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Miao L, Kang Y, Zhang XF. Nanotechnology for the theranostic opportunity of breast cancer lung metastasis: recent advancements and future challenges. Front Bioeng Biotechnol 2024; 12:1410017. [PMID: 38882636 PMCID: PMC11176448 DOI: 10.3389/fbioe.2024.1410017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 05/08/2024] [Indexed: 06/18/2024] Open
Abstract
Lung metastasis of breast cancer is rapidly becoming a thorny problem in the treatment of patients with breast cancer and an obstacle to long-term survival. The main challenges of treatment are the absence of therapeutic targets and drug resistance, which promotes the development of nanotechnology in the diagnosis and treatment process. Taking advantage of the controllability and targeting of nanotechnology, drug-targeted delivery, controlled sustained release, multi-drug combination, improved drug efficacy, and reduced side effects can be realized in the process of the diagnosis and treatment of metastatic breast cancer (MBC). Several nanotechnology-based theranostic strategies have been investigated in breast cancer lung metastases (BCLM): targeted drug delivery, imaging analysis, immunotherapy, gene therapy, and multi-modality combined therapy, and some clinical applications are in the research phase. In this review, we present current nanotechnology-based diagnosis and treatment approaches for patients of incurable breast cancer with lung metastases, and we hope to be able to summarize more effective and promising nano-drug diagnosis and treatment systems that aim to improve the survival of patients with advanced MBC. We describe nanoplatform-based experimental studies and clinical trials targeting the tumor and the tumor microenvironment (TME) for BCLM to obtain more targeted treatment and in the future treatment steps for patients to provide a pioneering strategy.
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Affiliation(s)
- Lin Miao
- Departemnt of Breast Surgery, Cancer Hospital of China Medical University, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Yue Kang
- Departemnt of Breast Surgery, Cancer Hospital of China Medical University, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Xin Feng Zhang
- Departemnt of Breast Surgery, Cancer Hospital of China Medical University, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang, China
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2
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Javed S, Khan A, Khalid A, Scalia G, Umana GE, Mahmood A, Yaqoob E, Pahwa B, Chaurasia B. Scalp metastasis from atypical meningioma: A case report and literature review. Clin Case Rep 2024; 12:e8789. [PMID: 38681044 PMCID: PMC11053248 DOI: 10.1002/ccr3.8789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/17/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
Key Clinical Message Scalp metastasis from atypical meningioma, though rare, underscores the importance of meticulous surgical techniques to prevent tumor cell implantation. Early detection and comprehensive management, including surgery and adjuvant therapy, are crucial for optimal outcomes. Abstract Meningiomas are tumors of the meninges that originate in the arachnoid layer from arachnoid cap cells. Atypical meningiomas, classified as WHO grade 2 tumors, tend to metastasize and recur if not surgically managed properly. Scalp metastasis is a rare occurrence that presents as a subcutaneous elevation. A 33-year-old patient presented with a complaint of a constant, dull pressure headache persisting for the past 12 months, exacerbated by exertion, along with seizures and neuropsychiatric symptoms. The patient had no significant medical history but had undergone surgery 4 years ago for a WHO grade 2 meningioma. The current brain MRI revealed a dural tail sign, along with masses on both the left and right sides of the frontal lobe, extending to involve the skin on the forehead and scalp. The patient underwent surgical resection and adjuvant radiation therapy. At the 12-month follow-up, no neurological deterioration or tumor recurrence was observed. A literature review on scalp metastasis in patients with atypical meningioma was also conducted, including eight articles published up to September 2023. The mechanism of metastasis development appears to be consistent in all eight reported cases, involving the implantation of tumor cells during resection. Therefore, there is a critical need for meticulous intra- and post-operative surgical techniques to prevent such implantation.
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Affiliation(s)
- Saad Javed
- Department of NeurosurgeryRawalpindi Medical UniversityRawalpindiPakistan
| | - Amina Khan
- Department of NeurosurgeryRawalpindi Medical University RawalpindiRawalpindiPakistan
| | - Ayesha Khalid
- Department of NeurosurgeryRawalpindi Medical University RawalpindiRawalpindiPakistan
| | - Gianluca Scalia
- Neurosurgery Unit, Department of Head and Neck SurgeryGaribaldi HospitalCataniaItaly
| | | | - Ashraf Mahmood
- Department of NeurosurgeryRawalpindi Medical University RawalpindiRawalpindiPakistan
| | - Eesha Yaqoob
- Department of Public HealthHealth Services Academy, Ministry of National Health Services Regulations and Coordination, Government of PakistanIslamabadPakistan
| | - Bhavya Pahwa
- University College of Medical Sciences and GTB HospitalDelhiIndia
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3
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Hübers C, Abdul Pari AA, Grieshober D, Petkov M, Schmidt A, Messmer T, Heyer CM, Schölch S, Kapel SS, Gengenbacher N, Singhal M, Schieb B, Fricke C, Will R, Remans K, Utikal JS, Reissfelder C, Schlesner M, Hodivala-Dilke KM, Kersten S, Goerdt S, Augustin HG, Felcht M. Primary tumor-derived systemic nANGPTL4 inhibits metastasis. J Exp Med 2023; 220:e20202595. [PMID: 36269299 PMCID: PMC9595206 DOI: 10.1084/jem.20202595] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/07/2022] [Accepted: 09/15/2022] [Indexed: 11/04/2022] Open
Abstract
Primary tumors and distant site metastases form a bidirectionally communicating system. Yet, the molecular mechanisms of this crosstalk are poorly understood. Here, we identified the proteolytically cleaved fragments of angiopoietin-like 4 (ANGPTL4) as contextually active protumorigenic and antitumorigenic contributors in this communication ecosystem. Preclinical studies in multiple tumor models revealed that the C-terminal fragment (cANGPTL4) promoted tumor growth and metastasis. In contrast, the N-terminal fragment of ANGPTL4 (nANGPTL4) inhibited metastasis and enhanced overall survival in a postsurgical metastasis model by inhibiting WNT signaling and reducing vascularity at the metastatic site. Tracing ANGPTL4 and its fragments in tumor patients detected full-length ANGPTL4 primarily in tumor tissues, whereas nANGPTL4 predominated in systemic circulation and correlated inversely with disease progression. The study highlights the spatial context of the proteolytic cleavage-dependent pro- and antitumorigenic functions of ANGPTL4 and identifies and validates nANGPTL4 as a novel biomarker of tumor progression and antimetastatic therapeutic agent.
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Affiliation(s)
- Corinne Hübers
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
| | - Ashik Ahmed Abdul Pari
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Denise Grieshober
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Martin Petkov
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | | | - Tatjana Messmer
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
| | - Christian Moritz Heyer
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
- Biomedical Informatics, Data Mining and Data Analytics, Augsburg University, Augsburg, Germany
| | - Sebastian Schölch
- JCCU Translational Surgical Oncology (A430), German Cancer Research Center, Heidelberg, Germany
- Department of Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- DKFZ-Hector Cancer Institute at University Medical Centre Mannheim, Mannheim, Germany
| | - Stephanie S. Kapel
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - Nicolas Gengenbacher
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - Mahak Singhal
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- Laboratory of AngioRhythms, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Benjamin Schieb
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - Claudine Fricke
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - Rainer Will
- Genomics & Proteomics Core Facilities, German Cancer Research Center, Heidelberg, Germany
| | - Kim Remans
- Protein Expression and Purification Core Facility, European Molecular Biology Center, Heidelberg, Germany
| | - Jochen Sven Utikal
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center, Heidelberg, Germany
| | - Christoph Reissfelder
- Department of Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- DKFZ-Hector Cancer Institute at University Medical Centre Mannheim, Mannheim, Germany
| | - Matthias Schlesner
- Biomedical Informatics, Data Mining and Data Analytics, Augsburg University, Augsburg, Germany
| | - Kairbaan M. Hodivala-Dilke
- Center for Tumor Biology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Center, London, United Kingdom
| | - Sander Kersten
- Nutrition, Metabolism and Genomics group, Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Sergij Goerdt
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
| | - Hellmut G. Augustin
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - Moritz Felcht
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
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A single local delivery of paclitaxel and nucleic acids via an immunoactive polymer eliminates tumors and induces antitumor immunity. Proc Natl Acad Sci U S A 2022; 119:e2122595119. [PMID: 35609195 DOI: 10.1073/pnas.2122595119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
SignificanceThe rationale of local cancer immunotherapy is that the treated tumor cells can serve as a depot of tumor antigens and activate/mobilize the patient's immune system to address systemic diseases. However, the challenge is to coordinate several events involved in the activation of antitumor immune responses, colocalize and retain multiple therapies in tumors, and support the functions of immune cells. Our carrier polyethyleneimine-lithocholic acid conjugate (2E') addresses these challenges based on the amphiphilic structure and inherent immunostimulatory activity. 2E' codelivers hydrophobic drugs and nucleic acids and leverages their effects to eliminate primary tumors and protect the hosts from distant and recurrent diseases. The versatility of 2E' will enable the use of therapeutic combinations to improve clinical outcomes of cancer immunotherapy.
