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Santarosa Vieira AG, da Silva LS, Albino da Silva EC, Laus AC, Faria TMV, van Helvoort Lengert A, Martins GE, de Oliveira MA, Reis RM, Lopes LF, Pinto MT. Comprehensive microRNA expression analysis of pediatric gonadal germ cell tumors: unveiling novel biomarkers and signatures. Mol Oncol 2024; 18:1593-1607. [PMID: 38725152 PMCID: PMC11161733 DOI: 10.1002/1878-0261.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/11/2023] [Accepted: 02/15/2024] [Indexed: 06/09/2024] Open
Abstract
microRNAs (miRNAs) are small endogenous noncoding RNAs, and alterations in their expression may contribute to oncogenesis. Discovering a unique miRNA pattern holds the potential for early detection and novel treatment possibilities in cancer. This study aimed to evaluate miRNA expression in pediatric patients with gonadal germ cell tumors (GCTs), focusing on characterizing the miRNA profiles of each histological subtype and identifying a distinct histological miRNA signature for a total of 42 samples of pediatric gonadal GCTs. The analysis revealed distinct miRNA expression profiles for all histological types, regardless of the primary site. We identified specific miRNA expression signatures for each histological type, including 34 miRNAs for dysgerminomas, 13 for embryonal carcinomas, 25 for yolk sac tumors, and one for immature teratoma, compared to healthy controls. Furthermore, we identified 26 miRNAs that were commonly expressed in malignant tumors, with six miRNAs (miR-302a-3p, miR-302b-3p, miR-371a-5p, miR-372-3p, miR-373-3p, and miR-367-3p) showing significant overexpression. Notably, miR-302b-3p exhibited a significant association with all the evaluated clinical features. Our findings suggest that miRNAs have the potential to aid in the diagnosis, prognosis, and management of patients with malignant GCTs.
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Affiliation(s)
- Ana Glenda Santarosa Vieira
- Barretos Children's Cancer Hospital from Hospital de AmorBrazil
- Brazilian Childhood Germ Cell Tumor Study GroupThe Brazilian Pediatric Oncology Society (SOBOPE)São PauloBrazil
- Pediatric Cancerology's Department of Santa Casa de Misericórdia de SantosBrazil
| | | | | | | | | | | | - Gisele Eiras Martins
- Barretos Children's Cancer Hospital from Hospital de AmorBrazil
- Brazilian Childhood Germ Cell Tumor Study GroupThe Brazilian Pediatric Oncology Society (SOBOPE)São PauloBrazil
| | | | - Rui Manuel Reis
- Molecular Oncology Research CenterBarretos Cancer HospitalBrazil
- Life and Health Sciences Research Institute (ICVS), Medical SchoolUniversity of MinhoBragaPortugal
- ICVS/3B's‐PT Government Associate LaboratoryBragaPortugal
| | - Luiz Fernando Lopes
- Barretos Children's Cancer Hospital from Hospital de AmorBrazil
- Brazilian Childhood Germ Cell Tumor Study GroupThe Brazilian Pediatric Oncology Society (SOBOPE)São PauloBrazil
| | - Mariana Tomazini Pinto
- Molecular Oncology Research CenterBarretos Cancer HospitalBrazil
- Pediatric Oncology Research Group (GPOPed), Molecular Oncology Research CenterBarretos Cancer HospitalBrazil
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2
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Mogensen H, Erdmann F, Mader L, Vrelits Sørensen G, Talbäck M, Tjørnelund Nielsen T, Hasle H, Heyman M, Winther JF, Feychting M, Tettamanti G, Kenborg L. Early mortality in children with cancer in Denmark and Sweden: The role of social background in a setting with universal healthcare. Int J Cancer 2024; 154:1719-1730. [PMID: 38259167 DOI: 10.1002/ijc.34851] [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: 08/11/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024]
Abstract
Socioeconomic differences in overall survival from childhood cancer have been shown previously, but the underlying mechanisms remain unclear. We aimed to investigate if social inequalities were seen already for early mortality in settings with universal healthcare. From national registers, all children diagnosed with cancer at ages 0-19 years, during 1991-2014, in Sweden and Denmark, were identified, and information on parental social characteristics was collected. We estimated odds ratios (OR) and 95% confidence intervals (CI) of early mortality (death within 90 days after cancer diagnosis) by parental education, income, employment, cohabitation, and country of birth using logistic regression. For