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Locquet MA, Brahmi M, Blay JY, Dutour A. Radiotherapy in bone sarcoma: the quest for better treatment option. BMC Cancer 2023; 23:742. [PMID: 37563551 PMCID: PMC10416357 DOI: 10.1186/s12885-023-11232-3] [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: 02/22/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023] Open
Abstract
Bone sarcomas are rare tumors representing 0.2% of all cancers. While osteosarcoma and Ewing sarcoma mainly affect children and young adults, chondrosarcoma and chordoma have a preferential incidence in people over the age of 40. Despite this range in populations affected, all bone sarcoma patients require complex transdisciplinary management and share some similarities. The cornerstone of all bone sarcoma treatment is monobloc resection of the tumor with adequate margins in healthy surrounding tissues. Adjuvant chemo- and/or radiotherapy are often included depending on the location of the tumor, quality of resection or presence of metastases. High dose radiotherapy is largely applied to allow better local control in case of incomplete primary tumor resection or for unresectable tumors. With the development of advanced techniques such as proton, carbon ion therapy, radiotherapy is gaining popularity for the treatment of bone sarcomas, enabling the delivery of higher doses of radiation, while sparing surrounding healthy tissues. Nevertheless, bone sarcomas are radioresistant tumors, and some mechanisms involved in this radioresistance have been reported. Hypoxia for instance, can potentially be targeted to improve tumor response to radiotherapy and decrease radiation-induced cellular toxicity. In this review, the benefits and drawbacks of radiotherapy in bone sarcoma will be addressed. Finally, new strategies combining a radiosensitizing agent and radiotherapy and their applicability in bone sarcoma will be presented.
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Affiliation(s)
- Marie-Anaïs Locquet
- Cell Death and Pediatric Cancer Team, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008, Lyon, France
| | - Mehdi Brahmi
- Department of Medical Oncology, Centre Leon Berard, Unicancer Lyon, 69008, Lyon, France
| | - Jean-Yves Blay
- Cell Death and Pediatric Cancer Team, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008, Lyon, France
- Department of Medical Oncology, Centre Leon Berard, Unicancer Lyon, 69008, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
| | - Aurélie Dutour
- Cell Death and Pediatric Cancer Team, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008, Lyon, France.
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2
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Kesari S, Wang F, Juarez T, Ashili S, Patro CPK, Carrillo J, Nguyen M, Truong J, Levy J, Sommer J, Freed DM, Xiu J, Takasumi Y, Bouffet E, Gill JM. Activity of pemetrexed in pre-clinical chordoma models and humans. Sci Rep 2023; 13:7317. [PMID: 37147496 PMCID: PMC10163028 DOI: 10.1038/s41598-023-34404-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023] Open
Abstract
Chordomas are rare slow growing tumors, arising from embryonic remnants of notochord with a close predilection for the axial skeleton. Recurrence is common and no effective standard medical therapy exists. Thymidylate synthase (TS), an intracellular enzyme, is a key rate-limiting enzyme of DNA biosynthesis and repair which is primarily active in proliferating and metabolically active cells. Eighty-four percent of chordoma samples had loss of TS expression which may predict response to anti-folates. Pemetrexed suppresses tumor growth by inhibiting enzymes involved in folate metabolism, resulting in decreased availability of thymidine which is necessary for DNA synthesis. Pemetrexed inhibited growth in a preclinical mouse xenograft model of human chordoma. We report three cases of metastatic chordoma that had been heavily treated previously with a variety of standard therapies with poor response. In two cases, pemetrexed was added and objective responses were observed on imaging with one patient on continuous treatment for > 2 years with continued shrinkage. One case demonstrated tumor growth after treatment with pemetrexed. The two cases which had a favorable response had a loss of TS expression, whereas the one case with progressive disease had TS present. These results demonstrate the activity of pemetrexed in recurrent chordoma and warrant a prospective clinical trial which is ongoing (NCT03955042).
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Affiliation(s)
- Santosh Kesari
- Department of Translational Neurosciences, Pacific Neuroscience Institute, Santa Monica, CA, USA.
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
| | - Feng Wang
- Department of Medical Oncology, Cancer Center, West China Hospital, West China Medical School, Sichuan University, Sichuan, Chengdu, China.
| | - Tiffany Juarez
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | | | - C Pawan K Patro
- CureScience, San Diego, CA, USA
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Jose Carrillo
- Department of Translational Neurosciences, Pacific Neuroscience Institute, Santa Monica, CA, USA
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Minhdan Nguyen
- Department of Translational Neurosciences, Pacific Neuroscience Institute, Santa Monica, CA, USA
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Judy Truong
- Department of Translational Neurosciences, Pacific Neuroscience Institute, Santa Monica, CA, USA
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Joan Levy
- Chordoma Foundation, Durham, NC, USA
| | | | | | | | - Yuki Takasumi
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Eric Bouffet
- The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Canada
| | - Jaya M Gill
- Department of Translational Neurosciences, Pacific Neuroscience Institute, Santa Monica, CA, USA
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Maciejczak A, Gasik R, Kotrych D, Rutkowski P, Antoniak K, Derenda M, Dobiecki K, Górski R, Grzelak L, Guzik G, Harat M, Janusz W, Jarmużek P, Łątka D, Maciejczyk A, Mandat T, Potaczek T, Rocławski M, Trembecki Ł, Załuski R. Spinal tumours: recommendations of the Polish Society of Spine Surgery, the Polish Society of Oncology, the Polish Society of Neurosurgeons, the Polish Society of Oncologic Surgery, the Polish Society of Oncologic Radiotherapy, and the Polish Society of Orthopaedics and Traumatology. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:1300-1325. [PMID: 36854861 DOI: 10.1007/s00586-023-07546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/31/2022] [Accepted: 01/13/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE The purpose of these recommendations is to spread the available evidence for evaluating and managing spinal tumours among clinicians who encounter such entities. METHODS The recommendations were developed by members of the Development Recommendations Group representing seven stakeholder scientific societies and organizations of specialists involved in various forms of care for patients with spinal tumours in Poland. The recommendations are based on data yielded from systematic reviews of the literature identified through electronic database searches. The strength of the recommendations was graded according to the North American Spine Society's grades of recommendation for summaries or reviews of studies. RESULTS The recommendation group developed 89 level A-C recommendations and a supplementary list of institutions able to manage primary malignant spinal tumours, namely, spinal sarcomas, at the expert level. This list, further called an appendix, helps clinicians who encounter spinal tumours refer patients with suspected spinal sarcoma or chordoma for pathological diagnosis, surgery and radiosurgery. The list constitutes a basis of the network of expertise for the management of primary malignant spinal tumours and should be understood as a communication network of specialists involved in the care of primary spinal malignancies. CONCLUSION The developed recommendations together with the national network of expertise should optimize the management of patients with spinal tumours, especially rare malignancies, and optimize their referral and allocation within the Polish national health service system.
