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Zhu Z, Xu S, Ren J, Jiang T, Zhang C, Yan Z. Anlotinib affects systemic lipid metabolism and induces lipid accumulation in human lung cancer cells. Lipids Health Dis 2023; 22:134. [PMID: 37612751 PMCID: PMC10464365 DOI: 10.1186/s12944-023-01907-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Anlotinib has demonstrated encouraging clinical outcomes in the treatment of lung cancer, soft tissue sarcoma and thyroid carcinoma. Several clinical studies have shown a relationship between anlotinib treatment and the occurrence of hyperlipidemia. The fundamental mechanisms, however, are still largely unclear. Here, the effect of anlotinib on lipid metabolism in an animal model and human cancer cells was evaluated and the role of lipid metabolism in the antitumor efficacy of anlotinib was investigated. METHODS The C57BL/6 J mouse model as well as A549 and H460 human lung cancer cell lines were used to examine the impact of anlotinib on lipid metabolism both in vivo and in vitro. Levels of triglycerides, high-density lipoprotein, low-density lipoprotein (LDL), and total cholesterol in serum or cell samples were determined using assay kits. The expression levels of crucial genes and proteins involved in lipid metabolism were measured by quantitative RT-PCR and Western blotting. Furthermore, exogenous LDL and knockdown of low-density lipoprotein receptor (LDLR) were used in H460 cells to investigate the relevance of lipid metabolism in the anticancer efficacy of anlotinib. RESULTS Anlotinib caused hyperlipidemia in C57BL/6 J mice, possibly by downregulating hepatic LDLR-mediated uptake of LDL cholesterol. AMP-activated protein kinase and mammalian target of rapamycin inhibition may also be involved. Additionally, anlotinib enhanced sterol response element binding protein 1/2 nuclear accumulation as well as upregulated LDLR expression in A549 and H460 cells, which may be attributable to intracellular lipid accumulation. Knockdown of LDLR reduced intracellular cholesterol content, but interestingly, anlotinib significantly improved intracellular cholesterol accumulation in LDLR-knockdown cells. Both exogenous LDL and LDLR knockdown decreased the sensitivity of cells to anlotinib. CONCLUSIONS Anlotinib modulates host lipid metabolism through multiple pathways. Anlotinib also exerts a significant impact on lipid metabolism in cancer cells by regulating key transcription factors and metabolic enzymes. In addition, these findings suggest lipid metabolism is implicated in anlotinib sensitivity.
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Affiliation(s)
- Zhongling Zhu
- Department of Clinical Pharmacology, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Shan Xu
- Department of Clinical Pharmacology, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Jing Ren
- Department of Clinical Pharmacology, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Teng Jiang
- Department of Clinical Pharmacology, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Cai Zhang
- Department of Clinical Pharmacology, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Zhao Yan
- Department of Clinical Pharmacology, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China.
- Department of Continuing Education and Science and Technology Service, China Anti-Cancer Association, Tianjin, China.
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Zhang X, Zhang H, Dai J, Liu Z, Zhu X, Ni Y, Yin X, Sun G, Zhu S, Chen J, Zhao J, Wang J, Zeng H, Shen P. The influence of dynamic changes in lipid metabolism on survival outcomes in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors. Jpn J Clin Oncol 2021; 50:1454-1463. [PMID: 32719852 DOI: 10.1093/jjco/hyaa120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The role of lipid metabolic status in tyrosine kinase inhibitors-treated patients with metastatic renal cell carcinoma is insufficient. OBJECTIVE To analyse the influence of dynamic changes of lipid metabolism on survival outcomes in tyrosine kinase inhibitors-treated metastatic renal cell carcinoma. PATIENTS AND METHODS Serum levels of triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol were collected, both before tyrosine kinase inhibitors therapy and at different time points of tyrosine kinase inhibitors treatment duration. Other clinicopathological and survival data were retrospectively reviewed. The clinical outcomes, including tumour response, progression-free survival and overall survival, were analysed. Kaplan-Meier survival curves were plotted and the log-rank test was used to analyse statistical significance. RESULTS A total of 127 patients with metastatic renal cell carcinoma, initially treated with tyrosine kinase inhibitors as first-line systemic therapy, were included. In the whole cohort, the serum levels of triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol fluctuated but gradually increased during tyrosine kinase inhibitors treatment. In survival analysis, the higher serum level of lipid metabolism, the longer progression-free survival was observed. In terms of overall survival, all post-treatment lipid metabolism, including the percentages of increasing change, were correlated with better survival. Further multivariate analysis showed that patients with five components of treatment-related dysfunction of lipid metabolism had superior survival to those with less than five components. However, lipid metabolism was not correlated with tumour response. CONCLUSION Increasing parameters of lipid metabolism indicated improvement of survival in tyrosine kinase inhibitors-treated metastatic renal cell carcinoma, especially the increasing percentages.
