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Rey V, Tornín J, Alba-Linares JJ, Robledo C, Murillo D, Rodríguez A, Gallego B, Huergo C, Viera C, Braña A, Astudillo A, Heymann D, Szuhai K, Bovée JVMG, Fernández AF, Fraga MF, Alonso J, Rodríguez R. A personalized medicine approach identifies enasidenib as an efficient treatment for IDH2 mutant chondrosarcoma. EBioMedicine 2024; 102:105090. [PMID: 38547578 PMCID: PMC10990714 DOI: 10.1016/j.ebiom.2024.105090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Sarcomas represent an extensive group of malignant diseases affecting mesodermal tissues. Among sarcomas, the clinical management of chondrosarcomas remains a complex challenge, as high-grade tumours do not respond to current therapies. Mutations in the isocitrate dehydrogenase (IDH) 1 and 2 genes are among the most common mutations detected in chondrosarcomas and may represent a therapeutic opportunity. The presence of mutated IDH (mIDH) enzymes results in the accumulation of the oncometabolite 2-HG leading to molecular alterations that contribute to drive tumour growth. METHODS We developed a personalized medicine strategy based on the targeted NGS/Sanger sequencing of sarcoma samples (n = 6) and the use of matched patient-derived cell lines as a drug-testing platform. The anti-tumour potential of IDH mutations found in two chondrosarcoma cases was analysed in vitro, in vivo and molecularly (transcriptomic and DNA methylation analyses). FINDINGS We treated several chondrosarcoma models with specific mIDH1/2 inhibitors. Among these treatments, only the mIDH2 inhibitor enasidenib was able to decrease 2-HG levels and efficiently reduce the viability of mIDH2 chondrosarcoma cells. Importantly, oral administration of enasidenib in xenografted mice resulted in a complete abrogation of tumour growth. Enasidenib induced a profound remodelling of the transcriptomic landscape not associated to changes in the 5 mC methylation levels and its anti-tumour effects were associated with the repression of proliferative pathways such as those controlled by E2F factors. INTERPRETATION Overall, this work provides preclinical evidence for the use of enasidenib to treat mIDH2 chondrosarcomas. FUNDING Supported by the Spanish Research Agency/FEDER (grants PID2022-142020OB-I00; PID2019-106666RB-I00), the ISC III/FEDER (PI20CIII/00020; DTS18CIII/00005; CB16/12/00390; CB06/07/1009; CB19/07/00057); the GEIS group (GEIS-62); and the PCTI (Asturias)/FEDER (IDI/2021/000027).
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Affiliation(s)
- Verónica Rey
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; CIBER en oncología (CIBERONC), 28029, Madrid, Spain
| | - Juan Tornín
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain
| | - Juan Jose Alba-Linares
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), El Entrego, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Cristina Robledo
- Unidad de Tumores Sólidos Infantiles, Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III (ISCIII), 28220, Madrid, Spain
| | - Dzohara Murillo
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain
| | - Aida Rodríguez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain
| | - Borja Gallego
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain
| | - Carmen Huergo
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; CIBER en oncología (CIBERONC), 28029, Madrid, Spain
| | - Cristina Viera
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain
| | - Alejandro Braña
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; Department of Traumatology, University Hospital of Asturias (HUCA), Oviedo, Spain
| | - Aurora Astudillo
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; Department of Pathology, University Hospital of Asturias (HUCA), Oviedo, Spain
| | - Dominique Heymann
- Nantes Université, CNRS, US2B, UMR 6286, 44000, Nantes, France; Institut de Cancérologie de l'Ouest, Tumor Heterogeneity and Precision Medicine Lab. Université de Nantes, 44805, Saint-Herblain, France; Department of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, UK
| | - Karoly Szuhai
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
| | - Agustín F Fernández
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), El Entrego, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Mario F Fraga
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), El Entrego, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Javier Alonso
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029, Madrid, Spain; Unidad de Tumores Sólidos Infantiles, Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III (ISCIII), 28220, Madrid, Spain
| | - René Rodríguez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain; CIBER en oncología (CIBERONC), 28029, Madrid, Spain.
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2
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Heim TE, Hankins ML, Belayneh R, Douglas N, Dinh V, Kovvur M, Boone DN, Ukani V, Bhogal S, Patel V, Moniz TMA, Bailey KM, John I, Schoedel K, Weiss KR, Watters RJ. RNA-sequencing predicts a role of androgen receptor and aldehyde dehydrogenase 1A1 in osteosarcoma lung metastases. Oncogene 2024; 43:1007-1018. [PMID: 38361046 PMCID: PMC10978487 DOI: 10.1038/s41388-024-02957-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 09/20/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
One-third of pediatric patients with osteosarcoma (OS) develop lung metastases (LM), which is the primary predictor of mortality. While current treatments of patients with localized bone disease have been successful in producing 5-year survival rates of 65-70%, patients with LM experience poor survival rates of only 19-30%. Unacceptably, this situation that has remained unchanged for 30 years. Thus, there is an urgent need to elucidate the mechanisms of metastatic spread in OS and to identify targetable molecular pathways that enable more effective treatments for patients with LM. We aimed to identify OS-specific gene alterations using RNA-sequencing of extremity and LM human tissues. Samples of extremity and LM tumors, including 4 matched sets, were obtained from patients with OS. Our data demonstrate aberrant regulation of the androgen receptor (AR) pathway in LM and predicts aldehyde dehydrogenase 1A1 (ALDH1A1) as a downstream target. Identification of AR pathway upregulation in human LM tissue samples may provide a target for novel therapeutics for patients with LM resistant to conventional chemotherapy.
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Affiliation(s)
- Tanya E Heim
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA.
| | - Margaret L Hankins
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Rebekah Belayneh
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Nerone Douglas
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Vu Dinh
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Murali Kovvur
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - David N Boone
- University of Pittsburgh Department of Biomedical Informatics, Pittsburgh, PA, USA
| | - Vrutika Ukani
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Sumail Bhogal
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Vaidehi Patel
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Taylor M A Moniz
- Columbia University with Trinity College, Dublin, UK
- UPMC Hillman Cancer Center Academy, Pittsburgh, PA, USA
| | - Kelly M Bailey
- University of Pittsburgh School of Medicine, Department of Pediatrics, Pittsburgh, PA, USA
| | - Ivy John
- University of Pittsburgh Department of Pathology, Pittsburgh, PA, USA
| | - Karen Schoedel
- University of Pittsburgh Department of Pathology, Pittsburgh, PA, USA
| | - Kurt R Weiss
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
| | - Rebecca J Watters
- University of Pittsburgh Department of Orthopaedic Surgery, Pittsburgh, PA, USA
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Tsukamoto S, Mavrogenis AF, Nitta Y, Righi A, Masunaga T, Honoki K, Fujii H, Kido A, Tanaka Y, Tanaka Y, Errani C. A Systematic Review of Adjuvant Chemotherapy in Localized Dedifferentiated Chondrosarcoma. Curr Oncol 2024; 31:566-578. [PMID: 38275833 PMCID: PMC10813944 DOI: 10.3390/curroncol31010040] [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: 12/01/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype of chondrosarcoma with the bimorphic histological appearance of a conventional chondrosarcoma component with abrupt transition to a high-grade, non-cartilaginous sarcoma. DDCS can be radiographically divided into central and peripheral types. Wide resection is currently the main therapeutic option for localized DDCS. Moreover, the effectiveness of adjuvant chemotherapy remains controversial. Therefore, we performed a systematic review of available evidence to evaluate the effect of adjuvant chemotherapy on localized DDCS. The purpose was to compare the 5-year survival rate among patients treated with surgery plus adjuvant chemotherapy or surgery alone for localized DDCS. The search was conducted in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Of the 217 studies shortlisted, 11 retrospective non-randomized studies (comprising 556 patients with localized DDCS) were selected. The 5-year survival rates were similar between the two treatment groups (28.2% (51/181) vs. 24.0% (90/375), respectively). The overall pooled odds ratio was 1.25 (95% confidence interval: 0.80-1.94; p = 0.324), and heterogeneity I2 was 2%. However, when limited to peripheral DDCS, adjuvant chemotherapy was associated with prolonged survival (p = 0.03). Due to the paucity of included studies and the absence of prospective comparative studies, no conclusions can be drawn regarding the effectiveness or ineffectiveness of adjuvant chemotherapy for localized DDCS.
