from January 1, 1977, through December 31, 2010. A total of 32 548 one-year cancer survivors diagnosed at ages 15 to 39 years were identified using the Danish Cancer Registry and 188 728 cancer-free comparison participants matched by year of birth and sex were randomly chosen from the Danish Civil Registration system. Analyses were performed from July 3, 2015, to February 27, 2018. EXPOSURES Individuals in the survivor cohort were diagnosed with a first primary cancer at ages 15 to 39 years and received treatment according to recommendations and guidelines at time of diagnosis. MAIN OUTCOMES AND MEASURES By linkage to the National Patient Register, all hospital contacts for endocrine diseases were identified, and standardized hospitalization rate ratios (RRs) and absolute excess risks (AERs) were calculated. RESULTS A total of 32 548 adolescent and young adult 1-year cancer survivors (14 021 [43.1%] male) in the Danish Patient Registry were followed up for 379 157 person-years (median [range]: 10 [0-34] years) and 188 728 cancer-free participants (82 669 [43.8%] male) for comparison were followed up for 2 958 994 person-years (median [range]: 15 [0-34] years). A total of 2129 survivors (6.5%) had at least 1 hospital contact for an endocrine disease, while 1232.0 (3.8%) were expected, yielding a statistically significant increased RR of 1.73 (95% CI, 1.65-1.81). The RRs were highest for testicular hypofunction (75.12; 95% CI, 45.99-122.70), ovarian hypofunction (14.65; 95% CI, 8.29-25.86), and pituitary hypofunction (11.14; 95% CI, 8.09-15.34). The leading reasons for hospital contacts were thyroid disease (38.0% of total AER), testicular dysfunction (17.1% of total AER), and diabetes (14.4% of total AER). Leukemia survivors were at a high risk for any endocrine disease (RR, 3.97; 95% CI, 3.10-5.09), while Hodgkin lymphoma survivors (RR, 3.06; 95% CI, 2.62-3.57) had the highest disease-specific excess risk for hypothyroidism (AER, 362 per 100 000 person-years; 95% CI, 280-443 per 100 000 person-years). CONCLUSIONS AND RELEVANCE The increased risk for endocrine diseases in adolescent and young adult cancer survivors indicates the need for counseling and follow-up, and could guide future preventive measures and surveillance strategies. Additional studies are required to determine exact associations between treatment regimens and endocrine diseases.
Collapse
Affiliation(s)
| | - Kathrine Rugbjerg
- Survivorship Unit, Danish Cancer Society Research
Center, Copenhagen, Denmark
| | - Sofie de Fine Licht
- Survivorship Unit, Danish Cancer Society Research
Center, Copenhagen, Denmark
| | - Christoffer Johansen
- Survivorship Unit, Danish Cancer Society Research
Center, Copenhagen, Denmark
- Department of Clinical Medicine, Juliane Marie Centre,
Rigshospitalet, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Clinical Medicine, Juliane Marie Centre,
Rigshospitalet, Copenhagen, Denmark
| | - Klaus Kaae Andersen
- Statistics, Bioinformatics, and Registries, Danish
Cancer Society Research Center, Copenhagen, Denmark
| | - Jeanette Falck Winther
- Survivorship Unit, Danish Cancer Society Research
Center, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health,
Aarhus University, Aarhus, Denmark
| |
Collapse
|
27
|
Svoboda LK, Teh SSK, Sud S, Kerk S, Zebolsky A, Treichel S, Thomas D, Halbrook CJ, Lee HJ, Kremer D, Zhang L, Klossowski S, Bankhead AR, Magnuson B, Ljungman M, Cierpicki T, Grembecka J, Lyssiotis CA, Lawlor ER. Menin regulates the serine biosynthetic pathway in Ewing sarcoma. J Pathol 2018; 245:324-336. [PMID: 29672864 DOI: 10.1002/path.5085] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/02/2018] [Accepted: 04/06/2018] [Indexed: 12/20/2022]
Abstract