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Affiliation(s)
- Xingming Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Haoran Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Jindong Dai
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Zhenhua Liu
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Xudong Zhu
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Yuchao Ni
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Xiaoxue Yin
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Guangxi Sun
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Sha Zhu
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Junru Chen
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Jinge Zhao
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Jia Wang
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Pengfei Shen
- Department of Urology, West China Hospital, Sichuan University, Chengdu.,Institute of Urology, West China Hospital, Sichuan University, Chengdu
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ProTargetMiner as a proteome signature library of anticancer molecules for functional discovery. Nat Commun 2019; 10:5715. [PMID: 31844049 PMCID: PMC6915695 DOI: 10.1038/s41467-019-13582-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 11/11/2019] [Indexed: 01/30/2023] Open
Abstract
Deconvolution of targets and action mechanisms of anticancer compounds is fundamental in drug development. Here, we report on ProTargetMiner as a publicly available expandable proteome signature library of anticancer molecules in cancer cell lines. Based on 287 A549 adenocarcinoma proteomes affected by 56 compounds, the main dataset contains 7,328 proteins and 1,307,859 refined protein-drug pairs. These proteomic signatures cluster by compound targets and action mechanisms. The targets and mechanistic proteins are deconvoluted by partial least square modeling, provided through the website http://protargetminer.genexplain.com. For 9 molecules representing the most diverse mechanisms and the common cancer cell lines MCF-7, RKO and A549, deep proteome datasets are obtained. Combining data from the three cell lines highlights common drug targets and cell-specific differences. The database can be easily extended and merged with new compound signatures. ProTargetMiner serves as a chemical proteomics resource for the cancer research community, and can become a valuable tool in drug discovery. Anticancer drugs often have widespread effects on the cellular proteome. Here, the authors generate a proteome signature library of drug-treated cancer cell lines and develop a software tool to deconvolute drug targets and gain insights into their mechanisms of action.
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Zhao Q, Zhang T, Xiao X, Huang J, Wang Y, Gonzalez FJ, Li F. Impaired clearance of sunitinib leads to metabolic disorders and hepatotoxicity. Br J Pharmacol 2019; 176:2162-2178. [PMID: 30875096 PMCID: PMC6555861 DOI: 10.1111/bph.14664] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/23/2019] [Accepted: 03/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND PURPOSE Sunitinib is a small-molecule TK inhibitor associated with hepatotoxicity. The mechanisms of its toxicity are still unclear. EXPERIMENTAL APPROACH In the present study, mice were treated with 60, 150, and 450 mg·kg-1 sunitinib to evaluate sunitinib hepatotoxicity. Sunitinib metabolites and endogenous metabolites in liver, serum, faeces, and urine were analysed using ultra-performance LC electrospray ionization quadrupole time-of-flight MS-based metabolomics. KEY RESULTS Four reactive metabolites and impaired clearance of sunitinib in liver played a dominant role in sunitinib-induced hepatotoxicity. Using a non-targeted metabolomics approach, various metabolic pathways, including mitochondrial fatty acid β-oxidation (β-FAO), bile acids, lipids, amino acids, nucleotides, and tricarboxylic acid cycle intermediates, were disrupted after sunitinib treatment. CONCLUSIONS AND IMPLICATIONS These studies identified significant alterations in mitochondrial β-FAO and bile acid homeostasis. Activation of PPARα and inhibition of xenobiotic metabolism may be of value in attenuating sunitinib hepatotoxicity.
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Affiliation(s)
- Qi Zhao
- State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunmingChina
- University of Chinese Academy of SciencesBeijingChina
| | - Ting Zhang
- State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunmingChina
- University of Chinese Academy of SciencesBeijingChina
| | - Xue‐Rong Xiao
- State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunmingChina
| | - Jian‐Feng Huang
- State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunmingChina
- University of Chinese Academy of SciencesBeijingChina
| | - Yan Wang
- Department of PathologyThe Second Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Frank J. Gonzalez
- Laboratory of Metabolism, Center for Cancer ResearchNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - Fei Li
- State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunmingChina
- Jiangxi University of Traditional Chinese MedicineNanchangChina
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5
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Buffier P, Bouillet B, Smati S, Archambeaud F, Cariou B, Verges B. Expert opinion on the metabolic complications of new anticancer therapies: Tyrosine kinase inhibitors. ANNALES D'ENDOCRINOLOGIE 2018; 79:574-582. [DOI: 10.1016/j.ando.2018.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Silva JMD, Lima BDS, Araújo TLD, Lima FET, Cunha GHD. Cardiovascular adverse events associated with oral antineoplastic therapy. Rev Bras Enferm 2018; 71:2561-2569. [PMID: 30304190 DOI: 10.1590/0034-7167-2017-0450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/18/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To identify in the literature the cardiovascular adverse events resulting from oral antineoplastic therapy. METHOD Integrative review of the literature through the SCOPUS, Scientific Electronic Library Online (SciELO), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE) databases. The antineoplastic, cardiotoxicity, cardiovascular system and adverse reaction descriptors were used in Portuguese, English and Spanish. We selected 23 articles published between 1985 and 2015. RESULTS Twenty studies were related to cardiac events and eleven to peripheral vascular events. The most frequent adverse cardiac events were reduced left ventricular ejection fraction, myocardial infarction, changes in the electrocardiogram, heart failure and angina, whereas peripheral vascular events were hypertension and thromboembolism. CONCLUSION Oral antineoplastic therapy is associated with different adverse events, including cardiac and peripheral vascular events.