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Affiliation(s)
- Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan; (T.M.); (K.H.); (H.F.); (Y.T.)
| | - Andreas F. Mavrogenis
- First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 41 Ventouri Street, Holargos, 15562 Athens, Greece;
| | - Yuji Nitta
- Department of Diagnostic Pathology, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan;
| | - Alberto Righi
- Department of Pathology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Tomoya Masunaga
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan; (T.M.); (K.H.); (H.F.); (Y.T.)
| | - Kanya Honoki
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan; (T.M.); (K.H.); (H.F.); (Y.T.)
| | - Hiromasa Fujii
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan; (T.M.); (K.H.); (H.F.); (Y.T.)
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan;
| | - Yuu Tanaka
- Department of Rehabilitation Medicine, Wakayama Professional University of Rehabilitation, 3-1, Minamoto-cho, Wakayama 640-8222, Japan;
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Japan; (T.M.); (K.H.); (H.F.); (Y.T.)
| | - Costantino Errani
- Department of Orthopaedic Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna, Italy;
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Trovarelli G, Sbaraglia M, Angelini A, Bellan E, Pala E, Belluzzi E, Pozzuoli A, Borga C, Dei Tos AP, Ruggieri P. Are IDH1 R132 Mutations Associated With Poor Prognosis in Patients With Chondrosarcoma of the Bone? Clin Orthop Relat Res 2024; 482:00003086-990000000-01457. [PMID: 38170705 PMCID: PMC11124741 DOI: 10.1097/corr.0000000000002960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Because chondrosarcomas vary widely in their behavior, and because anticipating their behavior based on histology alone can be challenging, genetic markers represent an appealing area of inquiry that may help us refine our prognostic approaches. Isocitrate dehydrogenase (IDH) mutations are involved in the pathogenesis of a variety of neoplasms, and recently, IDH1/2 mutations have been found in the tissue of benign cartilage tumors as well as in conventional chondrosarcomas and highly aggressive dedifferentiated chondrosarcomas. However, their association with patient survival is still controversial. QUESTIONS/PURPOSES (1) What proportion of patients with chondrosarcomas carry IDH mutations, and which IDH mutations can be found? (2) Are any specific IDH mutations associated with poorer overall survival, metastasis-free survival, or local recurrence-free survival? METHODS Between April 2017 and December 2022, we treated 74 patients for atypical cartilaginous tumors or chondrosarcomas in a musculoskeletal tumor referral center. Patients were considered potentially eligible for the present study if the histologic diagnosis was confirmed by two expert soft tissue and bone pathologists following the current WHO classification, complete preoperative imaging and follow-up data were available, surgical excision was performed by sarcoma orthopaedic surgeons directed by a team leader, and the minimum follow-up was 2 years after surgical treatment unless the patient died. Data including sex, age, diagnosis, grade, type of operation, local recurrence, metastasis, and oncologic follow-up were recorded. Forty-one patients (55%) were eligible for the study. For each patient, DNA was extracted and quantified from paraffin-embedded sections of tumor tissue, and the mutational status of IDH1 (codons 105 and 132) and IDH2 (codons 140 and 172) genes was assessed. Of those, 56% (23 of 41) of patients had adequate DNA for analysis of IDH mutations: 10 male and 13 female patients, with a median age of 59 years (range 15 to 98 years). There were 22 conventional chondrosarcomas (8 atypical cartilaginous tumors, 11 Grade 2, and 3 Grade 3) and 1 dedifferentiated chondrosarcoma. Stage was IA in 3 patients, IB in 5, IIA in 1, IIB in 13, and III in 1, according to the Musculoskeletal Tumor Society classification. At a median follow-up of 3.5 years (range 4 months to 5.6 years), 14 patients were disease-free, 2 were alive with disease, and 7 died (3 within 2 years from surgery). Eight patients had metastases, and 7 developed local recurrence. We determined the proportion of patients who carried IDH mutations, and compared patients with and without those mutations in terms of overall survival, metastasis-free survival, and local recurrence-free survival using Kaplan-Meier curves. RESULTS Six patients showed wild-type IDH genes, and 17 had IDH mutations (12 had IDH1 R132, 3 had IDH1 G105, and 2 had IDH2 R172). Overall survival at 2 years using the Kaplan-Meier estimator was lower in patients with an IDH mutation than in those with the wild-type gene (75% [95% confidence interval 50% to 99%] versus 100% [95% CI 100% to 100%]; p = 0.002). Two-year metastasis-free survival was also lower in patients with an IDH mutation than in those with the wild-type gene (33% [95% CI 7% to 60%] versus 100% [95% CI 100% to 100%]; p = 0.001), as was 2-year local recurrence-free survival (70% [95% CI 42% to 98%] versus 100% [95% CI 100% to 100%]; p = 0.02). CONCLUSION We found that IDH1 R132 mutations were negatively associated with the prognosis of patients with bone chondrosarcomas. Nevertheless, more extensive studies (such as multicenter international studies) are needed and advisable to confirm our observations in this preliminary small series. Moreover, evaluating mutational status in fresh samples instead of in paraffin-embedded sections could help to increase the number of patients with adequate DNA for analysis. If our findings will be confirmed, the evaluation of IDH mutational status in biopsy samples or resection specimens could be considered when stratifying patients, highlighting those who may benefit from more aggressive treatment (such as adjuvant chemotherapy) or closer follow-up. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Giulia Trovarelli
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Marta Sbaraglia
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Andrea Angelini
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Elena Bellan
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Elisa Pala
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Elisa Belluzzi
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Assunta Pozzuoli
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
| | - Chiara Borga
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padua, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology of University of Padova, Padua, Italy
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5
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Denu RA, Yang RK, Lazar AJ, Patel SS, Lewis VO, Roszik J, Livingston JA, Wang WL, Shaw KR, Ratan R, Zarzour MA, Bird J, Raza S, Akdemir KC, Ahnert JR, Subbiah V, Patel S, Conley AP. Clinico-Genomic Profiling of Conventional and Dedifferentiated Chondrosarcomas Reveals TP53 Mutation to Be Associated with Worse Outcomes. Clin Cancer Res 2023; 29:4844-4852. [PMID: 37747813 PMCID: PMC10835757 DOI: 10.1158/1078-0432.ccr-23-1703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/02/2023] [Accepted: 09/21/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Chondrosarcomas are the most common primary bone tumor in adults. Isocitrate dehydrogenase 1 (IDH1) and IDH2 mutations are prevalent. We aimed to assess the clinico-genomic properties of IDH mutant versus IDH wild-type (WT) chondrosarcomas as well as alterations in other genes. EXPERIMENTAL DESIGN We included 93 patients with conventional and dedifferentiated chondrosarcoma for which there were available clinical next-generation sequencing data. Clinical and genomic data were extracted and compared between IDH mutant and IDH WT chondrosarcomas and between TP53 mutant and TP53 WT chondrosarcomas. RESULTS IDH1 and IDH2 mutations are prevalent in chondrosarcoma (50.5%), more common in chondrosarcomas arising in the extremities, associated with higher age at diagnosis, and more common in dedifferentiated chondrosarcomas compared with grades 1-3 conventional chondrosarcoma. There was no difference in survival based on IDH mutation in univariate and multivariate analyses. TP53 mutation was the next most prevalent (41.9%) and is associated with worse overall survival and metastasis-free survival in both univariate and multivariate analyses. TP53 mutation was also associated with higher risk of recurrence following curative-intent surgery and worse survival among patients that presented with de novo metastatic disease. CONCLUSIONS IDH mutations are prevalent in chondrosarcoma though were not associated with survival outcomes in this cohort. TP53 mutations were the next most common alteration and were associated with worse outcomes.