Developmental transcription programs are epigenetically regulated by multi-protein complexes, including the menin- and MLL-containing trithorax (TrxG) complexes, which promote gene transcription by depositing the H3K4me3 activating mark at target gene promoters. We recently reported that in Ewing sarcoma, MLL1 (lysine methyltransferase 2A, KMT2A) and menin are overexpressed and function as oncogenes. Small molecule inhibition of the menin-MLL interaction leads to loss of menin and MLL1 protein expression, and to inhibition of growth and tumorigenicity. Here, we have investigated the mechanistic basis of menin-MLL-mediated oncogenic activity in Ewing sarcoma. Bromouridine sequencing (Bru-seq) was performed to identify changes in nascent gene transcription in Ewing sarcoma cells, following exposure to the menin-MLL interaction inhibitor MI-503. Menin-MLL inhibition resulted in early and widespread reprogramming of metabolic processes. In particular, the serine biosynthetic pathway (SSP) was the pathway most significantly affected by MI-503 treatment. Baseline expression of SSP genes and proteins (PHGDH, PSAT1, and PSPH), and metabolic flux through the SSP were confirmed to be high in Ewing sarcoma. In addition, inhibition of PHGDH resulted in reduced cell proliferation, viability, and tumor growth in vivo, revealing a key dependency of Ewing sarcoma on the SSP. Loss of function studies validated a mechanistic link between menin and the SSP. Specifically, inhibition of menin resulted in diminished expression of SSP genes, reduced H3K4me3 enrichment at the PHGDH promoter, and complete abrogation of de novo serine and glycine biosynthesis, as demonstrated by metabolic tracing studies with 13 C-labeled glucose. These data demonstrate that the SSP is highly active in Ewing sarcoma and that its oncogenic activation is maintained, at least in part, by menin-dependent epigenetic mechanisms involving trithorax complexes. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Laurie K Svoboda
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Selina Shiqing K Teh
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Sudha Sud
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Samuel Kerk
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Aaron Zebolsky
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Sydney Treichel
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Dafydd Thomas
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Christopher J Halbrook
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ho-Joon Lee
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Daniel Kremer
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Li Zhang
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Szymon Klossowski
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Armand R Bankhead
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Brian Magnuson
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Mats Ljungman
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Environmental Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Tomasz Cierpicki
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jolanta Grembecka
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Costas A Lyssiotis
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Elizabeth R Lawlor
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| |
Collapse
|
28
|
Abstract
Osteosarcoma is the most common primary bone malignancy in children and adolescents. Because the incidence of osteosarcoma is low and the disease occurs in physically active patients, it may be misdiagnosed as a more benign condition, thus leading to late diagnosis. This article describes the disease's most frequent presenting complaints and initial radiographic findings, as well as its risk factors and common misdiagnoses. Clinicians should consider osteosarcoma in young patients with persistent bone pain, especially pain with weight-bearing.
