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Ye T, Zhong Z, Cappellesso F, Deswarte K, Chen Y, Lauwers H, De Lombaerde E, Gontsarik M, Lienenklaus S, Van Lysebetten D, Sanders NN, Lambrecht BN, De Koker S, Laoui D, De Geest BG. CO-DELIVERY of glutamic acid-extended peptide antigen and imidazoquinoline TLR7/8 agonist via ionizable lipid nanoparticles induces protective anti-tumor immunity. Biomaterials 2024; 311:122693. [PMID: 38996672 DOI: 10.1016/j.biomaterials.2024.122693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/30/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024]
Abstract
Cancer vaccines aim at generating cytotoxic CD8+ T cells that kill cancer cells and confer durable tumor regression. Hereto, CD8+ peptide epitopes should be presented by antigen presenting cells to CD8+ T cells in lymphoid tissue. Unfortunately, in unformulated soluble form, peptide antigens are poorly taken up by antigen presenting cells and do not efficiently reach lymph nodes. Hence, the lack of efficient delivery remains a major limitation for successful clinical translation of cancer vaccination using peptide antigens. Here we propose a generic peptide nanoformulation strategy by extending the amino acid sequence of the peptide antigen epitope with 10 glutamic acid residues. The resulting overall anionic charge of the peptide allows encapsulation into lipid nanoparticles (peptide-LNP) by electrostatic interaction with an ionizable cationic lipid. We demonstrate that intravenous injection of peptide-LNP efficiently delivers the peptide to immune cells in the spleen. Peptide-LNP that co-encapsulate an imidazoquinoline TLR7/8 agonist (IMDQ) induce robust innate immune activation in a broad range of immune cell subsets in the spleen. Peptide-LNP containing the minimal CD8+ T cell epitope of the HPV type 16 E7 oncoprotein and IMDQ induces high levels of antigen-specific CD8+ T cells in the blood, and can confer protective immunity against E7-expressing tumors in both prophylactic and therapeutic settings.
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Affiliation(s)
- Tingting Ye
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Zifu Zhong
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Federica Cappellesso
- Lab of Cellular and Molecular Immunology, Brussel Center for Immunology, Vrije Universiteit Brussel, Brussels, Belgium; Lab of Dendritic Cell Biology and Cancer Immunotherapy, VIB Center for Inflammation Research, Brussels, Belgium
| | - Kim Deswarte
- Laboratory of Immunoregulation and Mucosal Immunology, VIB-UGent Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Yong Chen
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Heleen Lauwers
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | | | - Mark Gontsarik
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Stefan Lienenklaus
- Institute of Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | | | - Niek N Sanders
- Laboratory of Gene Therapy, Department of Veterinary and Biosciences, Ghent University, Merelbeke, Belgium
| | - Bart N Lambrecht
- Laboratory of Immunoregulation and Mucosal Immunology, VIB-UGent Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium; Department of Pulmonary Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Damya Laoui
- Lab of Cellular and Molecular Immunology, Brussel Center for Immunology, Vrije Universiteit Brussel, Brussels, Belgium; Lab of Dendritic Cell Biology and Cancer Immunotherapy, VIB Center for Inflammation Research, Brussels, Belgium.