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Affiliation(s)
- A Maciejczak
- Department of Neurosurgery, Szpital Wojewódzki Tarnów, University of Rzeszów, Rzeszów, Poland.
| | - R Gasik
- Department of Neuroorthopedics and Neurology, National Geriatrics, Rheumatology and Rehabilitation Institute, Warsaw, Poland
| | - D Kotrych
- Department of Orthopedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin, Poland
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - K Antoniak
- Department of Orthopedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin, Poland
| | - M Derenda
- Department of Neurosurgery, University of Warmia and Mazury, Olsztyn, Poland
| | - K Dobiecki
- Department of Orthopedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin, Poland
| | - R Górski
- Department of Neurosurgery and Spine Surgery, John Paul II Western Hospital, Grodzisk Mazowiecki, Poland
| | - L Grzelak
- Department of Neurosurgery, City Hospital, Toruń, Poland
| | - G Guzik
- Department of Oncologic Orthopedics, Sub-Carpathian Oncology Center, Brzozów, Poland
| | - M Harat
- Department of Oncology and Brachytherapy, Oncology Center Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - W Janusz
- Department of Orthopedics and Traumatology, Medical University of Lublin, Lublin, Poland
| | - P Jarmużek
- Department of Neurosurgery, University of Zielona Góra, Zielona Góra, Poland
| | - D Łątka
- Department of Neurosurgery, University of Opole, Opole, Poland
| | - A Maciejczyk
- Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - T Mandat
- Department of Nervous System Neoplasms, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - T Potaczek
- Department of Orthopedics and Rehabilitation, University Hospital Zakopane, Jagiellonian University, Kraków, Poland
| | - M Rocławski
- Department of Orthopaedics, Medical University of Gdansk, Gdańsk, Poland
| | - Ł Trembecki
- Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - R Załuski
- Department of Neurosurgery, Wroclaw Medical University, Wroclaw, Poland
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Frederico SC, Darling C, Zhang X, Huq S, Agnihotri S, Gardner PA, Snyderman CH, Wang EW, Zenonos GA. Circulating tumor DNA – A potential aid in the management of chordomas. Front Oncol 2022; 12:1016385. [PMID: 36338734 PMCID: PMC9632974 DOI: 10.3389/fonc.2022.1016385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Abstract
Chordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficulty in achieving a complete resection. Adjuvant therapy such as proton beam therapy is critical in preventing recurrence in patients who are at high risk, however this treatment is associated with increased risk of complication. Currently, intraoperative observation and imaging findings are used to determine recurrence and success of gross total resection. These methods can be unreliable due to limited operative view, bony and soft tissue involvement, and complex post-operative changes on MRI. Earlier detection of incomplete resection or recurrence will allow for earlier ability to intervene and potentially improve patient outcomes. Circulating-tumor DNA (ctDNA) is cell-free DNA that is released by tumor cells as they undergo cellular turn-over. Monitoring ctDNA has been shown to be more sensitive at predicting residual tumor than imaging in numerous solid malignancies. Furthermore, ctDNA could be detected earlier in peripheral blood as opposed to imaging changes, allowing for earlier intervention. In this review, we intend to give a brief overview of the current state of molecular diagnosis for skull base chordomas. We will then discuss current advances in the utilization of ctDNA for the management of CNS pathologies such as glioblastoma (GBM) and brain metastases. We will also discuss the role ctDNA has in the management of non-CNS pathologies such as osteosarcoma and Ewing sarcoma (EWS). Finally, we will discuss potential implications of ctDNA monitoring for chordoma management.
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Affiliation(s)
- Stephen C. Frederico
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Corbin Darling
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Xiaoran Zhang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sakibul Huq
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sameer Agnihotri
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Paul A. Gardner
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Carl H. Snyderman
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eric W. Wang
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Georgios A. Zenonos
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Georgios A. Zenonos,
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Gao J, Huang R, Yin H, Song D, Meng T. Research hotspots and trends of chordoma: A bibliometric analysis. Front Oncol 2022; 12:946597. [PMID: 36185236 PMCID: PMC9523362 DOI: 10.3389/fonc.2022.946597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Chordoma is a type of mesenchymal malignancy with a high recurrence rate and poor prognosis. Due to its rarity, the tumorigenic mechanism and optimal therapeutic strategy are not well known. Methods All relevant articles of chordoma research from 1 January 2000 to 26 April 2022 were obtained from Web of Science Core Collection database. Blibliometrix was used to acquire basic publication data. Visualization and data table of collaboration network, dynamic analysis, trend topics, thematic map, and factorial analysis were acquired using Blibliometrix package. VOSviewer was used to generate a visualization map of co-citation analysis and co-occurrence. Results A total of 2,285 articles related to chordoma were identified. The most influential and productive country/region was the United States, and Capital Medical University has published the most articles. Among all high-impact authors, Adrienne M. Flanagan had the highest average citation rate. Neurosurgery was the important periodical for chordoma research with the highest total/average citation rate. We focused on four hotspots in recent chordoma research. The research on surgical treatment and radiotherapy was relatively mature. The molecular signaling pathway, targeted therapy and immunotherapy for chordoma are not yet mature, which will be the future trends of chordoma research. Conclusion This study indicates that chordoma studies are increasing. Surgery and radiotherapy are well reported and always play fundamental roles in chordoma treatment. The molecular signaling pathway, targeted therapy, and immunotherapy of chordoma are the latest research hotspots.