Collapse
Affiliation(s)
- Chelsea Hiller
- Chelsea Hiller practices family medicine at the Scripps Clinic in San Diego, Calif. Jennifer L. Wegler is a clinical instructor of family medicine in the PA program at the University of Southern California in Alhambra, Calif., and practices orthopedics at Kaiser-Permanente in Baldwin Park, Calif. Christopher P. Forest is an assistant professor of clinical family medicine and director of research at the University of Southern California's Keck School of Medicine and practices urgent care and family medicine in Los Angeles, Calif. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | |
Collapse
|
29
|
Kirkham AA, Pituskin E, Paterson DI. Does Cancer Affect Cardiac Function Prior to Cancer Therapy Exposure? Can J Cardiol 2018; 34:234-235. [DOI: 10.1016/j.cjca.2017.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022] Open
|
30
|
Pinotti E, Sandini M, Famularo S, Jaconi M, Romano F, Nespoli L, Gianotti L. Disseminated and late metastatic disease from nasal pit leiomyosarcoma after radical surgical resection. Case report of a singular presentation of a rare disease. Clin Sarcoma Res 2017; 7:12. [PMID: 28593036 PMCID: PMC5461669 DOI: 10.1186/s13569-017-0078-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/15/2017] [Indexed: 11/19/2022] Open
Abstract
Background Leiomyosarcoma of the head and neck is a rare cancer with high local aggressiveness. Radical surgery and adjuvant treatment offer the best chance for cure, nonetheless 5-years recurrence rate remains high. Despite international guidelines are available for soft tissue sarcomas, no recommendations are specifically endorsed for leiomyosarcoma of the head and neck, due to the rarity of its presentation and consequently scarcity of data on long-term outcome. Case presentation A 50-year old woman, operated 10 years before for leiomyosarcoma of the nasal pit and with negative 5-years follow-up, was admitted to our ward for impairment of the hepatic function. Total-body CT scan detected multiple localizations at lungs, kidneys, pancreas, bones, muscles, lymph nodes and thyroid. The pathologic report after lung biopsy confirmed the diagnosis of metastasis from leiomyosarcoma and the patients was scheduled for first line chemo-radiotherapy. Conclusions Despite adequate primary treatment, distant and disseminated metastatic disease may be not excluded in leiomyosarcoma of the head and neck.
Collapse
Affiliation(s)
- Enrico Pinotti
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Marta Sandini
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Simone Famularo
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Marta Jaconi
- Unit of Pathology, School of Medicine and Surgery, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy
| | - Fabrizio Romano
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Luca Nespoli
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Luca Gianotti
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| |
Collapse
|
31
|
Abstract
A malignant tumor of striated muscle origin, rhabdomyosarcoma (RMS) is a childhood tumor that has benefited from nearly 30 years of multimodality therapy, culminating in a >70% overall 5-year survival. Prognosis for RMS is dependent on primary tumor site, age, completeness of resection, presence and number of metastatic sites, histology, and biology of the tumor cells. Multimodality treatment is based on risk stratification according to pre-treatment stage, postoperative group, histology, and site. Unique to RMS is the concept of postoperative clinical grouping that assesses the completeness of disease resection and takes into account lymph node evaluation at both the regional and metastatic basins. At all sites, if complete operative resection of disease is accomplished, including microscopic disease, survival is improved. Therefore, the surgeon plays a vital role in determining risk stratification for treatment, local control of the primary tumor and overall outcome for the patient with RMS.
Collapse
Affiliation(s)
- Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH.
| | - Jörg Fuchs
- Universitätsklinik für Kinder- und Jugendmedizin, Lehrstuhl für Kinderchirurgie und Kinderurologie, Vizepräsident der Deutschen Gesellschaft für Chirurgie, Tübingen, Germany
| | - David Rodeberg
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC
| |
Collapse
|
32
|
Abstract
Recent years have witnessed marked improvement in cytotoxic treatments with a parallel increase in patient survival. Despite efforts done to minimize long-term side effects of these treatment regimens, it is estimated that 40% of survivors of pediatric cancer will suffer from those. Some will be mild whereas others such as impaired fertility will be a heavy load on parents׳ expectations and patient׳s quality of life. Gonadal damage and severe loss of function is not a rare condition among children cured for cancer. Despite the young age of those patients, methods exist to try to reduce gonadal insult or to preserve gonadal function. Some of them are well studied and controlled; others are more experimental with encouraging results so far. This article aims to summarize all the procedures that can be offered to young patients treated for cancer in order to protect, as possible, their fertility potential.
