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Dehner CA, Johnson EF, Wieland CN, Camilleri MJ, Kajdacsy-Balla A, Oliveira AM, Halling KC, Gupta S, Guo R. Fusion-driven cutaneous and superficial mesenchymal and adnexal tumors-A clinicopathologic and molecular study of 15 cases, including a novel case of ACTB::ZMIZ2-rearranged adnexal carcinoma. J Cutan Pathol 2024; 51:538-548. [PMID: 38556256 DOI: 10.1111/cup.14610] [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: 09/27/2023] [Revised: 02/22/2024] [Accepted: 03/13/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND While the list of fusion-driven soft tissue neoplasms is expanding rapidly, their importance among cutaneous and superficial mesenchymal and adnexal neoplasms remains poorly understood. This challenge is especially evident in cases with ambiguous histopathology that are difficult to classify based on morphology. AIMS Our goal was to investigate the benefits of next-generation sequencing in diagnosing complex cutaneous neoplasms. MATERIALS & METHODS Departmental archives were searched for fusion-driven cutaneous neoplasms. Slides were retrieved and clinical information including follow-up was obtained. RESULTS Fifteen cases occurred in eight female and seven male patients, with a median age of 26 years (range: 1-83) at diagnosis. Tumors involved the extremities (9), scalp (5), and head and neck (1). Predominant features included myoepithelial (5), nested spindled with clear cytoplasm (2), atypical adnexal/squamoid (2), small round blue cell (2), cellular spindled (3), and fibrohistiocytic morphology (1). Most frequently encountered fusions involved EWSR1 (6) fused to ERG (1), FLI1 (1), CREB1 (2), CREM (1), PBX3 (1), followed by PLAG1 (4) with LIFR (2), TRPS1 (1) and CHCHD7. Additional fusions encountered were YAP1::NUTM1, EML4::ALK, SS18::SSX1 (2), and a novel fusion: ACTB::ZMIZ2. Integration of histologic features and molecular findings led to final diagnoses of primary cutaneous Ewing sarcoma (2), soft tissue myoepithelioma (4), cutaneous syncytial myoepithelioma (1), cutaneous adnexal carcinoma (1), porocarcinoma (1), inflammatory myofibroblastic tumor (1), synovial sarcoma (2), clear cell sarcoma (2), and angiomatoid fibrous histiocytoma (1). DISCUSSION AND CONCLUSION Our results show that fusion testing can be a helpful diagnostic tool, especially in cases with unusual or uncommon morphology in superficial sites. Furthermore, it can allow for the identification of potential therapeutic targets in some instances.
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Affiliation(s)
- Carina A Dehner
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Anatomic Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Emma F Johnson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Carrie N Wieland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J Camilleri
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Andre M Oliveira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin C Halling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ruifeng Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA
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Martinsen E, Jinnurine T, Subramani S, Rogne M. Advances in RNA therapeutics for modulation of 'undruggable' targets. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2024; 204:249-294. [PMID: 38458740 DOI: 10.1016/bs.pmbts.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Over the past decades, drug discovery utilizing small pharmacological compounds, fragment-based therapeutics, and antibody therapy have significantly advanced treatment options for many human diseases. However, a major bottleneck has been that>70% of human proteins/genomic regions are 'undruggable' by the above-mentioned approaches. Many of these proteins constitute essential drug targets against complex multifactorial diseases like cancer, immunological disorders, and neurological diseases. Therefore, alternative approaches are required to target these proteins or genomic regions in human cells. RNA therapeutics is a promising approach for many of the traditionally 'undruggable' targets by utilizing methods such as antisense oligonucleotides, RNA interference, CRISPR/Cas-based genome editing, aptamers, and the development of mRNA therapeutics. In the following chapter, we will put emphasis on recent advancements utilizing these approaches against challenging drug targets, such as intranuclear proteins, intrinsically disordered proteins, untranslated genomic regions, and targets expressed in inaccessible tissues.
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Affiliation(s)
| | | | - Saranya Subramani
- Pioneer Research AS, Oslo Science Park, Oslo, Norway; Department of Pharmacy, Section for Pharmacology and Pharmaceutical Biosciences, University of Oslo, Oslo, Norway
| | - Marie Rogne
- Pioneer Research AS, Oslo Science Park, Oslo, Norway; Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Zota V, Siegal GP, Kelly D, Bridge JA, Berglund A, Bui K, Khalil F, R Reed D, Altiok S, Magliocco A, Bui MM. Validation of PRKCB Immunohistochemistry as a Biomarker for the Diagnosis of Ewing Sarcoma. Fetal Pediatr Pathol 2023; 42:241-252. [PMID: 36062956 DOI: 10.1080/15513815.2022.2117579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: Ewing sarcoma (ES) can be confirmed by identifying the EWSR1-FLI1 fusion transcript. This study is to investigate whether immunostaining (IHC) of PRKCB-a protein directly regulated by EWSR1-FLI1 is a surrogate maker for diagnosing ES in routine practice. Methods: Microarray gene expression analyses were conducted. RKCB IHC was applied to 69 ES confirmed by morphology and molecular methods, and 41 non-Ewing small round cell tumors. EWSR1 rearrangement, EWSR1-FLI1 fusion or t(11;22)(q24;q12) were identified by fluorescence in situ hybridization, reverse transcriptase polymerase chain reaction, or cytogenetic analysis, respectively. Results: Gene array analyses showed significant overexpression of the PRKCB in ES. PRKCB IHC was positive in 19 cases of ES with EWSR1-FLI1 fusion, 3 cases with cytogenetic 11:22 translocation and 59 cases with EWSR1 rearrangement while negative in only one EWSR1 rearranged case. PRKCB IHC is sensitive (98%) and specific (96%) in detecting EWSR1 rearranged ES. Conclusions: PRKCB is a reliable antibody for diagnosing ES in routine practice.
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Affiliation(s)
- Victor Zota
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Kelly
- Department of Pathology and Laboratory, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julia A Bridge
- Molecular Pathology, ProPath, Dallas, TX, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anders Berglund
- Biostatistics and Bioinformatics Core, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Katherine Bui
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Farah Khalil
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Damon R Reed
- Department of Individualized Cancer Management, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Soner Altiok
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Anthony Magliocco
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Marilyn M Bui
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
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ETV6 dependency in Ewing sarcoma by antagonism of EWS-FLI1-mediated enhancer activation. Nat Cell Biol 2023; 25:298-308. [PMID: 36658219 PMCID: PMC10101761 DOI: 10.1038/s41556-022-01060-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/24/2022] [Indexed: 01/21/2023]
Abstract
The EWS-FLI1 fusion oncoprotein deregulates transcription to initiate the paediatric cancer Ewing sarcoma. Here we used a domain-focused CRISPR screen to implicate the transcriptional repressor ETV6 as a unique dependency in this tumour. Using biochemical assays and epigenomics, we show that ETV6 competes with EWS-FLI1 for binding to select DNA elements enriched for short GGAA repeat sequences. Upon inactivating ETV6, EWS-FLI1 overtakes and hyper-activates these cis-elements to promote mesenchymal differentiation, with SOX11 being a key downstream target. We show that squelching of ETV6 with a dominant-interfering peptide phenocopies these effects and suppresses Ewing sarcoma growth in vivo. These findings reveal targeting of ETV6 as a strategy for neutralizing the EWS-FLI1 oncoprotein by reprogramming of genomic occupancy.
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Li J, Nie F, Li Y. Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review. BMC Urol 2022; 22:197. [PMID: 36451163 PMCID: PMC9710127 DOI: 10.1186/s12894-022-01146-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 11/08/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumours(EWS/pPNETs) of the kidney are rare. Signs and symptoms are atypical in EWS patients. Presenting symptoms include haematuria, abdominal pain, or a palpable mass. A comprehensive review of the literature shows that it is difficult to make an accurate diagnosis based on physical examination alone. The imaging findings of EWS/pPNETs are nonspecific. We used contrast-enhanced ultrasound (CEUS) to diagnose an EWS/pPNET in our patient, which had never been reported previously to our knowledge. CASE PRESENTATION This article reports the case of a 20-year-old female with an abdominal mass and gross haematuria for 1 month. The ultrasound revealed a hypoechoic mass with a clear margin at the lower pole in the left kidney. CEUS demonstrated signs of annular enhancement and heterogeneous enhancement of the tumour, and simultaneous wash-in was predominant. Computed tomography images showed an elliptical low-density tumour. The patient underwent a left kidney resection, and the pathological diagnosis was an EWS/pPNET. Twenty-one days after the kidney operation, the patient underwent 8 cycles of a CAV (vinorelbine, ifosfamide, epirubicin) + IE (isocyclophosphamide, etoposide) chemotherapy regimen. Subsequently, radiotherapy (dose: 45 Gy, radiation field:the tumour bed following surgical resection) was administered for nearly 30 days. The patient had no signs of local recurrence or metastasis within a follow-up of 4 years. CONCLUSIONS As a radiation-free, inexpensive, convenient, and repeatable examination method, ultrasound was the primary choice for kidney examination. Early CEUS was helpful to make an accurate diagnosis. Surgery and adjuvant radiation or chemotherapy administered in a timely manner can prevent further deterioration.
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Affiliation(s)
- Jing Li
- grid.411294.b0000 0004 1798 9345Ultrasound Medicine Center, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030 Gansu China
| | - Fang Nie
- grid.411294.b0000 0004 1798 9345Ultrasound Medicine Center, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030 Gansu China
| | - Yan Li
- grid.411294.b0000 0004 1798 9345Ultrasound Medicine Center, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030 Gansu China
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Molecular classification of soft tissue sarcomas for adequate diagnosis: A study on the northeast population of Morocco. Heliyon 2022; 8:e10673. [PMID: 36164527 PMCID: PMC9508571 DOI: 10.1016/j.heliyon.2022.e10673] [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: 02/09/2022] [Revised: 06/24/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background Soft tissue sarcomas (STS) are a heterogeneous group of tumors. For adequate therapeutic management, an accurate diagnosis is necessary. In Morocco, the diagnosis is essentially based on the morphological and immunohistochemical study. Compared to other techniques, fluorescence in situ hybridization (FISH) is easier to develop and less expensive. This study aims to assess the feasibility and utility of implementing FISH technique to improve diagnostic accuracy and establish a good classification. Material and methods This is a retrospective cohort study. 211 cases of mesenchymal tumors were included. Hematoxylin Eosin Safran (HES) staining was performed in all cases followed by immunohistochemistry (IHC). FISH was performed in all cases with suspected STS. The probes used were EWSR1, MDM2 and SS18. The performance of FISH and histopathological test were evaluated by the ROC curve method (receiver operating characteristic). We evaluated the concordance between FISH and real time PCR by Cohen test. Results The real-time PCR technique showed good agreement with the FISH test by a Kappa coefficient of 60% (p = 0.035). FISH was able to confirm that it is more accurate (Youden's Index = 91%) than histological/immunohistochemical analysis (Youden's Index = 51%), as well as the positive predictive value was higher (100%) with an ROC curve finding a larger area under the curve of 0.953 (95% CI: 0.918-0.988), p = 0.000 which supports that FISH shows high performance to present an accurate final diagnosis. Conclusion This is the first and the largest Moroccan series for the molecular diagnosis of STS by FISH. Our study shows that paraffin FISH is a sensitive and specific ancillary tool in the diagnosis of STS when used in the appropriate clinicopathological context.