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Tyminski M, Ciacka K, Staszek P, Gniazdowska A, Krasuska U. Toxicity of meta-Tyrosine. PLANTS (BASEL, SWITZERLAND) 2021; 10:plants10122800. [PMID: 34961269 PMCID: PMC8707607 DOI: 10.3390/plants10122800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 05/15/2023]
Abstract
L-Tyrosine (Tyr) is one of the twenty proteinogenic amino acids and also acts as a precursor for secondary metabolites. Tyr is prone to modifications, especially under conditions of cellular redox imbalance. The oxidation of Tyr precursor phenylalanine leads to the formation of Tyr non-proteinogenic isomers, including meta-Tyr (m-Tyr), a marker of oxidative stress. The aim of this review is to summarize the current knowledge on m-Tyr toxicity. The direct m-Tyr mode of action is linked to its incorporation into proteins, resulting in their improper conformation. Furthermore, m-Tyr produced by some plants as an allelochemical impacts the growth and development of neighboring organisms. In plants, the direct harmful effect of m-Tyr is due to its modification of the proteins structure, whereas its indirect action is linked to the disruption of reactive oxygen and nitrogen species metabolism. In humans, the elevated concentration of m-Tyr is characteristic of various diseases and ageing. Indeed, m-Tyr is believed to play an important role in cancer physiology. Thus, since, in animal cells, m-Tyr is formed directly in response to oxidative stress, whereas, in plants, m-Tyr is also synthesized enzymatically and serves as a chemical weapon in plant-plant competition, the general concept of m-Tyr role in living organisms should be specified.
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Clark M, Kollara A, Brown TJ, May T. A mouse model of neoadjuvant chemotherapy followed by interval cytoreductive surgery indicates impaired efficacy of perioperative cisplatin. J Ovarian Res 2021; 14:157. [PMID: 34784944 PMCID: PMC8594094 DOI: 10.1186/s13048-021-00895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Investigate the impact of interval cytoreductive surgery (ICS) on progression in an orthotopic mouse model of ovarian cancer and the impact of chemotherapy delivered at various timelines following surgery. Methods Luciferase-expressing ID8 murine ovarian cancer cells were implanted intra-bursally and IP to C57BL/7 mice. Once disease was established by bioluminescence, 2 cycles of neoadjuvant cisplatin were administered, and animals received either ICS (removal of the injected bursa/primary tumor) or anesthesia alone. Postsurgical chemotherapy was administered on the same day as the intervention (ICS/anesthesia), or on day 7 or day 28 following the intervention. Progression was quantified serially with in vivo bioluminescence imaging. Volume of ascitic fluid volume collected at necropsy was measured. Results Animals were matched for tumor burden at stratification. There was no accelerated growth of residual tumor after interval cytoreduction compared to controls. Animals who received chemotherapy on postoperative day (POD) 7 had better disease control compared to standard-of-care POD 28. Animals who underwent surgery had less ascites at necropsy compared to those who had anesthesia alone. Conclusions In this animal model, surgical wounding with suboptimal cytoreduction after neoadjuvant chemotherapy did not cause accelerated expansion of residual disease. Surgical wounding appears to impair cisplatin activity when given at time of surgery.
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Affiliation(s)
- Mitchell Clark
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre, 700 University Avenue, Room 6-811, Toronto, ON, M5T 1Z5, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,Present address: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, USA
| | - Alexandra Kollara
- Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto, ON, Canada
| | - Theodore J Brown
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto, ON, Canada
| | - Taymaa May
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre, 700 University Avenue, Room 6-811, Toronto, ON, M5T 1Z5, Canada. .,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada. .,Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto, ON, Canada.
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7
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Wilkie KP, Aktar F. Mathematically modelling inflammation as a promoter of tumour growth. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2021; 37:491-514. [PMID: 32430508 DOI: 10.1093/imammb/dqaa005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 12/23/2022]
Abstract
Inflammation is now known to play a significant role in tumour growth and progression. It is also difficult to adequately quantify systemic inflammation and the resulting localized effects in cancer. Here, we use experimental data to infer the possible contributions of inflammation in a mouse model of cancer. The model is validated by predicting tumour growth under anti-inflammatory treatments, and combination cancer therapies are explored. We then extend the model to consider simultaneous tumour implants at two distinct sites, which experimentally was shown to result in one large and one small tumour. We use this model to examine the role inflammation may play in the growth rate separation. Finally, we use this predictive two-tumour model to explore implications of inflammation on metastases, surgical removal of the primary and adjuvant anti-inflammatory treatments. This work suggests that improved tumour control can be obtained by targeting both the cancer and host, through anti-inflammatory treatments, including reduced metastatic burden post-surgical removal of primary tumours.
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Affiliation(s)
- Kathleen P Wilkie
- Department of Mathematics, Ryerson University, Toronto, Ontario, Canada
| | - Farjana Aktar
- Department of Mathematics, Ryerson University, Toronto, Ontario, Canada
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Orlandi A, D'Archi S, Garufi G, Franco A, Carnassale B, Palazzo A, Bria E, Sanchez M, DI Leone A, Terribile D, Fabi A, Tortora G, Masetti R, Franceschini G. Impact on survival of primary tumor resection in patients with metastatic breast cancer: preliminary results of a retrospective analisys. Minerva Surg 2021; 76:506-511. [PMID: 34338469 DOI: 10.23736/s2724-5691.21.09007-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Treatment of de novo metastatic breast cancer is usually centered around systemic therapy, with local therapy (surgery and radiation therapy) largely reserved for palliation in patients with significant symptoms from primary tumour. The efficacy of locoregional treatment like surgery and/or radiotherapy is still controversial and the debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists. METHODS All patients with de novo MBC undergone surgical treatment between January 2015 and January 2020 at the Multidisciplinary Breast Center of the Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome were included in this study. The primary endpoint was overall survival (OS) after PT resection, the secondary endpoint was progression free survival (PFS). The survival analyses were done using Kaplan-Meier method. Patients and tumour characteristics were analyzed in an exploratory modality in order to identify prognostic factor. RESULTS 45 patients received resection of the primary breast cancer (26 mastectomy and 19 breast conserving surgery). Median age of diagnosis was 53 years old (range 25-75 years old). Median follow-up was 25.67 months. The median OS was not reached with 75% of patients alive over 2 years from PT resection. The median PFS was not reached with 64% of patients alive over 2 years from PT resection. For both PFS and OS only the triple negative (TN) immunophenotype appears to be a prognostically unfavorable factor in multivariate analysis. CONCLUSIONS In view of the low number of disease progression events and deaths, although our results are preliminary, surgical treatment of primary breast cancer in metastatic setting seems to be an option after systemic therapies in luminal and HER2 positive breast cancer. Randomized prospective trials in for each immunophenotype are necessary order to confirm this evidence.
