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Ippolito E, Silipigni S, Matteucci P, Greco C, Carrafiello S, Palumbo V, Tacconi C, Talocco C, Fiore M, D’Angelillo RM, Ramella S. Radiotherapy for HER 2 Positive Brain Metastases: Urgent Need for a Paradigm Shift. Cancers (Basel) 2022; 14:cancers14061514. [PMID: 35326665 PMCID: PMC8946529 DOI: 10.3390/cancers14061514] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 01/09/2023] Open
Abstract
Brain metastases (BMs) are common among patients affected by HER2+ metastatic breast cancer (>30%). The management of BMs is usually multimodal, including surgery, radiotherapy, systemic therapy and palliative care. Standard brain radiotherapy (RT) includes the use of stereotactic radiotherapy (SRT) for limited disease and whole brain radiotherapy (WBRT) for extensive disease. The latter is an effective palliative treatment but has a reduced effect on brain local control and BM overall survival, as it is also associated with severe neurocognitive sequelae. Recent advances both in radiation therapy and systemic treatment may change the paradigm in this subset of patients who can experience long survival notwithstanding BMs. In fact, in recent studies, SRT for multiple BM sites (>4) has shown similar efficacy when compared to irradiation of a limited number of lesions (one to three) without increasing toxicity. These findings, in addition to the introduction of new drugs with recognized intracranial activity, may further limit the use of WBRT in favor of SRT, which should be employed for treatment of both multiple-site BMs and for oligo-progressive brain disease. This review summarizes the supporting literature and highlights the need for optimizing combinations of the available treatments in this setting, with a particular focus on radiation therapy.
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Affiliation(s)
- Edy Ippolito
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Sonia Silipigni
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Paolo Matteucci
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
- Correspondence: ; Tel.: +39-06225411708
| | - Carlo Greco
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Sofia Carrafiello
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Vincenzo Palumbo
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Claudia Tacconi
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Claudia Talocco
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | - Michele Fiore
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
| | | | - Sara Ramella
- Radiation Oncology, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (E.I.); (S.S.); (C.G.); (S.C.); (V.P.); (C.T.); (C.T.); (M.F.); (S.R.)
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Ngamcherdtrakul W, Bejan DS, Cruz-Muñoz W, Reda M, Zaidan HY, Siriwon N, Marshall S, Wang R, Nelson MA, Rehwaldt JPC, Gray JW, Hynynen K, Yantasee W. Targeted Nanoparticle for Co-delivery of HER2 siRNA and a Taxane to Mirror the Standard Treatment of HER2+ Breast Cancer: Efficacy in Breast Tumor and Brain Metastasis. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2107550. [PMID: 35083840 PMCID: PMC8959011 DOI: 10.1002/smll.202107550] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Indexed: 06/12/2023]
Abstract
The first-line treatment of advanced and metastatic human epidermal growth factor receptor type 2 (HER2+) breast cancer requires two HER2-targeting antibodies (trastuzumab and pertuzumab) and a taxane (docetaxel or paclitaxel). The three-drug regimen costs over $320,000 per treatment course, requires a 4 h infusion time, and has many adverse side effects, while achieving only 18 months of progression-free survival. To replace this regimen, reduce infusion time, and enhance efficacy, a single therapeutic is developed based on trastuzumab-conjugated nanoparticles for co-delivering docetaxel and siRNA against HER2 (siHER2). The optimal nanoconstruct has a hydrodynamic size of 100 nm and specifically treats HER2+ breast cancer cells over organ-derived normal cells. In a drug-resistant orthotopic HER2+ HCC1954 tumor mouse model, the nanoconstruct inhibits tumor growth more effectively than the docetaxel and trastuzumab combination. When coupled with microbubble-assisted focused ultrasound that transiently disrupts the blood brain barrier, the nanoconstruct inhibits the growth of trastuzumab-resistant HER2+ BT474 tumors residing in the brains of mice. The nanoconstruct has a favorable safety profile in cells and in mice. Combination therapies have become the cornerstone of cancer treatment and this versatile nanoparticle platform can co-deliver multiple therapeutic types to ensure that they reach the target cells at the same time to realize their synergy.