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Affiliation(s)
- Ryan A. Denu
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Richard K. Yang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alexander J. Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Genomic Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shalin S. Patel
- Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Valerae O. Lewis
- Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jason Roszik
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J. Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wei-Lien Wang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kenna R. Shaw
- Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ravin Ratan
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maria A. Zarzour
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Justin Bird
- Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shaan Raza
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kadir C. Akdemir
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jordi Rodon Ahnert
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shreyaskumar Patel
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anthony P. Conley
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Setola E, Benini S, Righi A, Gamberi G, Carretta E, Ferrari C, Avnet S, Palmerini E, Magagnoli G, Gambarotti M, Lollini PL, Cesari M, Cocchi S, Paioli A, Longhi A, Scotlandi K, Laginestra MA, Donati DM, Baldini N, Ibrahim T. IDH mutations in G2-3 conventional central bone chondrosarcoma: a mono institutional experience. BMC Cancer 2023; 23:907. [PMID: 37752419 PMCID: PMC10521511 DOI: 10.1186/s12885-023-11396-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Heterozygous isocitrate dehydrogenase (IDH) mutations occur in about half of conventional central bone chondrosarcomas (CCBC). Aim of this study was to assess the frequency and prognostic impact of IDH mutations in high grade CCBC patients. METHODS 64 patients with G2 and G3 CCBC were included. DNA extraction, PCR amplification of IDH1/2 exon 4s, and sequencing analysis with Sanger were performed. RESULTS IDH mutations were detected in 24/54 patients (44%): IDH1 in 18, IDH2 in 4, and both IDH1/2 in 2 patients. The frequency of mutations was 37% in G2 vs. 69% in G3 (p = 0.039), and 100% in three Ollier disease associated chondrosarcoma. 5-year overall survival (OS) at 124 months (range 1-166) was 51%, with no significant difference based on the IDH mutational status: 61% in IDHmut vs. 44% in IDH wild type (IDHwt). The 5-year relapse free survival (RFS) was 33% (95% CI:10-57) for IDHmut vs. 57% (95%CI: 30-77) for IDHwt. Progression free survival (PFS) was 25% (95%CI:1-65) IDHmut vs. 16% (95%CI: 0.7-52) IDHwt. 55% (5/9) of IDHmut G2 became higher grade at the recurrence, as compared with 25% (3/12) of G2 IDHwt. CONCLUSIONS This study shows a higher frequency of IDH mutations in G3 CCBC as compared with G2. No significant differences in OS, RFS, and PFS by mutational status were detected. After relapse, a higher rate of G3 for IDH mutated CCBC was observed.
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Affiliation(s)
- Elisabetta Setola
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy.
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.
| | - S Benini
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - G Gamberi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - E Carretta
- IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - C Ferrari
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - S Avnet
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - E Palmerini
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy
| | - G Magagnoli
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M Gambarotti
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - P L Lollini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - M Cesari
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy
| | - S Cocchi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Paioli
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy
| | - A Longhi
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy
| | - K Scotlandi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M A Laginestra
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - D M Donati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - N Baldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Biomedical Science and Technologies Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - T Ibrahim
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy
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7
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Zając W, Dróżdż J, Kisielewska W, Karwowska W, Dudzisz-Śledź M, Zając AE, Borkowska A, Szumera-Ciećkiewicz A, Szostakowski B, Rutkowski P, Czarnecka AM. Dedifferentiated Chondrosarcoma from Molecular Pathology to Current Treatment and Clinical Trials. Cancers (Basel) 2023; 15:3924. [PMID: 37568740 PMCID: PMC10417069 DOI: 10.3390/cancers15153924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Dedifferentiated chondrosarcoma (DDCS) is a rare subtype of chondrosarcoma, a primary cartilaginous malignant neoplasm. It accounts for up to 1-2% of all chondrosarcomas and is generally associated with one of the poorest prognoses among all chondrosarcomas with the highest risk of metastasis. The 5-year survival rates range from 7% to 24%. DDCS may develop at any age, but the average presentation age is over 50. The most common locations are the femur, pelvis humerus, scapula, rib, and tibia. The standard treatment for localised disease is surgical resection. Most patients are diagnosed in unresectable and advanced stages, and chemotherapy for localised and metastatic dedifferentiated DDCS follows protocols used for osteosarcoma.
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Affiliation(s)
- Weronika Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Julia Dróżdż
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Weronika Kisielewska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Weronika Karwowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Monika Dudzisz-Śledź
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Aneta Borkowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
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8
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Tlemsani C, Larousserie F, De Percin S, Audard V, Hadjadj D, Chen J, Biau D, Anract P, Terris B, Goldwasser F, Pasmant E, Boudou-Rouquette P. Biology and Management of High-Grade Chondrosarcoma: An Update on Targets and Treatment Options. Int J Mol Sci 2023; 24:ijms24021361. [PMID: 36674874 PMCID: PMC9862566 DOI: 10.3390/ijms24021361] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/19/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
This review provides an overview of histopathology, clinical presentation, molecular pathways, and potential new systemic treatments of high-grade chondrosarcomas (CS), including grade 2−3 conventional, dedifferentiated, and mesenchymal CS. The diagnosis of CS combines radiological and histological data in conjunction with patient clinical presentations. Conventional CS is the most frequent subtype of CS (85%) and represents about 25% of primary bone tumors in adults; they can be categorized according to their bone location into central, peripheral, and periosteal chondrosarcomas. Central and peripheral CS differ at the molecular level with either IDH1/2 mutations or EXT1/2 mutations, respectively. CDKN2A/B deletions are also frequent in conventional CS, as well as COL2A1 mutations. Dedifferentiated CS develops when low-grade conventional CS transforms into a high-grade sarcoma and most frequently exhibits features of osteosarcoma, fibrosarcoma, or undifferentiated pleomorphic sarcoma. Their molecular characteristics are similar to conventional CS. Mesenchymal CS is a totally different pathological entity exhibiting recurrent translocations. Their clinical presentation and management are different too. The standard treatment of CSs is wide en-bloc resection. CS are relatively radiotherapy resistant; therefore, doses >60 Gy are needed in an attempt to achieve local control in unresectable tumors. Chemotherapy is possibly effective in mesenchymal chondrosarcoma and is of uncertain value in dedifferentiated chondrosarcoma. Due to resistance to standard anticancer agents, the prognosis is poor in patients with metastatic or unresectable chondrosarcomas. Recently, the refined characterization of the molecular profile, as well as the development of new treatments, allow new therapeutic options for these rare tumors. The efficiency of IDH1 inhibitors in other malignancies suggests that these inhibitors will be part of IDH1/2 mutated conventional CS management soon. Other treatment approaches, such as PIK3-AKT-mTOR inhibitors, cell cycle inhibitors, and epigenetic or immune modulators based on improving our understanding of CS molecular biology, are emerging.