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Affiliation(s)
- Armando Orlandi
- Comprehensive Cancer Center, UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy -
| | - Sabatino D'Archi
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanna Garufi
- Comprehensive Cancer Center, UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Franco
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Beatrice Carnassale
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonella Palazzo
- Comprehensive Cancer Center, UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Emilio Bria
- Comprehensive Cancer Center, UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martin Sanchez
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alba DI Leone
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniela Terribile
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandra Fabi
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giampaolo Tortora
- Comprehensive Cancer Center, UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Riccardo Masetti
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianluca Franceschini
- Breast Center Unit, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Liu S, Sun X, Li K, Zha R, Feng Y, Sano T, Dong C, Liu Y, Aryal UK, Sudo A, Li BY, Yokota H. Generation of the tumor-suppressive secretome from tumor cells. Am J Cancer Res 2021; 11:8517-8534. [PMID: 34373756 PMCID: PMC8344019 DOI: 10.7150/thno.61006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/09/2021] [Indexed: 12/13/2022] Open
Abstract
Rationale: The progression of cancer cells depends on the soil and building an inhibitory soil might be a therapeutic option. We previously created tumor-suppressive secretomes by activating Wnt signaling in MSCs. Here, we examined whether the anti-tumor secretomes can be produced from tumor cells. Methods: Wnt signaling was activated in tumor cells by overexpressing β-catenin or administering BML284, a Wnt activator. Their conditioned medium (CM) was applied to cancer cells or tissues, and the effects of CM were evaluated. Tumor growth in the mammary fat pad and tibia in C57BL/6 female mice was also evaluated through μCT imaging and histology. Whole-genome proteomics analysis was conducted to determine and characterize novel tumor-suppressing proteins, which were enriched in CM. Results: The overexpression of β-catenin or the administration of BML284 generated tumor-suppressive secretomes from breast, prostate and pancreatic cancer cells. In the mouse model, β-catenin-overexpressing CM reduced tumor growth and tumor-driven bone destruction. This inhibition was also observed with BML284-treated CM. Besides p53 and Trail, proteomics analysis revealed that CM was enriched with enolase 1 (Eno1) and ubiquitin C (Ubc) that presented notable tumor-suppressing actions. Importantly, Eno1 immunoprecipitated CD44, a cell-surface adhesion receptor, and its silencing suppressed Eno1-driven tumor inhibition. A pan-cancer survival analysis revealed that the downregulation of MMP9, Runx2 and Snail by CM had a significant impact on survival outcomes (p < 0.00001). CM presented a selective inhibition of tumor cells compared to non-tumor cells, and it downregulated PD-L1, an immune escape modulator. Conclusions: The tumor-suppressive secretome can be generated from tumor cells, in which β-catenin presented two opposing roles, as an intracellular tumor promoter in tumor cells and a generator of extracellular tumor suppressor in CM. Eno1 was enriched in CM and its interaction with CD44 was involved in Eno1's anti-tumor action. Besides presenting a potential option for treating primary cancers and metastases, the result indicates that aggressive tumors may inhibit the growth of less aggressive tumors via tumor-suppressive secretomes.
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Martin TW, Griffin L, Custis J, Ryan SD, Lafferty M, Boss MK, Regan D, Rao S, Leary D, Withrow SJ, LaRue SM. Outcome and prognosis for canine appendicular osteosarcoma treated with stereotactic body radiation therapy in 123 dogs. Vet Comp Oncol 2021; 19:284-294. [PMID: 33403752 DOI: 10.1111/vco.12674] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022]
Abstract
Canine appendicular osteosarcoma is commonly treated with limb amputation; however, limb-sparing options are frequently desired or necessary for a subset of patients. We evaluated 123 patients and 130 sites treated with stereotactic body radiation therapy (SBRT). Eighty-two out of 98 dogs (84%) had maximum lameness improvement at a median of 3 weeks for a median of 6 months duration. Histopathologic evaluation of available samples from amputation or necropsy revealed >80% tumor necrosis in 50% of limbs consistent with local disease control. Of evaluable patients, 41% fractured and 21% pursued an amputation after treatment. Fine needle aspirate (n = 52) and needle core biopsy (n = 28) did not result in increased fracture risk compared to those without tumor sampling (n = 50). Median survival time (MST) was 233 days and time to first event was 143 days. Gross tumor volume and planned target volume were significantly inversely associated with survival and tumor location was significantly associated with survival. Dogs with salvage amputation had a significantly longer MST compared to those without (346 vs 202 days; P = .04). The presence of metastatic disease at the time of treatment in 15 dogs did not significantly impact survival time (200 vs 237 days without metastasis; P = .58). Skin side effects correlated significantly with dose with 33% of patients with acute grade 3 effects developing consequential late grade 3 effects. While SBRT improves lameness in most patients, further investigation is needed to identify candidates with minimal early fracture risk prior to initiating therapy.
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Affiliation(s)
- Tiffany Wormhoudt Martin
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Lynn Griffin
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - James Custis
- Department of Radiation Oncology, VCA Animal Diagnostic Clinic, Dallas, Texas, USA
| | - Stewart D Ryan
- Veterinary Clinical Sciences, The University of Melbourne, Victoria, Australia
| | - Mary Lafferty
- Department of Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Mary-Keara Boss
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Daniel Regan
- Department of Microbiology, Immunology, and Pathology College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Sangeeta Rao
- Department of Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Del Leary
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Stephen J Withrow
- Department of Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Susan M LaRue
- Department of Environment and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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11
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Rhodes A, Hillen T. Implications of immune-mediated metastatic growth on metastatic dormancy, blow-up, early detection, and treatment. J Math Biol 2020; 81:799-843. [PMID: 32789610 DOI: 10.1007/s00285-020-01521-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 05/01/2020] [Indexed: 01/20/2023]
Abstract
Metastatic seeding of distant organs can occur in the very early stages of primary tumor development. Once seeded, these micrometastases may enter a dormant phase that can last decades. Curiously, the surgical removal of the primary tumor can stimulate the accelerated growth of distant metastases, a phenomenon known as metastatic blow-up. Recent clinical evidence has shown that the immune response can have strong tumor promoting effects. In this work, we investigate if the pro-tumor effects of the immune response can have a significant contribution to metastatic dormancy and metastatic blow-up. We develop an ordinary differential equation model of the immune-mediated theory of metastasis. We include both anti- and pro-tumor immune effects, in addition to the experimentally observed phenomenon of tumor-induced immune cell phenotypic plasticity. Using geometric singular perturbation analysis, we derive a rather simple model that captures the main processes and, at the same time, can be fully analyzed. Literature-derived parameter estimates are obtained, and model robustness is demonstrated through a time dependent sensitivity analysis. We determine conditions under which the parameterized model can successfully explain both metastatic dormancy and blow-up. The results confirm the significant active role of the immune system in the metastatic process. Numerical simulations suggest a novel measure to predict the occurrence of future metastatic blow-up in addition to new potential avenues for treatment of clinically undetectable micrometastases.