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Affiliation(s)
| | - Daniel S Bejan
- PDX Pharmaceuticals Inc., 3303 S Bond Ave, CH13B, Portland, OR, 97239, USA
| | - William Cruz-Muñoz
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
| | - Moataz Reda
- PDX Pharmaceuticals Inc., 3303 S Bond Ave, CH13B, Portland, OR, 97239, USA
| | - Husam Y Zaidan
- PDX Pharmaceuticals Inc., 3303 S Bond Ave, CH13B, Portland, OR, 97239, USA
| | - Natnaree Siriwon
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 S Bond Ave, Portland, OR, 97239, USA
| | - Suphalak Marshall
- Department of Radiology and Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand
| | - Ruijie Wang
- PDX Pharmaceuticals Inc., 3303 S Bond Ave, CH13B, Portland, OR, 97239, USA
| | - Molly A Nelson
- PDX Pharmaceuticals Inc., 3303 S Bond Ave, CH13B, Portland, OR, 97239, USA
| | | | - Joe W Gray
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 S Bond Ave, Portland, OR, 97239, USA
| | - Kullervo Hynynen
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
- Department of Medical Biophysics, Institute of Biomedical Engineering, University of Toronto, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
| | - Wassana Yantasee
- PDX Pharmaceuticals Inc., 3303 S Bond Ave, CH13B, Portland, OR, 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 S Bond Ave, Portland, OR, 97239, USA
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3
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Joe NS, Hodgdon C, Kraemer L, Redmond KJ, Stearns V, Gilkes DM. A common goal to CARE: Cancer Advocates, Researchers, and Clinicians Explore current treatments and clinical trials for breast cancer brain metastases. NPJ Breast Cancer 2021; 7:121. [PMID: 34521857 PMCID: PMC8440644 DOI: 10.1038/s41523-021-00326-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/09/2021] [Indexed: 02/08/2023] Open
Abstract
Breast cancer is the most commonly diagnosed cancer in women worldwide. Approximately one-tenth of all patients with advanced breast cancer develop brain metastases resulting in an overall survival rate of fewer than 2 years. The challenges lie in developing new approaches to treat, monitor, and prevent breast cancer brain metastasis (BCBM). This review will provide an overview of BCBM from the integrated perspective of clinicians, researchers, and patient advocates. We will summarize the current management of BCBM, including diagnosis, treatment, and monitoring. We will highlight ongoing translational research for BCBM, including clinical trials and improved detection methods that can become the mainstay for BCBM treatment if they demonstrate efficacy. We will discuss preclinical BCBM research that focuses on the intrinsic properties of breast cancer cells and the influence of the brain microenvironment. Finally, we will spotlight emerging studies and future research needs to improve survival outcomes and preserve the quality of life for patients with BCBM.
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Affiliation(s)
- Natalie S Joe
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Cellular and Molecular Medicine Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christine Hodgdon
- INSPIRE (Influencing Science through Patient-Informed Research & Education) Advocacy Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Kristin J Redmond
- Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vered Stearns
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- INSPIRE (Influencing Science through Patient-Informed Research & Education) Advocacy Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniele M Gilkes
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Cellular and Molecular Medicine Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- INSPIRE (Influencing Science through Patient-Informed Research & Education) Advocacy Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Chemical and Biomolecular Engineering, The Johns Hopkins University, Baltimore, MD, USA.
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Dionísio MR, Vieira AF, Carvalho R, Conde I, Oliveira M, Gomes M, Pinto MT, Pereira P, Pimentel J, Souza C, Marques MMC, Duval da Silva V, Barroso A, Preto D, Cameselle-Teijeiro JF, Schmitt F, Ribeiro AS, Paredes J. BR-BCSC Signature: The Cancer Stem Cell Profile Enriched in Brain Metastases that Predicts a Worse Prognosis in Lymph Node-Positive Breast Cancer. Cells 2020; 9:cells9112442. [PMID: 33182375 PMCID: PMC7695320 DOI: 10.3390/cells9112442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022] Open
Abstract
Brain metastases remain an unmet clinical need in breast oncology, being frequently found in HER2-overexpressing and triple-negative carcinomas. These tumors were reported to be highly cancer stem-like cell-enriched, suggesting that brain metastases probably arise by the seeding of cancer cells with stem features. Accordingly, we found that brain-tropic breast cancer cells show increased stem cell activity and tumorigenic capacity in the chick embryo choriallantoic membrane when compared to the parental cell line. These observations were supported by a significant increase in their stem cell frequency and by the enrichment for the breast cancer stem cell (BCSC) phenotype CD44+CD24−/low. Based on this data, the expression of BCSC markers (CD44, CD49f, P-cadherin, EpCAM, and ALDH1) was determined and found to be significantly enriched in breast cancer brain metastases when compared to primary tumors. Therefore, a brain (BR)-BCSC signature was defined (3–5 BCSC markers), which showed to be associated with decreased brain metastases-free and overall survival. Interestingly, this signature significantly predicted a worse prognosis in lymph node-positive patients, acting as an independent prognostic factor. Thus, an enrichment of a BCSC signature was found in brain metastases, which can be used as a new prognostic factor in clinically challenging breast cancer patients.