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Podlesek D, Beyer F, Alkhatib M, Daubner D, Hijazi MM, Juratli JH, Weise S, Eyüpoglu IY, Schackert G, Juratli TA, Hummel T. Correlation of Molecular Status with Preoperative Olfactory Function in Olfactory Groove Meningioma. Cancers (Basel) 2024; 16:1595. [PMID: 38672677 PMCID: PMC11048944 DOI: 10.3390/cancers16081595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024] Open
Abstract
PURPOSE The study aims to examine the possible correlation between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), due to the frequent presence of olfactory impairment. METHODS We utilised next-generation sequencing to analyse samples from 22 individuals with OGM in order to detect driver mutations. Tumour morphology was assessed using preoperative imaging, whereas olfactory function was examined using Sniffin' Sticks. RESULTS In a study of 22 OGM patients, mutations were as follows: 10 with SMO/SUFU, 7 with AKT1, and 5 as wild type. Planum sphenoidale hyperostosis (PSH) was present in 75% of patients, showing significant variation by mutation (p = 0.048). Tumour volumes, averaging 25 cm3, significantly differed among groups. PSH negatively impacted olfaction, notably affecting odour threshold, discrimination, identification, and global olfactory performance score (TDI) (p values ranging from <0.001 to 0.003). Perifocal oedema was associated with lower TDI (p = 0.009) and altered threshold scores (p = 0.038). Age over 65 and female gender were linked to lower thresholds and discrimination scores (p = 0.037 and p = 0.019). CONCLUSION The study highlights PSH and perifocal oedema's significant effect on olfactory function in OGM patients but finds no link between olfactory impairment and tumour mutations, possibly due to the small sample size. This suggests that age and gender affect olfactory impairment. Additional research with a larger group of participants is needed to explore the impact of OGM driver mutations on olfactory performance.
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Affiliation(s)
- Dino Podlesek
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Friederike Beyer
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Majd Alkhatib
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Dirk Daubner
- Institute of Diagnostic and Interventional Neuroradiology, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Mido Max Hijazi
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jerry Hadi Juratli
- Department of Otorhinolaryngology, Smell & Taste Clinic, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Susanne Weise
- Department of Otorhinolaryngology, Smell & Taste Clinic, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Ilker Y. Eyüpoglu
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Gabriele Schackert
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Tareq A. Juratli
- Department of Neurosurgery, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
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3D Model Characterization by 2D and 3D Imaging in t(14;18)-Positive B-NHL: Perspectives for In Vitro Drug Screens in Follicular Lymphoma. Cancers (Basel) 2021; 13:cancers13071490. [PMID: 33804934 PMCID: PMC8036410 DOI: 10.3390/cancers13071490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Follicular lymphoma is an indolent B cell lymphoproliferative disorder of transformed follicular center B cells, which accounts for 20–30 percent of all non-Hodgkin lymphoma (NHL) cases. Although huge efforts have been made in the last 10 years, this pathology is still considered as incurable, leaving open the discovery and testing of new therapeutic targets requiring relevant preclinical models. Here, we report a realistic 3D model of t (14;18)-positive B-NHL cell culture (ultra-low attachment (ULA)-multicellular aggregates of lymphoma cells (MALC)), which monitored by state-of-the-art 2D and 3D imaging, allows more robust drug testing. Abstract Follicular lymphoma (FL) is an indolent B cell lymphoproliferative disorder of transformed follicular center B cells, which accounts for 20–30 percent of all non-Hodgkin lymphoma (NHL) cases. Great advances have been made to identify the most relevant targets for precision therapy. However, no relevant models for in vitro studies have been developed or characterized in depth. To this purpose, we generated a 3D cell model from t(14;18)-positive B-NHL cell lines cultured in ultra-low attachment 96-well plates. Morphological features and cell growth behavior were evaluated by classical microscopy (2D imaging) and response to treatment with different drugs was evaluated by a high-content analysis system to determine the robustness of the model. We show that the ultra-low attachment (ULA) method allows the development of regular, spherical and viable ULA-multicellular aggregates of lymphoma cells (MALC). However, discrepancies in the results obtained after 2D imaging analyses on drug-treated ULA-MALC prompted us to develop 3D imaging and specific analyses. We show by using light sheet microscopy and specifically developed 3D imaging algorithms that 3D imaging and dedicated analyses are necessary to characterize morphological properties of 3D models and drug effects. This study proposes a new method, but also imaging tools and informatic solutions, developed for FL necessary for future preclinical studies.