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Affiliation(s)
- Adam Rhodes
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada.
| | - Thomas Hillen
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
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12
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Kallis MP, Maloney C, Blank B, Soffer SZ, Symons M, Steinberg BM. Pharmacological prevention of surgery-accelerated metastasis in an animal model of osteosarcoma. J Transl Med 2020; 18:183. [PMID: 32354335 PMCID: PMC7193344 DOI: 10.1186/s12967-020-02348-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Osteosarcoma is a highly metastatic primary bone tumor that predominantly affects adolescents and young adults. A mainstay of treatment in osteosarcoma is removal of the primary tumor. However, surgical excision itself has been implicated in promoting tumor growth and metastasis, an effect known as surgery-accelerated metastasis. The underlying mechanisms contributing to surgery-accelerated metastasis remain poorly understood, but pro-tumorigenic alterations in macrophage function have been implicated. METHODS The K7M2-BALB/c syngeneic murine model of osteosarcoma was used to study the effect of surgery on metastasis, macrophage phenotype, and overall survival. Pharmacological prevention of surgery-accelerated metastasis was examined utilizing gefitinib, a receptor interacting protein kinase 2 inhibitor previously shown to promote anti-tumor macrophage phenotype. RESULTS Surgical excision of the primary tumor resulted in increases in lung metastatic surface nodules, overall metastatic burden and number of micrometastatic foci. This post-surgical metastatic enhancement was associated with a shift in macrophage phenotype within the lung to a more pro-tumor state. Treatment with gefitinib prevented tumor-supportive alterations in macrophage phenotype and resulted in reduced metastasis. Removal of the primary tumor coupled with gefitinib treatment resulted in enhanced median and overall survival. CONCLUSIONS Surgery-accelerated metastasis is mediated in part through tumor supportive alterations in macrophage phenotype. Targeted pharmacologic therapies that prevent pro-tumor changes in macrophage phenotype could be utilized perioperatively to mitigate surgery-accelerated metastasis and improve the therapeutic benefits of surgery.
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Affiliation(s)
- Michelle P Kallis
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA
- The Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Caroline Maloney
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA
- The Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Brandon Blank
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Samuel Z Soffer
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA
- The Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Marc Symons
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA
- The Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Bettie M Steinberg
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA.
- The Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA.
- Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
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13
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Lopez-Tarruella S, Escudero MJ, Pollan M, Martín M, Jara C, Bermejo B, Guerrero-Zotano A, García-Saenz J, Santaballa A, Alba E, Andrés R, Martínez P, Calvo L, Fernández A, Batista N, Llombart-Cussac A, Antón A, Lahuerta A, de la Haba J, López-Vega JM, Carrasco E. Survival impact of primary tumor resection in de novo metastatic breast cancer patients (GEICAM/El Alamo Registry). Sci Rep 2019; 9:20081. [PMID: 31882586 PMCID: PMC6934456 DOI: 10.1038/s41598-019-55765-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/02/2019] [Indexed: 01/14/2023] Open
Abstract
The debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists. We explored this approach's outcomes in patients included in a retrospective registry, named El Álamo, of breast cancer patients diagnosed in Spain (1990-2001). In this analysis we only included de novo MBC patients, 1415 of whom met the study's criteria. Descriptive, Kaplan-Meier and Cox regression analyses were carried out. Median age was 63.1 years, 49.2% of patients had single-organ metastasis (skin/soft tissue [16.3%], bone [33.8%], or viscera [48.3%]). PT surgery (S) was performed in 44.5% of the cases. S-group patients were younger, had smaller tumors, higher prevalence of bone and oligometastatic disease, and lower prevalence of visceral involvement. With a median follow-up of 23.3 months, overall survival (OS) was 39.6 versus 22.4 months (HR = 0.59, p < 0.0001) in the S- and non-S groups, respectively. The S-group OS benefit remained statistically and clinically significant regardless of metastatic location, histological type, histological grade, hormone receptor status and tumor size. PT surgery (versus no surgery) was associated with an OS benefit suggesting that loco-regional PT control may be considered in selected MBC patients. Data from randomized controlled trials are of utmost importance to confirm these results.
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Affiliation(s)
- Sara Lopez-Tarruella
- Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.
| | - M J Escudero
- GEICAM, Spanish Breast Cancer Research Group, Madrid, Spain
| | - Marina Pollan
- Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Martín
- Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Carlos Jara
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Begoña Bermejo
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Hospital Clínico Universitario, Valencia. Biomedical Research Institute INCLIVA, Universidad de Valencia, Valencia, Spain
| | | | - José García-Saenz
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - Emilio Alba
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Complejo Hospitalario Virgen de la Victoria, Málaga, Spain
| | - Raquel Andrés
- Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Lourdes Calvo
- Complejo Hospitalario Juan Canalejo, A Coruña, Spain
| | | | | | | | - Antonio Antón
- Hospital General Universitario Miguel Servet, Zaragoza, Spain
| | | | - Juan de la Haba
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Complejo Hospitalario Reina Sofía, Córdoba, Spain
| | | | - E Carrasco
- GEICAM, Spanish Breast Cancer Research Group, Madrid, Spain
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14
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Enhanced metastatic growth after local tumor resection in the presence of synchronous metastasis in a mouse allograft model of neuroblastoma. Pediatr Surg Int 2019; 35:1403-1411. [PMID: 31555858 DOI: 10.1007/s00383-019-04568-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE We investigated how local tumor resection affects metastatic lesions in neuroblastoma. METHODS MYCN Tg tumor-derived cells were injected subcutaneously into 129+Ter/SvJcl wild-type mice. First, the frequency of metastasis-bearing mice was investigated immunohistochemically (metastatic ratio) at endpoint or post-injection day (PID) 90. Second, the threshold volume of local tumor in mice bearing microscopic lymph node metastasis (mLNM) was investigated at PID 30. Finally, local tumors were resected after exceeding the threshold. Mice were divided into local tumor resection (Resection) and observation (Observation) groups, and the metastatic ratio and volume of LNM were compared between the groups at endpoint or PID 74. RESULTS The metastatic ratio without local resection was 88% at PID 78-90. The threshold local tumor volume in the mice with mLNM was 745 mm3 at PID 30, so local tumors were resected after exceeding 700 mm3. The metastatic ratio and LNM volume were significantly greater in the Resection group (n = 16) than in the Observation group (n = 16) (94% vs. 38%, p < 0.001; 2092 ± 2310 vs. 275 ± 218 mm3, p < 0.01; respectively) at PID 50-74. CONCLUSION Local tumor resection might augment the growth of synchronous microscopic metastases. Our results provide insights into the appropriate timing of local resection for high-risk neuroblastoma.
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15
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Taha MS, Cresswell GM, Park J, Lee W, Ratliff TL, Yeo Y. Sustained Delivery of Carfilzomib by Tannic Acid-Based Nanocapsules Helps Develop Antitumor Immunity. NANO LETTERS 2019; 19:8333-8341. [PMID: 31657935 PMCID: PMC6885327 DOI: 10.1021/acs.nanolett.9b04147] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A group of chemotherapeutic drugs has gained increasing interest in cancer immunotherapy due to the potential to induce immunogenic cell death (ICD). A critical challenge in using the ICD inducers in cancer immunotherapy is the immunotoxicity accompanying their antiproliferative effects. To alleviate this, a nanocapsule formulation of carfilzomib (CFZ), an ICD-inducing proteasome inhibitor, was developed using interfacial supramolecular assembly of tannic acid (TA) and iron, supplemented with albumin coating. The albumin-coated CFZ nanocapsules (CFZ-pTA-alb) attenuated CFZ release, reducing toxicity to immune cells. Moreover, due to the adhesive nature of the TA assembly, CFZ-pTA-alb served as a reservoir of damage-associated molecular patterns released from dying tumor cells to activate dendritic cells. Upon intratumoral administration, CFZ-pTA-alb prolonged tumor retention of CFZ and showed consistently greater antitumor effects than cyclodextrin-solubilized CFZ (CFZ-CD) in B16F10 and CT26 tumor models. Unlike CFZ-CD, the locally injected CFZ-pTA-alb protected or enhanced CD8+ T cell population in tumors, helped develop splenocytes with tumor-specific interferon-γ response, and delayed tumor development on the contralateral side in immunocompetent mice (but not in athymic nude mice), supporting that CFZ-pTA-alb contributed to activating antitumor immunity. This study demonstrates that sustained delivery of ICD inducers by TA-based nanocapsules is an effective way of translating local ICD induction to systemic antitumor immunity.