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Affiliation(s)
- Camille Tlemsani
- Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
- INSERM U1016-CNRS UMR8104, Cochin Institute, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Frédérique Larousserie
- Department of Pathology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Sixtine De Percin
- Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Virginie Audard
- Department of Pathology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Djihad Hadjadj
- INSERM U1016-CNRS UMR8104, Cochin Institute, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Jeanne Chen
- Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - David Biau
- Department of Orthopedic Surgery, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Philippe Anract
- Department of Orthopedic Surgery, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Benoit Terris
- Department of Pathology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - François Goldwasser
- Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Eric Pasmant
- INSERM U1016-CNRS UMR8104, Cochin Institute, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
- Department of Genetics, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
| | - Pascaline Boudou-Rouquette
- Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
- INSERM U1016-CNRS UMR8104, Cochin Institute, Paris Cancer Institute CARPEM, Université Paris Cité, APHP.Centre, 75014 Paris, France
- Correspondence: ; Tel.: +33-1-58-41-23-30; Fax: +33-1-58-41-14-34
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9
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Cross W, Lyskjær I, Lesluyes T, Hargreaves S, Strobl AC, Davies C, Waise S, Hames-Fathi S, Oukrif D, Ye H, Amary F, Tirabosco R, Gerrand C, Baker T, Barnes D, Steele C, Alexandrov L, Bond G, Cool P, Pillay N, Loo PV, Flanagan AM. A genetic model for central chondrosarcoma evolution correlates with patient outcome. Genome Med 2022; 14:99. [PMID: 36042521 PMCID: PMC9426036 DOI: 10.1186/s13073-022-01084-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 07/07/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Central conventional chondrosarcoma (CS) is the most common subtype of primary malignant bone tumour in adults. Treatment options are usually limited to surgery, and prognosis is challenging. These tumours are characterised by the presence and absence of IDH1 and IDH2 mutations, and recently, TERT promoter alterations have been reported in around 20% of cases. The effect of these mutations on clinical outcome remains unclear. The purpose of this study was to determine if prognostic accuracy can be improved by the addition of genomic data, and specifically by examination of IDH1, IDH2, and TERT mutations. METHODS In this study, we combined both archival samples and data sourced from the Genomics England 100,000 Genomes Project (n = 356). Mutations in IDH1, IDH2, and TERT were profiled using digital droplet PCR (n = 346), whole genome sequencing (n=68), or both (n = 64). Complex events and other genetic features were also examined, along with methylation array data (n = 84). We correlated clinical features and patient outcomes with our genetic findings. RESULTS IDH2-mutant tumours occur in older patients and commonly present with high-grade or dedifferentiated disease. Notably, TERT mutations occur most frequently in IDH2-mutant tumours, although have no effect on survival in this group. In contrast, TERT mutations are rarer in IDH1-mutant tumours, yet they are associated with a less favourable outcome in this group. We also found that methylation profiles distinguish IDH1- from IDH2-mutant tumours. IDH wild-type tumours rarely exhibit TERT mutations and tend to be diagnosed in a younger population than those with tumours harbouring IDH1 and IDH2 mutations. A major genetic feature of this group is haploidisation and subsequent genome doubling. These tumours evolve less frequently to dedifferentiated disease and therefore constitute a lower risk group. CONCLUSIONS Tumours with IDH1 or IDH2 mutations or those that are IDHwt have significantly different genetic pathways and outcomes in relation to TERT mutation. Diagnostic testing for IDH1, IDH2, and TERT mutations could therefore help to guide clinical monitoring and prognostication.
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Affiliation(s)
- William Cross
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK
| | - Iben Lyskjær
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK ,grid.83440.3b0000000121901201Medical Genomics Research Group, University College London, UCL Cancer Institute, London, UK
| | - Tom Lesluyes
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Steven Hargreaves
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK
| | - Anna-Christina Strobl
- grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Christopher Davies
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK ,grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Sara Waise
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.5491.90000 0004 1936 9297Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - Shadi Hames-Fathi
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK
| | - Dahmane Oukrif
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK
| | - Hongtao Ye
- grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Fernanda Amary
- grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Roberto Tirabosco
- grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Craig Gerrand
- grid.416177.20000 0004 0417 7890Bone Tumour Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Toby Baker
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - David Barnes
- grid.6572.60000 0004 1936 7486Institute of Cancer and Genomic Sciences, Birmingham University, Birmingham, UK
| | - Christopher Steele
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK
| | - Ludmil Alexandrov
- grid.266100.30000 0001 2107 4242University of California, San Diego, USA
| | - Gareth Bond
- grid.6572.60000 0004 1936 7486Institute of Cancer and Genomic Sciences, Birmingham University, Birmingham, UK
| | | | - Paul Cool
- grid.412943.90000 0001 0507 535XRobert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK ,grid.9757.c0000 0004 0415 6205Keele University, Keele, UK
| | - Nischalan Pillay
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK ,grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Peter Van Loo
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Adrienne M. Flanagan
- grid.83440.3b0000000121901201Research Department of Pathology, University College London, UCL Cancer Institute, London, UK ,grid.416177.20000 0004 0417 7890Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK
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10
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Lyskjær I, Davies C, Strobl A, Hindley J, James S, Lalam RK, Cross W, Hide G, Rankin KS, Jeys L, Tirabosco R, Stevenson J, O’Donnell P, Cool P, Flanagan AM. Circulating tumour DNA is a promising biomarker for risk stratification of central chondrosarcoma with IDH1/2 and GNAS mutations. Mol Oncol 2021; 15:3679-3690. [PMID: 34528398 PMCID: PMC8637565 DOI: 10.1002/1878-0261.13102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
Chondrosarcoma (CS) is a rare tumour type and the most common primary malignant bone cancer in adults. The prognosis, currently based on tumour grade, imaging and anatomical location, is not reliable, and more objective biomarkers are required. We aimed to determine whether the level of circulating tumour DNA (ctDNA) in the blood of CS patients could be used to predict outcome. In this multi-institutional study, we recruited 145 patients with cartilaginous tumours, of which 41 were excluded. ctDNA levels were assessed in 83 of the remaining 104 patients, whose tumours harboured a hotspot mutation in IDH1/2 or GNAS. ctDNA was detected pre-operatively in 31/83 (37%) and in 12/31 (39%) patients postoperatively. We found that detection of ctDNA was more accurate than pathology for identification of high-grade tumours and was associated with a poor prognosis; ctDNA was never associated with CS grade 1/atypical cartilaginous tumours (ACT) in the long bones, in neoplasms sited in the small bones of the hands and feet or in tumours measuring less than 80 mm. Although the results are promising, they are based on a small number of patients, and therefore, introduction of this blood test into clinical practice as a complementary assay to current standard-of-care protocols would allow the assay to be assessed more stringently and developed for a more personalised approach for the treatment of patients with CS.