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Muralidhar D, Vasugi GA, Sundaram S. Incidence and Demographic Profile of Ewings Sarcoma: Experience From a Tertiary Care Hospital. Cureus 2021; 13:e18339. [PMID: 34722090 PMCID: PMC8551935 DOI: 10.7759/cureus.18339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction Ewing sarcoma (ES) family of tumors (EFT) represents the second most common primary bone malignancy affecting children and adolescents after osteosarcoma. The tumor is characteristically associated with a chromosomal translocation resulting in a fusion transcript (EWSR1-FLI1). However, new molecular techniques have significantly transformed our understanding of this rare disease. The present study aims to analyze the incidence and demographic profile of Ewings sarcoma with an insight into the recent updates of the Ewing sarcoma (ES) family of tumors (EFT). Materials and methods All cases of Ewings sarcoma/peripheral neuroectodermal tumor (PNET) presented at a tertiary care center in South India from January 2010-December 2020 were included in this study. The demographic profile and patient details were obtained from the medical records section. Pathology reports of the included cases were retrieved, and associated factors were analyzed, including immunohistochemical studies and molecular workup. Results Out of the 58 cases included in the study, 30 cases (52%) were children and adolescents (< 20 years) and the rest 28 cases (48%) were adults. The mean age was 22.56. Female preponderance was noted, with 32 cases (56%) being females and 26 cases (44%) were males. The location of the tumor was variable. Twenty-five (25) cases (44%) were found in bones such as the clavicle, tibia, and mandible. Seven cases were seen on the anterior chest wall. Other sites included the oropharynx, lungs, endobronchial, infrascapular region, retroperitoneum, and thighs. One case presented as metastatic Ewings sarcoma with divergent differentiation in lungs with the primary site of the tumor being the right humerus. Immunohistochemical (IHC) studies were done on 55 of the 58 tumors. Forty-six (46) cases (80.9%) were CD99 positive and 41 cases(71.4%) were FLI-1 positive. Eleven (11) cases were both CD 99 and FLI-1 positive. NKX2.2, a recent IHC marker, was positive in six cases. Conclusion Ewings sarcoma has a peak incidence in the second decade of life with a propensity toward the axial skeletal location. Understanding the pathobiology and molecular updates of ES is significant to differentiate them from aggressive round cell sarcomas. They not only aid in predicting the prognosis of these aggressive tumors but also guide in therapy.
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Affiliation(s)
- Deeksha Muralidhar
- Pathology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, IND
| | - Gramani Arumugam Vasugi
- Pathology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, IND
| | - Sandhya Sundaram
- Pathology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, IND
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Kumar TKJ, Pai PK, Rajasubramanya P. A Rare Case of Ewing's-like Adamantinoma of Tibia Managed by Limb Salvage Surgery Using Long Segment Ilizarov Bone Transport: A Case Report and Review of Literature. J Orthop Case Rep 2021; 11:61-67. [PMID: 34557442 PMCID: PMC8422014 DOI: 10.13107/jocr.2021.v11.i05.2208] [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] [Indexed: 11/30/2022] Open
Abstract
Introduction Adamantinoma is a rare low-grade malignant tumor in young adults. Recent advances in molecular techniques have shown different variants with discordance between genotype and phenotype. This poses a challenge in diagnosis and management. Ewing’s-like adamantinoma is one such variant. The appropriate treatment protocol for this dedifferentiated tumor remains to be established. Here, we present a rare case of Ewing’s-like Adamantinoma treated with limb salvage surgery using three step Ilizarov technique with good results. Case Report A 38-year-old lady presented at our OPD complaining of recent onset pain and gradual increase in size over a long standing swelling in the right lower tibia. Radiologically was diagnosed as Ewing’s but was not responsive to chemotherapy. A Tru-Cut biopsy showed histological picture of dedifferentiated adamantinoma. Immunohistochemistry showed CD99 positivity. FISH revealed (11;22) translocation confirming Ewing’s-like adamantinoma. She was managed with wide excision followed by staged Ilizarov distraction-osteogenesis and bone transport to correct the 13 cm discrepancy in bone length. There have been no signs of recurrence on post-resection follow-up of 2 years. Patient attained full range of knee and ankle movements. Conclusion The controversy as to what constitutes the difference between adamantinoma-like Ewing’s and Ewing’s-like adamantinoma persists despite technological advances. The appropriate treatment protocol remains to be established. Ilizarov three step techniques provide a feasible alternative to amputation while circumventing the difficulties of large bone reconstruction in the distal tibia.
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Affiliation(s)
- T K Jeejesh Kumar
- Department of Orthopedics, Government Medical College, Kozhikode, Kerala, India
| | - Puneeth K Pai
- Department of Orthopedics, Government Medical College, Kozhikode, Kerala, India
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Kamimura YR, Kanai M. Chemical Insights into Liquid-Liquid Phase Separation in Molecular Biology. BULLETIN OF THE CHEMICAL SOCIETY OF JAPAN 2021. [DOI: 10.1246/bcsj.20200397] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Yugo R. Kamimura
- Graduate School of Pharmaceutical Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Motomu Kanai
- Graduate School of Pharmaceutical Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Schulz RE, de Lima MHA, Lopes RN, Pinto CAL, Nicolau UR, Araujo JP. A rare case of Ewing sarcoma metastasis to the oral cavity. Imaging Sci Dent 2021; 51:217-222. [PMID: 34235068 PMCID: PMC8219447 DOI: 10.5624/isd.20200318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/31/2020] [Accepted: 01/14/2021] [Indexed: 11/18/2022] Open
Abstract
Ewing sarcoma in the head and neck is rare, and metastasis from other bones to the mandible accounts for 0.7% of cases. This report presents a case of oral metastasis in a 24-year-old male patient diagnosed with Ewing sarcoma of the femur (p53 gene mutation and EWSR1-ERG fusion). The chief complaint was numbness in the mandible and pain for 1 month and a hardened, ulcerated exophytic lesion in the right retromolar region. Imaging exams revealed an unspecified thinning of the cortical bone of the inferior alveolar canal in the right mandibular ramus, associated with erosion of the alveolar bone. Histopathological analysis confirmed metastasis of Ewing sarcoma. The patient presented an aggressive disease progression and died 1 month after the oral diagnosis. It is important to recognize the signs and symptoms compatible with rare clinical outcomes, leading to an early diagnosis that can improve patients' quality of life and survival.
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Affiliation(s)
- Riéli Elis Schulz
- Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
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Goh TC, Bajuri MY, Yusof MF, Mohd Apandi H, Sarifulnizam FA. Ewing's Sarcoma of the Vertebral Body in an Adolescent: A Rare Case Report and Literature Review. Cureus 2021; 13:e13664. [PMID: 33824815 PMCID: PMC8017601 DOI: 10.7759/cureus.13664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We report the case of a 14-year-old girl who presented with a one-month history of back pain and bilateral lower limb weakness preceded by constitutional symptoms. She neither had a family history of malignancy nor a previous history of trauma. A series of imaging procedures revealed an aggressive lesion of the T12 vertebra with a large soft-tissue component and intraspinal extension leading to spinal cord compression causing cord edema. She underwent urgent posterior instrumentation and fixation of T9 to T12 vertebrae due to worsening neurological deficits. Adjuvant and neoadjuvant chemotherapy with palliative spinal stabilisation were also performed. Features of the lesion were highly consistent with ES on immunohistochemical study and fluorescence in situ hybridization (FISH) analysis for the EWSR1 gene. Postoperatively, both of her lower limbs improved in power and she benefited from regular physiotherapy.
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Affiliation(s)
- Teik Chiang Goh
- Orthopaedics and Traumatology, Hospital Melaka, Melaka City, MYS
| | - Mohd Yazid Bajuri
- Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | | | - Husna Mohd Apandi
- Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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p21-activated kinases as viable therapeutic targets for the treatment of high-risk Ewing sarcoma. Oncogene 2021; 40:1176-1190. [PMID: 33414491 DOI: 10.1038/s41388-020-01600-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/23/2020] [Accepted: 12/02/2020] [Indexed: 01/04/2023]
Abstract
Ewing sarcoma (ES) is the second most common bone tumor in children and young adults. Unfortunately, there have been minimal recent advancements in improving patient outcomes, especially in metastatic and recurrent diseases. In this study, we investigated the biological role of p21-activated kinases (PAKs) in ES, and the ability to therapeutically target them in high-risk disease. Via informatics analysis, we established the inverse association of PAK1 and PAK4 expression with clinical stage and outcome in ES patients. Through expression knockdown and small-molecule inhibition of PAKs, utilizing FRAX-597, KPT-9274, and PF-3758309 in multiple ES cell lines and patient-derived xenograft models, we further explored the role of PAKs in ES tumor growth and metastatic capabilities. In vitro studies in several ES cell lines indicated that diminishing PAK1 and PAK4 expression reduces tumor cell viability, migratory, and invasive properties. In vivo studies using PAK4 inhibitors, KPT-9274 and PF-3758309 demonstrated significant inhibition of primary and metastatic tumor formation, while transcriptomic analysis of PAK4-inhibitor-treated tumors identified concomitant suppression of Notch, β-catenin, and hypoxia-mediated signatures. In addition, the analysis showed enrichment of anti-tumor immune regulatory mechanisms, including interferon (IFN)-ɣ and IFN-α responses. Altogether, our molecular and pre-clinical studies are the first to establish a critical role for PAKs in ES development and progression, and consequently as viable therapeutic targets for the treatment of high-risk ES in the near future.