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Affiliation(s)
- Maie S. Taha
- Department of Industrial and Physical Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Gregory M. Cresswell
- Department of Comparative Pathobiology and Purdue University Center for Cancer Research, 625 Harrison Street, West Lafayette, IN, 47907, USA
| | - Joonyoung Park
- Department of Industrial and Physical Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA
| | - Wooin Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Republic of Korea
| | - Timothy L. Ratliff
- Department of Comparative Pathobiology and Purdue University Center for Cancer Research, 625 Harrison Street, West Lafayette, IN, 47907, USA
| | - Yoon Yeo
- Department of Industrial and Physical Pharmacy, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
- Corresponding author: Yoon Yeo, Ph.D., Phone: 1.765.496.9608, Fax: 1.765.494.6545,
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16
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Perry JA, Douglas H. Immunomodulatory Effects of Surgery, Pain, and Opioids in Cancer Patients. Vet Clin North Am Small Anim Pract 2019; 49:981-991. [PMID: 31581985 DOI: 10.1016/j.cvsm.2019.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Surgery is the mainstay of therapy for canine and human solid cancers. Alarmingly, evidence suggests that the process of surgery may exacerbate metastasis and accelerate the kinetics of cancer progression. Understanding the mechanisms by which cancer progression is accelerated as a result of surgery may provide pharmacologic interventions. This review discusses surgery-induced cancer progression. It focuses on immunomodulatory properties of anesthesia and opioids and evidence that studies evaluating the role of opioids in tumor progression are indicated. It concludes by discussing why companion animals with spontaneously arising cancer are an ideal model for clinical trials to investigate this phenomenon.
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Affiliation(s)
- James A Perry
- Veterinary Cancer and Surgery Specialists, 10400 Southeast Main Street, Milwaukie, OR 97222, USA.
| | - Hope Douglas
- University of Pennsylvania, Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, PA 19104, USA
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17
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An S, Tiruthani K, Wang Y, Xu L, Hu M, Li J, Song W, Jiang H, Sun J, Liu R, Huang L. Locally Trapping the C-C Chemokine Receptor Type 7 by Gene Delivery Nanoparticle Inhibits Lymphatic Metastasis Prior to Tumor Resection. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2019; 15:e1805182. [PMID: 30690891 PMCID: PMC6878664 DOI: 10.1002/smll.201805182] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Indexed: 05/29/2023]
Abstract
Triple negative breast cancer (TNBC) is the most aggressive breast cancer subtype. Currently, no targeted treatment is available for TNBC, and the most common clinical therapy is tumor resection, which often promotes metastasis risks. Strong evidence suggests that the lymphatic metastasis is mediated by the C-C chemokine receptor type 7 (CCR7)/C-C motif chemokine ligand 21 crosstalk between tumor cells and the lymphatic system. It is hypothesized that CCR7 is a key immune modulator in the tumor microenvironment and the local blockade of CCR7 could effectively inhibit TNBC lymphatic metastasis. Accordingly, a plasmid encoding an antagonistic CCR7 affinity protein-CCR7 trap is delivered by tumor targeting nanoparticles in a highly metastatic 4T1 TNBC mouse model. Results show that CCR7 traps are transiently expressed, locally disrupt the signaling pathways in the tumor site, and efficiently inhibit TNBC lymphatic metastasis, without inducing immunosuppression as observed in systemic therapies using CCR7 monoclonal antibody. Significantly, upon applying CCR7 trap therapy prior to tumor resection, a 4T1 TNBC mouse model shows good prognosis without any further metastasis and relapse. In addition, CCR7 trap therapy efficiently inhibits the lymphatic metastasis in a B16F10 melanoma mouse model, indicating its great potential for various metastatic diseases treatment.
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Affiliation(s)
- Sai An
- Division of Pharmacoengineering and Molecular Pharmaceutics and Center for Nanotechnology in Drug Delivery, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Karthik Tiruthani
- Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Ying Wang
- Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Ligeng Xu
- Division of Pharmacoengineering and Molecular Pharmaceutics and Center for Nanotechnology in Drug Delivery, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Mengying Hu
- Division of Pharmacoengineering and Molecular Pharmaceutics and Center for Nanotechnology in Drug Delivery, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Jingjing Li
- Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Wantong Song
- Division of Pharmacoengineering and Molecular Pharmaceutics and Center for Nanotechnology in Drug Delivery, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Hongnan Jiang
- Department of Breast Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, China
| | - Jirui Sun
- Department of Pathology, Baoding First Central Hospital, Baoding, Hebei, 071000, China
| | - Rihe Liu
- Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Leaf Huang
- Division of Pharmacoengineering and Molecular Pharmaceutics and Center for Nanotechnology in Drug Delivery, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
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18
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To resect or not to resect: The hamletic dilemma of primary tumor resection in patients with asymptomatic stage IV colorectal cancer. Crit Rev Oncol Hematol 2018; 132:154-160. [PMID: 30447921 DOI: 10.1016/j.critrevonc.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/05/2018] [Indexed: 02/07/2023] Open
Abstract
Primary tumor resection (PTR) in advanced asymptomatic colorectal cancer (CRC) has been a matter of intense debate for long time. With the advances in systemic treatments, this practice has decreased over the years, although it remains still pervasive. Although the removal of primary tumor has been extensively interrogated both in retrospective and prospective studies, it still remains a clinical conundrum. There are many arguments for and against PTR in CRC both from the preclinical and the clinical point of view. Two scoring models have been published aiming at identifying patients who are suitable candidate for PTR, but they deserve further investigations in larger datasets. While awaiting the results of ongoing randomized clinical trials (RCTs) on this controversial topic, both upfront systemic treatment and PTR followed by chemotherapy should be considered valid options in patients with asymptomatic mCRC. Clinical selection and a shared-decision making approach are the keys to success.
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19
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Parkins KM, Dubois VP, Hamilton AM, Makela AV, Ronald JA, Foster PJ. Multimodality cellular and molecular imaging of concomitant tumour enhancement in a syngeneic mouse model of breast cancer metastasis. Sci Rep 2018; 8:8930. [PMID: 29895974 PMCID: PMC5997674 DOI: 10.1038/s41598-018-27208-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/25/2018] [Indexed: 01/10/2023] Open
Abstract
The mechanisms that influence metastatic growth rates are poorly understood. One mechanism of interest known as concomitant tumour resistance (CTR) can be defined as the inhibition of metastasis by existing tumour mass. Conversely, the presence of a primary tumour has also been shown to increase metastatic outgrowth, termed concomitant tumour enhancement (CTE). The majority of studies evaluating CTR/CTE in preclinical models have relied on endpoint histological evaluation of tumour burden. The goal of this research was to use conventional magnetic resonance imaging (MRI), cellular MRI, and bioluminescence imaging to study the impact of a primary tumour on the development of brain metastases in a syngeneic mouse model. Here, we report that the presence of a 4T1 primary tumour significantly enhances total brain tumour burden in Balb/C mice. Using in vivo BLI/MRI we could determine this was not related to differences in initial arrest or clearance of viable cells in the brain, which suggests that the presence of a primary tumour can increase the proliferative growth of brain metastases in this model. The continued application of our longitudinal cellular and molecular imaging tools will yield a better understanding of the mechanism(s) by which this physiological inhibition (CTR) and/or enhancement (CTE) occurs.
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Affiliation(s)
- Katie M Parkins
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
- The Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada
| | - Veronica P Dubois
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
- The Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada
| | - Amanda M Hamilton
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Ashley V Makela
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
- The Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada
| | - John A Ronald
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
- The Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Paula J Foster
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.
- The Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada.