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Affiliation(s)
- Iben Lyskjær
- Research Department of PathologyUniversity College LondonUCL Cancer InstituteLondonUK
- Medical Genomics Research GroupUniversity College LondonUCL Cancer InstituteLondonUK
| | - Christopher Davies
- Research Department of PathologyUniversity College LondonUCL Cancer InstituteLondonUK
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Anna‐Christina Strobl
- Research Department of PathologyUniversity College LondonUCL Cancer InstituteLondonUK
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Joanna Hindley
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Steven James
- Department of Musculoskeletal ImagingRoyal Orthopaedic HospitalBirminghamUK
| | - Radhesh K. Lalam
- Department of RadiologyRoyal National Orthopaedic HospitalStanmoreUK
| | - William Cross
- Research Department of PathologyUniversity College LondonUCL Cancer InstituteLondonUK
| | - Geoff Hide
- North of England Bone and Soft Tissue Tumour ServiceFreeman HospitalNewcastleUK
| | - Kenneth S. Rankin
- North of England Bone and Soft Tissue Tumour ServiceFreeman HospitalNewcastleUK
- Newcastle Centre for CancerNewcastle UniversityUK
| | - Lee Jeys
- Orthopaedic DepartmentRoyal Orthopaedic Hospital NHS Foundation TrustBirminghamUK
| | - Roberto Tirabosco
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Jonathan Stevenson
- Department of Orthopaedic Oncology and ArthroplastyRoyal Orthopaedic Hospital NHS Foundation TrustBirminghamUK
| | | | - Paul O’Donnell
- Research Department of PathologyUniversity College LondonUCL Cancer InstituteLondonUK
- Department of RadiologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Paul Cool
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation TrustOswestryUK
- Keele UniversityUK
| | - Adrienne M. Flanagan
- Research Department of PathologyUniversity College LondonUCL Cancer InstituteLondonUK
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
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11
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Gong LH, Su YB, Zhang W, Liu WF, Dong RF, Sun XQ, Zhang M, Ding Y. Dedifferentiated Central Chondrosarcoma: A Clinical, Histopathological, and Immunohistochemical Analysis of 57 Cases. Front Med (Lausanne) 2021; 8:746909. [PMID: 34631758 PMCID: PMC8494968 DOI: 10.3389/fmed.2021.746909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 08/31/2021] [Indexed: 11/24/2022] Open
Abstract
Dedifferentiated central chondrosarcoma (DCCS) is a rare cartilage tumor with invasive biological behavior and a poor prognosis. To better understand the morphological characteristics of this type of tumor and its internal mechanism of dedifferentiation, we retrospectively analyzed 57 cases of DCCS. A total of 29 female and 28 male patients were included, ranging in age from 20 to 76 years, with a median age of 54 years. Fifty-seven cases of DCCS occurred in the pelvis (n = 29), femur (n = 17), scapula (n = 4), tibia (n = 2), humerus (n = 2), metatarsals (n = 1), fibula (n = 1), and radius (n = 1). Radiologically, DCCS had two different appearances on imaging, with an area showing calcifications of the cartilage forming the tumor juxtaposed to a lytic area with a highly aggressive, non-cartilaginous component. Histopathologically, the distinctive morphological features consisted of two kinds of defined components: a well-differentiated cartilaginous tumor and non-cartilaginous sarcoma. The cartilaginous components included grade 1 (n = 38; 66.7%) and grade 2 (n = 19; 33.3%) cartilage. The sarcoma components included those of osteosarcoma (n = 29; 50.9%), undifferentiated pleomorphic sarcoma (n = 20; 35.1%), rhabdomyosarcoma (n = 3; 5.2%), fibrosarcoma (n = 2; 3.5%), spindle cell sarcoma (n = 2; 3.5%) and angiosarcoma (n = 1; 1.8%). Immunohistochemistry showed that the expression of p53 and RB in the sarcoma components was significantly higher than that in the cartilaginous components, suggesting that these factors play roles in the dedifferentiation process of chondrosarcoma. DCCS is a highly malignant tumor with a poor prognosis. Except for the patients who were lost to follow-up, most of our patients died.
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Affiliation(s)
- Li-Hua Gong
- Department of Pathology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
| | - Yong-Bin Su
- Department of Radiology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
| | - Wen Zhang
- Department of Pathology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
| | - Wei-Feng Liu
- Department of Orthopedic Oncology Surgery, Beijing Jishuitan Hospital, Fourth Medical College of Peking University, Beijing, China
| | - Rong-Fang Dong
- Department of Pathology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
| | - Xiao-Qi Sun
- Department of Pathology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
| | - Ming Zhang
- Department of Pathology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
| | - Yi Ding
- Department of Pathology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, China
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Zając AE, Kopeć S, Szostakowski B, Spałek MJ, Fiedorowicz M, Bylina E, Filipowicz P, Szumera-Ciećkiewicz A, Tysarowski A, Czarnecka AM, Rutkowski P. Chondrosarcoma-from Molecular Pathology to Novel Therapies. Cancers (Basel) 2021; 13:2390. [PMID: 34069269 PMCID: PMC8155983 DOI: 10.3390/cancers13102390] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Chondrosarcoma (CHS) is the second most common primary malignant bone sarcoma. Overall survival and prognosis of this tumor are various and often extreme, depending on histological grade and tumor subtype. CHS treatment is difficult, and surgery remains still the gold standard due to the resistance of this tumor to other therapeutic options. Considering the role of differentiation of CHS subtypes and the need to develop new treatment strategies, in this review, we introduced a multidisciplinary characterization of CHS from its pathology to therapies. We described the morphology of each subtype with the role of immunohistochemical markers in diagnostics of CHS. We also summarized the most frequently mutated genes and genome regions with altered pathways involved in the pathology of this tumor. Subsequently, we discussed imaging methods and the role of currently used therapies, including surgery and the limitations of chemo and radiotherapy. Finally, in this review, we presented novel targeted therapies, including those at ongoing clinical trials, which can be a potential future target in designing new therapeutics for patients with CHS.
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Affiliation(s)
- Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Sylwia Kopeć
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Mateusz J. Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Michał Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland;
| | - Elżbieta Bylina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paulina Filipowicz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Andrzej Tysarowski
- Department of Pathology and Laboratory Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
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Abstract
Bone tumors are a rare and heterogeneous group of neoplasms that occur in the bone. The diversity and considerable morphologic overlap of bone tumors with other mesenchymal and nonmesenchymal bone lesions can complicate diagnosis. Accurate histologic diagnosis is crucial for appropriate management and prognostication. Since the publication of the fourth edition of the World Health Organization (WHO) classification of tumors of soft tissue and bone in 2013, significant advances have been made in our understanding of bone tumor molecular biology, classification, prognostication, and treatment. Detection of tumor-specific molecular alterations can facilitate the accurate diagnosis of histologically challenging cases. The fifth edition of the 2020 WHO classification of tumors of soft tissue and bone tumors provides an updated classification scheme and essential diagnostic criteria for bone tumors. Herein, we summarize these updates, focusing on major changes in each category of bone tumor, the newly described tumor entities and subtypes of existing tumor types, and newly described molecular and genetic data.
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Affiliation(s)
- Joon Hyuk Choi
- Department of Pathology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jae Y Ro
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX
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Ma R, Mandell J, Lu F, Heim T, Schoedel K, Duensing A, Watters RJ, Weiss KR. Do Patient-derived Spheroid Culture Models Have Relevance in Chondrosarcoma Research? Clin Orthop Relat Res 2021; 479:477-490. [PMID: 32469486 PMCID: PMC7899730 DOI: 10.1097/corr.0000000000001317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/27/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND In high-grade chondrosarcoma, 5-year survival is lower than 50%. Therefore, it is important that preclinical models that mimic the disease with the greatest possible fidelity are used to potentially develop new treatments. Accumulating evidence suggests that two-dimensional (2-D) cell culture may not accurately represent the tumor's biology. It has been demonstrated in other cancers that three-dimensional (3-D) cancer cell spheroids may recapitulate tumor biology and response to treatment with greater fidelity than traditional 2-D techniques. To our knowledge, the formation of patient-derived chondrosarcoma spheroids has not been described. QUESTIONS/PURPOSES (1) Can patient-derived chondrosarcoma spheroids be produced? (2) Do spheroids recapitulate human chondrosarcoma better than 2-D cultures, both morphologically and molecularly? (3) Can chondrosarcoma spheroids provide an accurate model to test novel treatments? METHODS Experiments to test the feasibility of spheroid formation of chondrosarcoma cells were performed using HT-1080, an established chondrosarcoma cell line, and two patient-derived populations, TP19-S26 and TP19-S115. Cells were cultured in flasks, trypsinized, and seeded into 96-well ultra-low attachment plates with