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Affiliation(s)
- Maria Rita Dionísio
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal; (P.P.); (J.P.)
| | - André F. Vieira
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Rita Carvalho
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Inês Conde
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Mónica Oliveira
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Madalena Gomes
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Marta T. Pinto
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- In vivo CAM assays, i3S - Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal
| | - Pedro Pereira
- Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal; (P.P.); (J.P.)
| | - José Pimentel
- Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal; (P.P.); (J.P.)
| | - Cristiano Souza
- Department of Breast and Gynecologic Oncology, Barretos Cancer Hospital, Barretos-SP 14784-400, Brazil; (C.S.); (A.B.); (D.P.)
| | - Márcia M. C. Marques
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos-SP 14784-400, Brazil;
- Barretos School of Health Sciences - FACISB, Barretos-SP 14784-400, Brazil
| | | | - Alison Barroso
- Department of Breast and Gynecologic Oncology, Barretos Cancer Hospital, Barretos-SP 14784-400, Brazil; (C.S.); (A.B.); (D.P.)
| | - Daniel Preto
- Department of Breast and Gynecologic Oncology, Barretos Cancer Hospital, Barretos-SP 14784-400, Brazil; (C.S.); (A.B.); (D.P.)
| | | | - Fernando Schmitt
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- Department of Pathology, Faculty of Medicine of Porto University (FMUP), 4200-135 Porto, Portugal
| | - Ana Sofia Ribeiro
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Joana Paredes
- Epithelial Interactions in Cancer (EPIC) group, i3S, Institute of Investigation and Innovation in Health, University of Porto, 4200-135 Porto, Portugal; (M.R.D.); (A.F.V.); (R.C.); (I.C.); (M.O.); (M.G.); (M.T.P.); (F.S.); (A.S.R.)
- IPATIMUP- Institute of Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- Department of Pathology, Faculty of Medicine of Porto University (FMUP), 4200-135 Porto, Portugal
- Correspondence: ; Tel.: +35-12-2557-0700
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5
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Wong GL, Abu Jalboush S, Lo HW. Exosomal MicroRNAs and Organotropism in Breast Cancer Metastasis. Cancers (Basel) 2020; 12:E1827. [PMID: 32646059 PMCID: PMC7408921 DOI: 10.3390/cancers12071827] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 12/14/2022] Open
Abstract
Breast cancer is the most frequent malignancy for women in which one in eight women will be diagnosed with the disease in their lifetime. Despite advances made in treating primary breast cancer, there is still no effective treatment for metastatic breast cancer. Consequently, metastatic breast cancer is responsible for 90% of breast cancer-related deaths while only accounting for approximately one third of all breast cancer cases. To help develop effective treatments for metastatic breast cancer, it is important to gain a deeper understanding of the mechanisms by which breast cancer metastasizes, particularly, those underlying organotropism towards brain, bone, and lungs. In this review, we will primarily focus on the roles that circulating exosomal microRNAs (miRNAs) play in organotropism of breast cancer metastasis. Exosomes are extracellular vesicles that play critical roles in intercellular communication. MicroRNAs can be encapsulated in exosomes; cargo-loaded exosomes can be secreted by tumor cells into the tumor microenvironment to facilitate tumor-stroma interactions or released to circulation to prime distant organs for subsequent metastasis. Here, we will summarize our current knowledge on the biogenesis of exosomes and miRNAs, mechanisms of cargo sorting into exosomes, the exosomal miRNAs implicated in breast cancer metastasis, and therapeutic exosomal miRNAs.
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Affiliation(s)
- Grace L. Wong
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA; (G.L.W.); (S.A.J.)
| | - Sara Abu Jalboush
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA; (G.L.W.); (S.A.J.)
| | - Hui-Wen Lo
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA; (G.L.W.); (S.A.J.)