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Affiliation(s)
- Jianxuan Gao
- Department of Spine Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Tongji University Cancer Center, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Runzhi Huang
- Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Huabin Yin
- Department of Spine Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Dianwen Song
- Department of Spine Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- *Correspondence: Tong Meng, ; Dianwen Song,
| | - Tong Meng
- Department of Spine Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Tongji University Cancer Center, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Tong Meng, ; Dianwen Song,
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Walker CJ, Chang H, Henegar L, Kashyap T, Shacham S, Sommer J, Wick MJ, Levy J, Landesman Y. Selinexor inhibits growth of patient derived chordomas in vivo as a single agent and in combination with abemaciclib through diverse mechanisms. Front Oncol 2022; 12:808021. [PMID: 36059685 PMCID: PMC9434827 DOI: 10.3389/fonc.2022.808021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Chordoma is a rare cancer that grows in the base of the skull and along the mobile spine from remnants of embryonic notochord tissue. The cornerstone of current treatments is surgical excision with adjuvant radiation therapy, although complete surgical removal is not always possible. Chordomas have high rates of metastasis and recurrence, with no approved targeted agents. Selinexor and eltanexor are selective inhibitors of nuclear export (SINE) that prevent the karyopherin protein exportin-1 (XPO1) from shuttling its cargo proteins through nuclear pore complexes out of the nucleus and into the cytoplasm. As cancer cells overexpress XPO1, and many of its cargos include tumor suppressor proteins and complexes bound to oncogene mRNAs, XPO1 inhibition can suppress oncogene translation and restore tumor suppressor protein activity in different cancer types. SINE compounds have exhibited anti-cancer activity in a wide range of hematological and solid tumor malignancies. Here we demonstrate the preclinical effectiveness of SINE compounds used as single agents or in combination with either the proteasome inhibitor, bortezomib, or the CDK4/6 inhibitor, abemaciclib, against various patient- derived xenograft (PDX) mouse models of chordoma, which included clival and sacral chordomas from adult or pediatric patients with either primary or metastatic disease, with either differentiated or poorly differentiated subtypes. SINE treatment significantly impaired tumor growth in all five tested chordoma models, with the selinexor and abemaciclib combination showing the strongest activity (tumor growth inhibition of 78-92%). Immunohistochemistry analysis of excised tumors revealed that selinexor treatment resulted in marked induction of apoptosis and reduced cell proliferation, as well as nuclear accumulation of SMAD4, and reduction of Brachyury and YAP1. RNA sequencing showed selinexor treatment resulted in differences in activated and repressed signaling pathways between the PDX models, including changes in WNT signaling, E2F pathways and glucocorticoid receptor signaling. This is consistent with SINE-compound mediated XPO1 inhibition exhibiting anti-cancer activity through a broad range of different mechanisms in different molecular chordoma subsets. Our findings validate the need for further investigation into selinexor as a targeted therapeutic for chordoma, especially in combination with abemaciclib.
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Affiliation(s)
- Christopher J. Walker
- Department of Translational Research, Karyopharm Therapeutics, Inc, Newton, MA, United States
| | - Hua Chang
- Department of Translational Research, Karyopharm Therapeutics, Inc, Newton, MA, United States
| | - Leah Henegar
- Department of Translational Research, Karyopharm Therapeutics, Inc, Newton, MA, United States
| | - Trinayan Kashyap
- Department of Translational Research, Karyopharm Therapeutics, Inc, Newton, MA, United States
| | - Sharon Shacham
- Department of Translational Research, Karyopharm Therapeutics, Inc, Newton, MA, United States
| | - Josh Sommer
- Department of Research, Chordoma Foundation, Durham, NC, United States
| | - Michael J. Wick
- Department of Research, XenoSTART, San Antonio, TX, United States
| | - Joan Levy
- Department of Research, Chordoma Foundation, Durham, NC, United States
| | - Yosef Landesman
- Department of Translational Research, Karyopharm Therapeutics, Inc, Newton, MA, United States
- *Correspondence: Yosef Landesman,
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Al Shihabi A, Davarifar A, Nguyen HTL, Tavanaie N, Nelson SD, Yanagawa J, Federman N, Bernthal N, Hornicek F, Soragni A. Personalized chordoma organoids for drug discovery studies. SCIENCE ADVANCES 2022; 8:eabl3674. [PMID: 35171675 PMCID: PMC8849332 DOI: 10.1126/sciadv.abl3674] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/21/2021] [Indexed: 05/03/2023]
Abstract
Chordomas are rare tumors of notochordal origin, most commonly arising in the sacrum or skull base. Chordomas are considered insensitive to conventional chemotherapy, and their rarity complicates running timely and adequately powered trials to identify effective treatments. Therefore, there is a need for discovery of novel therapeutic approaches. Patient-derived organoids can accelerate drug discovery and development studies and predict patient responses to therapy. In this proof-of-concept study, we successfully established organoids from seven chordoma tumor samples obtained from five patients presenting with tumors in different sites and stages of disease. The organoids recapitulated features of the original parent tumors and inter- as well as intrapatient heterogeneity. High-throughput screenings performed on the organoids highlighted targeted agents such as PI3K/mTOR, EGFR, and JAK2/STAT3 inhibitors among the most effective molecules. Pathway analysis underscored how the NF-κB and IGF-1R pathways are sensitive to perturbations and potential targets to pursue for combination therapy of chordoma.
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Affiliation(s)
- Ahmad Al Shihabi
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pathology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ardalan Davarifar
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Division of Hematology-Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Huyen Thi Lam Nguyen
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nasrin Tavanaie
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott D. Nelson
- Department of Pathology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jane Yanagawa
- Division of Thoracic Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Noah Federman
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nicholas Bernthal
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Francis Hornicek
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alice Soragni
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, USA
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Endoscopic endonasal approach for loco-regional recurrent clivus chordomas. BRAIN AND SPINE 2022; 2:100918. [PMID: 36248100 PMCID: PMC9560577 DOI: 10.1016/j.bas.2022.100918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022]
Abstract
EEA represents an ideal approach for loco-regional recurrent CCs. EEA is well tolerated, with preservation of patients QoL. EEA can be considered for patients with perspectives of adjuvant therapies. Otherwise, EEA can be considered only in selected cases with a palliative aim.
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Hoke AT, Padget MR, Fabian KP, Nandal A, Gallia GL, Bilusic M, Soon-Shiong P, Hodge JW, London NR. Combinatorial Natural Killer Cell-based Immunotherapy Approaches Selectively Target Chordoma Cancer Stem Cells. CANCER RESEARCH COMMUNICATIONS 2021; 1:127-139. [PMID: 35765577 PMCID: PMC9236084 DOI: 10.1158/2767-9764.crc-21-0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Chordoma is a rare tumor derived from notochord remnants that has a propensity to recur and metastasize despite conventional multimodal treatment. Cancer stem cells (CSC) are implicated in chordoma's resistant and recurrent behavior; thus strategies that target CSCs are of particular interest. Using in vitro cytotoxicity models, we demonstrated that anti-programmed death-ligand 1 (N-601) and anti-epidermal growth factor receptor (cetuximab) antibodies enhanced lysis of chordoma cells by healthy donor and chordoma patient NK cells through antibody-dependent cellular cytotoxicity (ADCC). Treatment of NK cells with an IL-15 superagonist complex (N-803) increased their cytotoxicity against chordoma cells, which was further enhanced by treatment with N-601 and/or cetuximab. PD-L1-targeted chimeric antigen receptor NK cells (PD-L1 t-haNKs) were also effective against chordoma cells. CSCs were preferentially vulnerable to NK cell killing in the presence of N-601 and N-803. Flow cytometric analysis of a chordoma CSC population showed that CSCs expressed significantly more NK activating ligand B7-H6 and PD-L1 than non-CSCs, thus explaining a potential mechanism of selective targeting. These data suggest that chordoma may be effectively targeted by combinatorial NK cell-mediated immunotherapeutic approaches and that the efficacy of these approaches in chordoma and other CSC-driven tumor types should be investigated further in clinical studies.