culture media. After spheroids formed, they were monitored daily by bright-field microscopy. Spheroids were fixed using paraformaldehyde and embedded in agarose. After dehydration with isopropanol, paraffin-embedded spheroids were sectioned, and slides were stained with hematoxylin and eosin. To compare differences and similarities in gene expression between 2-D and 3-D chondrosarcoma cultures and primary tumors, and to determine whether these spheroids recapitulated the biology of chondrosarcoma, RNA was extracted from 2-D cultures, spheroids, and tumors. Quantitative polymerase chain reaction was performed to detect chondrosarcoma markers of interest, including vascular endothelial growth factor alpha, hypoxia-inducible factor 1α, COL2A1, and COL10A1. To determine whether 2-D and 3-D cultures responded differently to novel chondrosarcoma treatments, we compared their sensitivities to disulfiram and copper chloride treatment. To test their sensitivity to disulfiram and copper chloride treatment, 10,000 cells were seeded into 96-well plates for 2-D culturing and 3000 cells in each well for 3-D culturing. After treating the cells with disulfiram and copper for 48 hours, we detected cell viability using quantitative presto-blue staining and measured via plate reader. RESULTS Cell-line and patient-derived spheroids were cultured and monitored over 12 days. Qualitatively, we observed that HT-1080 demonstrated unlimited growth, while TP19-S26 and TP19-S115 contracted during culturing relative to their initial size. Hematoxylin and eosin staining of HT-1080 spheroids revealed that cell-cell attachments were more pronounced at the periphery of the spheroid structure than at the core, while the core was less dense. Spheroids derived from the intermediate-grade chondrosarcoma TP19-S26 were abundant in extracellular matrix, and spheroids derived from the dedifferentiated chondrosarcoma TP19-S115 had a higher cellularity and heterogeneity with spindle cells at the periphery. In the HT-1080 cells, differences in gene expression were appreciated with spheroids demonstrating greater expressions of VEGF-α (1.01 ± 0.16 versus 6.48 ± 0.55; p = 0.003), COL2A1 (1.00 ± 0.10 versus 7.46 ± 2.52; p < 0.001), and COL10A1 (1.01 ± 0.19 versus 22.53 ± 4.91; p < 0.001). Differences in gene expressions were also noted between primary tumors, spheroids, and 2-D cultures in the patient-derived samples TP19-S26 and TP19-S115. TP19-S26 is an intermediate-grade chondrosarcoma. With the numbers we had, we could not detect a difference in VEGF-α and HIF1α gene expression compared with the primary tumor. COL2A1 (1.00 ± 0.14 versus 1.76 ± 0.10 versus 335.66 ± 31.13) and COL10A1 (1.06 ± 0.378 versus 5.98 ± 0.45 versus 138.82 ± 23.4) expressions were both greater in the tumor (p (COL2A1) < 0.001; p (COL10A1) < 0.0001) and 3-D cultures (p (COL2A1) = 0.004; p (COL10A1) < 0.0001) compared with 2-D cultures. We could not demonstrate a difference in VEGF-α and HIF1α expressions in TP19-S115, a dedifferentiated chondrosarcoma, in the tumor compared with 2-D and 3-D cultures. COL2A1 (1.00 ± 0.02 versus 1.86 ± 0.18 versus 2.95 ± 0.56) and COL10A1 (1.00 ± 0.03 versus 5.52 ± 0.66 versus 3.79 ± 0.36) expressions were both greater in spheroids (p (COL2A1) = 0.003; p (COL10A1) < 0.0001) and tumors (p (COL2A1) < 0.001; p (COL10A1) < 0.0001) compared with 2-D cultures. Disulfiram-copper chloride treatment demonstrated high cytotoxicity in HT-1080 and SW-1353 chondrosarcoma cells grown in the 2-D monolayer, but 3-D spheroids were highly resistant to this treatment. CONCLUSION We provide preliminary findings that it is possible to generate 3-D spheroids from chondrosarcoma cell lines and two human chondrosarcomas (one dedifferentiated chondrosarcoma and one intermediate-grade chondrosarcoma). Chondrosarcoma spheroids derived from human tumors demonstrated morphology more reminiscent of primary tumors than cells grown in 2-D culture. Spheroids displayed similar expressions of cartilage markers as the primary tumor, and we observed a higher expression of collagen markers in the spheroids compared with cells grown in monolayer. Spheroids also demonstrated greater chemotherapy resistance than monolayer cells, but more patient-derived spheroids are needed to further conclude that 3-D cultures may mimic the chemoresistance that chondrosarcomas demonstrate clinically. Additional studies on patient-derived chondrosarcoma spheroids are warranted. CLINICAL RELEVANCE Chondrosarcomas demonstrate resistance to chemotherapy and radiation, and we believe that if they can be replicated, models such as 3-D spheroids may provide a method to test novel treatments for human chondrosarcoma. Additional comprehensive genomic studies are required to compare 2-D and 3-D models with the primary tumor to determine the most effective way to study this disease in vitro.
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Affiliation(s)
- Ruichen Ma
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Jonathan Mandell
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Feiqi Lu
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Tanya Heim
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Karen Schoedel
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Anette Duensing
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Rebecca J Watters
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Kurt R Weiss
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
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Nacev BA, Jones KB, Intlekofer AM, Yu JSE, Allis CD, Tap WD, Ladanyi M, Nielsen TO. The epigenomics of sarcoma. Nat Rev Cancer 2020; 20:608-623. [PMID: 32782366 PMCID: PMC8380451 DOI: 10.1038/s41568-020-0288-4] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
Epigenetic regulation is critical to physiological control of development, cell fate, cell proliferation, genomic integrity and, fundamentally, transcriptional regulation. This epigenetic control occurs at multiple levels including through DNA methylation, histone modification, nucleosome remodelling and modulation of the 3D chromatin structure. Alterations in genes that encode chromatin regulators are common among mesenchymal neoplasms, a collection of more than 160 tumour types including over 60 malignant variants (sarcomas) that have unique and varied genetic, biological and clinical characteristics. Herein, we review those sarcomas in which chromatin pathway alterations drive disease biology. Specifically, we emphasize examples of dysregulation of each level of epigenetic control though mechanisms that include alterations in metabolic enzymes that regulate DNA methylation and histone post-translational modifications, mutations in histone genes, subunit loss or fusions in chromatin remodelling and modifying complexes, and disruption of higher-order chromatin structure. Epigenetic mechanisms of tumorigenesis have been implicated in mesenchymal tumours ranging from chondroblastoma and giant cell tumour of bone to chondrosarcoma, malignant peripheral nerve sheath tumour, synovial sarcoma, epithelioid sarcoma and Ewing sarcoma - all diseases that present in a younger patient population than most cancers. Finally, we review current and potential future approaches for the development of sarcoma therapies based on this emerging understanding of chromatin dysregulation.
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Affiliation(s)
- Benjamin A Nacev
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- The Laboratory of Chromatin Biology and Epigenetics, The Rockefeller University, New York, NY, USA
| | - Kevin B Jones
- Department of Orthopaedics, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Andrew M Intlekofer
- Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jamie S E Yu
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - C David Allis
- The Laboratory of Chromatin Biology and Epigenetics, The Rockefeller University, New York, NY, USA
| | - William D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Torsten O Nielsen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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Genomics and Therapeutic Vulnerabilities of Primary Bone Tumors. Cells 2020; 9:cells9040968. [PMID: 32295254 PMCID: PMC7227002 DOI: 10.3390/cells9040968] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 12/17/2022] Open
Abstract
Osteosarcoma, Ewing sarcoma and chondrosarcoma are rare diseases but the most common primary tumors of bone. The genes directly involved in the sarcomagenesis, tumor progression and treatment responsiveness are not completely defined for these tumors, and the powerful discovery of genetic analysis is highly warranted in the view of improving the therapy and cure of patients. The review summarizes recent advances concerning the molecular and genetic background of these three neoplasms and, of their most common variants, highlights the putative therapeutic targets and the clinical trials that are presently active, and notes the fundamental issues that remain unanswered. In the era of personalized medicine, the rarity of sarcomas may not be the major obstacle, provided that each patient is studied extensively according to a road map that combines emerging genomic and functional approaches toward the selection of novel therapeutic strategies.
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Abstract
AbstractChondrosarcomas are rare cancers of bone that arise from the malignant transformation of cells of chondrocytic lineage. They are known to be resistant to systemic cytotoxic chemotherapy and radiotherapy. The mainstay of management of localised disease is en bloc surgical resection with curative intent. Metastatic chondrosarcoma has a dismal prognosis, and to date, there are no proven effective systemic therapies in the advanced setting. Genomic studies have demonstrated that 50 to 80% of chondrosarcomas harbour a mutation in either the IDH1 or IDH2 gene. IDH inhibitors are currently under investigation in clinical trials, after showing promising results in phase 1 studies in IDH mutated cancers. In chondrosarcoma, IDH mutations represent an attractive target, however, early results with IDH inhibitors in IDH mutated chondrosarcoma are modest and the final results of ongoing trials are eagerly awaited.