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20
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Mertens B, Cristina de Araujo Nogueira T, Topalis D, Stranska R, Snoeck R, Andrei G. Investigation of tumor-tumor interactions in a double human cervical carcinoma xenograft model in nude mice. Oncotarget 2018; 9:21978-22000. [PMID: 29774117 PMCID: PMC5955163 DOI: 10.18632/oncotarget.25140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 03/27/2018] [Indexed: 12/15/2022] Open
Abstract
Tumor-tumor distant interactions within one organism are of major clinical relevance determining clinical outcome. To investigate this poorly understood phenomenon, a double human cervical xenograft model in nude mice was developed. A first tumor was induced subcutaneously by injection of human papillomavirus positive cervical carcinoma cells into the mouse lower right flank and 3 weeks later, animals were challenged with the same tumor cell line injected subcutaneously into the upper left flank. These tumors had no direct physical contact and we found no systemic changes induced by the primary tumor affecting the growth of a secondary tumor. However, ablation of the primary tumor by local treatment with cidofovir, a nucleotide analogue with known antiviral and antiproliferative properties, resulted not only in a local antitumor effect but also in a temporary far-reaching effect leading to retarded growth of the challenged tumor. Cidofovir far-reaching effects were linked to a reduced tumor-driven inflammation, to increased anti-tumor immune responses, and could not be enhanced by co-administration with immune stimulating adjuvants. Our findings point to the potential use of cidofovir in novel therapeutic strategies aiming to kill tumor cells as well as to influence the immune system to fight cancer.
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Affiliation(s)
- Barbara Mertens
- Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | | | | | - Ruzena Stranska
- Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Robert Snoeck
- Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Graciela Andrei
- Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
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21
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Game-changing restraint of Ros-damaged phenylalanine, upon tumor metastasis. Cell Death Dis 2018; 9:140. [PMID: 29396431 PMCID: PMC5833805 DOI: 10.1038/s41419-017-0147-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 12/16/2022]
Abstract
An abrupt increase in metastatic growth as a consequence of the removal of primary tumors suggests that the concomitant resistance (CR) phenomenon might occur in human cancer. CR occurs in murine tumors and ROS-damaged phenylalanine, meta-tyrosine (m-Tyr), was proposed as the serum anti-tumor factor primarily responsible for CR. Herein, we demonstrate for the first time that CR happens in different experimental human solid tumors (prostate, lung anaplastic, and nasopharyngeal carcinoma). Moreover, m-Tyr was detected in the serum of mice bearing prostate cancer (PCa) xenografts. Primary tumor growth was inhibited in animals injected with m-Tyr. Further, the CR phenomenon was reversed when secondary implants were injected into mice with phenylalanine (Phe), a protective amino acid highly present in primary tumors. PCa cells exposed to m-Tyr in vitro showed reduced cell viability, downregulated NFκB/STAT3/Notch axis, and induced autophagy; effects reversed by Phe. Strikingly, m-Tyr administration also impaired both, spontaneous metastasis derived from murine mammary carcinomas (4T1, C7HI, and LMM3) and PCa experimental metastases. Altogether, our findings propose m-Tyr delivery as a novel approach to boost the therapeutic efficacy of the current treatment for metastasis preventing the escape from tumor dormancy.
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22
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Benzekry S, Lamont C, Barbolosi D, Hlatky L, Hahnfeldt P. Mathematical Modeling of Tumor-Tumor Distant Interactions Supports a Systemic Control of Tumor Growth. Cancer Res 2017; 77:5183-5193. [PMID: 28729417 PMCID: PMC5600871 DOI: 10.1158/0008-5472.can-17-0564] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/01/2017] [Accepted: 07/11/2017] [Indexed: 12/21/2022]
Abstract
Interactions between different tumors within the same organism have major clinical implications, especially in the context of surgery and metastatic disease. Three main explanatory theories (competition, angiogenesis inhibition, and proliferation inhibition) have been proposed, but precise determinants of the phenomenon remain poorly understood. Here, we formalized these theories into mathematical models and performed biological experiments to test them with empirical data. In syngeneic mice bearing two simultaneously implanted tumors, growth of only one of the tumors was significantly suppressed (61% size reduction at day 15, P < 0.05). The competition model had to be rejected, whereas the angiogenesis inhibition and proliferation inhibition models were able to describe the data. Additional models including a theory based on distant cytotoxic log-kill effects were unable to fit the data. The proliferation inhibition model was identifiable and minimal (four parameters), and its descriptive power was validated against the data, including consistency in predictions of single tumor growth when no secondary tumor was present. This theory may also shed new light on single cancer growth insofar as it offers a biologically translatable picture of how local and global action may combine to control local tumor growth and, in particular, the role of tumor-tumor inhibition. This model offers a depiction of concomitant resistance that provides an improved theoretical basis for tumor growth control and may also find utility in therapeutic planning to avoid postsurgery metastatic acceleration. Cancer Res; 77(18); 5183-93. ©2017 AACR.
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Affiliation(s)
- Sebastien Benzekry
- Inria team MONC, Inria Bordeaux Sud-Ouest, Talence, France.
- Institut de Mathématiques de Bordeaux, Talence, France
| | - Clare Lamont
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts
| | | | - Lynn Hlatky
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts
| | - Philip Hahnfeldt
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts
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23
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Tohme S, Simmons RL, Tsung A. Surgery for Cancer: A Trigger for Metastases. Cancer Res 2017; 77:1548-1552. [PMID: 28330928 DOI: 10.1158/0008-5472.can-16-1536] [Citation(s) in RCA: 391] [Impact Index Per Article: 55.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 12/03/2016] [Accepted: 12/07/2016] [Indexed: 12/12/2022]
Abstract
Surgery is a crucial intervention and provides a chance of cure for patients with cancer. The perioperative period is characterized by an increased risk for accelerated growth of micrometastatic disease and increased formation of new metastatic foci. The true impact for cancer patients remains unclear. This review summarizes the often fragmentary clinical and experimental evidence supporting the role of surgery and inflammation as potential triggers for disease recurrence. Surgery induces increased shedding of cancer cells into the circulation, suppresses antitumor immunity allowing circulating cells to survive, upregulates adhesion molecules in target organs, recruits immune cells capable of entrapping tumor cells, and induces changes in the target tissue and in the cancer cells themselves to enhance migration and invasion to establish at the target site. Surgical trauma induces local and systemic inflammatory responses that can also contribute to the accelerated growth of residual and micrometastatic disease. Furthermore, we address the role of perioperative factors, including anesthesia, transfusions, hypothermia, and postoperative complications, as probable deleterious factors contributing to early recurrence. Through the admittedly limited understanding of these processes, we will attempt to provide suggestions for potential new therapeutic approaches to target the protumorigenic perioperative window and ultimately improve long-term oncological outcomes. Cancer Res; 77(7); 1548-52. ©2017 AACR.
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Affiliation(s)
- Samer Tohme
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Richard L Simmons
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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24
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Hamilton AM, Parkins KM, Murrell DH, Ronald JA, Foster PJ. Investigating the Impact of a Primary Tumor on Metastasis and Dormancy Using MRI: New Insights into the Mechanism of Concomitant Tumor Resistance. ACTA ACUST UNITED AC 2016; 2:79-84. [PMID: 30042958 PMCID: PMC6024418 DOI: 10.18383/j.tom.2016.00151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dormant cancer cells, also referred to as quiescent, slowly cycling or “nonproliferative” cells, are believed to contribute to tumor recurrence and present a therapeutic problem because they are nonresponsive to current therapies that target proliferating cells. Concomitant tumor resistance (CTR) is the ability of a primary tumor to restrict the growth of secondary metastases. In this paper, we investigate these 2 cancer concepts using cellular magnetic resonance imaging (MRI). A new model for CTR is presented where a primary mammary fat pad tumor is generated using a human breast cancer cell line (231) and breast cancer brain metastases are generated using a cell line derived from 231 to be brain metastatic (231-BR). Iron oxide particles are used to label the 231BR cells to allow for tracking of the proliferating cells, which form metastases, and the nonproliferating cells, which remain dormant in the brain. Bioluminescence and fluorescence-activated cell sorting are used to validate the MRI data. The presence of a primary 231 mammary fat pad tumor inhibited the formation of MRI-detectable 231BR brain metastases. More iron-retaining cells persisted in the brains of mice with a primary tumor. Bioluminescence and fluorescence-activated cell sorting provide evidence that signal voids detectable by MRI on day 0 represent live, iron-labeled cells in the brain. This work shows that retention of iron by nonproliferative cancer cells can be exploited to monitor the fate of this important cell population in vivo, and it points to a new mechanism for CTR, the enhancement of dormancy by a primary tumor.