- Wake Forest Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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Masci G, Agostinetto E, Giordano L, Bottai G, Torrisi R, Losurdo A, De Sanctis R, Navarria P, Scorsetti M, Zuradelli M, de Rose F, Bello L, Santoro A. Prognostic factors and outcome of HER2+ breast cancer with CNS metastases. Future Oncol 2020; 16:269-279. [PMID: 32043375 DOI: 10.2217/fon-2019-0602] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim: Trastuzumab prolongs progression-free and overall survival in HER2+ breast cancer (BC), but these are associated with increased distant recurrences and central nervous system metastases (CNSm). We retrospectively evaluated outcome and prognostic factors in CNSm and non-CNSm patients. Methods: Records of HER2+ BC treated in 2000-2017 were reviewed. Results: 283/1171 (24%) HER2+ BC patients developed metastatic disease. 109/283 patients (39%) have CNSm associated with worse prognosis and increased risk of death (hazard ratio: 4.7; 95% CI: 3.5-6.4). Prognostic factors were: number of CNSm (single vs multiple lesions; 3-year overall survival 39 vs 18%; p = 0.003); brain radiation (30 vs 14%; p < 0.001); new HER2-targeting therapies (30.6 vs 22.5%; p = 0.025). Conclusion: Prognosis of BC patients with CNSm has improved using HER2-targeting therapies but remains poor.
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Affiliation(s)
- Giovanna Masci
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Elisa Agostinetto
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Laura Giordano
- Biostatistic Unit, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Giulia Bottai
- Oncology Experimental Therapeutics, Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Rosalba Torrisi
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Agnese Losurdo
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Rita De Sanctis
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy.,Humanitas University, Rozzano, Milan, Italy
| | - Piera Navarria
- Radiotherapy Unit, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Marta Scorsetti
- Radiotherapy Unit, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Monica Zuradelli
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Fiorenza de Rose
- Radiotherapy Unit, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Lorenzo Bello
- Neurosurgery Unit, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy
| | - Armando Santoro
- Division of Oncology & Hematology, IRCCS Humanitas Clinical & Research Center, Rozzano, Milan, Italy.,Humanitas University, Rozzano, Milan, Italy
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7
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Naruphontjirakul P, Viravaidya-Pasuwat K. Development of anti-HER2-targeted doxorubicin-core-shell chitosan nanoparticles for the treatment of human breast cancer. Int J Nanomedicine 2019; 14:4105-4121. [PMID: 31239670 PMCID: PMC6557189 DOI: 10.2147/ijn.s198552] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/01/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose: Doxorubicin (DOX) encapsulated O-succinyl chitosan graft Pluronic® F127 (OCP) copolymer nanoparticles conjugated with an anti-HER2 monoclonal antibody were developed as targeted drug delivery vehicles for the treatment of HER2-overexpressing breast cancer. Methods: Five percent and 10% (w/w) of O-succinyl chitosan was grafted onto Pluronic® F127 using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS) as mediated cross-linking agents. DOX was added to the copolymer solution to form DOX-nanoparticles before conjugation with anti-HER2 on the surface of the nanoparticles. Results: DOX was encapsulated within the NP matrices at an encapsulation efficiency of 73.69 ± 0.53% to 74.65 ± 0.44% (the initial DOX concentration was 5 µg/mL). Anti-HER2 was successfully conjugated onto the surface of the nanoparticles at a moderately high conjugation efficiency of approximately 57.23 ± 0.38% to 61.20 ± 4.42%. In the in vitro DOX dissolution study, the nanoparticle formulations exhibited a biphasic drug release with an initial burst release followed by a sustained release profile at both pH 5.0 and pH 7.4. The drug was rapidly and completely released from the nanoparticles at pH 5.0. In the in vitro cytotoxicity, the anti-HER2 conjugated OCP copolymer nanoparticles showed the lowest IC50, which indicated an increase in the therapeutic efficacy of DOX to treat human breast cancer cells with the HER2 overexpression. Conclusion: Our study shows that anti-HER2 conjugated OCP copolymer nanoparticles have the potential for the development of anticancer drug carriers.
