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Malvi D, Vasuri F, Albertini E, Carbone M, Novelli L, Mescoli C, Cardillo M, Pagni F, D'Errico A, Eccher A. Donors risk assessment in transplantation: From the guidelines to their real-world application. Pathol Res Pract 2024; 255:155210. [PMID: 38422913 DOI: 10.1016/j.prp.2024.155210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
Transplantation of an organ from a donor carries an unavoidable risk of tumor transmission. The need to extend the donor pool increases the use of organs from donors with malignancies and potential disease transmission is a constant tension influencing donor suitability decisions. Current classification systems for the assessment of donor malignancy transmission risk have evolved from reports of potential transmission events in recipients to national donation and transplant surveillance agencies. Although the risk of malignancy transmission is very low in the general transplant setting it must constantly be balanced with the transplant benefits. Guidelines are mainly based on large registries and sparse case reports of transmission, so they cannot cover all the possible situations. For this reason, in 2004 in Italy, the National Transplant Center gave rise to the Second Opinion Service, charged by the Ministry of Health, by structuring expertise in diagnostic oncology and risk transmission and making it available to the Italian Transplant Centers. In this paper the registry of the Italian Oncological Second Opinion was reviewed, from 2016 to 2018, to detail the most frequent and problematic neoplastic topics addressed, those are separately reported and discussed. Furthermore, a review of the most recent strategies and risk stratification is provided, according to the most recent literature evidence and to the European Guidelines.
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Affiliation(s)
- Deborah Malvi
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Francesco Vasuri
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Elisa Albertini
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; School of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Maurizio Carbone
- University Milan Bicocca, Department of Medicine and Surgery, Departmental Center of Digital Medicine, Milan, Italy
| | - Luca Novelli
- Institute of Histopathology and Molecular Diagnosis, Careggi University Hospital, Florence, Italy
| | - Claudia Mescoli
- Surgical Pathology and Cytopathology Unit, Department of Medicine, University and Hospital Trust of Padua, Italy
| | - Massimo Cardillo
- Italian National Transplantation Center, Italian National Institute of Health, Rome, Italy
| | - Fabio Pagni
- University Milan Bicocca, Department of Medicine and Surgery, Departmental Center of Digital Medicine, Milan, Italy
| | - Antonia D'Errico
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
| | - Albino Eccher
- Section of Pathology, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, Modena, Italy
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Cotarelo CL, Schad A, Schmidt M, Hönig A, Sleeman JP, Thaler S. Detection of Cellular Senescence Reveals the Existence of Senescent Tumor Cells within Invasive Breast Carcinomas and Related Metastases. Cancers (Basel) 2023; 15:cancers15061860. [PMID: 36980745 PMCID: PMC10047432 DOI: 10.3390/cancers15061860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
Oncogene-induced senescence is thought to constitute a barrier to carcinogenesis by arresting cells at risk of malignant transformation. However, numerous findings suggest that senescent cells may conversely promote tumor growth and metastatic progression, for example, through the senescence-associated secretory phenotype (SASP) they produce. Here, we investigated the degree to which senescent tumor cells exist within untreated human primary breast carcinomas and whether the presence of senescent cancer cells in primary tumors is recapitulated in their matched lymph node metastases. For the detection of senescence, we used SA-β-galactosidase (SA-β-gal) staining and other senescence markers such as Ki67, p21, p53, and p16. In patients with invasive luminal A and B breast carcinomas, we found broad similarities in the appearance of cancer cells between primary tumors and their corresponding metastases. Analysis of lymph nodes from patients with other breast cancer subtypes also revealed senescent tumor cells within metastatic lesions. Collectively, our findings show that senescent tumor cells exist within primary breast carcinomas and metastatic lesions. These results suggest a potential role for senescent breast tumor cells during metastatic progression and raise the question as to whether the targeting of senescent tumor cells with anti-senescent drugs might represent a novel avenue for improved treatment of breast and other cancers.