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Affiliation(s)
- Austin T.K. Hoke
- Sinonasal and Skull Base Tumor Program, National Institutes on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland
- University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North Carolina
| | - Michelle R. Padget
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Kellsye P. Fabian
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Anjali Nandal
- Sinonasal and Skull Base Tumor Program, National Institutes on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland
| | - Gary L. Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marijo Bilusic
- Genitourinary Malignancies Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | | | - James W. Hodge
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Nyall R. London
- Sinonasal and Skull Base Tumor Program, National Institutes on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Corresponding Author: Nyall R. London Jr., Sinonasal and Skull Base Tumor Program, National Institute on Deafness and Other Communications Disorders (NIDCD), NIH, 10 Center Drive Room #7N256, Bethesda, MD USA 20892-2320. Phone: 301-402-4216; E-mail:
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Abstract
Amongst the several types of brain cancers known to humankind, glioma is one of the most severe and life-threatening types of cancer, comprising 40% of all primary brain tumors. Recent reports have shown the incident rate of gliomas to be 6 per 100,000 individuals per year globally. Despite the various therapeutics used in the treatment of glioma, patient survival rate remains at a median of 15 months after undergoing first-line treatment including surgery, radiation, and chemotherapy with Temozolomide. As such, the discovery of newer and more effective therapeutic agents is imperative for patient survival rate. The advent of computer-aided drug design in the development of drug discovery has emerged as a powerful means to ascertain potential hit compounds with distinctively high therapeutic effectiveness against glioma. This review encompasses the recent advances of bio-computational in-silico modeling that have elicited the discovery of small molecule inhibitors and/or drugs against various therapeutic targets in glioma. The relevant information provided in this report will assist researchers, especially in the drug design domains, to develop more effective therapeutics against this global disease.
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Singh P, Eley J, Saeed A, Bhandary B, Mahmood N, Chen M, Dukic T, Mossahebi S, Rodrigues DB, Mahmood J, Vujaskovic Z, Shukla HD. Effect of hyperthermia and proton beam radiation as a novel approach in chordoma cells death and its clinical implication to treat chordoma. Int J Radiat Biol 2021; 97:1675-1686. [PMID: 34495790 DOI: 10.1080/09553002.2021.1976861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Chordoma is a locally aggressive tumor that most commonly affects the base of the skull/clivus, cervical, and sacral spine. Conventional radiotherapy (RT), cannot be safely increased further to improve disease control due to the risk of toxicity to the surrounding critical structures. Tumor-targeted hyperthermia (HT) combined with Proton Beam Radiation Therapy (PBRT) is known to act as a potent radiosensitizer in cancer control. In this study, we investigated whether PBRT efficacy for chordoma can be enhanced in combination with HT as a radiosensitizer. MATERIAL AND METHODS Human chordoma cell lines, U-CH2 and Mug-chor1 were treated in vitro with HT followed by PBRT with variable doses. The colony-forming assay was performed, and dose-response was characterized by linear-quadratic model fits. HSP-70 and Brachyury (TBXT) biomarkers for chordoma aggression levels were quantified by western blot analysis. Gene microarray analysis was performed by U133 Arrays. Pathway Analysis was also performed using IPA bioinformatic software. RESULTS Our findings in both U-CH2 and Mug-Chor1 cell lines demonstrate that hyperthermia followed by PBRT has an enhanced cell killing effect when compared with PBRT-alone (p < .01). Western blot analysis showed HT decreased the expression of Brachyury protein (p < .05), which is considered a biomarker for chordoma tumor aggression. HT with PBRT also exhibited an RT-dose-dependent decrease of Brachyury expression (p < .05). We also observed enhanced HSP-70 expression due to HT, RT, and HT + RT combined in both cell lines. Interestingly, genomic data showed 344 genes expressed by the treatment of HT + RT compared to HT (68 genes) or RT (112 genes) as individual treatment. We also identified activation of death receptor and apoptotic pathway in HT + RT treated cells. CONCLUSION We found that Hyperthermia (HT) combined with Proton Beam Radiation (PBRT) could significantly increase chordoma cell death by activating the death receptor pathway and apoptosis which has the promise to treat metastatic chordoma.
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Affiliation(s)
- Prerna Singh
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - John Eley
- Department of Radiation Oncology, School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Ali Saeed
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Binny Bhandary
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nayab Mahmood
- College of Information Science, University of Maryland College Park, MD, USA
| | - Minjie Chen
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tijana Dukic
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sina Mossahebi
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dario B Rodrigues
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Javed Mahmood
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zeljko Vujaskovic
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hem D Shukla
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
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12
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Raghavapudi H, Singroul P, Kohila V. Brain Tumor Causes, Symptoms, Diagnosis and Radiotherapy Treatment. Curr Med Imaging 2021; 17:931-942. [PMID: 33573575 DOI: 10.2174/1573405617666210126160206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022]
Abstract
The strategy used for the treatment of given brain cancer is critical in determining the post effects and survival. An oncological diagnosis of tumor evaluates a range of parameters such as shape, size, volume, location and neurological complexity that define the symptomatic severity. The evaluation determines a suitable treatment approach chosen from a range of options such as surgery, chemotherapy, hormone therapy, radiation therapy and other targeted therapies. Often, a combination of such therapies is applied to achieve superior results. Radiotherapy serves as a better treatment strategy because of a higher survival rate. It offers the flexibility of synergy with other treatment strategies and fewer side effects on organs at risk. This review presents a radiobiological perspective in the treatment of brain tumor. The cause, symptoms, diagnosis, treatment, post-treatment effects and the framework involved in its elimination are summarized.
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Affiliation(s)
- Haarika Raghavapudi
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
| | - Pankaj Singroul
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
| | - V Kohila
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
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13
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Wedekind MF, Widemann BC, Cote G. Chordoma: Current status, problems, and future directions. Curr Probl Cancer 2021; 45:100771. [PMID: 34266694 DOI: 10.1016/j.currproblcancer.2021.100771] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/17/2022]
Abstract
Chordoma is a rare tumor that occurs along the axial spine in pediatrics and adults, with an incidence of approximately 350 cases per year in the United States. While typically described as slow-growing, many patients will eventually develop loco-regional relapse or metastatic disease with few treatment options. Despite numerous efforts over the last 10+ years, effective treatments for patients are lacking. As subtypes of chordoma are identified and described in more detail, further knowledge regarding the natural history of each type, tumor location, age differences, genomic variability, and an overall better understanding of chordoma may be the key to developing meaningful clinical trials and effective therapies for patients with chordoma.