Collapse
Affiliation(s)
- Raffoul Lara
- Department of Pediatric Surgery, APHP, Necker Enfants Malades Hospital, Paris, France
| | - Capito Carmen
- Department of Pediatric Surgery, APHP, Necker Enfants Malades Hospital, Paris, France
| | - Sarnacki Sabine
- Department of Pediatric Surgery, APHP, Necker Enfants Malades Hospital, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France.
| |
Collapse
|
33
|
Li YJ, Dai YL, Cheng YS, Zhang WB, Tu CQ. Positron emission tomography (18)F-fluorodeoxyglucose uptake and prognosis in patients with bone and soft tissue sarcoma: A meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2016; 42:1103-14. [PMID: 27189833 DOI: 10.1016/j.ejso.2016.04.056] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/04/2016] [Accepted: 04/08/2016] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate the prognostic significance of (18)F-FDG PET imaging in patients with bone and soft tissue sarcoma, a meta-analysis was conducted. METHODS Comprehensive literature searches were performed in PubMed, Embase, Web of Science and Cochrane Library. Pooled hazard ratio (HR) values were calculated to assess the correlations of pre-chemotherapy SUV (SUV1), post-chemotherapy SUV (SUV2), SUV Ratio, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) with event-free survival (EFS) and overall survival (OS). RESULTS Twenty-three studies with 1261 patients were identified. The combined HRs for EFS were 1.84 (95% CI: 1.54-2.20) for SUV1, 2.92 (95% CI: 2.15-3.97) for SUV2, 1.90 (95% CI: 1.43-2.52) for SUV Ratio, 3.01 (95% CI: 1.36-6.67) for TLG and 2.32 (95% CI: 1.44-3.75) for MTV. The pooled HRs for OS were 1.85 (95% CI: 1.49-2.30) for SUV1, 2.00 (95% CI: 1.39-2.88) for SUV2, 2.20 (95% CI: 1.18-4.10) for SUV Ratio, 6.19 (95% CI: 2.17-17.66) for TLG and 2.67 (95% CI: 1.52-4.68) for MTV. Besides, high SUV1 was found to be significantly associated with higher rate of metastasis (RR 5.55, 95% CI: 2.75-11.18) and local recurrence (RR 1.87 95% CI: 1.28-2.72). CONCLUSION (18)F-FDG PET parameters of SUV1, SUV2, SUV Ratio, TLG and MTV may have effective prognostic significance for patients with bone and soft tissue sarcoma. (18)F-FDG PET imaging may be a promising tool to help predict survival outcomes of these patients.
Collapse
Affiliation(s)
- Y-J Li
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, PR China; Department of Cancer Center, West China Hospital, Sichuan University, Chengdu, PR China.
| | - Y-L Dai
- College of Computer Science, Sichuan Normal University, Chengdu, PR China
| | - Y-S Cheng
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, PR China
| | - W-B Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, PR China
| | - C-Q Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, PR China.
| |
Collapse
|
34
|
Richardson DP, Daly C, Sutradhar R, Paszat LF, Wilton AS, Rabeneck L, Baxter NN. Hospitalization Rates Among Survivors of Young Adult Malignancies. J Clin Oncol 2015; 33:2655-9. [DOI: 10.1200/jco.2014.60.1914] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose There are limited data on health care use among survivors of young adult cancers. We aimed to describe patterns of hospitalization among a cohort of long-term survivors compared with noncancer controls. Methods Persons diagnosed between the ages of 20 and 44 years with malignancies in Ontario, Canada, from 1992 to 1999, who lived at least 5 years recurrence free, were identified using the Ontario Cancer Registry and matched to noncancer controls. Hospitalizations were determined using hospital discharges, and rates were compared between survivors and controls. The absolute excess rate of hospitalizations was determined for each type of malignancy in survivors per 100 person-years of follow-up. Results The cohort included 20,275 survivors and 101,344 noncancer controls. During the study period, 6,948 (34.3%) survivors were admitted to the hospital and the adjusted relative rate (ARR) of hospitalizations in survivors compared with controls was 1.51 (95% CI, 1.48 to 1.54). The rate of hospitalization was highest for survivors of upper GI, leukemia, and urologic malignancies. The hospitalization rate (per person) for survivors significantly decreased from 0.22 in the first time period examined (5 to 8 years after diagnosis) to 0.15 in the last time period examined (18 to 20 years after diagnosis, P < .0001). However, at all time periods, survivors were more likely to be hospitalized than controls (ARR at 5 to 8 years, 1.67 [95% CI, 1.57 to 1.81]; ARR at 18 to 20 years, 1.22 [95% CI, 1.08 to 1.37]). Conclusion Survivors of young adult cancers have an increased rate of hospitalization compared with controls. The rate of hospitalization for 20-year survivors did not return to baseline, indicating a substantial and persistent burden of late effects among this generally young population.