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Molecular Genetics in the Multidisciplinary Management of Sarcoma. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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14
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Immunohistochemistry in Bone and Soft Tissue Tumours. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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15
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Tran V, Slavin J. Bone Tumour Pathology. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Suzuki T. [Research on Analysis of Final Diagnosis and Prognostic Factors, and Development of New Therapeutic Drugs for Malignant Tumors (Especially Malignant Pediatric Tumors)]. YAKUGAKU ZASSHI 2020; 140:229-271. [PMID: 32009046 DOI: 10.1248/yakushi.19-00178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Outcomes of treatment for malignant pediatric tumors including leukemia are improving by conventional multimodal treatment with strong chemotherapy, surgical resection, radiotherapy, and bone marrow transplantation. However, patients with advanced neuroblastoma, metastatic Ewing's sarcoma family of tumor (ESFT), and metastatic osteosarcoma continue to have an extremely poor prognosis. Therefore novel therapeutic strategies are urgently needed to improve their survival. Apoptotic cell death is a key mechanism for normal cellular homeostasis. Intact apoptotic mechanisms are pivotal for embryonic development, tissue remodeling, immune regulation, and tumor regression. Genetic aberrations disrupting programmed cell death often underpin tumorigenesis and drug resistance. Moreover, it has been suggested that apoptosis or cell differentiation proceeds to spontaneous regression in early stage neuroblastoma. Therefore apoptosis or cell differentiation is a critical event in this cancer. We extracted many compounds from natural plants (Angelica keiskei, Alpinia officiarum, Lycaria puchury-major, Brassica rapa) or synthesized cyclophane pyridine, indirubin derivatives, vitamin K3 derivatives, burchellin derivatives, and GANT61, and examined their effects on apoptosis, cell differentiation, and cell cycle in neuroblastoma and ESFT cell lines compared with normal cells. Some compounds were very effective against these tumor cells. These results suggest that they may be applicable as an efficacious and safe drug for the treatment of malignant pediatric tumors.
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Affiliation(s)
- Takashi Suzuki
- Laboratory of Clinical Medicine, School of Pharmacy, Nihon University
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Amin HM, Morani AC, Daw NC, Lamhamedi-Cherradi SE, Subbiah V, Menegaz BA, Vishwamitra D, Eskandari G, George B, Benjamin RS, Patel S, Song J, Lazar AJ, Wang WL, Kurzrock R, Pappo A, Anderson PM, Schwartz GK, Araujo D, Cuglievan B, Ratan R, McCall D, Mohiuddin S, Livingston JA, Molina ER, Naing A, Ludwig JA. IGF-1R/mTOR Targeted Therapy for Ewing Sarcoma: A Meta-Analysis of Five IGF-1R-Related Trials Matched to Proteomic and Radiologic Predictive Biomarkers. Cancers (Basel) 2020; 12:cancers12071768. [PMID: 32630797 PMCID: PMC7408058 DOI: 10.3390/cancers12071768] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/29/2022] Open
Abstract
Background : Ten to fourteen percent of Ewing sarcoma (ES) study participants treated nationwide with IGF-1 receptor (IGF-1R)-targeted antibodies achieved tumor regression. Despite this success, low response rates and short response durations (approximately 7-weeks) have slowed the development of this therapy. Methods: We performed a meta-analysis of five phase-1b/2 ES-oriented trials that evaluated the anticancer activity of IGF-1R antibodies +/− mTOR inhibitors (mTORi). Our meta-analysis provided a head-to-head comparison of the clinical benefits of IGF-1R antibodies vs. the IGF-1R/mTOR-targeted combination. Available pretreatment clinical samples were semi-quantitatively scored using immunohistochemistry to detect proteins in the IGF-1R/PI3K/AKT/mTOR pathway linked to clinical response. Early PET/CT imaging, obtained within the first 2 weeks (median 10 days), were examined to determine if reduced FDG avidity was predictive of progression-free survival (PFS). Results: Among 56 ES patients treated at MD Anderson Cancer Center (MDACC) with IGF-1R antibodies, our analysis revealed a significant ~two-fold improvement in PFS that favored a combination of IGF-1R/mTORi therapy (1.6 vs. 3.3-months, p = 0.042). Low pIGF-1R in the pretreatment specimens was associated with treatment response. Reduced total-lesion glycolysis more accurately predicted the IGF-1R response than other previously reported radiological biomarkers. Conclusion: Synergistic drug combinations, and newly identified proteomic or radiological biomarkers of IGF-1R response, may be incorporated into future IGF-1R-related trials to improve the response rate in ES patients.
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Affiliation(s)
- Hesham M. Amin
- Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (H.M.A.); (D.V.); (G.E.); (B.G.)
| | - Ajaykumar C. Morani
- Department of Nuclear Medicine, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Najat C. Daw
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.C.D.); (B.C.); (D.M.); (S.M.)
| | - Salah-Eddine Lamhamedi-Cherradi
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics, 7Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (V.S.); (A.N.)
| | - Brian A. Menegaz
- Baylor College of Medicine, Department of Surgery, Breast Surgical Oncology, Houston, TX 77030, USA; (B.A.M.); (E.R.M.)
| | - Deeksha Vishwamitra
- Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (H.M.A.); (D.V.); (G.E.); (B.G.)
| | - Ghazaleh Eskandari
- Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (H.M.A.); (D.V.); (G.E.); (B.G.)
| | - Bhawana George
- Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (H.M.A.); (D.V.); (G.E.); (B.G.)
| | - Robert S. Benjamin
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
| | - Shreyaskumar Patel
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
| | - Juhee Song
- Department of Biostatistics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Alexander J. Lazar
- Department of Pathology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (A.J.L.); (W.-L.W.)
| | - Wei-Lien Wang
- Department of Pathology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (A.J.L.); (W.-L.W.)
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, University of California San Diego (UCSD) Moores Cancer Center, San Diego, CA 92037, USA;
| | - Alberto Pappo
- Department of Pathology, St. Jude’s Cancer Research Hospital, Memphis, TN 38105, USA;
| | | | - Gary K. Schwartz
- Division of Hematology & Oncology, Columbia University Medical Center, New York, NY 10032, USA;
| | - Dejka Araujo
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
| | - Branko Cuglievan
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.C.D.); (B.C.); (D.M.); (S.M.)
| | - Ravin Ratan
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
| | - David McCall
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.C.D.); (B.C.); (D.M.); (S.M.)
| | - Sana Mohiuddin
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.C.D.); (B.C.); (D.M.); (S.M.)
| | - John A. Livingston
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
| | - Eric R. Molina
- Baylor College of Medicine, Department of Surgery, Breast Surgical Oncology, Houston, TX 77030, USA; (B.A.M.); (E.R.M.)
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, 7Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (V.S.); (A.N.)
| | - Joseph A. Ludwig
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.-E.L.-C.); (R.S.B.); (S.P.); (D.A.); (R.R.); (J.A.L.)
- Correspondence: ; Tel.: +1-(713)-792-3626
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18
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Costa IE, Sousa Menezes A, Lima AF, Rodrigues B. Extra-skeletal Ewing's sarcoma of the frontal sinus: a rare disorder in pediatric age. BMJ Case Rep 2020; 13:13/5/e232460. [PMID: 32439742 DOI: 10.1136/bcr-2019-232460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Paediatric sinonasal tumours comprise numerous aetiologies. Ewing's sarcoma (ES) consists of a malignancy of neuroectodermal origin. This type of sarcoma affects mainly children and adolescents and can assume the skeletal or extra-skeletal form. Primary ES of head and neck is extremely rare, accounting for only 4%-9% of all cases. So far, as much as we know, only a few cases of sinonasal ES have been reported in literature. The authors present a case of a previous healthy 12-year-old girl who presented with a rapidly growing and expansive frontal mass and unilateral nasal obstruction. Immunohistochemical, molecular and cytogenetic analysis of the lesion showed diffuse expression of CD56 and CD99 on tumour cells and a translocation involving chromosome 22q12, confirming ES diagnosis.
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Affiliation(s)
- Isabel Esteves Costa
- Department of Otorhinolaryngology and Head & Neck Surgery, Hospital de Braga, Braga, Portugal
| | - Ana Sousa Menezes
- Department of Otorhinolaryngology and Head & Neck Surgery, Hospital de Braga, Braga, Portugal
| | - Antonio Fontes Lima
- Department of Otorhinolaryngology and Head & Neck Surgery, Hospital de Braga, Braga, Portugal
| | - Berta Rodrigues
- Department of Otorhinolaryngology and Head & Neck Surgery, Hospital de Braga, Braga, Portugal
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19
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Chrzanowska NM, Kowalewski J, Lewandowska MA. Use of Fluorescence In Situ Hybridization (FISH) in Diagnosis and Tailored Therapies in Solid Tumors. Molecules 2020; 25:molecules25081864. [PMID: 32316657 PMCID: PMC7221545 DOI: 10.3390/molecules25081864] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/05/2020] [Accepted: 04/10/2020] [Indexed: 11/16/2022] Open
Abstract
Fluorescence in situ hybridization (FISH) is a standard technique used in routine diagnostics of genetic aberrations. Thanks to simple FISH procedure is possible to recognize tumor-specific abnormality. Its applications are limited to designed probe type. Gene rearrangements e.g., ALK, ROS1 reflecting numerous translocational partners, deletions of critical regions e.g., 1p and 19q, gene fusions e.g., COL1A1-PDGFB, genomic imbalances e.g., 6p, 6q, 11q and amplifications e.g., HER2 are targets in personalized oncology. Confirmation of genetic marker is frequently a direct indication to start specific, targeted treatment. In other cases, detected aberration helps pathologists to better distinguish soft tissue sarcomas, or to state a final diagnosis. Our main goal is to show that applying FISH to formalin-fixed paraffin-embedded tissue sample (FFPE) enables assessing genomic status in the population of cells deriving from a primary tumor or metastasis. Although many more sophisticated techniques are available, like Real-Time PCR or new generation sequencing, FISH remains a commonly used method in many genetic laboratories.