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Affiliation(s)
- Mary Frances Wedekind
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
| | - Brigitte C Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Gregory Cote
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
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14
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DeMaria PJ, Bilusic M, Park DM, Heery CR, Donahue RN, Madan RA, Bagheri MH, Strauss J, Shen V, Marté JL, Steinberg SM, Schlom J, Gilbert MR, Gulley JL. Randomized, Double-Blind, Placebo-Controlled Phase II Study of Yeast-Brachyury Vaccine (GI-6301) in Combination with Standard-of-Care Radiotherapy in Locally Advanced, Unresectable Chordoma. Oncologist 2021; 26:e847-e858. [PMID: 33594772 PMCID: PMC8100546 DOI: 10.1002/onco.13720] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 02/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Brachyury is a transcription factor overexpressed in chordoma and is associated with chemotherapy resistance and epithelial-to-mesenchymal transition. GI-6301 is a recombinant, heat-killed Saccharomyces cerevisiae yeast-based vaccine targeting brachyury. A previous phase I trial of GI-6301 demonstrated a signal of clinical activity in chordomas. This trial evaluated synergistic effects of GI-6301 vaccine plus radiation. MATERIALS AND METHODS Adults with locally advanced, unresectable chordoma were treated on a randomized, placebo-controlled trial. Patients received three doses of GI-6301 (80 × 107 yeast cells) or placebo followed by radiation, followed by continued vaccine or placebo until progression. Primary endpoint was overall response rate, defined as a complete response (CR) or partial response (PR) in the irradiated tumor site at 24 months. Immune assays were conducted to evaluate immunogenicity. RESULTS Between May 2015 and September 2019, 24 patients enrolled on the first randomized phase II study in chordoma. There was one PR in each arm; no CRs were observed. Median progressive-free survival for vaccine and placebo arms was 20.6 months (95% confidence interval [CI], 5.7-37.5 months) and 25.9 months (95% CI, 9.2-30.8 months), respectively. Hazard ratio was 1.02 (95% CI, 0.38-2.71). Vaccine was well tolerated with no vaccine-related serious adverse events. Preexisting brachyury-specific T cells were detected in most patients in both arms. Most patients developed T-cell responses during therapy, with no difference between arms in frequency or magnitude of response. CONCLUSION No difference in overall response rate was observed, leading to early discontinuation of this trial due to low conditional power to detect statistical difference at the planned end of accrual. IMPLICATIONS FOR PRACTICE Chordoma is a rare neoplasm lacking effective systemic therapies for advanced, unresectable disease. Lack of clinically actionable somatic mutations in chordoma makes development of targeted therapy quite challenging. While the combination of yeast-brachyury vaccine (GI-6301) and standard radiation therapy did not demonstrate synergistic antitumor effects, brachyury still remains a good target for developmental therapeutics in chordoma. Patients and their oncologists should consider early referral to centers with expertise in chordoma (or sarcoma) and encourage participation in clinical trials.
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Affiliation(s)
- Peter Joseph DeMaria
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Marijo Bilusic
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Deric M Park
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
- University of Chicago, Chicago, Illinois, USA
| | - Christopher R Heery
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
- Precision Biosciences, Durham, North Carolina, USA
| | - Renee N Donahue
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ravi A Madan
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mohammad Hadi Bagheri
- Clinical Image Processing Service, National Institutes of Health, Bethesda, Maryland, USA
| | - Julius Strauss
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Victoria Shen
- Clinical Image Processing Service, National Institutes of Health, Bethesda, Maryland, USA
| | - Jennifer L Marté
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Seth M Steinberg
- Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeffrey Schlom
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James L Gulley
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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15
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Locquet MA, Dechaume AL, Berchard P, Abbes L, Pissaloux D, Tirode F, Ramos I, Bedoucha J, Valantin J, Karanian M, Perret R, Gille O, Blay JY, Dutour A. Aldehyde Dehydrogenase, a Therapeutic Target in Chordoma: Analysis in 3D Cellular Models. Cells 2021; 10:cells10020399. [PMID: 33672032 PMCID: PMC7919493 DOI: 10.3390/cells10020399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Chordomas are rare, slow-growing tumors of the axial skeleton. These tumors are locally aggressive and refractory to conventional therapies. Radical surgery and radiation remain the first-line treatments. Despite these aggressive treatments, chordomas often recur and second-line treatment options are limited. The mechanisms underlying chordoma radioresistance remain unknown, although several radioresistant cancer cells have been shown to respond favorably to aldehyde dehydrogenase (ALDH) inhibition. The study of chordoma has been delayed by small patient cohorts and few available models due to the scarcity of these tumors. We thus created cellular 3D models of chordoma by using low-adherence culture systems. Then, we evaluated their radiosensitivity using colony-forming and spheroid size assays. Finally, we determined whether pharmacologically inhibiting ALDH increased their radiosensitivity. We found that 3D cellular models of chordoma (derived from primary, relapse, and metastatic tumors) reproduce the histological and gene expression features of the disease. The metastatic, relapse, and primary spheroids displayed high, medium, and low radioresistance, respectively. Moreover, inhibiting ALDH decreased the radioresistance in all three models.
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Affiliation(s)
- Marie-Anaïs Locquet
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
| | - Anne-Lise Dechaume
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
| | - Paul Berchard
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
| | - Lhorra Abbes
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
| | - Daniel Pissaloux
- Department of Biopathology, Centre Leon Berard, F-69008 Lyon, France;
- Team Genetics, Epigenetics and Biology of Sarcomas, Univ Lyon, Université Claude Bernard Lyon 1, INSERM1052, CNRS5286, Cancer Research Center of Lyon, Centre Leon Berard, F-69008 Lyon, France; (F.T.); (M.K.)
| | - Franck Tirode
- Team Genetics, Epigenetics and Biology of Sarcomas, Univ Lyon, Université Claude Bernard Lyon 1, INSERM1052, CNRS5286, Cancer Research Center of Lyon, Centre Leon Berard, F-69008 Lyon, France; (F.T.); (M.K.)