Collapse
Affiliation(s)
- Devon P. Richardson
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| | - Corinne Daly
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| | - Rinku Sutradhar
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| | - Lawrence F. Paszat
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| | - Andrew S. Wilton
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| | - Linda Rabeneck
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| | - Nancy N. Baxter
- Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck,
| |
Collapse
|
35
|
Fung C, Fossa SD, Milano MT, Sahasrabudhe DM, Peterson DR, Travis LB. Cardiovascular Disease Mortality After Chemotherapy or Surgery for Testicular Nonseminoma: A Population-Based Study. J Clin Oncol 2015; 33:3105-15. [PMID: 26240226 DOI: 10.1200/jco.2014.60.3654] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Increased risks of incident cardiovascular disease (CVD) in patients with testicular cancer (TC) given chemotherapy in European studies were largely restricted to long-term survivors and included patients from the 1960s. Few population-based investigations have quantified CVD mortality during, shortly after, and for two decades after TC diagnosis in the era of cisplatin-based chemotherapy. PATIENTS AND METHODS Standardized mortality ratios (SMRs) for CVD and absolute excess risks (AERs; number of excess deaths per 10,000 person-years) were calculated for 15,006 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2010) who initially received chemotherapy (n=6,909) or surgery (n=8,097) without radiotherapy and accrued 60,065 and 81,227 person-years of follow-up, respectively. Multivariable modeling evaluated effects of age, treatment, extent of disease, and other factors on CVD mortality. RESULTS Significantly increased CVD mortality occurred after chemotherapy (SMR, 1.36; 95% CI, 1.03 to 1.78; n=54) but not surgery (SMR, 0.81; 95% CI, 0.60 to 1.07; n=50). Significant excess deaths after chemotherapy were restricted to the first year after TC diagnosis (SMR, 5.31; AER, 13.90; n=11) and included cerebrovascular disease (SMR, 21.72; AER, 7.43; n=5) and heart disease (SMR, 3.45; AER, 6.64; n=6). In multivariable analyses, increased CVD mortality after chemotherapy was confined to the first year after TC diagnosis (hazard ratio, 4.86; 95% CI, 1.25 to 32.08); distant disease (P<.05) and older age at diagnosis (P<.01) were independent risk factors. CONCLUSION This is the first population-based study, to our knowledge, to quantify short- and long-term CVD mortality after TC diagnosis. The increased short-term risk of CVD deaths should be further explored in analytic studies that enumerate incident events and can serve to develop comprehensive evidence-based approaches for risk stratification and application of preventive and interventional efforts.