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Affiliation(s)
| | - Katie M Parkins
- Imaging Lab, Robarts Research Institute, London, Ontario; and.,Department of Medical Biophysics, University of Western Ontario, London, Ontario
| | - Donna H Murrell
- Imaging Lab, Robarts Research Institute, London, Ontario; and.,Department of Medical Biophysics, University of Western Ontario, London, Ontario
| | - John A Ronald
- Imaging Lab, Robarts Research Institute, London, Ontario; and.,Department of Medical Biophysics, University of Western Ontario, London, Ontario
| | - Paula J Foster
- Imaging Lab, Robarts Research Institute, London, Ontario; and.,Department of Medical Biophysics, University of Western Ontario, London, Ontario
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25
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Ipson BR, Fisher AL. Roles of the tyrosine isomers meta-tyrosine and ortho-tyrosine in oxidative stress. Ageing Res Rev 2016; 27:93-107. [PMID: 27039887 DOI: 10.1016/j.arr.2016.03.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/20/2016] [Accepted: 03/30/2016] [Indexed: 12/11/2022]
Abstract
The damage to cellular components by reactive oxygen species, termed oxidative stress, both increases with age and likely contributes to age-related diseases including Alzheimer's disease, atherosclerosis, diabetes, and cataract formation. In the setting of oxidative stress, hydroxyl radicals can oxidize the benzyl ring of the amino acid phenylalanine, which then produces the abnormal tyrosine isomers meta-tyrosine or ortho-tyrosine. While elevations in m-tyrosine and o-tyrosine concentrations have been used as a biological marker of oxidative stress, there is emerging evidence from bacterial, plant, and mammalian studies demonstrating that these isomers, particularly m-tyrosine, directly produce adverse effects to cells and tissues. These new findings suggest that the abnormal tyrosine isomers could in fact represent mediators of the effects of oxidative stress. Consequently the accumulation of m- and o-tyrosine may disrupt cellular homeostasis and contribute to disease pathogenesis, and as result, effective defenses against oxidative stress can encompass not only the elimination of reactive oxygen species but also the metabolism and ultimately the removal of the abnormal tyrosine isomers from the cellular amino acid pool. Future research in this area is needed to clarify the biologic mechanisms by which the tyrosine isomers damage cells and disrupt the function of tissues and organs and to identify the metabolic pathways involved in removing the accumulated isomers after exposure to oxidative stress.
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Affiliation(s)
- Brett R Ipson
- MD/PhD Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States; Department of Cell and Structural Biology, Graduate School of Biomedical Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States; Center for Healthy Aging, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Alfred L Fisher
- Center for Healthy Aging, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States; Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States; GRECC, South Texas VA Health Care System, San Antonio, TX, United States.
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26
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Kirstein JM, Hague MN, McGowan PM, Tuck AB, Chambers AF. Primary melanoma tumor inhibits metastasis through alterations in systemic hemostasis. J Mol Med (Berl) 2016; 94:899-910. [PMID: 27048169 DOI: 10.1007/s00109-016-1415-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/21/2016] [Accepted: 03/24/2016] [Indexed: 02/07/2023]
Abstract
Progression from a primary tumor to distant metastases requires extensive interactions between tumor cells and their microenvironment. The primary tumor is not only the source of metastatic cells but also can also modulate host responses to these cells, leading to an enhancement or inhibition of metastasis. Tumor-mediated stimulation of bone marrow can result in pre-metastatic niche formation and increased metastasis. However, a primary tumor can also inhibit metastasis through concomitant tumor resistance-inhibition of metastatic growth by existing tumor mass. Here, we report that the presence of a B16F10 primary tumor significantly restricted numbers and sizes of experimental lung metastases through reduction of circulating platelets and reduced formation of metastatic tumor cell-associated thrombi. Tumor-bearing mice displayed splenomegaly, correlated with primary tumor size and platelet count. Reduction in platelet numbers in tumor-bearing animals was responsible for metastatic inhibition, as restoration of platelet numbers using isolated platelets re-established both tumor cell-associated thrombus formation and experimental metastasis. Consumption of platelets due to a B16F10 primary tumor is a form of concomitant tumor resistance and demonstrates the systemic impact of a growing tumor. Understanding the interplay between primary tumors and metastases is essential, as clarification of concomitant tumor resistance mechanisms may allow inhibition of metastatic growth following tumor resection. Key messages Mice with a primary B16F10 tumor had reduced metastasis vs. mice without a primary tumor. Tumor-bearing mice had splenomegaly and fewer platelets and tumor-associated thrombi. Restoring platelets restored tumor-associated thrombi and increased metastasis. This work shows the impact that a primary tumor can have on systemic metastasis. Understanding these interactions may lead to improved ways to inhibit metastasis.
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Affiliation(s)
- Jennifer M Kirstein
- London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, ON, N6A 4L6, Canada.,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
| | - M Nicole Hague
- London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, ON, N6A 4L6, Canada
| | - Patricia M McGowan
- London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, ON, N6A 4L6, Canada
| | - Alan B Tuck
- London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, ON, N6A 4L6, Canada.,Department of Pathology and Laboratory Medicine, University of Western Ontario, London, ON, Canada.,Department of Oncology, University of Western Ontario, London, ON, Canada
| | - Ann F Chambers
- London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, ON, N6A 4L6, Canada. .,Department of Medical Biophysics, University of Western Ontario, London, ON, Canada. .,Department of Pathology and Laboratory Medicine, University of Western Ontario, London, ON, Canada. .,Department of Oncology, University of Western Ontario, London, ON, Canada.
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27
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Benzekry S, Tracz A, Mastri M, Corbelli R, Barbolosi D, Ebos JML. Modeling Spontaneous Metastasis following Surgery: An In Vivo-In Silico Approach. Cancer Res 2015; 76:535-47. [PMID: 26511632 DOI: 10.1158/0008-5472.can-15-1389] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/29/2015] [Indexed: 12/19/2022]
Abstract
Rapid improvements in the detection and tracking of early-stage tumor progression aim to guide decisions regarding cancer treatments as well as predict metastatic recurrence in patients following surgery. Mathematical models may have the potential to further assist in estimating metastatic risk, particularly when paired with in vivo tumor data that faithfully represent all stages of disease progression. Herein, we describe mathematical analysis that uses data from mouse models of spontaneous metastasis developing after surgical removal of orthotopically implanted primary tumors. Both presurgical (primary tumor) growth and postsurgical (metastatic) growth were quantified using bioluminescence and were then used to generate a mathematical formalism based on general laws of the disease (i.e., dissemination and growth). The model was able to fit and predict pre/postsurgical data at the level of the individual as well as the population. Our approach also enabled retrospective analysis of clinical data describing the probability of metastatic relapse as a function of primary tumor size. In these data-based models, interindividual variability was quantified by a key parameter of intrinsic metastatic potential. Critically, our analysis identified a highly nonlinear relationship between primary tumor size and postsurgical survival, suggesting possible threshold limits for the utility of tumor size as a predictor of metastatic recurrence. These findings represent a novel use of clinically relevant models to assess the impact of surgery on metastatic potential and may guide optimal timing of treatments in neoadjuvant (presurgical) and adjuvant (postsurgical) settings to maximize patient benefit.