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Affiliation(s)
- Parichart Naruphontjirakul
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Kwanchanok Viravaidya-Pasuwat
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok, Thailand.,Department of Chemical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
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8
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Yu H, Guan Z, Cuk K, Zhang Y, Brenner H. Circulating MicroRNA Biomarkers for Lung Cancer Detection in East Asian Populations. Cancers (Basel) 2019; 11:E415. [PMID: 30909610 PMCID: PMC6468694 DOI: 10.3390/cancers11030415] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Lung cancer (LC) is the leading cause of cancer-related death in Eastern Asia. The prognosis of LC highly depends on tumor stages and early detection could substantially reduce LC mortality. Accumulating evidence suggested that circulating miRNAs in plasma or serum may have applications in early LC detection. We thus conducted a systematic literature review on the diagnostic value of miRNAs markers for LC in East Asian populations. METHODS PubMed and ISI Web of Knowledge were searched to retrieve relevant articles published up to 17 September 2018. Information on study design, population characteristics, investigated miRNAs and diagnostic accuracy (including sensitivity, specificity and area under the curve (AUC)) were independently extracted by two reviewers. RESULTS Overall, 46 studies that evaluated a total of 88 miRNA markers for LC diagnosis in East Asian populations were identified. Sixteen of the 46 studies have incorporated individual miRNA markers as panels (with 2⁻20 markers). Three promising miRNA panels with ≥90% sensitivity and ≥90% specificity were discovered, two of which were externally validated. Diagnostic performance of circulating miRNAs in East Asian populations was comparable to previously summarized performance in Western populations. Forty-four miRNAs were reported in both populations. No major differences in diagnostic performance by ethnicity of the same miRNA was observed. CONCLUSIONS Circulating miRNAs or miRNA panels, possibly in combination with other promising molecular markers including epigenetic and genetic markers, may be promising candidates for noninvasive LC early detection. However, large studies with samples collected prospectively in true screening settings are required to validate the promising markers or marker panels.
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Affiliation(s)
- Haixin Yu
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- Medical Faculty Heidelberg, University of Heidelberg, 69120 Heidelberg, Germany.
| | - Zhong Guan
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- Medical Faculty Heidelberg, University of Heidelberg, 69120 Heidelberg, Germany.
| | - Katarina Cuk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Yan Zhang
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
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Aydiner A. Systemic Treatment of HER2-Overexpressing Metastatic Breast Cancer. Breast Cancer 2019. [DOI: 10.1007/978-3-319-96947-3_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Larionov AA. Current Therapies for Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer Patients. Front Oncol 2018; 8:89. [PMID: 29670855 PMCID: PMC5894159 DOI: 10.3389/fonc.2018.00089] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/14/2018] [Indexed: 01/01/2023] Open
Abstract
The median survival of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) has more than doubled, since the discovery of HER2-targeted treatments: it rose from less than 2 years in 2001 (prior introduction of trastuzumab) to more than 4 years in 2017. The initial generation of HER2-targeted therapies included trastuzumab with taxanes in the first line, followed by the addition of lapatinib and by a switch to another cytotoxic agent after progression. Results of CLEOPATRA, EMILIA, and TH3RESA trials have changed this clinical practice. The current consensus includes horizontal dual blockade (trastuzumab + pertuzumab) with taxanes or vinorelbine in the first line, followed by trastuzumab-emtansine (T-DM1) in the second line, with addition of lapatinib in the later lines of treatment. However, the fast and simultaneous development of new drugs led to a relative shortage of clinical evidence to support this sequence. Triple-positive breast cancers (TPBC), which express both hormonal receptors and HER2, constitute nearly half of HER2-positive cases. For these tumors, the current consensus is to add endocrine therapy after completion of cytotoxic treatment. Again, this consensus is not fully evidence-based. In view of the recent progress in treatment of estrogen-receptor positive breast cancers, a series of trials is evaluating addition of CDK4/6 inhibitors, aromatase inhibitors or fulvestrant to HER2-targeted and cytotoxic chemotherapy in TPBC patients. Despite the remarkable progress in treatment of HER2-positive breast cancer, metastatic disease is still incurable in the majority of patients. A wide range of novel therapies are under development to prevent and overcome resistance to current HER2-targeted agents. This review discusses pivotal clinical trials that have shaped current clinical practices, the current consensus recommendations, and the new experimental treatments in metastatic HER2-positive breast cancer.
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Affiliation(s)
- Alexey A Larionov
- Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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