Collapse
Affiliation(s)
- Chunkit Fung
- Chunkit Fung, Michael T. Milano, Deepak M. Sahasrabudhe, Derick R. Peterson, and Lois B. Travis, University of Rochester Medical Center, Rochester, NY; and Sophie D. Fossa, Norwegian Radium Hospital, Oslo, Norway
| | - Sophie D Fossa
- Chunkit Fung, Michael T. Milano, Deepak M. Sahasrabudhe, Derick R. Peterson, and Lois B. Travis, University of Rochester Medical Center, Rochester, NY; and Sophie D. Fossa, Norwegian Radium Hospital, Oslo, Norway
| | - Michael T Milano
- Chunkit Fung, Michael T. Milano, Deepak M. Sahasrabudhe, Derick R. Peterson, and Lois B. Travis, University of Rochester Medical Center, Rochester, NY; and Sophie D. Fossa, Norwegian Radium Hospital, Oslo, Norway
| | - Deepak M Sahasrabudhe
- Chunkit Fung, Michael T. Milano, Deepak M. Sahasrabudhe, Derick R. Peterson, and Lois B. Travis, University of Rochester Medical Center, Rochester, NY; and Sophie D. Fossa, Norwegian Radium Hospital, Oslo, Norway
| | - Derick R Peterson
- Chunkit Fung, Michael T. Milano, Deepak M. Sahasrabudhe, Derick R. Peterson, and Lois B. Travis, University of Rochester Medical Center, Rochester, NY; and Sophie D. Fossa, Norwegian Radium Hospital, Oslo, Norway
| | - Lois B Travis
- Chunkit Fung, Michael T. Milano, Deepak M. Sahasrabudhe, Derick R. Peterson, and Lois B. Travis, University of Rochester Medical Center, Rochester, NY; and Sophie D. Fossa, Norwegian Radium Hospital, Oslo, Norway.
| |
Collapse
|
36
|
Dinkelspiel HE, Champer M, Hou J, Tergas A, Burke WM, Huang Y, Neugut AI, Ananth CV, Hershman DL, Wright JD. Long-term mortality among women with epithelial ovarian cancer. Gynecol Oncol 2015; 138:421-8. [PMID: 26050923 PMCID: PMC4522327 DOI: 10.1016/j.ygyno.2015.06.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Patients with solid tumors are at greatest risk for dying from their cancers in the five years following diagnosis. For most malignancies, deaths from other chronic diseases begin to exceed those from cancer at some point. As little is known about the causes of death among long-term survivors of ovarian cancer, we examined causes of death by years from diagnosis. METHODS The Surveillance, Epidemiology, and End Results (SEER) database was used to identify women diagnosed with ovarian cancer between 1988 and 2012. We compared causes of death by stage, age, and interval time after diagnosis. RESULTS A total of 67,385 women were identified. For stage I neoplasms, 13.6% (CI, 13.0-14.2%) died from ovarian cancer, 4.2% (CI, 3.8-4.5%) from cardiovascular disease, 3.6% (CI, 3.3-3.9%) from other causes and 2.6% (CI, 2.4-2.9%) from other tumors; ovarian cancer was the leading cause of death until 7 years after diagnosis after which time deaths are more frequently due to other causes. For those with stage III-IV tumors, 67.8% (CI, 67.3-68.2%) died from ovarian cancer, 2.8% (CI, 2.6-2.9%) from other causes, 2.3% (CI, 2.2-2.4%) from cardiovascular disease and 1.9% (CI, 1.7-2.0%) from other cancers; ovarian cancer was the most frequent cause of death in years 1-15 after which time deaths were more commonly due to other causes. CONCLUSIONS The probability of dying from ovarian cancer decreases with time. Ovarian cancer remains the most common cause of death for 15 years after diagnosis in women with stage III-IV tumors.
Collapse
Affiliation(s)
- Helen E Dinkelspiel
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States
| | - Miriam Champer
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States
| | - June Hou
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States
| | - Ana Tergas
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States
| | - William M Burke
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States
| | - Yongmei Huang
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States
| | - Alfred I Neugut
- Department of Medicine, Columbia University College of Physicians and Surgeons, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States
| | - Cande V Ananth
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, United States
| | - Dawn L Hershman
- Department of Medicine, Columbia University College of Physicians and Surgeons, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States
| | - Jason D Wright
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, United States; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, United States; New York Presbyterian Hospital, United States.