| | - Inès Ramos
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
| | - Julie Bedoucha
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
| | - Julie Valantin
- Research Pathology Platform, Department of Translational Research and Innovation, Centre Leon Berard, F-69008 Lyon, France;
- Fondation Synergie Lyon Cancer, F-69008 Lyon, France
| | - Marie Karanian
- Department of Biopathology, Centre Leon Berard, F-69008 Lyon, France;
- Team Genetics, Epigenetics and Biology of Sarcomas, Univ Lyon, Université Claude Bernard Lyon 1, INSERM1052, CNRS5286, Cancer Research Center of Lyon, Centre Leon Berard, F-69008 Lyon, France; (F.T.); (M.K.)
| | - Raul Perret
- Department of Biopathology, Institut Bergonié, F-33000 Bordeaux, France;
| | - Olivier Gille
- Orthopedic Spinal Surgery Unit 1, Bordeaux University Hospital, F-33000 Bordeaux, France;
| | - Jean-Yves Blay
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
- Medical Oncology Department, Centre Leon Berard, F-69008 Lyon, France
| | - Aurélie Dutour
- Team Cell Death and Pediatric Cancer, Cancer Initiation and Tumor Cell Identity Department, INSERM1052, CNRS5286, Cancer Research Center of Lyon, F-69008 Lyon, France; (M.-A.L.); (A.-L.D.); (P.B.); (L.A.); (I.R.); (J.B.); (J.-Y.B.)
- Correspondence:
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16
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He X, Gao K, Lu S, Wu R. LncRNA HOTTIP leads to osteoarthritis progression via regulating miR-663a/ Fyn-related kinase axis. BMC Musculoskelet Disord 2021; 22:67. [PMID: 33435956 PMCID: PMC7802157 DOI: 10.1186/s12891-020-03861-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 12/04/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Long non-coding RNA (lncRNA) has been implicated in the progression of osteoarthritis (OA). This study was aimed to explore the role and molecular mechanism of lncRNA HOXA terminal transcriptional RNA (HOTTIP) in the development of OA. METHODS The expression of HOTTIP, miR-663a and Fyn-related kinase (FRK) in the OA articular cartilage and OA chondrocyte model induced by IL-1β was determined by qRT-PCR. CCK-8, colony formation and flow cytometry were used to determine the cell proliferation and apoptosis of OA chondrocytes. The specific molecular mechanism of HOTTIP in OA chondrocytes was determined by dual luciferase reporter assay, qRT-PCR, western blotting and RNA pull-down. RESULTS The expression of HOTTIP and FRK were up-regulated, while miR-663a was down-regulated in OA cartilage tissues. Knockdown of HOTTIP decreased the proliferation and induced the apoptosis of OA cartilage model cells, while overexpression of HOTTIP increased the proliferation and reduced the apoptosis of OA cartilage model cells. Moreover, HOTTIP could bind to miR-663a as competitive endogenous RNA. Inhibition of miR-663a expression could alleviate the effect of HOTTIP knockdown on the proliferation and apoptosis of OA cartilage model cells. Furthermore, FRK was found to be a direct target of miR-663a, which could markedly down-regulate the expression of FRK in OA chondrocytes, while HOTTIP could remarkably up-regulate the expression of FRK. In addition, miR-663a inhibition increased the proliferation and reduced the apoptosis of OA cells, while FRK knockdown reversed the effect of miR-663a inhibition on the proliferation and apoptosis of OA cells. Meanwhile, overexpression of miR-663a decreased the proliferation and induced the apoptosis of OA cells, while overexpression of FRK reversed the effect of miR-663a overexpression on the proliferation and apoptosis of OA cells. CONCLUSION HOTTIP was involved in the proliferation and apoptosis of OA chondrocytes via miR-663a/ FRK axis, and HOTTIP/miR-663a/FRK might be a potential target for the treatment of OA.
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Affiliation(s)
- Xianwei He
- Department of Orthopaedics, Fudan University Jinshan Hospital, No.1508 Longhang Road, Jinshan District, Shanghai City, 201508, China
| | - Kun Gao
- Ze Tian Xing Zhi Di Cosmetology Clinic, Shanghai, 200000, China
| | - Shuaihua Lu
- Ze Tian Xing Zhi Di Cosmetology Clinic, Shanghai, 200000, China
| | - Rongbo Wu
- Department of Orthopaedics, Fudan University Jinshan Hospital, No.1508 Longhang Road, Jinshan District, Shanghai City, 201508, China.
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17
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[From bench to bedside for new treatment paradigms in chordomas: An update]. Bull Cancer 2019; 107:129-135. [PMID: 31882268 DOI: 10.1016/j.bulcan.2019.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 11/23/2022]
Abstract
Chordomas are rare malignant tumours, which typically occur in the axial skeleton and skull base. They arise from embryonic remnants of the notochord. They constitute less than 5 % of primary bone tumours. They are characterised by their locally aggressive potential with high frequency of recurrences and a median overall survival of 6 years. The initial therapeutic strategy must be discussed in an expert centre and may involve surgery, preoperative radiotherapy, exclusive radiotherapy or therapeutic abstention. Despite this, more than 50 % of patients will be facing recurrences with few therapeutic options available at this advanced stage. This review aims to outline current treatment options available in chordomas, as well as discussing potentiality of new therapeutic approaches through their molecular characterization and the comprehension of their immunological environment.
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18
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Yan X, Li Z, Li H, Liu P, Zhao Z, Cheng S, Wang Z, Zhang Q. Inhibition Of Glycogen Synthase Kinase 3 Beta Suppresses The Growth And Survival Of Skull Base Chordoma Cells By Downregulating Brachyury Expression. Onco Targets Ther 2019; 12:9783-9791. [PMID: 31819479 PMCID: PMC6874116 DOI: 10.2147/ott.s218930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/31/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose Chordomas are locally aggressive tumors arising from notochordal remnants. Brachyury, a protein coded by T-gene, is crucial for chordoma cell proliferation. The aim of this study was to evaluate the effects of glycogen synthase kinase 3 beta (GSK3β) activity on brachyury expression and on the growth and survival of skull base chordoma cells. Patients and methods In this study, 16 paraffin-embedded specimens of primary skull base chordomas were analyzed for the expression of phosphorylated GSK3β and brachyury using immunohistochemistry. The UM-Chor1 cell line derived from a clival chordoma was treated with AR-A014418 (AR), an inhibitor of GSK3β, and brachyury expression was analyzed by qRT-PCR and Western blotting. The possible mechanism by which brachyury regulates the Wnt/β-catenin signaling pathway was investigated by immunocytochemistry. The effects of AR on cell proliferation as well as sensitivity to chemotherapeutic drugs were also examined. Results The results suggested that phosphorylated GSK3β and brachyury were upregulated in chordoma tissues. The GSK3β inhibitor (AR) decreased brachyury expression and suppressed the growth and survival of the chordoma cells, possibly via regulation of the Wnt/β-catenin signaling pathway. Moreover, AR increased the sensitivity of chordoma cells to chemotherapeutic drugs in vitro. Conclusion This study provides evidence for the clinical development of the GSK3β inhibitor (AR-A014418) as a potential chemotherapeutic adjuvant for the treatment of chordoma.