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Tian Q, Guo J, Zhang Q, Fang L, Liu C, Xu H. Development and Evaluation of Cucurbitacin B Microemulsion: the Effect of Oil Phase and Aqueous Phase on Drug Percutaneous Absorption Based on ATR-FTIR Spectroscopy and Molecular Modeling. AAPS PharmSciTech 2020; 21:258. [PMID: 32895882 DOI: 10.1208/s12249-020-01797-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/18/2020] [Indexed: 12/24/2022] Open
Abstract
The present study aimed to develop a cucurbitacin B microemulsion (CuB-ME) and investigate the mechanism of the enhanced drug skin absorption at the molecular level. Firstly, the pseudo-ternary phase diagrams were developed to evaluate the effect of composition on microemulsion properties systematically. The formulation composition types and ratios of oil phase, surfactant, co-surfactant, and aqueous phase were optimized by an in vitro skin permeation experiment, and the optimized formula was confirmed with the pharmacodynamics study. Furthermore, the molecular mechanism of enhanced skin permeation was investigated using ATR-FTIR and molecular modeling. As a result, the optimized CuB-ME formulation was composed of Azone:Tween 80:ethanol:water = 2.5:16.9:5.6:75.0 (w/w/w/w). The oil phase improved skin permeation by disordering the stratum corneum intercellular liquid, while the aqueous phase impacted the particle size of the microemulsion and permeability coefficient of the drug. Besides, the hydration state of skin lipid also enhanced drug permeation by the interaction of water and the polar head of ceramide. The in vitro skin permeation amount was 45.47 ± 10.39 μg/cm2, and no significant skin irritation was observed. The pharmacodynamics study demonstrated that CuB-ME had a significant therapeutic effect on the animal tumor model. In conclusion, the CuB-ME was developed successfully and the effect of the oil phase and aqueous phase on drug skin permeation was clarified at the molecular level.
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Coche E. Evaluation of lung tumor response to therapy: Current and emerging techniques. Diagn Interv Imaging 2016; 97:1053-1065. [PMID: 27693090 DOI: 10.1016/j.diii.2016.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/19/2016] [Accepted: 09/02/2016] [Indexed: 12/31/2022]
Abstract
Lung tumor response to therapy may be evaluated in most instances by morphological criteria such as RECIST 1.1 on computed tomography (CT) or magnetic resonance imaging (MRI). However, those criteria are limited because they are based on tumoral dimensional changes and do not take into account other morphologic criteria such as density evaluation, functional or metabolic changes that may occur following conventional or targeted chemotherapy. New techniques such as dual-energy CT, PET-CT, MRI including diffusion-weighted MRI has to be considered into the new technical armamentarium for tumor response evaluation. Integration of all informations provided by the different imaging modalities has to be integrated and represents probably the future goal of tumor response evaluation. The aim of the present paper is to review the current and emerging imaging criteria used to evaluate the response of therapy in the field of lung cancer.
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Affiliation(s)
- E Coche
- Radiology Department, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200 Brussels, Belgium.
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Ivanov DP, Parker TL, Walker DA, Alexander C, Ashford MB, Gellert PR, Garnett MC. Multiplexing spheroid volume, resazurin and acid phosphatase viability assays for high-throughput screening of tumour spheroids and stem cell neurospheres. PLoS One 2014; 9:e103817. [PMID: 25119185 PMCID: PMC4131917 DOI: 10.1371/journal.pone.0103817] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 07/03/2014] [Indexed: 12/31/2022] Open
Abstract
Three-dimensional cell culture has many advantages over monolayer cultures, and spheroids have been hailed as the best current representation of small avascular tumours in vitro. However their adoption in regular screening programs has been hindered by uneven culture growth, poor reproducibility and lack of high-throughput analysis methods for 3D. The objective of this study was to develop a method for a quick and reliable anticancer drug screen in 3D for tumour and human foetal brain tissue in order to investigate drug effectiveness and selective cytotoxic effects. Commercially available ultra-low attachment 96-well round-bottom plates were employed to culture spheroids in a rapid, reproducible manner amenable to automation. A set of three mechanistically different methods for spheroid health assessment (Spheroid volume, metabolic activity and acid phosphatase enzyme activity) were validated against cell numbers in healthy and drug-treated spheroids. An automated open-source ImageJ macro was developed to enable high-throughput volume measurements. Although spheroid volume determination was superior to the other assays, multiplexing it with resazurin reduction and phosphatase activity produced a richer picture of spheroid condition. The ability to distinguish between effects on malignant and the proliferating component of normal brain was tested using etoposide on UW228-3 medulloblastoma cell line and human neural stem cells. At levels below 10 µM etoposide exhibited higher toxicity towards proliferating stem cells, whereas at concentrations above 10 µM the tumour spheroids were affected to a greater extent. The high-throughput assay procedures use ready-made plates, open-source software and are compatible with standard plate readers, therefore offering high predictive power with substantial savings in time and money.