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Affiliation(s)
- Jacqueline Mota da Silva
- Universidade Federal do Ceará, Faculty of Pharmacy, Dentistry and Nursing, Department of Nursing. Fortaleza, Ceará, Brazil
| | - Beatriz da Silva Lima
- Universidade Federal do Ceará, Faculty of Pharmacy, Dentistry and Nursing, Department of Nursing. Fortaleza, Ceará, Brazil
| | - Thelma Leite de Araújo
- Universidade Federal do Ceará, Faculty of Pharmacy, Dentistry and Nursing, Department of Nursing. Fortaleza, Ceará, Brazil
| | | | - Gilmara Holanda da Cunha
- Universidade Federal do Ceará, Faculty of Pharmacy, Dentistry and Nursing, Department of Nursing. Fortaleza, Ceará, Brazil
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Non-Targeted Metabolomics Analysis of the Effects of Tyrosine Kinase Inhibitors Sunitinib and Erlotinib on Heart, Muscle, Liver and Serum Metabolism In Vivo. Metabolites 2017. [PMID: 28640223 PMCID: PMC5618316 DOI: 10.3390/metabo7030031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: More than 90 tyrosine kinases have been implicated in the pathogenesis of malignant transformation and tumor angiogenesis. Tyrosine kinase inhibitors (TKIs) have emerged as effective therapies in treating cancer by exploiting this kinase dependency. The TKI erlotinib targets the epidermal growth factor receptor (EGFR), whereas sunitinib targets primarily vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR).TKIs that impact the function of non-malignant cells and have on- and off-target toxicities, including cardiotoxicities. Cardiotoxicity is very rare in patients treated with erlotinib, but considerably more common after sunitinib treatment. We hypothesized that the deleterious effects of TKIs on the heart were related to their impact on cardiac metabolism. Methods: Female FVB/N mice (10/group) were treated with therapeutic doses of sunitinib (40 mg/kg), erlotinib (50 mg/kg), or vehicle daily for two weeks. Echocardiographic assessment of the heart in vivo was performed at baseline and on Day 14. Heart, skeletal muscle, liver and serum were flash frozen and prepped for non-targeted GC-MS metabolomics analysis. Results: Compared to vehicle-treated controls, sunitinib-treated mice had significant decreases in systolic function, whereas erlotinib-treated mice did not. Non-targeted metabolomics analysis of heart identified significant decreases in docosahexaenoic acid (DHA), arachidonic acid (AA)/ eicosapentaenoic acid (EPA), O-phosphocolamine, and 6-hydroxynicotinic acid after sunitinib treatment. DHA was significantly decreased in skeletal muscle (quadriceps femoris), while elevated cholesterol was identified in liver and elevated ethanolamine identified in serum. In contrast, erlotinib affected only one metabolite (spermidine significantly increased). Conclusions: Mice treated with sunitinib exhibited systolic dysfunction within two weeks, with significantly lower heart and skeletal muscle levels of long chain omega-3 fatty acids docosahexaenoic acid (DHA), arachidonic acid (AA)/eicosapentaenoic acid (EPA) and increased serum O-phosphocholine phospholipid. This is the first link between sunitinib-induced cardiotoxicity and depletion of the polyunsaturated fatty acids (PUFAs) and inflammatory mediators DHA and AA/EPA in the heart. These compounds have important roles in maintaining mitochondrial function, and their loss may contribute to cardiac dysfunction.