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Affiliation(s)
- Natalia Magdalena Chrzanowska
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland;
| | - Janusz Kowalewski
- Department of Thoracic Surgery and Tumors, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-067 Torun, Poland;
| | - Marzena Anna Lewandowska
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland;
- Department of Thoracic Surgery and Tumors, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-067 Torun, Poland;
- Correspondence: ; Tel.: +48-52-3743030
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20
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Yan D, Zhang J, Zhong D. Ewing's sarcoma in the spinal canal of T12-L3: A case report and review of the literature. Oncol Lett 2019; 18:6157-6163. [PMID: 31788090 PMCID: PMC6865001 DOI: 10.3892/ol.2019.10958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 09/11/2019] [Indexed: 02/01/2023] Open
Abstract
Primary Ewing's sarcoma (ES) is rare, especially when it occurs in the spinal canal during middle or old age. The rarity of Ewing's sarcoma breakpoint region 1 fusion-negative ES has been reported in the literature. The present case report describes a 60-year-old Chinese patient who was diagnosed with ES originating from the spinal canal in 2016. The patient was hospitalized with pain resembling electric shock in the waist and buttocks, which occurred intermittently for 1 month, and incontinence for 1 week. Magnetic resonance imaging demonstrated multiple inhomogeneous, oval-shaped nodules in the intradural and cauda equina spaces of T12-L3. The largest nodule was ~23×11×10 mm. The patient underwent right adrenal tumour resection. A histopathologic examination of the focal area revealed that the tumour consisted of small, circular haematoxylin stained cells that formed typical Homer-Wright rosettes. Immunohistochemical analysis confirmed that the patient suffered from ES due to positive staining for membranous cluster of differentiation 99 (CD99), cytokeratin (CK) and nuclear foetal-liver infusion 1 (FLI-1). In conclusion, the histopathological presence of Homer-Wright rosettes and immunohistochemical markers such as CD99, FLI-1 and CK are valuable factors for the diagnosis of ES, although cytogenetic analysis is considered the gold standard. Complete surgery is the most effective treatment option for ES treatment. Adjuvant radiotherapy and combination chemotherapy can also improve the survival rate of patients postoperatively.
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Affiliation(s)
- Dajun Yan
- Neurosurgical Research Institute, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong 510060, P.R. China
| | - Jie Zhang
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, Guangdong 510000, P.R. China
| | - Dequan Zhong
- Neurosurgical Research Institute, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong 510060, P.R. China
- Correspondence to: Dr Dequan Zhong, Neurosurgical Research Institute, The First Affiliated Hospital of Guangdong Pharmaceutical University, 19 Nonglin Xia Road, Guangzhou, Guangdong 510060, P.R. China, E-mail:
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21
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Kaul T, Lotterman C, Warrier R. Adolescent With Down Syndrome Who Refuses to Walk. Clin Pediatr (Phila) 2019; 58:1357-1359. [PMID: 31402688 DOI: 10.1177/0009922819868685] [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: 11/15/2022]
Affiliation(s)
| | | | - Rajasekharan Warrier
- Ochsner Children's Hospital, New Orleans, LA, USA.,University of Queensland, Brisbane, Queensland, Australia
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22
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Puerto-Camacho P, Amaral AT, Lamhamedi-Cherradi SE, Menegaz BA, Castillo-Ecija H, Ordóñez JL, Domínguez S, Jordan-Perez C, Diaz-Martin J, Romero-Pérez L, Lopez-Alvarez M, Civantos-Jubera G, Robles-Frías MJ, Biscuola M, Ferrer C, Mora J, Cuglievan B, Schadler K, Seifert O, Kontermann R, Pfizenmaier K, Simón L, Fabre M, Carcaboso ÁM, Ludwig JA, de Álava E. Preclinical Efficacy of Endoglin-Targeting Antibody-Drug Conjugates for the Treatment of Ewing Sarcoma. Clin Cancer Res 2018; 25:2228-2240. [PMID: 30420447 DOI: 10.1158/1078-0432.ccr-18-0936] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/13/2018] [Accepted: 11/06/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Endoglin (ENG; CD105) is a coreceptor of the TGFβ family that is highly expressed in proliferating endothelial cells. Often coopted by cancer cells, ENG can lead to neo-angiogenesis and vasculogenic mimicry in aggressive malignancies. It exists both as a transmembrane cell surface protein, where it primarily interacts with TGFβ, and as a soluble matricellular protein (sENG) when cleaved by matrix metalloproteinase 14 (MMP14). High ENG expression has been associated with poor prognosis in Ewing sarcoma, an aggressive bone cancer that primarily occurs in adolescents and young adults. However, the therapeutic value of ENG targeting has not been fully explored in this disease. EXPERIMENTAL DESIGN We characterized the expression pattern of transmembrane ENG, sENG, and MMP14 in preclinical and clinical samples. Subsequently, the antineoplastic potential of two novel ENG-targeting monoclonal antibody-drug conjugates (ADC), OMTX503 and OMTX703, which differed only by their drug payload (nigrin-b A chain and cytolysin, respectively), was assessed in cell lines and preclinical animal models of Ewing sarcoma. RESULTS Both ADCs suppressed cell proliferation in proportion to the endogenous levels of ENG observed in vitro. Moreover, the ADCs significantly delayed tumor growth in Ewing sarcoma cell line-derived xenografts and patient-derived xenografts in a dose-dependent manner. CONCLUSIONS Taken together, these studies demonstrate potent preclinical activity of first-in-class anti-ENG ADCs as a nascent strategy to eradicate Ewing sarcoma.
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Affiliation(s)
- Pilar Puerto-Camacho
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Ana Teresa Amaral
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | | | - Brian A Menegaz
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Helena Castillo-Ecija
- Institut de Recerca Sant Joan de Déu, Pediatric Hematology and Oncology, Hospital Sant Joan de Déu Barcelona, Spain
| | - José Luis Ordóñez
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | | | - Carmen Jordan-Perez
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Juan Diaz-Martin
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Laura Romero-Pérez
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Maria Lopez-Alvarez
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Gema Civantos-Jubera
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - María José Robles-Frías
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Michele Biscuola
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | | | - Jaume Mora
- Institut de Recerca Sant Joan de Déu, Pediatric Hematology and Oncology, Hospital Sant Joan de Déu Barcelona, Spain
| | - Branko Cuglievan
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Keri Schadler
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | - Ángel M Carcaboso
- Institut de Recerca Sant Joan de Déu, Pediatric Hematology and Oncology, Hospital Sant Joan de Déu Barcelona, Spain
| | - Joseph A Ludwig
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas.
| | - Enrique de Álava
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain.
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23
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McArdle DJT, Nott L, Harle R, McArdle JP. Extraosseous Ewing sarcoma arising in a chronically lymphedematous limb. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2018; 4:210-215. [PMID: 30148241 PMCID: PMC6105752 DOI: 10.1016/j.jvscit.2018.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 04/14/2018] [Indexed: 12/30/2022]
Abstract
Ewing sarcoma is a highly aggressive small round cell malignant neoplasm of bone and soft tissue that typically is manifested in children and young adults. It is most commonly a primary bone tumor; however, extraosseous cases have been increasingly reported. We report a case of metastatic extraosseous Ewing sarcoma with the primary lesion occurring within a limb affected by primary lymphedema. Lymphedema, in this case, played a role not only in the genesis of the tumor because of the relative local immunosuppression but also in masking the development of the lower limb mass.
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Affiliation(s)
| | - Louise Nott
- Department of Medical Oncology, Royal Hobart Hospital, Tasmania, Australia
| | - Robin Harle
- Department of Medical Imaging, Royal Hobart Hospital, Tasmania, Australia
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24
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Yoon Y, Park H, Kim S, Nguyen PT, Hyeon SJ, Chung S, Im H, Lee J, Lee SB, Ryu H. Genetic Ablation of EWS RNA Binding Protein 1 (EWSR1) Leads to Neuroanatomical Changes and Motor Dysfunction in Mice. Exp Neurobiol 2018; 27:103-111. [PMID: 29731676 PMCID: PMC5934541 DOI: 10.5607/en.2018.27.2.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/13/2018] [Accepted: 04/13/2018] [Indexed: 12/23/2022] Open
Abstract
A recent study reveals that missense mutations of EWSR1 are associated with neurodegenerative disorders such as amyotrophic lateral sclerosis, but the function of wild-type (WT) EWSR1 in the central nervous system (CNS) is not known yet. Herein, we investigated the neuroanatomical and motor function changes in Ewsr1 knock out (KO) mice. First, we quantified neuronal nucleus size in the motor cortex, dorsal striatum and hippocampus of three different groups: WT, heterozygous Ewsr1 KO (+/−), and homozygous Ewsr1 KO (−/−) mice. The neuronal nucleus size was significantly smaller in the motor cortex and striatum of homozygous Ewsr1 KO (−/−) mice than that of WT. In addition, in the hippocampus, the neuronal nucleus size was significantly smaller in both heterozygous Ewsr1 KO (+/−) and homozygous Ewsr1 KO (−/−) mice. We then assessed motor function of Ewsr1 KO (−/−) and WT mice by a tail suspension test. Both forelimb and hindlimb movements were significantly increased in Ewsr1 KO (−/−) mice. Lastly, we performed immunohistochemistry to examine the expression of TH, DARPP-32, and phosphorylated (p)-DARPP-32 (Thr75) in the striatum and substantia nigra, which are associated with dopaminergic signaling. The immunoreactivity of TH and DARPP-32 was decreased in Ewsr1 KO (−/−) mice. Together, our results suggest that EWSR1 plays a significant role in neuronal morphology, dopaminergic signaling pathways, and motor function in the CNS of mice.