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Affiliation(s)
- Xudong Yan
- Department of Otolaryngology-Head and Neck Surgery, Skull Base Surgery Center, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhiyuan Li
- Key Laboratory, Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Hong Li
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Pei Liu
- Department of Anesthesiology, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Zehang Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China
| | - Shan Cheng
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China
| | - Zhenlin Wang
- Department of Otolaryngology-Head and Neck Surgery, Skull Base Surgery Center, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qiuhang Zhang
- Department of Otolaryngology-Head and Neck Surgery, Skull Base Surgery Center, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
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19
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Abstract
Bone sarcomas are rare tumors arising in bone, representing only a small fraction of solid malignant tumors. Desmoids are benign, infiltrative soft tissue neoplasms. Because of their scarcity and a paucity of data, the management of these tumors can be challenging, especially for clinicians who infrequently encounter these tumors. This article reviews the current literature regarding the diagnosis, work-up, and treatment of these uncommon mesenchymal tumors.
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Affiliation(s)
- Jeremy M Brownstein
- Francis H. Burr Proton Beam Therapy Center, Massachusetts General Hospital, 30 Fruit Street, Boston, MA 02114, USA; Department of Radiation Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Thomas F DeLaney
- Department of Radiation Oncology, Harvard Medical School, Francis H. Burr Proton Therapy Center, Massachusetts General Hospital, 30 Fruit Street, Boston, MA 02114, USA.
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20
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Liu L, Wang T, Yang X, Xu C, Liao Z, Wang X, Su D, Li Y, Zhou H, Qiu X, Chen Y, Huang D, Lian C, Su P. MTNR1B loss promotes chordoma recurrence by abrogating melatonin-mediated β-catenin signaling repression. J Pineal Res 2019; 67:e12588. [PMID: 31140197 DOI: 10.1111/jpi.12588] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/16/2019] [Accepted: 05/22/2019] [Indexed: 01/03/2023]
Abstract
Chordoma is an extremely rare malignant bone tumor with a high rate of relapse. While cancer stem cells (CSCs) are closely associated with tumor recurrence, which depend on its capacity to self-renew and induce chemo-/radioresistance, whether and how CSCs participate in chordoma recurrence remains unclear. The current study found that tumor cells in recurrent chordoma displayed more dedifferentiated CSC-like properties than those in corresponding primary tumor tissues. Meanwhile, MTNR1B deletion along with melatonin receptor 1B (MTNR1B) down-regulation was observed in recurrent chordoma. Further investigation revealed that activation of Gαi2 by MTNR1B upon melatonin stimulation could inhibit SRC kinase activity via recruiting CSK and SRC, increasing SRC Y530 phosphorylation, and decreasing SRC Y419 phosphorylation. This subsequently suppressed β-catenin signaling and stemness via decreasing β-catenin p-Y86/Y333/Y654. However, MTNR1B loss in chordoma mediated increased CSC properties, chemoresistance, and tumor progression by releasing melatonin's repression of β-catenin signaling. Clinically, MTNR1B deletion was found to correlate with patients' survival. Together, our study establishes a novel convergence between melatonin and β-catenin signaling pathways and reveals the significance of this cross talk in chordoma recurrence. Besides, we propose that MTNR1B is a potential biomarker for prediction of chordoma prognosis and selection of treatment options, and chordoma patients might benefit from targeting MTNR1B/Gαi2/SRC/β-catenin axis.
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MESH Headings
- Animals
- Biomarkers, Tumor/deficiency
- Biomarkers, Tumor/genetics
- Bone Neoplasms/drug therapy
- Bone Neoplasms/genetics
- Bone Neoplasms/metabolism
- Bone Neoplasms/pathology
- Cell Line, Tumor
- Chondroma/drug therapy
- Chondroma/genetics
- Chondroma/metabolism
- Chondroma/pathology
- Female
- Humans
- Melatonin/pharmacology
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Receptor, Melatonin, MT2/deficiency
- Receptor, Melatonin, MT2/metabolism
- Signal Transduction/drug effects
- Xenograft Model Antitumor Assays
- beta Catenin/genetics
- beta Catenin/metabolism
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Affiliation(s)
- Lei Liu
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Center for Peripheral Nerve Tissue Engineering and Technology Research, Guangzhou, China
- Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Tingting Wang
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoming Yang
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Caixia Xu
- Research Centre for Translational Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhiheng Liao
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xudong Wang
- Department of Spine Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Deying Su
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yongyong Li
- Research Centre for Translational Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hang Zhou
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xianjian Qiu
- Department of Spine Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuyu Chen
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dongsheng Huang
- Department of Spine Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chengjie Lian
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peiqiang Su
- Department of Orthopaedic Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Center for Peripheral Nerve Tissue Engineering and Technology Research, Guangzhou, China
- Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
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21
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The Evolution of Endoscopic Skull Base Surgery Outcomes: Defining the Edge of the Envelope. World Neurosurg 2019. [DOI: 10.1016/j.wneu.2019.01.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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22
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Abstract
OPINION STATEMENT Soft tissue sarcomas are rare cancers with an expected incidence of about 14,000 new cases in 2018, and account for less than 1% of all cancers. It includes in excess of 75 heterogeneous subtypes with varying biology, molecular aberrations, and variable response to treatment. Because of the rarity of these tumors and the many different subtypes, there is no large-scale data to guide treatment, and hence the need for a multidisciplinary individualized approach to treatment, preferably at a high-volume tertiary referral center. For localized disease, surgery with or without radiation is the preferred treatment. In metastatic disease, the longest track record is with use of anthracyclines, either alone or in combination with ifosfamide, but the median overall survival even with combination was just over a year. There have been recent advances in understanding the heterogeneity of these tumors and the need for an individualized approach. With that new knowledge, recent approvals of trabectedin, eribulin, and pazopanib have been limited to some select histologic subtypes with improved outcomes. More recently, immunotherapy has been tested in select histotypes of sarcoma with encouraging activity and has led to further evaluation in combination with immunotherapeutic agents, as well as with chemotherapy and radiation treatments. Here, in this article, we summarize the data of the currently approved therapies in metastatic soft tissue sarcoma, with the principal focus on first-line therapies. We also review the recent encouraging data with PDGFR-targeted antibody (olaratumab) with doxorubicin which showed an impressive improvement in overall survival in phase II study. Molecular characterization of sarcoma subtypes will likely improve understanding of these very diverse tumors and improve target characterization. The ongoing efforts in better understanding these rare tumors hold the key to make a difference in the outcome of these patients.