children with acute lymphoblastic leukaemia (ALL), clinical characteristics were obtained. Among 13,926 included children, 355 (2.5%) died within 90 days after diagnosis. Indications of higher early mortality were seen among the disadvantaged groups, with the most pronounced associations observed for maternal education (ORadj_Low_vs_High 1.65 [95% CI 1.22-2.23]) and income (ORadj_Q1(lowest)_vs_Q4(highest) 1.77 [1.25-2.49]). We found attenuated or null associations between social characteristics and later mortality (deaths occurring 1-5 years after cancer diagnosis). In children with ALL, the associations between social factors and early mortality remained unchanged when adjusting for potential mediation by clinical characteristics. In conclusion, this population-based cohort study indicated differences in early mortality after childhood cancer by social background, also in countries with universal healthcare. Social differences occurring this early in the disease course requires further investigation, also regarding the timing of diagnosis.
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Affiliation(s)
- Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Institute, Copenhagen, Denmark
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Institute, Copenhagen, Denmark
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Cancer Registry Bern-Solothurn, University of Bern, Bern, Switzerland
| | - Gitte Vrelits Sørensen
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
| | - Mats Talbäck
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Mats Heyman
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Institute, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Giorgio Tettamanti
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Line Kenborg
- Childhood Cancer Research Group, Danish Cancer Institute, Copenhagen, Denmark
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3
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Clinical pharmacology of cytotoxic drugs in neonates and infants: Providing evidence-based dosing guidance. Eur J Cancer 2021; 164:137-154. [PMID: 34865945 PMCID: PMC8914347 DOI: 10.1016/j.ejca.2021.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 01/29/2023]
Abstract
Cancer in neonates and infants is a rare but challenging entity. Treatment is complicated by marked physiological changes during the first year of life, excess rates of toxicity, mortality, and late effects. Dose optimisation of chemotherapeutics may be an important step to improving outcomes. Body size–based dosing is used for most anticancer drugs used in infants. However, dose regimens are generally not evidence based, and dosing strategies are frequently inconsistent between tumour types and treatment protocols. In this review, we collate available pharmacological evidence supporting dosing regimens in infants for a wide range of cytotoxic drugs. A systematic review was conducted, and available data ranked by a level of evidence (1–5) and a grade of recommendation (A–D) provided on a consensus basis, with recommended dosing approaches indicated as appropriate. For 9 of 29 drugs (busulfan, carboplatin, cyclophosphamide, daunorubicin, etoposide, fludarabine, isotretinoin, melphalan and vincristine), grade A was scored, indicating sufficient pharmacological evidence to recommend a dosing algorithm for infants. For busulfan and carboplatin, sufficient data were available to recommend therapeutic drug monitoring in infants. For eight drugs (actinomycin D, blinatumomab, dinutuximab, doxorubicin, mercaptopurine, pegaspargase, thioguanine and topotecan), some pharmacological evidence was available to guide dosing (graded as B). For the remaining drugs, including commonly used agents such as cisplatin, cytarabine, ifosfamide, and methotrexate, pharmacological evidence for dosing in infants was limited or non-existent: grades C and D were scored for 10 and 2 drugs, respectively. The review provides clinically relevant evidence-based dosing guidance for cytotoxic drugs in neonates and infants. Treating cancer in neonates and infants is challenging. Dose optimisation of cytotoxic drugs is an important step to improving outcomes. Clinical pharmacological evidence supporting dosing regimens in infants was collated. All available pharmacological evidence was ranked by a level of evidence. A grade of recommendation was derived and a recommended dose per agent provided.