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Amary F, Perez-Casanova L, Ye H, Cottone L, Strobl AC, Cool P, Miranda E, Berisha F, Aston W, Rocha M, O'Donnell P, Pillay N, Tirabosco R, Baumhoer D, Hookway ES, Flanagan AM. Synovial chondromatosis and soft tissue chondroma: extraosseous cartilaginous tumor defined by FN1 gene rearrangement. Mod Pathol 2019; 32:1762-1771. [PMID: 31273315 PMCID: PMC6882679 DOI: 10.1038/s41379-019-0315-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 12/21/2022]
Abstract
A fusion between fibronectin 1 (FN1) and activin receptor 2A (ACVR2A) has been reported previously in isolated cases of the synovial chondromatosis. To analyze further and validate the findings, we performed FISH and demonstrated recurrent FN1-ACVR2A rearrangements in synovial chondromatosis (57%), and chondrosarcoma secondary to synovial chondromatosis (75%), showing that FN1 and/or AVCR2A gene rearrangements do not distinguish between benign and malignant synovial chondromatosis. RNA sequencing revealed the presence of the FN1-ACVR2A fusion in several cases that were negative by FISH suggesting that the true prevalence of this fusion is potentially higher than 57%. In soft tissue chondromas, FN1 alterations were detected by FISH in 50% of cases but no ACVR2A alterations were identified. RNA sequencing identified a fusion involving FN1 and fibroblast growth factor receptor 2 (FGFR2) in the case of soft tissue chondroma and FISH confirmed recurrent involvement of both FGFR1 and FGFR2. These fusions were present in a subset of soft tissue chondromas characterized by grungy calcification, a feature reminiscent of phosphaturic mesenchymal tumor. However, unlike the latter, fibroblast growth factor 23 (FGF23) mRNA expression was not elevated in soft tissue chondromas harboring the FN1-FGFR1 fusion. The mutual exclusivity of ACVR2A rearrangements observed in synovial chondromatosis and FGFR1/2 in soft tissue chondromas suggests these represent separate entities. There have been no reports of malignant soft tissue chondromas, therefore differentiating these lesions will potentially alter clinical management by allowing soft tissue chondromas to be managed more conservatively.
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Affiliation(s)
- Fernanda Amary
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Luis Perez-Casanova
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Hongtao Ye
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Lucia Cottone
- Cancer Institute, 72 Huntley Street, University College London, London, WC1E 6BT, UK
| | | | - Paul Cool
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG, UK
| | - Elena Miranda
- Cancer Institute, 72 Huntley Street, University College London, London, WC1E 6BT, UK
| | - Fitim Berisha
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - William Aston
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Maia Rocha
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
- Cancer Institute, 72 Huntley Street, University College London, London, WC1E 6BT, UK
| | - Paul O'Donnell
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Nischalan Pillay
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
- Cancer Institute, 72 Huntley Street, University College London, London, WC1E 6BT, UK
| | - Roberto Tirabosco
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK
| | - Daniel Baumhoer
- Bone Tumor Reference Center, Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Edward S Hookway
- Cancer Institute, 72 Huntley Street, University College London, London, WC1E 6BT, UK.
| | - Adrienne M Flanagan
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK.
- Cancer Institute, 72 Huntley Street, University College London, London, WC1E 6BT, UK.
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Baumhoer D, Amary F, Flanagan AM. An update of molecular pathology of bone tumors. Lessons learned from investigating samples by next generation sequencing. Genes Chromosomes Cancer 2018; 58:88-99. [PMID: 30582658 DOI: 10.1002/gcc.22699] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 12/27/2022] Open
Abstract
The last decade has seen the majority of primary bone tumor subtypes become defined by molecular genetic alteration. Examples include giant cell tumour of bone (H3F3A p.G34W), chondroblastoma (H3F3B p.K36M), mesenchymal chondrosarcoma (HEY1-NCOA2), chondromyxoid fibroma (GRM1 rearrangements), aneurysmal bone cyst (USP6 rearrangements), osteoblastoma/osteoid osteoma (FOS/FOSB rearrangements), and synovial chondromatosis (FN1-ACVR2A and ACVR2A-FN1). All such alterations are mutually exclusive. Many of these have been translated into clinical service using immunohistochemistry or FISH. 60% of central chondrosarcoma is characterised by either isocitrate dehydrogenase (IDH) 1 or IDH2 mutations distinguishing them from other cartilaginous tumours. In contrast, recurrent alterations which are clinically helpful have not been found in high grade osteosarcoma. High throughput next generation sequencing has also proved valuable in identifying germ line alterations in a significant proportion of young patients with primary malignant bone tumors. These findings will play an increasing role in reaching a diagnosis and in patient management.
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Affiliation(s)
- Daniel Baumhoer
- Bone Tumour Reference Centre, Institute of Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Fernanda Amary
- Department of Pathology, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom.,Department of Pathology, Cancer Institute, University College London, London, United Kingdom
| | - Adrienne M Flanagan
- Department of Pathology, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom.,Department of Pathology, Cancer Institute, University College London, London, United Kingdom
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Linos K, Tafe LJ. Isocitrate dehydrogenase 1 mutations in melanoma frequently co-occur with NRAS mutations. Histopathology 2018; 73:963-968. [PMID: 30003571 DOI: 10.1111/his.13707] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/11/2018] [Indexed: 01/19/2023]
Abstract
AIMS Isocitrate dehydrogenase 1 (IDH1) is a metabolic enzyme that converts isocitrate to α-ketoglutarate. IDH1 mutations are associated with the accumulation of the oncometabolite D-2-hydroxyglutarate, which acts as an epigenetic modifier, and the development of multiple malignancies. METHODS AND RESULTS From May 2013 to June 2017, 252 melanoma samples from 214 patients with advanced or distant metastatic disease were tested for somatic mutations with the 50-gene AmpliSeq version 2 Cancer Hotspot Panel. Two hundred and twenty-six samples were sequenced successfully from 206 patients with 26 samples being characterised as quantity not sufficient. Melanomas from 10 separate patients (4.9%) were positive for IDH1 R132C (nine) or R132S (one). In six cases, the tumours also had a co-existing NRAS mutation (p.Q61R, Q61L and Q61K in two patients each) (P = 0.0044), whereas three patients had BRAF non-V600E mutations (V600K, V600G and V600R). Two cases had a TP53 variant, two cases an ATM variant, one a CDKN2A variant and one had an APC variant. The patients' ages ranged from 45 to 82 years (mean = 65.3, median = 65 years) and three of 10 patients were female (M:F ratio = 2:3). Three patients were stage 3 and seven were stage 4. Two are deceased, five are alive with stable disease (four on pembrolizumab) and three have no evidence of disease. CONCLUSION IDH mutations may define a unique subset of melanoma patients who are eligible for IDH1 targeted therapies or combined therapies, such as MEK inhibitors when there is co-existing NRAS mutations, or immunotherapy.
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Affiliation(s)
- Konstantinos Linos
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Laura J Tafe
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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Boehme KA, Schleicher SB, Traub F, Rolauffs B. Chondrosarcoma: A Rare Misfortune in Aging Human Cartilage? The Role of Stem and Progenitor Cells in Proliferation, Malignant Degeneration and Therapeutic Resistance. Int J Mol Sci 2018; 19:ijms19010311. [PMID: 29361725 PMCID: PMC5796255 DOI: 10.3390/ijms19010311] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/07/2018] [Accepted: 01/18/2018] [Indexed: 02/07/2023] Open
Abstract
Unlike other malignant bone tumors including osteosarcomas and Ewing sarcomas with a peak incidence in adolescents and young adults, conventional and dedifferentiated chondrosarcomas mainly affect people in the 4th to 7th decade of life. To date, the cell type of chondrosarcoma origin is not clearly defined. However, it seems that mesenchymal stem and progenitor cells (MSPC) in the bone marrow facing a pro-proliferative as well as predominantly chondrogenic differentiation milieu, as is implicated in early stage osteoarthritis (OA) at that age, are the source of chondrosarcoma genesis. But how can MSPC become malignant? Indeed, only one person in 1,000,000 will develop a chondrosarcoma, whereas the incidence of OA is a thousandfold higher. This means a rare coincidence of factors allowing escape from senescence and apoptosis together with induction of angiogenesis and migration is needed to generate a chondrosarcoma. At early stages, chondrosarcomas are still assumed to be an intermediate type of tumor which rarely metastasizes. Unfortunately, advanced stages show a pronounced resistance both against chemo- and radiation-therapy and frequently metastasize. In this review, we elucidate signaling pathways involved in the genesis and therapeutic resistance of chondrosarcomas with a focus on MSPC compared to signaling in articular cartilage (AC).