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Affiliation(s)
- Yeojun Yoon
- Yonsei University College of Medicine, Seoul 03722, Korea
| | - Hasang Park
- Yonsei University College of Medicine, Seoul 03722, Korea
| | - Sangyeon Kim
- Yonsei University College of Medicine, Seoul 03722, Korea
| | - Phuong T Nguyen
- Center for Neuromedicine and Neuroscience, Brain Science Institute, Korea Institute of Science and Technology, Seoul 02792, Korea
| | - Seung Jae Hyeon
- Center for Neuromedicine and Neuroscience, Brain Science Institute, Korea Institute of Science and Technology, Seoul 02792, Korea
| | - Sooyoung Chung
- Center for Neuromedicine and Neuroscience, Brain Science Institute, Korea Institute of Science and Technology, Seoul 02792, Korea
| | - Hyeonjoo Im
- Center for Neuromedicine and Neuroscience, Brain Science Institute, Korea Institute of Science and Technology, Seoul 02792, Korea
| | - Junghee Lee
- VA Boston Healthcare System, Boston, MA 02130, USA.,Boston University Alzheimer's Disease Center and Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Sean Bong Lee
- Department of Pathology & Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Hoon Ryu
- Center for Neuromedicine and Neuroscience, Brain Science Institute, Korea Institute of Science and Technology, Seoul 02792, Korea.,VA Boston Healthcare System, Boston, MA 02130, USA.,Boston University Alzheimer's Disease Center and Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
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25
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McBride MJ, Kadoch C. Disruption of mammalian SWI/SNF and polycomb complexes in human sarcomas: mechanisms and therapeutic opportunities. J Pathol 2018; 244:638-649. [PMID: 29359803 DOI: 10.1002/path.5042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 01/01/2023]
Abstract
Soft-tissue sarcomas are increasingly characterized and subclassified by genetic abnormalities that represent underlying drivers of their pathology. Hallmark tumor suppressor gene mutations and pathognomonic gene fusions collectively account for approximately one-third of all sarcomas. These genetic abnormalities most often result in global transcriptional misregulation via disruption of protein regulatory complexes which govern chromatin architecture. Specifically, alterations to mammalian SWI/SNF (mSWI/SNF or BAF) ATP-dependent chromatin remodeling complexes and polycomb repressive complexes cause disease-specific changes in chromatin architecture and gene expression across a number of sarcoma subtypes. Understanding the functions of chromatin regulatory complexes and the mechanisms underpinning their roles in oncogenesis will be required for the design and development of new therapeutic strategies in sarcomas. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Matthew J McBride
- Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Chemical Biology Program, Harvard University, Cambridge, MA, USA
| | - Cigall Kadoch
- Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
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26
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Werner H, Meisel-Sharon S, Bruchim I. Oncogenic fusion proteins adopt the insulin-like growth factor signaling pathway. Mol Cancer 2018; 17:28. [PMID: 29455671 PMCID: PMC5817802 DOI: 10.1186/s12943-018-0807-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 02/05/2018] [Indexed: 02/08/2023] Open
Abstract
The insulin-like growth factor-1 receptor (IGF1R) has been identified as a potent anti-apoptotic, pro-survival tyrosine kinase-containing receptor. Overexpression of the IGF1R gene constitutes a typical feature of most human cancers. Consistent with these biological roles, cells expressing high levels of IGF1R are expected not to die, a quintessential feature of cancer cells. Tumor specific chromosomal translocations that disrupt the architecture of transcription factors are a common theme in carcinogenesis. Increasing evidence gathered over the past fifteen years demonstrate that this type of genomic rearrangements is common not only among pediatric and hematological malignancies, as classically thought, but may also provide a molecular and cytogenetic foundation for an ever-increasing portion of adult epithelial tumors. In this review article we provide evidence that the mechanism of action of oncogenic fusion proteins associated with both pediatric and adult malignancies involves transactivation of the IGF1R gene, with ensuing increases in IGF1R levels and ligand-mediated receptor phosphorylation. Disrupted transcription factors adopt the IGF1R signaling pathway and elicit their oncogenic activities via activation of this critical regulatory network. Combined targeting of oncogenic fusion proteins along with the IGF1R may constitute a promising therapeutic approach.
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Affiliation(s)
- Haim Werner
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel. .,Yoran Institute for Human Genome Research, Tel Aviv University, 69978, Tel Aviv, Israel.
| | - Shilhav Meisel-Sharon
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Ilan Bruchim
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, affiliated with the Technion Institute of Technology, Haifa, Israel
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Bar-Sela G, Peer A, Rothschild S, Haim N. Treatment of Patients Aged over 50 Years with Non-Osseous Ewing's Sarcoma Family Tumors: Five Cases and Review of Literature. TUMORI JOURNAL 2018; 94:809-12. [DOI: 10.1177/030089160809400606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Most clinical trials on Ewing's sarcoma family of tumors include pediatric and adolescent populations, whereas clinical data on older patients are limited. Patients and Methods We report on 5 patients older than 50 years with a tumor of the Ewing's sarcoma family treated recently in our department. Results Myelosuppression and infectious complications were the main toxicity encountered. Major dose reductions and/or treatment delays were required in all 5 patients. One patient died of septic shock. Complete remission was achieved in the remaining 4 patients with the addition of different treatment modalities. One patient had lung metastasis 3 years after starting chemotherapy, and 3 patients have remained without evidence of recurrent disease for 1–6 years from the onset of chemotherapy. Conclusions There is no definite answer as to whether older age is a poor prognostic factor in patients with a tumor of the Ewing's sarcoma family. In our experience, patients over 50 poorly tolerated the standard chemotherapy protocol used in the pediatric population.
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Affiliation(s)
- Gil Bar-Sela
- Division of Oncology, Rambam-Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
| | - Avivit Peer
- Division of Oncology, Rambam-Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
| | - Shelly Rothschild
- Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee District, Israel
| | - Nissim Haim
- Division of Oncology, Rambam-Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
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Alasmari F, Albadawe H, Alkhateeb S, Alsufiani F, Ghandurah S. Primary Ewing's sarcoma of the kidney: A case report. Int J Surg Case Rep 2017; 41:65-67. [PMID: 29040902 PMCID: PMC5645000 DOI: 10.1016/j.ijscr.2017.07.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 11/30/2022] Open
Abstract
This is a 15-year-old female who presented with sudden onset left flank pain associated with nausea and vomiting and a history of weight loss. Radiological investigation revealed a large non-obstructive tumor involving the lower pole of the left kidney which was primarily thought to be a renal cell carcinoma. She underwent left open radical nephrectomy with adrenalectomy. Histopathology of the resected specimen showed features of Ewing's sarcoma of the kidney which was confirmed by cytogenetic analysis. This is a rare disease especially in the pediatric group and in reporting such a rare case we hope it helps in identifying a potential course of the disease and its response to the involved treatment.
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Affiliation(s)
- Faris Alasmari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Hani Albadawe
- Department of Urology, King Abdulaziz Medical City, Saudi Arabia.
| | - Sultan Alkhateeb
- Department of Urology, King Abdulaziz Medical City, Saudi Arabia
| | - Fahd Alsufiani
- Department of Pathology, King Abdulaziz Medical City, Saudi Arabia
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29
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Ahmad I, Chufal KS, Bhargava A, Bashir I. Primitive neuroectodermal tumour of the cervix: a rare diagnosis. BMJ Case Rep 2017; 2017:bcr-2016-217461. [PMID: 28052947 DOI: 10.1136/bcr-2016-217461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A 48-year-old woman presented with symptoms of lower abdominal pain and vaginal discharge for 6 months. Clinical examination and pelvic ultrasound scan suggested a diagnosis of infected Gartner's cyst, for which she underwent vaginal cystectomy. However, histopathology and immunohistochemistry revealed a diagnosis of primitive neuroectodermal tumour of the cervix. Further investigations revealed the stage to be FIGO IIIB, which was inoperable. She received neoadjuvant chemotherapy (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, cisplatin and etoposide, every 21 days), but the tumour did not respond to treatment and she was started on radiotherapy with definitive intent (55.8 Gray in 31 fractions over 6.2 weeks). A PET-CT performed 2 months after completion of radiotherapy showed complete response, and she is now receiving adjuvant chemotherapy.
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Affiliation(s)
- Irfan Ahmad
- Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India
| | - Kundan Singh Chufal
- Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India
| | - Amit Bhargava
- Department of Medical Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India
| | - Irfan Bashir
- Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India
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30
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Mahan MC, Frisch N, Durrant B, Parsons T, Woods T, Mott M. Ewing Sarcoma in the Fifth Metacarpal of an Adult Woman: A Case Report. JBJS Case Connect 2016; 6:e95. [PMID: 29252749 DOI: 10.2106/jbjs.cc.16.00051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE Atypical presentations of Ewing sarcoma (ES) can lead to misdiagnosis and delays in treatment. We present a rare case of ES in the hand of an adult woman who underwent multiple interventions prior to referral to our institution. At 22 months after definitive treatment, the patient remained pleased with the result and had no evidence of recurrence. CONCLUSION To our knowledge, ES of the hand in an adult woman has not yet been reported in the literature, and a lack of recognition of this condition might be secondary to the absence of features traditionally associated with malignant bone neoplasms. A broader differential diagnosis after intervention failures offers the opportunity for diagnosis and appropriate treatment.
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Affiliation(s)
- M Chad Mahan
- Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
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31
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Abstract
Since its foundation by remarkably talented and insightful individuals, prominently including Pepper Dehner, pediatric soft tissue tumor pathology has developed at an immense rate. The morphologic classification of tumoral entities has extensively been corroborated, but has also evolved with refinement or realignment of these classifications, through accruing molecular data, with many derivative ancillary diagnostic assays now already well-established. Tumors of unclear histogenesis, classically morphologically undifferentiated, are prominent amongst pediatric sarcomas, however, the classes of undifferentiated round- or spindle-cell-tumors-not-otherwise-specified are being dismantled gradually with the identification of their molecular underpinnings. Within recent years, for example, numerous subcategories of 'Ewing-like' round cell sarcoma have emerged. Such advances have provided the basis for novel diagnostic and prognostic sub-classifications. Efforts at defining cell- or lineage-of-origin for several tumor types have produced interesting insights especially for rhabdomyosarcoma. The remarkably early onset of pediatric sarcomas defies the theory necessitating stochastic accumulation of several somatic mutations for cancer development and indeed, these tumors may be remarkably genomically stable, often belying their aggressive nature. Much is coming to light recently regarding the role of epigenetic modifications in the evolution of these sarcomas. Indeed the morphologic features of embryonal tumors generally (not just sarcomas) may be highly reminiscent of arrested differentiation, and given the tight epigenetic regulation of cell fate determination and cell identity maintenance, a theory of epigenetically-driven oncogenesis sits easily with these tumors. The age-delimited distinct biologies of 'pediatric' and adult GIST are intriguing, particularly, the SDH-deficient 'pediatric' form, driven by a metabolic defect, but resulting in epigenetic dysregulation with genome-wide DNA methylation changes. There is little doubt that many of the gaps in our understanding of pediatric sarcoma biology will be filled by a deeper appreciation of the role of dysregulated epigenetics including chromatin biology, perhaps best exemplified in malignant rhabdoid tumor. The field of pediatric soft tissue tumor pathology grows ever more interesting. Importantly though, it must be emphasized, that none of this progress could have occurred, or indeed continue, without the initial step of accurate diagnosis, founded solidly on morphology - thank you Pepper for your unparalleled contributions to this field! The opportunity to be your apprentice for five years has been a bigger and more positive influence than words can express.
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Affiliation(s)
- Maureen O'Sullivan
- National Children's Research Centre, Crumlin, Dublin, Ireland; Our Lady's Children's Hospital Crumlin, Dublin, Ireland; Trinity College, Dublin, Ireland.