| |
Collapse
|
37
|
Effinger KE. Survival and Quality of Life Following Treatment for Sarcoma. CURRENT PEDIATRICS REPORTS 2015. [DOI: 10.1007/s40124-015-0074-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
38
|
Volchenboum SL, Andrade J, Huang L, Barkauskas DA, Krailo M, Womer RB, Ranft A, Potratz J, Dirksen U, Triche TJ, Lawlor ER. Gene Expression Profiling of Ewing Sarcoma Tumors Reveals the Prognostic Importance of Tumor-Stromal Interactions: A Report from the Children's Oncology Group. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2015; 1:83-94. [PMID: 26052443 PMCID: PMC4457396 DOI: 10.1002/cjp2.9] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Relapse of Ewing sarcoma (ES) can occur months or years after initial remission, and salvage therapy for relapsed disease is usually ineffective. Thus, there is great need to develop biomarkers that can predict which patients are at risk for relapse so that therapy and post‐therapy evaluation can be adjusted accordingly. For this study, we performed whole genome expression profiling on two independent cohorts of clinically annotated ES tumours in an effort to identify and validate prognostic gene signatures. ES specimens were obtained from the Children's Oncology Group and whole genome expression profiling performed using Affymetrix Human Exon 1.0 ST arrays. Lists of differentially expressed genes between survivors and non‐survivors were used to identify prognostic gene signatures. An independent cohort of tumours from the Euro‐Ewing cooperative group was similarly analysed as a validation cohort. Unsupervised clustering of gene expression data failed to segregate tumours based on outcome. Supervised analysis of survivors versus non‐survivors revealed a small number of differentially expressed genes and several statistically significant gene signatures. Gene‐specific enrichment analysis demonstrated that integrin and chemokine genes were associated with survival in tumours where stromal contamination was present. Tumours that did not harbour stromal contamination showed no association of any genes or pathways with clinical outcome. Our results reflect the challenges of performing RNA‐based assays on archived bone tumour specimens. In addition, they reveal a key role for tumour stroma in determining ES prognosis. Future biological and clinical investigations should focus on elucidating the contribution of tumour:micro‐environment interactions on ES progression and response to therapy.
Collapse
Affiliation(s)
- Samuel L Volchenboum
- Center for Research Informatics, University of Chicago ; Department of Pediatrics, University of Chicago
| | - Jorge Andrade
- Center for Research Informatics, University of Chicago
| | - Lei Huang
- Center for Research Informatics, University of Chicago
| | - Donald A Barkauskas
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern
| | - Mark Krailo
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern
| | - Richard B Womer
- Children's Hospital of Philadelphia and University of Pennsylvania
| | - Andreas Ranft
- University Hospital Muenster, Department of Pediatrics and Pediatric Hematology and Oncology
| | - Jenny Potratz
- University Hospital Muenster, Department of Pediatrics and Pediatric Hematology and Oncology
| | - Uta Dirksen
- University Hospital Muenster, Department of Pediatrics and Pediatric Hematology and Oncology
| | - Timothy J Triche
- Department of Pathology, Keck School of Medicine of the University of Southern California
| | - Elizabeth R Lawlor
- Department of Pediatrics and Department of Pathology, University of Michigan
| |
Collapse
|
39
|
Nass SJ, Beaupin LK, Demark-Wahnefried W, Fasciano K, Ganz PA, Hayes-Lattin B, Hudson MM, Nevidjon B, Oeffinger KC, Rechis R, Richardson LC, Seibel NL, Smith AW. Identifying and addressing the needs of adolescents and young adults with cancer: summary of an Institute of Medicine workshop. Oncologist 2015; 20:186-95. [PMID: 25568146 DOI: 10.1634/theoncologist.2014-0265] [Citation(s) in RCA: 200] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cancer is the leading disease-related cause of death in adolescents and young adults (AYAs). This population faces many short- and long-term health and psychosocial consequences of cancer diagnosis and treatment, but many programs for cancer treatment, survivorship care, and psychosocial support do not focus on the specific needs of AYA cancer patients. Recognizing this health care disparity, the National Cancer Policy Forum of the Institute of Medicine convened a public workshop to examine the needs of AYA patients with cancer. Workshop participants identified many gaps and challenges in the care of AYA cancer patients and discussed potential strategies to address these needs. Suggestions included ways to improve access to care for AYAs, to deliver cancer care that better meets the medical and psychosocial needs of AYAs, to develop educational programs for providers who care for AYA cancer survivors, and to enhance the evidence base for AYAs with cancer by facilitating participation in research.