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Zhou Y, Shan S, Li ZB, Xin LJ, Pan DS, Yang QJ, Liu YP, Yue XP, Liu XR, Gao JZ, Zhang JW, Ning ZQ, Lu XP. CS2164, a novel multi-target inhibitor against tumor angiogenesis, mitosis and chronic inflammation with anti-tumor potency. Cancer Sci 2017; 108:469-477. [PMID: 28004478 PMCID: PMC5378272 DOI: 10.1111/cas.13141] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/07/2016] [Accepted: 12/14/2016] [Indexed: 02/06/2023] Open
Abstract
Although inhibitors targeting tumor angiogenic pathway have provided improvement for clinical treatment in patients with various solid tumors, the still very limited anti-cancer efficacy and acquired drug resistance demand new agents that may offer better clinical benefits. In the effort to find a small molecule potentially targeting several key pathways for tumor development, we designed, discovered and evaluated a novel multi-kinase inhibitor, CS2164. CS2164 inhibited the angiogenesis-related kinases (VEGFR2, VEGFR1, VEGFR3, PDGFRα and c-Kit), mitosis-related kinase Aurora B and chronic inflammation-related kinase CSF-1R in a high potency manner with the IC50 at a single-digit nanomolar range. Consequently, CS2164 displayed anti-angiogenic activities through suppression of VEGFR/PDGFR phosphorylation, inhibition of ligand-dependent cell proliferation and capillary tube formation, and prevention of vasculature formation in tumor tissues. CS2164 also showed induction of G2/M cell cycle arrest and suppression of cell proliferation in tumor tissues through the inhibition of Aurora B-mediated H3 phosphorylation. Furthermore, CS2164 demonstrated the inhibitory effect on CSF-1R phosphorylation that led to the suppression of ligand-stimulated monocyte-to-macrophage differentiation and reduced CSF-1R+ cells in tumor tissues. The in vivo animal efficacy studies revealed that CS2164 induced remarkable regression or complete inhibition of tumor growth at well-tolerated oral doses in several human tumor xenograft models. Collectively, these results indicate that CS2164 is a highly selective multi-kinase inhibitor with potent anti-tumor activities against tumor angiogenesis, mitosis and chronic inflammation, which may provide the rationale for further clinical assessment of CS2164 as a therapeutic agent in the treatment of cancer.
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Affiliation(s)
- You Zhou
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Song Shan
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Zhi-Bin Li
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Li-Jun Xin
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - De-Si Pan
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Qian-Jiao Yang
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Ying-Ping Liu
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Xu-Peng Yue
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Xiao-Rong Liu
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Ji-Zhou Gao
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Jin-Wen Zhang
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Zhi-Qiang Ning
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
| | - Xian-Ping Lu
- Shenzhen Chipscreen Biosciences Ltd, Shenzhen, Guangdong, China
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Golčić M, Petković M. Changes in metabolic profile, iron and ferritin levels during the treatment of metastatic renal cancer - A new potential biomarker? Med Hypotheses 2016; 94:148-50. [PMID: 27515221 DOI: 10.1016/j.mehy.2016.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 07/24/2016] [Indexed: 01/20/2023]
Abstract
Metastatic renal cell carcinoma (mRCC) develops in approximately 33% of all renal cancer patients. First line treatment of mRCC includes drugs such as sunitinib, temsirolimus and pazopanib, with overall survival now reaching up to 43,6months in patients with favorable-risk metastatic disease. Several side-effects in mRCC treatment, such as hypothyroidism, can be used as positive prognostic factors and indicate good response to therapy. Hypercholesterolemia and hypertriglyceridemia independent of hypothyroidism are reported as side-effects in temsirolimus treatment and recently in sunitinib treatment, but the exact mechanism and significance of the changes remains elusive. Most likely, metabolic changes are caused by inhibition of mechanistic target of rapamycin (mTOR), a positive target of tumor growth suppression, but also a regulator of iron homeostasis. There are no clinical studies reporting changes in iron and ferritin levels during mRCC biotherapy, but we hypothesize that inhibition of mTOR will also affect iron and ferritin levels. If both lipid and iron changes correlate, there is a high possibility that both changes are primarily caused by mTOR inhibition and the level of change should correlate with the inhibition of mTOR pathway and hence the efficacy of targeted treatment. We lastly hypothesize that mRCC biotherapy causes hypercholesterolemia with a possibly improved cholesterol profile due to increase HDL/LDL ratio, so statins might not have a role as supplementary treatment, whereas a sharp rise in triglyceride levels seems to be the primary target for additional therapy.
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Affiliation(s)
- Marin Golčić
- Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia.
| | - Marija Petković
- Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia
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Song Y, Du C, Zhang W, Sun Y, Yang L, Cui C, Chi Y, Shou J, Zhou A, Wang J, Sun Y. A study on the association between hyperlipidemia and hypothyroidism and the response to TKIs in metastatic renal cell carcinoma. Asia Pac J Clin Oncol 2016; 12:174-80. [PMID: 26997520 DOI: 10.1111/ajco.12473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/06/2016] [Accepted: 01/17/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Yan Song
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Chunxia Du
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Wen Zhang
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Yongkun Sun
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Lin Yang
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Chengxu Cui
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Yihebali Chi
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Jianzhong Shou
- Department of Urology Surgery, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Aiping Zhou
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Jinwan Wang
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
| | - Yan Sun
- Department of Medical Oncology, Cancer Hospital (Institute); Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing China
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