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32
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Llombart-Bosch A. Ewing's Sarcoma and Peripheral Primitive Neuroectodermal Tumor of Bone and Soft Tissue. Int J Surg Pathol 2016. [DOI: 10.1177/106689699900700401] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The histological diagnosis of Ewing's sarcoma (Es) continues to be a difficult task for pathologists. A number of new Es varieties has been described, leading to further complexity. Conventional Es, atypical Es, and peripheral neuroectodermal tumor (pPNET), including peripheral neuroepithelioma, belong genetically to the same family of neoplasms, displaying common chromosomal rearrangements and analogous gene reorganizations. The main translocations are t(11;22) and t(21;22), with genes EWS, FLI-1 and ERG being involved, as well as other members of the ETS family of transcription factors. The prevalence of morphology should be maintained with the use of conventional histological techniques and supported with the analysis of the expression of CD99 Mic2 (HBA 71, 0.13) antigen, which is present in over 90% of cases, as well as with FLI-1 rearranged gene derived protein. Moreover, FISH and RT-PCR in paraffin-embedded tumor tissue may be of use in extremely difficult cases for differential diagnosis. Nevertheless, a number of mixed tumor types, such as primitive sarcoma or biphenotypic sarcoma, may show structural and genetic diversity, thus rendering their diagnosis even more complex.
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Affiliation(s)
- Antonio Llombart-Bosch
- Department of Pathology, University of Valencia Medical School, Valencia, Spain; Departamento de Patologia, Facultad de Medicina, Avenida Blasco Ibañez 17, Universidad de Valencia, Valencia 46010, Spain
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33
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Ding Y, Huang Z, Ding Y, Jia Z, Gu C, Xue R, Yang J. Primary Ewing's Sarcoma/Primitive Neuroectodermal Tumor of Kidney with Caval Involvement in a Pregnant Woman. Urol Int 2016; 97:365-368. [PMID: 27035149 DOI: 10.1159/000445357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 03/09/2016] [Indexed: 11/19/2022]
Abstract
In this article, we report the case of a woman in whom was found an abdominal mass during pregnancy and who underwent nephrectomy and extraction of the emboli after delivery. The kidney had a volume of 15 × 10 × 8 cm and pathological diagnosis was primary Ewing's sarcoma. The patient was treated with conventional chemotherapy for 1 year after surgery, at which time multiple metastases were found. From this case, we surmise that hormonal changes that occur during pregnancy may accelerate the growth of Ewing's sarcoma of the kidney, suggesting that renal tumors in pregnant women demand serious attention and that anti-cancer treatment should begin as soon as possible.
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Affiliation(s)
- Yinghui Ding
- Department of Urology, Urological Institute of Henan, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
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34
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Grohar PJ, Kim S, Rangel Rivera GO, Sen N, Haddock S, Harlow ML, Maloney NK, Zhu J, O'Neill M, Jones TL, Huppi K, Grandin M, Gehlhaus K, Klumpp-Thomas CA, Buehler E, Helman LJ, Martin SE, Caplen NJ. Functional Genomic Screening Reveals Splicing of the EWS-FLI1 Fusion Transcript as a Vulnerability in Ewing Sarcoma. Cell Rep 2016; 14:598-610. [PMID: 26776507 PMCID: PMC4755295 DOI: 10.1016/j.celrep.2015.12.063] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/30/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022] Open
Abstract
Ewing sarcoma cells depend on the EWS-FLI1 fusion transcription factor for cell survival. Using an assay of EWS-FLI1 activity and genome-wide RNAi screening, we have identified proteins required for the processing of the EWS-FLI1 pre-mRNA. We show that Ewing sarcoma cells harboring a genomic breakpoint that retains exon 8 of EWSR1 require the RNA-binding protein HNRNPH1 to express in-frame EWS-FLI1. We also demonstrate the sensitivity of EWS-FLI1 fusion transcripts to the loss of function of the U2 snRNP component, SF3B1. Disrupted splicing of the EWS-FLI1 transcript alters EWS-FLI1 protein expression and EWS-FLI1-driven expression. Our results show that the processing of the EWS-FLI1 fusion RNA is a potentially targetable vulnerability in Ewing sarcoma cells.
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MESH Headings
- Base Sequence
- Binding Sites
- Calmodulin-Binding Proteins/antagonists & inhibitors
- Calmodulin-Binding Proteins/genetics
- Calmodulin-Binding Proteins/metabolism
- Cell Line, Tumor
- Cell Survival
- Exons
- Gene Expression Regulation, Neoplastic
- Heterogeneous-Nuclear Ribonucleoprotein Group F-H/antagonists & inhibitors
- Heterogeneous-Nuclear Ribonucleoprotein Group F-H/genetics
- Heterogeneous-Nuclear Ribonucleoprotein Group F-H/metabolism
- Humans
- Microfilament Proteins/antagonists & inhibitors
- Microfilament Proteins/genetics
- Microfilament Proteins/metabolism
- Oncogene Proteins, Fusion/antagonists & inhibitors
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Phosphoproteins/antagonists & inhibitors
- Phosphoproteins/genetics
- Phosphoproteins/metabolism
- Proto-Oncogene Protein c-fli-1/antagonists & inhibitors
- Proto-Oncogene Protein c-fli-1/genetics
- Proto-Oncogene Protein c-fli-1/metabolism
- RNA Interference
- RNA Precursors/metabolism
- RNA Splicing
- RNA Splicing Factors
- RNA, Small Interfering/metabolism
- RNA-Binding Protein EWS/antagonists & inhibitors
- RNA-Binding Protein EWS/genetics
- RNA-Binding Protein EWS/metabolism
- RNA-Binding Proteins/antagonists & inhibitors
- RNA-Binding Proteins/genetics
- RNA-Binding Proteins/metabolism
- Receptors, Cytoplasmic and Nuclear/antagonists & inhibitors
- Receptors, Cytoplasmic and Nuclear/genetics
- Receptors, Cytoplasmic and Nuclear/metabolism
- Ribonucleoprotein, U2 Small Nuclear/antagonists & inhibitors
- Ribonucleoprotein, U2 Small Nuclear/genetics
- Ribonucleoprotein, U2 Small Nuclear/metabolism
- Sarcoma, Ewing/pathology
- Trans-Activators
- Transcription Factors/antagonists & inhibitors
- Transcription Factors/genetics
- Transcription Factors/metabolism
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Affiliation(s)
- Patrick J Grohar
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Department of Cancer Biology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Suntae Kim
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Guillermo O Rangel Rivera
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA; NIH Academy, Office of Intramural Training and Education, NIH, Bethesda, MD 20892, USA
| | - Nirmalya Sen
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Sara Haddock
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Matt L Harlow
- Department of Cancer Biology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Nichole K Maloney
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Jack Zhu
- Molecular Genetics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Maura O'Neill
- Protein Characterization Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA
| | - Tamara L Jones
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Konrad Huppi
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Magdalena Grandin
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Kristen Gehlhaus
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Carleen A Klumpp-Thomas
- Trans-NIH RNAi Screening Facility, Division of Preclinical Innovation, National Center for Advancing Translational Sciences, NIH, Rockville, MD 20850, USA
| | - Eugen Buehler
- Trans-NIH RNAi Screening Facility, Division of Preclinical Innovation, National Center for Advancing Translational Sciences, NIH, Rockville, MD 20850, USA
| | - Lee J Helman
- Molecular Oncology Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Scott E Martin
- Trans-NIH RNAi Screening Facility, Division of Preclinical Innovation, National Center for Advancing Translational Sciences, NIH, Rockville, MD 20850, USA
| | - Natasha J Caplen
- Gene Silencing Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA.
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Mashriqi N, Gujjarlapudi JK, Sidhu J, Zur M, Yalamanchili M. Ewing's sarcoma of the cervix, a diagnostic dilemma: a case report and review of the literature. J Med Case Rep 2015; 9:255. [PMID: 26549660 PMCID: PMC4638088 DOI: 10.1186/s13256-015-0733-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/12/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ewing's sarcoma belongs to a spectrum of neoplastic diseases known as Ewing's family of tumors. This family of tumors is usually seen in osseous sites. Ewing's sarcoma of the cervix is extremely rare, with only 18 cases reported in the English literature. The immunohistochemical profile of Ewing's sarcoma overlaps with other malignancies like small cell carcinoma. The rarity and complex pathologic picture of Ewing's sarcoma of the cervix creates the potential for misdiagnosis. Hence, we believe this case needs to be reported to add to the available literature. CASE PRESENTATION A 49-year-old white Caucasian woman presented with vaginal bleeding. A pelvic examination revealed a cystic lesion arising from her cervix. Examination of a biopsy specimen revealed a poorly differentiated neoplasm, with sheets of small hyperchromatic cells, staining weakly for neuroendocrine markers. She was diagnosed with small cell carcinoma and started on concurrent chemotherapy and radiation. However, additional positive immunostaining for CD99 was strongly suggestive of Ewing's sarcoma. Fluorescence in situ hybridization revealed ESWR1 gene rearrangement, confirming Ewing's sarcoma. Our patient underwent surgery, which confirmed stage IIB Ewing's sarcoma. She received adjuvant chemotherapy but died from progressive metastatic disease after four cycles. CONCLUSION With early diagnosis and appropriate treatment, Ewing's sarcoma of the cervix can be a potentially curable disease. However, owing to overlapping clinical and histopathological features, the diagnosis poses a challenge to oncologists and pathologists. This article guides pathologists to consider Ewing's sarcoma in the differential diagnosis of small cell carcinoma with weak staining for neuroendocrine markers. This literature review will benefit oncologists encountering this rare entity.
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Affiliation(s)
- Nazia Mashriqi
- United Health Services Wilson Medical Center, Johnson, NY, 13790, USA. .,Broome Oncology, United Health Services Wilson Medical Center, Johnson, NY, 13790, USA.
| | - Jaya Kranthi Gujjarlapudi
- United Health Services Wilson Medical Center, Johnson, NY, 13790, USA. .,Broome Oncology, United Health Services Wilson Medical Center, Johnson, NY, 13790, USA.
| | - Jagmohan Sidhu
- United Health Services Wilson Medical Center, Johnson, NY, 13790, USA. .,Broome Oncology, United Health Services Wilson Medical Center, Johnson, NY, 13790, USA.
| | - Michael Zur
- Our Lady of Lourdes Hospital, Binghamton, NY, 13905, USA.
| | - Madhuri Yalamanchili
- United Health Services Wilson Medical Center, Johnson, NY, 13790, USA. .,Broome Oncology, United Health Services Wilson Medical Center, Johnson, NY, 13790, USA.