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Affiliation(s)
- Sebastien Benzekry
- Inria Bordeaux Sud-Ouest, Team MONC, Institut de Mathematiques de Bordeaux, Bordeaux, France.
| | - Amanda Tracz
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, New York
| | - Michalis Mastri
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, New York
| | - Ryan Corbelli
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, New York
| | - Dominique Barbolosi
- SMARTc Pharmacokinetics Unit, Inserm S 911 CRO2, Aix Marseille University, Marseille, France
| | - John M L Ebos
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, New York. Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
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28
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Brodbeck T, Nehmann N, Bethge A, Wedemann G, Schumacher U. Perforin-dependent direct cytotoxicity in natural killer cells induces considerable knockdown of spontaneous lung metastases and computer modelling-proven tumor cell dormancy in a HT29 human colon cancer xenograft mouse model. Mol Cancer 2014; 13:244. [PMID: 25373310 PMCID: PMC4239380 DOI: 10.1186/1476-4598-13-244] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/27/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND For long, natural killer (NK) cells have been suspected to play a critical role in suppressing the development of spontaneous metastases in cancer patients. Despite a wide range of studies it remains unclear so far to what extent primary tumor growth together with formation of distant metastases and NK cell activity influence each other. METHODS To precisely investigate the role of NK cells with a perforin-deficiency in cancer growth and metastasis formation, human HT29 colon cancer cells were subcutaneously grafted into pore forming protein and recombination activating gene 2 double knock out (pfp/rag2) mice and in recombination activating gene 2 only knock out (rag2) mice both with black six background. Both mice lack B and T cell functions due to the absence of rag2. RESULTS Primary tumors developed in 16/16 in pfp/rag2 and 20/20 rag2 mice. At sacrifice primary tumor weight did not differ significantly. However, tumors grew faster in pfp/rag2 mice (50 days) than in pfp/rag2 mice (70 days). Circulating tumor cells (CTC) in murine blood were nearly three times higher in pfp/rag2 (68 cells/ml) than in rag2 mice (24 cells/ml). Lung metastases occurred frequently in pfp/rag2 mice (13/16) and infrequently in rag2 mice (5/20). The mean number of metastases was 789 in pfp/rag2 mice compared to 210 in rag2 mice. Lung metastases in pfp/rag2 mice consisted of 10-100 tumor cells while those in rag2 mice were generally disseminated tumor cells (DTCs).Computer modelling showed that perforin-dependent killing of NK cells decelerates the growth of the primary tumour and kills 80% of CTCs. Furthermore, perforin-mediated cytotoxicity hampers the proliferation of the malignant cells in host tissue forcing them to stay dormant for at least 30 days. CONCLUSION The results exactly quantified the effect of perforin-dependent direct cytotoxicity of NK cells on HT29 on primary tumor growth, number of CTCs in the blood and the number of metastases. The largest effects were seen in the number of mice developing spontaneous lung metastases and the mean number of lung metastases. Hence, perforin-mediated cytotoxicity used for direct killing by NK cells is more important than indirect killing by secretion of death-inducing ligands by NK cells.
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Affiliation(s)
- Tobias Brodbeck
- />Experimental Morphology, Center for Experimental Medicine, University Medical Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
| | - Nina Nehmann
- />Experimental Morphology, Center for Experimental Medicine, University Medical Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
| | - Anja Bethge
- />Competence Center Bioinformatics, Institute for Applied Computer Science, University of Applied Sciences Stralsund, Zur Schwedenschanze 15, 18435 Stralsund, Germany
| | - Gero Wedemann
- />Competence Center Bioinformatics, Institute for Applied Computer Science, University of Applied Sciences Stralsund, Zur Schwedenschanze 15, 18435 Stralsund, Germany
| | - Udo Schumacher
- />Experimental Morphology, Center for Experimental Medicine, University Medical Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
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29
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Benzekry S, Gandolfi A, Hahnfeldt P. Global dormancy of metastases due to systemic inhibition of angiogenesis. PLoS One 2014; 9:e84249. [PMID: 24465399 PMCID: PMC3897365 DOI: 10.1371/journal.pone.0084249] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/13/2013] [Indexed: 12/12/2022] Open
Abstract
Autopsy studies of adults dying of non-cancer causes have shown that virtually all of us possess occult, cancerous lesions. This suggests that, for most individuals, cancer will become dormant and not progress, while only in some will it become symptomatic disease. Meanwhile, it was recently shown in animal models that a tumor can produce both stimulators and inhibitors of its own blood supply. To explain the autopsy findings in light of the preclinical research data, we propose a mathematical model of cancer development at the organism scale describing a growing population of metastases, which, together with the primary tumor, can exert a progressively greater level of systemic angiogenesis-inhibitory influence that eventually overcomes local angiogenesis stimulation to suppress the growth of all lesions. As a departure from modeling efforts to date, we look not just at signaling from and effects on the primary tumor, but integrate over this increasingly negative global signaling from all sources to track the development of total tumor burden. This in silico study of the dynamics of the tumor/metastasis system identifies ranges of parameter values where mutual angio-inhibitory interactions within a population of tumor lesions could yield global dormancy, i.e., an organism-level homeostatic steady state in total tumor burden. Given that mortality arises most often from metastatic disease rather than growth of the primary per se, this finding may have important therapeutic implications.
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Affiliation(s)
- Sébastien Benzekry
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- Inria team MC2, Institut de Mathématiques de Bordeaux, Bordeaux, France
| | - Alberto Gandolfi
- Istituto di Analisi dei Sistemi ed Informatica “Antonio Ruberti”, Roma, Italy
| | - Philip Hahnfeldt
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts, United States of America
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30
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Jones PC. Does a "thiol shield" protect tumors from natural IgM antibody, and, if so, how can it be suppressed? Med Hypotheses 2013; 80:425-30. [PMID: 23375413 DOI: 10.1016/j.mehy.2012.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 11/04/2012] [Accepted: 12/29/2012] [Indexed: 11/26/2022]
Abstract
Natural anti-tumor IgM antibodies are prevalent in the serum of cancer patients and normal subjects. Extensive research has been directed toward the ultimate goal of achieving a therapeutic effect from these antibodies either augmented by vaccination or by passive infusion. To date, the therapeutic effects have been limited. This thesis asserts that thiols within solid tumors reduce pentameric IgM to monomeric or other subunit form resulting in inactivation of its complement fixing and cross linking apoptosis inducing properties. A rationale for this normal physiological inactivation mechanism, possibly necessary for wound healing and pregnancy, is proposed along with therapeutic approaches, which would potentially suppress IgM inactivation.
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31
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Retsky M, Demicheli R, Hrushesky WJM, Forget P, De Kock M, Gukas I, Rogers RA, Baum M, Sukhatme V, Vaidya JS. Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: new findings and a review. Curr Med Chem 2013; 20:4163-76. [PMID: 23992307 PMCID: PMC3831877 DOI: 10.2174/09298673113209990250] [Citation(s) in RCA: 88] [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: 02/17/2013] [Revised: 03/26/2013] [Accepted: 03/31/2013] [Indexed: 12/21/2022]
Abstract
To explain a bimodal pattern of hazard of relapse among early stage breast cancer patients identified in multiple databases, we proposed that late relapses result from steady stochastic progressions from single dormant malignant cells to avascular micrometastases and then on to growing deposits. However in order to explain early relapses, we had to postulate that something happens at about the time of surgery to provoke sudden exits from dormant phases to active growth and then to detection. Most relapses in breast cancer are in the early category. Recent data from Forget et al. suggest an unexpected mechanism. They retrospectively studied results from 327 consecutive breast cancer patients comparing various perioperative analgesics and anesthetics in one Belgian hospital and one surgeon. Patients were treated with mastectomy and conventional adjuvant therapy. Relapse hazard updated Sept 2011 are presented. A common Non-Steroidal Anti-Inflammatory Drug (NSAID) analgesic used in surgery produced far superior disease-free survival in the first 5 years after surgery. The expected prominent early relapse events in months 9-18 are reduced 5-fold. If this observation holds up to further scrutiny, it could mean that the simple use of this safe, inexpensive and effective anti-inflammatory agent at surgery might eliminate early relapses. Transient systemic inflammation accompanying surgery could facilitate angiogenesis of dormant micrometastases, proliferation of dormant single cells, and seeding of circulating cancer stem cells (perhaps in part released from bone marrow) resulting in early relapse and could have been effectively blocked by the perioperative anti-inflammatory agent.
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Affiliation(s)
- Michael Retsky
- Harvard School of Public Health, BLDG I, Rm 1311, 665 Huntington, Ave, Boston, MA 02115, USA.
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