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Affiliation(s)
- Karen A Boehme
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79108 Freiburg, Germany.
| | - Sabine B Schleicher
- Department of Hematology and Oncology, Eberhard Karls University Tuebingen, Children's Hospital, 72076 Tuebingen, Germany.
| | - Frank Traub
- Department of Orthopedic Surgery, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany.
| | - Bernd Rolauffs
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79108 Freiburg, Germany.
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Gutteridge A, Rathbone VM, Gibbons R, Bi M, Archard N, Davies KEJ, Brown J, Plagnol V, Pillay N, Amary F, O'Donnell P, Gupta M, Tirabosco R, Flanagan AM, Forshew T. Digital PCR analysis of circulating tumor DNA: a biomarker for chondrosarcoma diagnosis, prognostication, and residual disease detection. Cancer Med 2017; 6:2194-2202. [PMID: 28834325 PMCID: PMC5633548 DOI: 10.1002/cam4.1146] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/17/2017] [Accepted: 06/04/2017] [Indexed: 01/17/2023] Open
Abstract
Conventional chondrosarcoma is the most common primary bone tumor in adults. Prognosis corresponds with tumor grade but remains variable, especially for individuals with grade (G) II disease. There are currently no biomarkers available for monitoring or prognostication of chondrosarcoma. Circulating tumor DNA (ctDNA) has recently emerged as a promising biomarker for a broad range of tumor types. To date, little has been done to study the presence of ctDNA and its potential utility in the management of sarcomas, including chondrosarcoma. In this study, we have assessed ctDNA levels in a cohort of 71 patients, 32 with sarcoma, including 29 individuals with central chondrosarcoma (CS) and 39 with locally aggressive and benign bone and soft tissue tumors, using digital PCR. In patients with CS, ctDNA was detected in pretreatment samples in 14/29 patients, which showed clear correlation with tumor grade as demonstrated by the detection of ctDNA in all patients with GIII and dedifferentiated disease (n = 6) and in 8/17 patients with GII disease, but never associated with GI CS. Notably detection of ctDNA preoperatively in GII disease was associated with a poor outcome. A total of 14 patients with CS had ctDNA levels assessed at multiple time points and in most patients there was a clear reduction following surgical removal. This research lays the foundation for larger studies to assess the utility of ctDNA for chondrosarcoma diagnosis, prognostication, early detection of residual disease and monitoring disease progression.
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Affiliation(s)
| | | | - Rebecca Gibbons
- Royal National Orthopaedic Hospital NHS Trust (Histopathology)StanmoreMiddlesexUnited Kingdom
| | - Mark Bi
- Department of GeneticsYale School of MedicineNew HavenCT0651, USA
- Howard Hughes Medical InstituteYale School of MedicineNew HavenCT, USA
| | | | | | - Jake Brown
- University College London Cancer InstituteLondonUnited Kingdom
| | - Vincent Plagnol
- University College London Cancer InstituteLondonUnited Kingdom
| | - Nischalan Pillay
- Royal National Orthopaedic Hospital NHS Trust (Histopathology)StanmoreMiddlesexUnited Kingdom
- Royal National Orthopaedic Hospital NHS Trust (Radiology)StanmoreUnited Kingdom
| | - Fernanda Amary
- Royal National Orthopaedic Hospital NHS Trust (Histopathology)StanmoreMiddlesexUnited Kingdom
| | - Paul O'Donnell
- Royal National Orthopaedic Hospital NHS Trust (Radiology)StanmoreUnited Kingdom
| | - Manu Gupta
- University College London Cancer InstituteLondonUnited Kingdom
| | - Roberto Tirabosco
- Royal National Orthopaedic Hospital NHS Trust (Radiology)StanmoreUnited Kingdom
| | - Adrienne M. Flanagan
- Royal National Orthopaedic Hospital NHS Trust (Histopathology)StanmoreMiddlesexUnited Kingdom
- Royal National Orthopaedic Hospital NHS Trust (Radiology)StanmoreUnited Kingdom
| | - Tim Forshew
- University College London Cancer InstituteLondonUnited Kingdom
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Wright JM, Vered M. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odontogenic and Maxillofacial Bone Tumors. Head Neck Pathol 2017; 11:68-77. [PMID: 28247226 PMCID: PMC5340735 DOI: 10.1007/s12105-017-0794-1] [Citation(s) in RCA: 335] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/02/2017] [Indexed: 12/23/2022]
Abstract
The 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January of 2017. This article provides a summary of the changes to Chapter 4 Tumours of the oral cavity and mobile tongue and Chapter 8 Odontogenic and maxillofacial bone tumours. Odontogenic cysts which were eliminated from the 3rd 2005 edition were included in the 4th edition as well as other unique allied conditons of the jaws. Many new tumors published since 2005 have been included in the 2017 classification.
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Affiliation(s)
- John M. Wright
- Department of Diagnostic Sciences, Texas A&M University, School of Dentistry, 3302 Gaston Ave, Dallas, TX 75246 USA
| | - Marilena Vered
- Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel ,Institute of Pathology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Clinical Decision Making: Integrating Advances in the Molecular Understanding of Spine Tumors. Spine (Phila Pa 1976) 2016; 41 Suppl 20:S171-S177. [PMID: 27488298 DOI: 10.1097/brs.0000000000001836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Literature review. OBJECTIVE To describe advancements in molecular techniques, biomarkers, technology, and targeted therapeutics and the potential these modalities hold to predict treatment paradigms, clinical outcomes, and/or survival in patients diagnosed with primary spinal column tumors. SUMMARY OF BACKGROUND DATA Advances in molecular technologies and techniques have influenced the prevention, diagnosis, and overall management of patients diagnosed with cancer. Assessment of genomic, proteomic alterations, epigenetic, and posttranslational modifications as well as developments in diagnostic modalities and targeted therapeutics, although the best studied in nonspinal metastatic disease, have led to increased understanding of spine oncology that is expected to improve patient outcomes. In this manuscript, the technological advancements that are expected to change the landscape of spinal oncology are discussed with a focus on how these technologies will aid in clinical decision-making for patients diagnosed with primary spinal tumors. METHODS A review of the literature was performed focusing on studies that integrated next-generation sequencing, circulating tumor cells/circulating tumor DNA, advances in imaging modalities and/or radiotherapy in the diagnosis and treatment of cancer. RESULTS We discuss genetic and epigenetic drivers, aberrations in receptor tyrosine kinase signaling, and emerging therapeutic strategies that include receptor tyrosine kinase inhibitors, immunotherapy strategies, and vaccine-based cancer prevention strategies. CONCLUSION The wide range of approaches currently in use and the emerging technologies yet to be fully realized will allow for better development of rationale therapeutics to improve patient outcomes. LEVEL OF EVIDENCE N/A.
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Dang L, Yen K, Attar E. IDH mutations in cancer and progress toward development of targeted therapeutics. Ann Oncol 2016; 27:599-608. [DOI: 10.1093/annonc/mdw013] [Citation(s) in RCA: 301] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/24/2015] [Indexed: 12/29/2022] Open
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