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36
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Wong T, Goldsby RE, Wustrack R, Cash T, Isakoff MS, DuBois SG. Clinical features and outcomes of infants with Ewing sarcoma under 12 months of age. Pediatr Blood Cancer 2015; 62:1947-51. [PMID: 26173989 DOI: 10.1002/pbc.25635] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 05/18/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ewing sarcoma peaks in incidence in adolescence. Infants <12 months old have rarely been reported. We aimed to compare clinical features, treatment, and survival of infants <12 months to those of older pediatric patients with Ewing sarcoma. PROCEDURE We utilized the SEER database to identify patients <12 months of age diagnosed with Ewing sarcoma between 1973 and 2011. We used Fisher exact tests to compare clinical features and treatment modalities between these patients and patients aged 1-19 years. We used Kaplan-Meier methods to describe overall survival in these two groups. RESULTS Of 1,957 patients in the cohort, 39 (2.0%) were diagnosed at <12 months of age. Infants had a different distribution of primary tumor sites, with lower extremity tumors under represented. Compared to older patients, infants were more likely to have soft tissue tumors (81.6% vs. 27.1%; P < 0.001); have primitive neuroectodermal tumor/Askin tumor (61.5% vs. 19.9%; P < 0.001); and have tumors <8 cm (81.0% vs. 53.2%; P < 0.014). Infants were less likely to receive radiation therapy (13.2% vs. 53.3%; P < 0.001). Infants were at increased risk for early death (P < 0.013 by Wilcoxon), though long-term overall survival was not different between age groups (P < 0.25 by log rank). CONCLUSIONS Ewing sarcoma is rare in infants, with different clinical presentations and treatment approaches. These patients appear to be at higher risk for early death, but long-term survival is similar to older pediatric patients.
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Affiliation(s)
- Thalia Wong
- Department of Pediatrics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, California
| | - Robert E Goldsby
- Department of Pediatrics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, California
| | - Rosanna Wustrack
- Department of Orthopedics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, California
| | - Thomas Cash
- Department of Pediatrics, Emory University, Atlanta, Georgia
| | - Michael S Isakoff
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, University of Connecticut, Hartford, Connecticut
| | - Steven G DuBois
- Department of Pediatrics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, California
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Friedman GK, Beierle EA, Gillespie GY, Markert JM, Waters AM, Chen CY, Denton NL, Haworth KB, Hutzen B, Leddon JL, Streby KA, Wang PY, Cripe TP. Pediatric cancer gone viral. Part II: potential clinical application of oncolytic herpes simplex virus-1 in children. MOLECULAR THERAPY-ONCOLYTICS 2015; 2:S2372-7705(16)30018-3. [PMID: 26436134 PMCID: PMC4589754 DOI: 10.1038/mto.2015.16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Oncolytic engineered herpes simplex viruses (HSVs) possess many biologic and functional attributes that support their use in clinical trials in children with solid tumors. Tumor cells, in an effort to escape regulatory mechanisms that would impair their growth and progression, have removed many mechanisms that would have protected them from virus infection and eventual virus-mediated destruction. Viruses engineered to exploit this weakness, like mutant HSV, can be safely employed as tumor cell killers, since normal cells retain these antiviral strategies. Many preclinical studies and early phase trials in adults demonstrated that oncolytic HSV can be safely used and are highly effective in killing tumor cells that comprise pediatric malignancies, without generating the toxic side effects of nondiscriminatory chemotherapy or radiation therapy. A variety of engineered viruses have been developed and tested in numerous preclinical models of pediatric cancers and initial trials in patients are underway. In Part II of this review series, we examine the preclinical evidence to support the further advancement of oncolytic HSV in the pediatric population. We discuss clinical advances made to date in this emerging era of oncolytic virotherapy.
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Affiliation(s)
- Gregory K Friedman
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elizabeth A Beierle
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - James M Markert
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alicia M Waters
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chun-Yu Chen
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Nicholas L Denton
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Kellie B Haworth
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Brian Hutzen
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Jennifer L Leddon
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Keri A Streby
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Pin-Yi Wang
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Timothy P Cripe
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
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38
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Attia S, Okuno SH, Robinson SI, Webber NP, Indelicato DJ, Jones RL, Bagaria SP, Jones RL, Sherman C, Kozak KR, Cortese CM, McFarland T, Trent JC, Maki RG. Clinical Activity of Pazopanib in Metastatic Extraosseous Ewing Sarcoma. Rare Tumors 2015; 7:5992. [PMID: 26266019 PMCID: PMC4508650 DOI: 10.4081/rt.2015.5992] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/13/2015] [Indexed: 11/23/2022] Open
Abstract
We report a response to pazopanib in a 69-year-old man with heavily pre-treated metastatic extraosseous Ewing sarcoma in addition to molecular profiling of his tumor. To our knowledge, this case is the earliest to demonstrate activity of an oral multi-targeted kinase inhibitor in Ewing sarcoma. This case provides rationale for adding a Ewing sarcoma arm to SARC024, a phase II study of regorafenib, another multi-targeted kinase inhibitor, in patients with liposarcoma, osteosarcoma and Ewing and Ewing-like sarcomas (NCT02048371). This national multi-institutional study is ongoing.
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Jiang Y, Ludwig J, Janku F. Targeted therapies for advanced Ewing sarcoma family of tumors. Cancer Treat Rev 2015; 41:391-400. [PMID: 25869102 DOI: 10.1016/j.ctrv.2015.03.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/17/2015] [Accepted: 03/20/2015] [Indexed: 12/30/2022]
Abstract
The prognosis of adolescent and young adult patients battling metastatic Ewing sarcoma family of tumors (ESFT) remains less than 30% despite the development of systemic therapies. In the era of personalized medicine, novel molecular targets have been tested in preclinical or clinical settings in ESFT. In this review, we focus on early clinical and translational research that identified multiple molecular targets, including IGF-1R; mTOR; tyrosine kinase inhibitors; EWS-FLI1-related targets, and others. Overall, novel targeted therapies demonstrated modest efficacy; however pronounced and durable antineoplastic responses have been observed in small subsets of treated patients, for example with IGF-1R antibodies. Identifying outcome-predicting biomarkers and overcoming treatment resistance remain major challenges. Due to the rarity of ESFT, multi-institutional collaboration efforts of clinicians, basic and translational scientists are needed in order to understand biology of therapeutic response or resistance, which can lead to development of novel therapeutic methods and improved patient outcomes.
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Affiliation(s)
- Yunyun Jiang
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph Ludwig
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Filip Janku
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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40
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3D tissue-engineered model of Ewing's sarcoma. Adv Drug Deliv Rev 2014; 79-80:155-71. [PMID: 25109853 DOI: 10.1016/j.addr.2014.07.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 06/28/2014] [Accepted: 07/24/2014] [Indexed: 12/30/2022]
Abstract
Despite longstanding reliance upon monolayer culture for studying cancer cells, and numerous advantages from both a practical and experimental standpoint, a growing body of evidence suggests that more complex three-dimensional (3D) models are necessary to properly mimic many of the critical hallmarks associated with the oncogenesis, maintenance and spread of Ewing's sarcoma (ES), the second most common pediatric bone tumor. And as clinicians increasingly turn to biologically-targeted therapies that exert their effects not only on the tumor cells themselves, but also on the surrounding extracellular matrix, it is especially important that preclinical models evolve in parallel to reliably measure antineoplastic effects and possible mechanisms of de novo and acquired drug resistance. Herein, we highlight a number of innovative methods used to fabricate biomimetic ES tumors, encompassing both the surrounding cellular milieu and the extracellular matrix (ECM), and suggest potential applications to advance our understanding of ES biology, preclinical drug testing, and personalized medicine.
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41
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Caria P, Vanni R. FISH molecular testing in cytological preparations from solid tumors. Mol Cytogenet 2014; 7:56. [PMID: 25478010 PMCID: PMC4255722 DOI: 10.1186/s13039-014-0056-9] [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: 05/12/2014] [Accepted: 07/30/2014] [Indexed: 11/10/2022] Open
Abstract
Many of the exciting new developments in solid tumor molecular cytogenetics impact classical and molecular pathology. Fluorescence in situ hybridization to identify specific DNA target sequences in nuclei of non-dividing cells in solid neoplasms has contributed to the integration of molecular cytogenetics into cytology in spite of the remarkable promiscuity of cancer genes. Indeed, although it is a low-throughput assay, fluorescence in situ hybridization enables the direct disclosure and localization of genetic markers in single nuclei. Gene fusions are among the most prominent genetic alterations in cancer, providing markers that may be determinant in needle biopsies that are negative or suspicious for malignancy, and may contribute to the correct classification of the tumors. In view of the expanding use of fluorescence in situ hybridization in cytology, future challenges include automated sample evaluation and the specification of common criteria for interpreting and reporting results.
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Affiliation(s)
- Paola Caria
- Department of Biomedical Sciences, University of Cagliari – Cittadella Universitaria, 09042 Monserrato (CA), Cagliari, Italy
| | - Roberta Vanni
- Department of Biomedical Sciences, University of Cagliari – Cittadella Universitaria, 09042 Monserrato (CA), Cagliari, Italy
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Yamamoto Y, Nozawa M, Shimizu N, Minami T, Yoshimura K, Uemura H. Pazopanib for recurrent extraosseous Ewing's sarcoma of the retroperitoneum. Int J Urol 2014; 21:1183-4. [PMID: 25040171 DOI: 10.1111/iju.12546] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yutaka Yamamoto
- Department of Urology, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
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Findlay VJ, LaRue AC, Turner DP, Watson PM, Watson DK. Understanding the role of ETS-mediated gene regulation in complex biological processes. Adv Cancer Res 2014; 119:1-61. [PMID: 23870508 DOI: 10.1016/b978-0-12-407190-2.00001-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ets factors are members of one of the largest families of evolutionarily conserved transcription factors, regulating critical functions in normal cell homeostasis, which when perturbed contribute to tumor progression. The well-documented alterations in ETS factor expression and function during cancer progression result in pleiotropic effects manifested by the downstream effect on their target genes. Multiple ETS factors bind to the same regulatory sites present on target genes, suggesting redundant or competitive functions. The anti- and prometastatic signatures obtained by examining specific ETS regulatory networks will significantly improve our ability to accurately predict tumor progression and advance our understanding of gene regulation in cancer. Coordination of multiple ETS gene functions also mediates interactions between tumor and stromal cells and thus contributes to the cancer phenotype. As such, these new insights may provide a novel view of the ETS gene family as well as a focal point for studying the complex biological control involved in tumor progression. One of the goals of molecular biology is to elucidate the mechanisms that contribute to the development and progression of cancer. Such an understanding of the molecular basis of cancer will provide new possibilities for: (1) earlier detection, as well as better diagnosis and staging of disease; (2) detection of minimal residual disease recurrences and evaluation of response to therapy; (3) prevention; and (4) novel treatment strategies. Increased understanding of ETS-regulated biological pathways will directly impact these areas.