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Affiliation(s)
- Delyan P. Ivanov
- School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
| | - Terry L. Parker
- Medical School, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - David A. Walker
- Children's Brain Tumour Research Centre, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Cameron Alexander
- School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
| | | | | | - Martin C. Garnett
- School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
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Lee BJ, Sohn MJ, Han SR, Choi CY, Lee DJ, Kang JH. Analysis of risk factors and management of cerebrospinal fluid morbidity in the treatment of spinal dysraphism. J Korean Neurosurg Soc 2013; 54:225-31. [PMID: 24278652 PMCID: PMC3836930 DOI: 10.3340/jkns.2013.54.3.225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/30/2013] [Accepted: 09/08/2013] [Indexed: 11/27/2022] Open
Abstract
Objective Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results The overall median skin lesion area was 36.2 cm2 (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of 64.4±32.5 cm2 versus 27.7±27.8 cm2, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 cm2 or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.
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Affiliation(s)
- Byung-Jou Lee
- Department of Neurosurgery, Inje University Ilsan Paik Hospital, College of Medicine, Goyang, Korea
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Saif MW, Merritt J, Robbins J, Stewart J, Schupp J. Phase III multicenter randomized clinical trial to evaluate the safety and efficacy of CoFactor/5-fluorouracil/bevacizumab versus leucovorin/5-fluorouracil/bevacizumab as initial treatment for metastatic colorectal carcinoma. Clin Colorectal Cancer 2006; 6:229-34. [PMID: 17026795 DOI: 10.3816/ccc.2006.n.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Muhammad Wasif Saif
- Developmental Therapeutics Program, Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06520, USA.
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Oxnard GR, Armato SG, Kindler HL. Modeling of mesothelioma growth demonstrates weaknesses of current response criteria. Lung Cancer 2006; 52:141-8. [PMID: 16530882 DOI: 10.1016/j.lungcan.2005.12.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Accepted: 12/20/2005] [Indexed: 10/24/2022]
Abstract
Applicability of the Response Evaluation Criteria in Solid Tumors (RECIST) to the geometry of mesothelioma has been recently investigated. A "modified RECIST" measurement technique developed for mesothelioma proposes measurement of tumor thickness rather than maximum diameter. This study evaluated the volumetric consistency of the RECIST response criteria as applied to the modified RECIST measurement technique. Geometric models were developed to simulate mesothelioma growth, and measurements of these models were calculated. Relationships between change in model measurements and corresponding change in model volume were derived and evaluated. Application of the RECIST response criteria to the typical spherical tumor model results in partial response (PR) classification based on a 66% volume decrease and progressive disease (PD) based on a 73% volume increase; for mesothelioma model thickness measurements, the RECIST criteria result in PR classification based on a 30% volume decrease and PD based on a 20% volume increase. Alternative response criteria for mesothelioma thickness measurement (-66% for PR, +74% for PD) achieve volumetric equivalence with the RECIST criteria for spherical tumor measurement. Application of the RECIST response criteria to mesothelioma thickness measurements yields PR and PD classifications based on smaller volume changes than for spherical tumors.