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Soliman RM, Elhaddad A, Oke J, Eweida W, Sidhom I, Ahmed S, Abdelrahman H, Moussa E, Fawzy M, Zamzam M, Zekri W, Hafez H, Sedky M, Abdalla A, Hammad M, Elzomor H, Ahmed S, Awad M, Abdelhameed S, Mohsen E, Shalaby L, Fouad H, Tarek N, Abouelnaga S, Heneghan C. Temporal trends in childhood cancer survival in Egypt, 2007 to 2017: A large retrospective study of 14 808 children with cancer from the Children's Cancer Hospital Egypt. Int J Cancer 2020; 148:1562-1574. [PMID: 32997796 DOI: 10.1002/ijc.33321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 12/28/2022]
Abstract
Childhood cancer is a priority in Egypt due to large numbers of children with cancer, suboptimal care and insufficient resources. It is difficult to evaluate progress in survival because of paucity of data in National Cancer Registry. In this study, we studied survival rates and trends in survival of the largest available cohort of children with cancer (n = 15 779, aged 0-18 years) from Egypt between 2007 and 2017, treated at Children's Cancer Hospital Egypt-(CCHE), representing 40% to 50% of all childhood cancers across Egypt. We estimated 5-year overall survival (OS) for 14 808 eligible patients using Kaplan-Meier method, and determined survival trends using Cox regression by single year of diagnosis and by diagnosis periods. We compared age-standardized rates to international benchmarks in England and the United States, identified cancers with inferior survival and provided recommendations for improvement. Five-year OS was 72.1% (95% CI 71.3-72.9) for all cancers combined, and survival trends increased significantly by single year of diagnosis (P < .001) and by calendar periods from 69.6% to 74.2% (P < .0001) between 2007-2012 and 2013-2017. Survival trends improved significantly for leukemias, lymphomas, CNS tumors, neuroblastoma, hepatoblastoma and Ewing Sarcoma. Survival was significantly lower by 9% and 11.2% (P < .001) than England and the United States, respectively. Significantly inferior survival was observed for the majority of cancers. Although survival trends are improving for childhood cancers in Egypt/CCHE, survival is still inferior in high-income countries. We provide evidence-based recommendations to improve survival in Egypt by reflecting on current obstacles in care, with further implications on practice and policy.
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Affiliation(s)
- Ranin M Soliman
- Department of Continuing Education, University of Oxford, Oxford, UK.,Health Economics and Value Unit, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt
| | - Alaa Elhaddad
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence Based Medicine, University of Oxford, Oxford, UK
| | - Wael Eweida
- Chief Operating Office, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt
| | - Iman Sidhom
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Sonia Ahmed
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hany Abdelrahman
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Emad Moussa
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Clinical Oncology Department, Menoufia University, Al Minufya, Egypt
| | - Mohamed Fawzy
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Manal Zamzam
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Wael Zekri
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hanafy Hafez
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mohamed Sedky
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Department, National Research Centre, Giza, Egypt
| | - Amr Abdalla
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mahmoud Hammad
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hossam Elzomor
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Sahar Ahmed
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Madeha Awad
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Department of Paediatric Oncology, Nasser Institute for Research and Treatment, Cairo, Egypt
| | - Sayed Abdelhameed
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Enas Mohsen
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Clinical Oncology Department, Beni-Suef University, Beni-Suef, Egypt
| | - Lobna Shalaby
- Paediatric Oncology Department, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt.,Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Heba Fouad
- World Health Organization, Non-communicable Diseases Surveillance Unit, Eastern Mediterranean Regional Office (EMRO), Cairo, Egypt
| | - Nourhan Tarek
- Health Economics and Value Unit, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt
| | - Sherif Abouelnaga
- Paediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.,Chief Executive Office, Children's Cancer Hospital 57357 Egypt (CCHE), Cairo, Egypt
| | - Carl Heneghan
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence Based Medicine, University of Oxford, Oxford, UK
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