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Affiliation(s)
- Victoria J Findlay
- Department of Pathology and Laboratory Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
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44
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Ponce-Castañeda MV, García-Chéquer AJ, Eguía Aguilar P, Abundes-Ramírez MA, Hernández-Angeles A, Nieto-Martínez K, Gómez-Laguna L, Sadowinski-Pine S, Cabrera-Muñoz MDL. Detection of common chromosomal translocations in small round blue cell pediatric tumors. Arch Med Res 2014; 45:143-51. [PMID: 24486246 DOI: 10.1016/j.arcmed.2013.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 12/13/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Recurrent and specific chromosomal translocations have been described in four pediatric sarcomas belonging to the small round blue cell (SRBC) group of tumors. Identification of mRNA chimeras using RT-PCR discriminates among alveolar rhabdomyosarcoma (ARMS), Ewing's sarcoma (ES/pPNET), synovial sarcoma (SS) and desmoplastic small round cell tumor (DSRCT); however, frequencies of these translocations are variable. We present a retrospective study comparing histological examination and occurrence of major chromosomal translocations to validate the diagnosis and to assess the frequency of these molecular markers in a group of 92 small round blue cell (SRBC) tumor samples from Hospital Infantil de Mexico. METHODS We tested a panel of RT-PCR assays to each RNA tumor sample from formalin-fixed, paraffin-embedded tumors to detect specific mRNA chimeras in 47 ES/pPNET, 19 ARMS, four SS, three DSRCT, and 19 other SRBC tumors. RESULTS After excluding poor RNA quality samples, we found translocations in 17/31 ES/pPNET (54.8%), 10/19 ARMS (52.6%), 4/4 SS (100%) and 4/4 DSRCT (100%). We found disagreement in only three samples: one ES/pPNET and one embryonal rhabdomyosarcoma harbor a PAX3-FOXO1 translocation (for ARMS), and one neuroepithelioma harboring a EWS-WT1 (for DSRCT). Unsuitable RNA was found in 20/92 samples (21.7%) and was related to necrosis, small amount of tumor tissue, and use of nitric acid in bone biopsies, but was not related to age of the block. CONCLUSIONS We found a significantly lower occurrence of chromosomal translocations in ES/pPNET compared to reports from other groups. Differences may exist in the frequencies of these molecular markers among different populations.
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Affiliation(s)
- M Verónica Ponce-Castañeda
- Unidad de Investigación Médica en Enfermedades Infecciosas, Hospital de Pediatría, Instituto Mexicano del Seguro Social, Centro Médico Nacional SXXI, Mexico, D.F., Mexico.
| | - Adda Jeanette García-Chéquer
- Unidad de Investigación Médica en Enfermedades Infecciosas, Hospital de Pediatría, Instituto Mexicano del Seguro Social, Centro Médico Nacional SXXI, Mexico, D.F., Mexico
| | - Pilar Eguía Aguilar
- Departamento de Patología, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico, D.F., Mexico
| | - Marco A Abundes-Ramírez
- Unidad de Investigación Médica en Enfermedades Infecciosas, Hospital de Pediatría, Instituto Mexicano del Seguro Social, Centro Médico Nacional SXXI, Mexico, D.F., Mexico
| | - Adriana Hernández-Angeles
- Unidad de Investigación Médica en Enfermedades Infecciosas, Hospital de Pediatría, Instituto Mexicano del Seguro Social, Centro Médico Nacional SXXI, Mexico, D.F., Mexico
| | - Karem Nieto-Martínez
- Departamento de Genética, Hospital General de México, Secretaría de Salud, Mexico, D.F., Mexico
| | - Laura Gómez-Laguna
- Departamento de Genética, Hospital General de México, Secretaría de Salud, Mexico, D.F., Mexico
| | - Stanislaw Sadowinski-Pine
- Departamento de Patología, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico, D.F., Mexico
| | - M de Lourdes Cabrera-Muñoz
- Departamento de Patología, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico, D.F., Mexico
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45
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Khoury JD. Ewing sarcoma family of tumors: a model for the new era of integrated laboratory diagnostics. Expert Rev Mol Diagn 2014; 8:97-105. [DOI: 10.1586/14737159.8.1.97] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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46
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Sarcomas. Mol Oncol 2013. [DOI: 10.1017/cbo9781139046947.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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47
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Kishore S, Piscuoglio S, Kovac MB, Gylling A, Wenzel F, Trapani F, Altermatt HJ, Mele V, Marra G, Peltomäki P, Terracciano L, Zavolan M, Heinimann K. 3'-UTR poly(T/U) tract deletions and altered expression of EWSR1 are a hallmark of mismatch repair-deficient cancers. Cancer Res 2013; 74:224-34. [PMID: 24158095 DOI: 10.1158/0008-5472.can-13-2100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The genome-wide accumulation of DNA replication errors known as microsatellite instability (MSI) is the hallmark lesion of DNA mismatch repair (MMR)-deficient cancers. Although testing for MSI is widely used to guide clinical management, the contribution of MSI at distinct genic loci to the phenotype remains largely unexplored. Here, we report that a mononucleotide (T/U)16 tract located in the 3' untranslated region (3'-UTR) of the Ewing sarcoma breakpoint region 1 (EWSR1) gene is a novel MSI target locus that shows perfect sensitivity and specificity in detecting mismatch repair-deficient cancers in two independent populations. We further found a striking relocalization of the EWSR1 protein from nucleus to cytoplasm in MMR-deficient cancers and that the nonprotein-coding MSI target locus itself has a modulatory effect on EWSR1 gene expression through alternative 3' end processing of the EWSR1 gene. Our results point to a MSI target gene-specific effect in MMR-deficient cancers.
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Affiliation(s)
- Shivendra Kishore
- Authors' Affiliations: Biozentrum, University of Basel; Research Group Human Genetics, Dept of Biomedicine, University of Basel, and Division of Medical Genetics, University Hospital Basel; Institute for Surgical Research and Hospital Management and Department of Biomedicine, University of Basel; Institute of Pathology, University Hospital of Basel, Basel; Pathologie Laenggasse Bern, Bern; Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland; Department of Medical Genetics, Haartman Institute, University of Helsinki, Helsinki, Finland; and Paterson Institute for Cancer Research, University of Manchester, Manchester, United Kingdom
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Abstract
Ewing's sarcoma is the second most common bone malignancy in children, but is extremely rare in adults. The outcome of patients with localized disease has improved over the past decades due to better combination chemotherapies, and better methods of local control. Unfortunately, patients with metastatic disease have a very poor outcome with current antineoplastic therapies. In this article, we will review the primary treatment for adult patients with Ewing's sarcoma, both for localized and metastatic disease. The prognostic factors in adult patients with EWS will also be reviewed.
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49
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Barroca H, Souto Moura C, Lopes JM, Lisboa S, Teixeira MR, Damasceno M, Bastos P, Sobrinho-Simões M. PNET with neuroendocrine differentiation of the lung: Report of an unusual entity. Int J Surg Pathol 2013; 22:427-33. [PMID: 24141023 DOI: 10.1177/1066896913502227] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ewing's sarcoma/primitive neuroectodermal tumor (PNET) has been the subject of recent reports describing morphologic variants (adamantinoma-like, large cell, spindle cell, sclerosing, clear cell, and vascular-like) of the most classic form, as well as cases displaying unusual morphologic differentiation and atypical immunohistochemical features. We report a case of an uncommon lung tumor in a 20-year-old female, morphologically and molecularly consistent with an Ewing's sarcoma/PNET tumor with foci of squamous differentiation, and peculiar expression of vimentin, high-molecular-weight keratins, p63, synaptophysin, and chromogranin. This case raises a challenging differential diagnostic problem with therapeutic implications: Should the patient be treated following the protocols for Ewing's sarcoma/PNET tumors or as for lung carcinoma with neuroendocrine features? The patient we report here was treated with neoadjuvant chemotherapy for Ewing's sarcoma/PNET according to Euro Ewing 99 study protocol followed by surgery and has no evidence of disease 15 months after the initial diagnosis. This highlights the importance of achieving the correct diagnosis of these atypical tumors using all clinical, morphological, and ancillary methods available to allow for their correct and timely treatment.
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Affiliation(s)
- Helena Barroca
- Centro Hospitalar S João, Porto, Portugal Departamento de Patologia e Oncologia Médica da Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Conceição Souto Moura
- Centro Hospitalar S João, Porto, Portugal Departamento de Patologia e Oncologia Médica da Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - José Manuel Lopes
- Centro Hospitalar S João, Porto, Portugal Departamento de Patologia e Oncologia Médica da Faculdade de Medicina da Universidade do Porto, Porto, Portugal Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - Susana Lisboa
- Instituto Português de Oncologia do Porto e Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
| | - Manuel R Teixeira
- Instituto Português de Oncologia do Porto e Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
| | - Margarida Damasceno
- Centro Hospitalar S João, Porto, Portugal Departamento de Patologia e Oncologia Médica da Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Manuel Sobrinho-Simões
- Centro Hospitalar S João, Porto, Portugal Departamento de Patologia e Oncologia Médica da Faculdade de Medicina da Universidade do Porto, Porto, Portugal Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
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50
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Steyn N, Heggie A, MacGregor D, Aldred MJ, Talacko AA, Coleman H, Bonar F, Slavin J, Wall M, Firth N. Clinical pathologic conference case 4: a 15-year-old boy with radiographic changes in the left mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e71-5. [PMID: 23926615 DOI: 10.1016/j.oooo.2013.01.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
MESH Headings
- 12E7 Antigen
- Adolescent
- Antigens, CD/analysis
- Antigens, CD/genetics
- Cell Adhesion Molecules/analysis
- Cell Adhesion Molecules/genetics
- Diagnosis, Differential
- Humans
- In Situ Hybridization, Fluorescence
- Jaw Neoplasms/drug therapy
- Jaw Neoplasms/genetics
- Jaw Neoplasms/pathology
- Male
- Mandible/pathology
- Proto-Oncogene Protein c-fli-1/analysis
- Proto-Oncogene Protein c-fli-1/genetics
- Radiography, Panoramic
- Sarcoma, Ewing/drug therapy
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/pathology
- Sarcoma, Small Cell/pathology
- Translocation, Genetic
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Affiliation(s)
- N Steyn
- Dorevitch Pathology, Royal Children's Hospital
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