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Affiliation(s)
- Geoffrey R Oxnard
- Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, 02114, USA
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Monetti F, Casanova S, Grasso A, Cafferata MA, Ardizzoni A, Neumaier CE. Inadequacy of the new Response Evaluation Criteria in Solid Tumors (RECIST) in patients with malignant pleural mesothelioma: report of four cases. Lung Cancer 2004; 43:71-4. [PMID: 14698539 DOI: 10.1016/j.lungcan.2003.07.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Unidimensional Response Evaluation Criteria in Solid Tumor (RECIST) has been recently proposed in the attempt to simplify the standardized bidimensional World Health Organization (WHO) criteria. The complete accord between these two measurement systems was established in a large comparative study [J. Natl. Cancer Inst. 92(3) (2000) 205] that demonstrated the validity and the good performance of RECIST criteria. We report four cases of inadequacy of RECIST criteria in the evaluation of response to chemotherapy in patients with malignant pleural mesothelioma. These four patients were enrolled in two consecutive multicenter phase II clinical trials investigating the activity of a novel chemotherapy regimen in advanced pleural mesothelioma. They were judged as having an objective response to chemotherapy according to WHO criteria. Reassessed according to both methods, we found that results obtained with RECIST criteria do not correspond to WHO underestimating response to chemotherapy. Our data raise doubts about the applicability of unidimensional RECIST response criteria to mesothelioma and, possibly, to any tumor involving the chest wall.
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Affiliation(s)
- F Monetti
- Department Radiology, Istituto Nazionale Ricerca Cancro, Largo R. Benzi 10, 16125 Genova, Italy.
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McHugh K, Kao S. Can paediatric radiologists resist RECIST (response evaluation criteria in solid tumours)? Pediatr Radiol 2003; 33:739-43. [PMID: 14655676 DOI: 10.1007/s00247-003-1067-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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McHugh K, Kao S. Response evaluation criteria in solid tumours (RECIST): problems and need for modifications in paediatric oncology? Br J Radiol 2003; 76:433-6. [PMID: 12857700 DOI: 10.1259/bjr/15521966] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- K McHugh
- Radiology Department, Great Ormond Street Hospital For Children, London WC1N 3JH, UK
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Prasad SR, Saini S, Sumner JE, Hahn PF, Sahani D, Boland GW. Radiological measurement of breast cancer metastases to lung and liver: comparison between WHO (bidimensional) and RECIST (unidimensional) guidelines. J Comput Assist Tomogr 2003; 27:380-4. [PMID: 12794603 DOI: 10.1097/00004728-200305000-00014] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Radiologic assessment of "response-to-treatment" during clinical trials of anticancer drugs has been conventionally based on bidirectional tumor measurement. Recently, the revised guidelines were published, which recommended unidirectional tumor measurements. The purpose of this study was to compare response to treatment between the two measurement techniques in breast cancer patients with lung and liver metastases. METHOD Contrast-enhanced computed tomography studies of 86 breast cancer patients who had lung (n = 27) and liver (n = 59) metastases and who were enrolled in a phase-III oncology trial were evaluated before initiation of treatment and at 6 months after treatment. Lesions were measured by subspecialist radiologists on digitized images using electronic calipers. The largest diameter of the lesions was extracted from bidimensional measurements. Response to treatment was categorized into one of four categories: complete response indicating lesion disappearance, partial response indicating >30% decrease in tumor diameter, or >50% reduction in tumor area, disease progression indicating >20% increase in tumor diameter, or >25% increase in tumor area, and stable disease (neither complete response, partial response, nor disease progression). Response to treatment between the two measurement techniques was compared statistically using the chi2 test. RESULTS Response to treatment was concordant in 76 patients between unidimensional and bidimensional measurement techniques. In 5 patients (2 lung and 3 liver metastases) the response assessment was improved using unidimensional criteria and in 5 patients (2 lung and 3 liver metastases) the response was worse using unidimensional guidelines. Thus, the overall response rate was 50% for both unidimensional and bidimensional measurement techniques. There was no statistical difference between the two techniques. CONCLUSION Unidimensional measurements are appropriate for measuring the size of liver and lung metastases for determining response to treatment during clinical testing of oncologic drugs.