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Affiliation(s)
- Megan Meyer
- Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd., Phoenix, AZ, 85054, USA
| | - Mahesh Seetharam
- Hematology and Oncology, Mayo Clinic, 5881 E Mayo Blvd., Phoenix, AZ, 85054, USA.
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23
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Immunophenotypic features of dedifferentiated skull base chordoma: An insight into the intratumoural heterogeneity. Contemp Oncol (Pozn) 2018; 21:267-273. [PMID: 29416431 PMCID: PMC5798418 DOI: 10.5114/wo.2017.72385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 08/26/2017] [Indexed: 01/05/2023] Open
Abstract
Chordomas are rare and low-grade malignant solid tumours, despite their histologically benign appearance, that arise in the bone from embryonic notochordal vestiges of the axial skeleton, a mesoderm-derived structure that is involved in the process of neurulation and embryonic development. Chordomas occurring in the skull base tend to arise in the basiocciput along the clivus. Three major morphological variants have been described (classical, chondroid, and atypical/dedifferentiated). The pathogenesis and molecular mechanisms involved in chordoma development remain uncertain. From a pathological standpoint, the microenvironment of a chordoma is heterogeneous, showing a dual epithelial-mesenchymal differentiation. These tumours are characterised by slow modality of biologic growth, local recurrence, low incidence of metastasis rates, and cancer stem cell (CSC) phenotype. The main molecular findings are connected with brachyury immunoexpression and activation of the downstream Akt and mTOR signalling pathways. The differentiation between typical and atypical chordomas is relevant because the tumoural microenvironment and prognosis are partially different. This review provides an insight into the recent and relevant concepts and histochemical markers expressed in chordomas, with special emphasis on dedifferentiated chordomas and their prognostic implications.
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24
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GAMBOA I, VILHENA D, RESENDE M, DUARTE D, LOPES G. Resección endoscópica de cordoma del clivus. Descripción de un caso. REVISTA ORL 2017. [DOI: 10.14201/orl.17383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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25
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Wang Y, Chen K, Chen H, Zhang K, Lu J, Mao H, Yang H. Low expression of miRNA-1290 associated with local invasion and recurrence in sacral chordoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:10934-10940. [PMID: 31966437 PMCID: PMC6965869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/24/2017] [Indexed: 06/10/2023]
Abstract
Chordoma is a rare, locally aggressive neoplasm of bone, usually with poor prognosis. The treatment for chordoma has been unsatisfactory for decades. MiRNAs were recently introduced into this field and provided new insights to the pathogenesis and pathophysiology of chordoma. However, molecular basis of chordoma remains ambiguous up to now. This research aims to discover novel miRNA molecules as potential biomarkers and therapeutic targets. We measured the expression of miRNA-1290 in chordoma tissues and fetal nucleus pulposus tissues by quantitative real-time PCR. Further, we analyzed its association with the clinical features as well as the prognosis of patients. The expression of miRNA-1290 in chordoma samples was significantly lower than fetal nucleus pulposus samples (P=0.026). Low expression of miRNA-1290 contributed to tumor invasion into surrounding muscle (P=0.013), while no obvious significance was identified between miRNA-1290 expression and patients' age, gender, tumor location and size (P>0.05). Log-rank test showed that low-level miRNA-1290 expression had a prominent impact on the patients' RFS (P=0.004). Conclusively, miRNA-1290 might be a valuable prognostic biomarker and efficient therapeutic target for sacral chordoma.
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Affiliation(s)
- Yucheng Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
| | - Kangwu Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
| | - Hao Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
| | - Kai Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
| | - Jian Lu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
| | - Haiqing Mao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
| | - Huilin Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, P. R. China
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26
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Marginal En Bloc Resection of C2-C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases. World Neurosurg 2017; 108:993.e1-993.e7. [PMID: 28889042 DOI: 10.1016/j.wneu.2017.08.178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/26/2017] [Accepted: 08/28/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Chordomas arise from remnants of the notochord and occur throughout the neuroaxis. En bloc resection of chordomas can prove especially challenging in the upper cervical spine secondary to the unique structural anatomy and intimate relationship to the vertebral arteries and spinal cord. CASE DESCRIPTION We describe the resection of a C2-C3 chordoma in a 55-year-old woman in 2-stage fashion with preservation of the vertebral arteries. First, a posterior instrumented fusion and removal of the posterior elements was performed, followed by an anterior transmandibular en bloc resection with cage reconstruction with kick-plate support achievable with off-the-shelf products. CONCLUSIONS Chordomas in the upper cervical spine pose a surgical challenge but are amenable to en bloc resection. With careful planning and intraoperative adaptability, the surgeon can achieve a suitable reconstruction with off-the-shelf products.
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27
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Trapani V, Bonaldo P, Corallo D. Role of the ECM in notochord formation, function and disease. J Cell Sci 2017; 130:3203-3211. [PMID: 28883093 DOI: 10.1242/jcs.175950] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The notochord is a midline structure common to all chordate animals; it provides mechanical and signaling cues for the developing embryo. In vertebrates, the notochord plays key functions during embryogenesis, being a source of developmental signals that pattern the surrounding tissues. It is composed of a core of vacuolated cells surrounded by an epithelial-like sheath of cells that secrete a thick peri-notochordal basement membrane made of different extracellular matrix (ECM) proteins. The correct deposition and organization of the ECM is essential for proper notochord morphogenesis and function. Work carried out in the past two decades has allowed researchers to dissect the contribution of different ECM components to this embryonic tissue. Here, we will provide an overview of these genetic and mechanistic studies. In particular, we highlight the specific functions of distinct matrix molecules in regulating notochord development and notochord-derived signals. Moreover, we also discuss the involvement of ECM synthesis and its remodeling in the pathogenesis of chordoma, a malignant bone cancer that originates from remnants of notochord remaining after embryogenesis.
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Affiliation(s)
- Valeria Trapani
- Department of Molecular Medicine, University of Padova, 35131 Padova, Italy
| | - Paolo Bonaldo
- Department of Molecular Medicine, University of Padova, 35131 Padova, Italy .,CRIBI Biotechnology Center, University of Padova, Padova, 35131, Italy
| | - Diana Corallo
- Department of Molecular Medicine, University of Padova, 35131 Padova, Italy .,Pediatric Research Institute, Città della Speranza, 35127 Padova, Italy
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