Collapse
Affiliation(s)
- Sharyl J Nass
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Lynda K Beaupin
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Wendy Demark-Wahnefried
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Karen Fasciano
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Patricia A Ganz
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Brandon Hayes-Lattin
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Melissa M Hudson
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Brenda Nevidjon
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Kevin C Oeffinger
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Ruth Rechis
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Lisa C Richardson
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Nita L Seibel
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| | - Ashley W Smith
- Institute of Medicine, Washington, D.C., USA; Roswell Park Cancer Institute, Buffalo, New York, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA; Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA: School of Medicine & Public Health, University of California, Los Angeles, Los Angeles, California, USA; Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA; St. Jude Children's Research Hospital, Memphis, Tennessee, USA; Oncology Nursing Society, Pittsburgh, Pennsylvania, USA; Memorial Sloan-Kettering Cancer Center, New York, New York, USA; LIVESTRONG Foundation, Austin, Texas, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA; National Cancer Institute, Bethesda, Maryland, USA
| |
Collapse
|
40
|
Kovar H. Blocking the road, stopping the engine or killing the driver? Advances in targeting EWS/FLI-1 fusion in Ewing sarcoma as novel therapy. Expert Opin Ther Targets 2014; 18:1315-28. [PMID: 25162919 DOI: 10.1517/14728222.2014.947963] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Ewing sarcoma (ES) represents the paradigm of an aberrant E-twenty-six (ETS) oncogene-driven cancer. It is characterized by specific rearrangements of one of five alternative ETS family member genes with EWSR1. There is experimental evidence that the resulting fusion proteins act as aberrant transcription factors driving ES pathogenesis. The transcriptional gene regulatory network driven by EWS-ETS proteins provides the oncogenic engine to the tumor. Therefore, EWS-ETS and their downstream machinery are considered ideal tumor-specific therapeutic targets. AREAS COVERED This review critically discusses the literature on the development of EWS-ETS-directed ES targeting strategies considering current knowledge of EWS-ETS biology and cellular context. It focuses on determinants of EWS-FLI1 function with an emphasis on interactions with chromatin structure. We speculate about the relevance of poorly investigated aspects in ES research such as chromatin remodeling and DNA damage repair for the development of targeted therapies. EXPERT OPINION This review questions the specificity of signature-based screening approaches to the identification of EWS-FLI1-targeted compounds. It challenges the view that targeting the downstream gene regulatory network carries potential for therapeutic breakthroughs because of resistance-inducing network rewiring. Instead, we propose to combine targeting of the fusion protein with epigenetic therapy as a future treatment strategy in ES.
Collapse
Affiliation(s)
- Heinrich Kovar
- Children´s Cancer Research Institute, St. Anna Kinderkrebsforschung, and Medical University Vienna, Department of Pediatrics , Zimmermannplatz 10, A1090 Vienna , Austria +43 1 40470 4092 ; +43 1 40470 64092 ;
| |
Collapse
|
41
|
Choy E. Sarcoma after 5 years of progression-free survival: lessons from the French sarcoma group. Cancer 2014; 120:2942-3. [PMID: 24942785 DOI: 10.1002/cncr.28834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 05/15/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Edwin Choy
- Division of Hematology Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|