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Affiliation(s)
- Srinivasa R Prasad
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Prasad SR, Saini S. Radiological evaluation of oncologic treatment response: current update. Cancer Imaging 2003. [PMCID: PMC4448649 DOI: 10.1102/1470-7330.2003.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Affiliation(s)
- Srinivasa R. Prasad
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 270, 55 Fruit Street, Boston, MA 02114 USA
| | - Sanjay Saini
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 270, 55 Fruit Street, Boston, MA 02114 USA
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Saini S. Radiologic measurement of tumor size in clinical trials: past, present, and future. AJR Am J Roentgenol 2001; 176:333-4. [PMID: 11159068 DOI: 10.2214/ajr.176.2.1760333] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S Saini
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 32 Fruit St., Boston, MA 02114, USA
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Schwartz LH, Ginsberg MS, DeCorato D, Rothenberg LN, Einstein S, Kijewski P, Panicek DM. Evaluation of tumor measurements in oncology: use of film-based and electronic techniques. J Clin Oncol 2000; 18:2179-84. [PMID: 10811683 DOI: 10.1200/jco.2000.18.10.2179] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the variability in bidimensional computed tomography (CT) measurements obtained of actual tumors and of tumor phantoms by use of three measurement techniques: hand-held calipers on film, electronic calipers on a workstation, and an autocontour technique on a workstation. MATERIALS AND METHODS Three radiologists measured 45 actual tumors (in the lung, liver, and lymph nodes) on CT images, using each of the three techniques. Bidimensional measurements were recorded, and their cross-products calculated. The coefficient of variation was calculated to assess interobserver variability. CT images of 48 phantoms were measured by three radiologists with each of the techniques. In addition to the coefficient of variation, the differences between the cross-product measurements of tumor phantoms themselves and the measurements obtained with each of the techniques were calculated. RESULTS The differences between the coefficients of variation were statistically significantly different for the autocontour technique, compared with the other techniques, both for actual tumors and for tumor phantoms. There was no statistically significant difference in the coefficient of variation between measurements obtained with hand-held calipers and electronic calipers. The cross-products for tumor phantoms were 12% less than the actual cross-product when calipers on film were used, 11% less using electronic calipers, and 1% greater using the autocontour technique. CONCLUSION Tumor size is obtained more accurately and consistently between readers using an automated autocontour technique than between those using hand-held or electronic calipers. This finding has substantial implications for monitoring tumor therapy in an individual patient, as well as for evaluating the effectiveness of new therapies under development.
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Affiliation(s)
- L H Schwartz
- Departments of Radiology and Medical Physics, Memorial Sloan-Kettering Cancer Center, and Weill Medical College at Cornell University, New York, NY, 10021-6007, USA.
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James K, Eisenhauer E, Christian M, Terenziani M, Vena D, Muldal A, Therasse P. Measuring response in solid tumors: unidimensional versus bidimensional measurement. J Natl Cancer Inst 1999; 91:523-8. [PMID: 10088622 DOI: 10.1093/jnci/91.6.523] [Citation(s) in RCA: 298] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Tumor shrinkage is a common end point used in screening new cytotoxic agents. The standard World Health Organization criterion for partial response is a 50% or more decrease in the sum of the products of two measurements (the maximum diameter of a tumor and the largest diameter perpendicular to this maximum diameter) of individual tumors. However, theoretically, the simple sum of the maximum diameters of individual tumors is more linearly related to cell kill than is the sum of the bidimensional products. It has been hypothesized that the calculation of bidimensional products is unnecessary, and a 30% decrease in the sum of maximum diameters of individual tumors (assuming spherical shape and equivalence to a 50% reduction in the sum of the bidimensional products) was proposed as a new criterion. We have applied the standard response and the new response criteria to the same data to determine whether the same number of responses in the same patients would result. METHODS Data from 569 patients included in eight studies of a variety of cancers were reanalyzed. The two response criteria were separately applied, and the results were compared using the kappa statistic. The importance of confirmatory measurements and the frequency of nonspherical tumors were also examined. In addition, for a subset of 128 patients, a unidimensional criterion for disease progression (30% increase in the sum of maximum diameters) was applied and compared with the standard definition of a 25% increase in the sum of the bidimensional products. RESULTS Agreement between the unidimensional and bidimensional criteria was generally found to be good. The kappa statistic for concordance for overall response was 0.95. CONCLUSION We conclude that one dimensional measurement of tumor maximum diameter may be sufficient to assess change in solid tumors.
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Affiliation(s)
- K James
- National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, ON.
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