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Affiliation(s)
- Cristina L Cotarelo
- Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Arno Schad
- Institute of Pathology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Marcus Schmidt
- Department of Gynecology and Obstetrics, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Arnd Hönig
- Breast Center, Women's Hospital, Marienhaus Hospital Mainz, 55131 Mainz, Germany
| | - Jonathan P Sleeman
- European Center for Angioscience, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Institute of Biological and Chemical Systems-Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology (KIT), Campus Nord, 76344 Eggenstein-Leopoldshafen, Germany
| | - Sonja Thaler
- European Center for Angioscience, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
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3
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Chen Y, Zhang J, Zhang M, Song Y, Zhang Y, Fan S, Ren S, Fu L, Zhang N, Hui H, Shen X. Baicalein resensitizes tamoxifen-resistant breast cancer cells by reducing aerobic glycolysis and reversing mitochondrial dysfunction via inhibition of hypoxia-inducible factor-1α. Clin Transl Med 2021; 11:e577. [PMID: 34841716 PMCID: PMC8567056 DOI: 10.1002/ctm2.577] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 12/19/2022] Open
Abstract
Drug resistance is a major hurdle for the effectiveness of tamoxifen (TAM) to provide clinical benefit. Therefore, it is essential to identify a sensitizer that could be used to improve TAM efficacy in treating TAM-resistant breast cancer. Here, we investigated the ability of baicalein to reverse TAM resistance. We found that baicalein increased the efficacy of TAM in inhibiting proliferation and inducing apoptosis of TAM-resistant cells. It also enhanced the TAM-induced growth reduction of resistant cells from NOD/SCID mouse mammary fat pads, without causing obvious systemic toxicity. Analyses using the CellMiner tool and the Kaplan-Meier plotter database showed that HIF-1α expression was inversely correlated with TAM therapeutic response in NCI-60 cancer cells and breast cancer patients. HIF-1α expression was increased in TAM-resistant cells due to an increase in mRNA levels and reduced ubiquitin-mediated degradation. Baicalein reduced HIF-1α expression by promoting its interaction with PHD2 and pVHL, thus facilitating ubiquitin ligase-mediated proteasomal degradation and thereby suppressing the nuclear translocation, binding to the hypoxia-response element, and transcriptional activity of HIF-1α. As a result, baicalein downregulated aerobic glycolysis by restricting glucose uptake, lactate production, ATP generation, lactate/pyruvate ratio and expression of HIF-1α-targeted glycolytic genes, thereby enhancing the antiproliferative efficacy of TAM. Furthermore, baicalein interfered with HIF-1α inhibition of mitochondrial biosynthesis, which increased mitochondrial DNA content and mitochondrial numbers, restored the generation of reactive oxygen species in mitochondria, and thus enhanced the TAM-induced mitochondrial apoptotic pathway. The HIF-1α stabilizer dimethyloxallyl glycine prevented the baicalein-induced downregulation of glycolysis and mitochondrial biosynthesis and reduced the effects of baicalein on reversing TAM resistance. Our results indicate that baicalein is a promising candidate to help overcome TAM resistance by sensitizing resistant cells to TAM-induced growth inhibition and apoptosis. The mechanism underlying the effects of baicalein consists of inhibition of HIF-1α-mediated aerobic glycolysis and mitochondrial dysfunction.
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Affiliation(s)
- Yan Chen
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Jingyu Zhang
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Minqin Zhang
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Yuxuan Song
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Yue Zhang
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Key Laboratory of Optimal Utilization of Natural Medicine ResourcesSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Shuangqin Fan
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Key Laboratory of Optimal Utilization of Natural Medicine ResourcesSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Shuang Ren
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Lingyun Fu
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Nenling Zhang
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The Key Laboratory of Optimal Utilization of Natural Medicine ResourcesSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
| | - Hui Hui
- State Key Laboratory of Natural MedicinesJiangsu Key Laboratory of Carcinogenesis and InterventionChina Pharmaceutical UniversityNanjingChina
| | - Xiangchun Shen
- The State Key Laboratory of Functions and Applications of Medicinal PlantsGuizhou Medical UniversityGuizhouChina
- The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou ProvinceSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Union Key Laboratory of Guiyang City‐Guizhou Medical UniversitySchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
- The Key Laboratory of Optimal Utilization of Natural Medicine ResourcesSchool of Pharmaceutical SciencesGuizhou Medical UniversityGuizhouChina
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Bölükbasi Y, Oymak E, Sezen D, Onal C. Hypofractionated Radiation Therapy (HFRT) of Breast/Chest Wall and Regional Nodes in Locally Advanced Breast Cancer: Toxicity Profile and Survival Outcomes in Retrospective Mono-Institutional Study: In Regard to De Matteis et al. Clin Breast Cancer 2021; 22:e426-e427. [PMID: 34815173 DOI: 10.1016/j.clbc.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Yasemin Bölükbasi
- Koc University, School of Medicine, Department of Radiation Oncology, Istanbul, Turkey; MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX
| | - Ezgi Oymak
- Iskenderun Gelisim Hospital, Division of Radiation Oncology, Hatay, Turkey
| | - Duygu Sezen
- Koc University, School of Medicine, Department of Radiation Oncology, Istanbul, Turkey
| | - Cem Onal
- Başkent University Faculty of Medicine, Adana Dr Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Adana, Turkey; Department of Radiation Oncology, Baskent University Faculty of Medicine, Ankara, Turkey.
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5
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Roßwag S, Cotarelo CL, Pantel K, Riethdorf S, Sleeman JP, Schmidt M, Thaler S. Functional Characterization of Circulating Tumor Cells (CTCs) from Metastatic ER+/HER2- Breast Cancer Reveals Dependence on HER2 and FOXM1 for Endocrine Therapy Resistance and Tumor Cell Survival: Implications for Treatment of ER+/HER2- Breast Cancer. Cancers (Basel) 2021; 13:cancers13081810. [PMID: 33920089 PMCID: PMC8070196 DOI: 10.3390/cancers13081810] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Acquired endocrine resistance and late recurrence in patients with ER+/HER2− breast cancer are complex and not fully understood. Here, we evaluated mechanisms of acquired resistance in circulating tumor cells (CTCs) from an ER+/HER2− breast cancer patient who initially responded but later progressed under endocrine treatment. We found a switch from ERα-dependent to HER2-dependent and ERα-independent expression of FOXM1, which may enable disseminated ER+/HER2− cells to re-initiate tumor cell growth and metastasis formation in the presence of endocrine treatment. We found that NFkB signaling sustains HER2 and FOXM1 expression in CTCs in the presence of ERα inhibitors suggesting that NFkB and FOXM1 might be an efficient therapeutic approach to prevent late recurrence and to treat endocrine resistance. Collectively our data show that CTCs from patients with endocrine resistance allow mechanisms of acquired endocrine resistance to be delineated, and can be used to test potential drug regimens for combatting resistance. Abstract Mechanisms of acquired endocrine resistance and late recurrence in patients with ER+/HER2− breast cancer are complex and not fully understood. Here, we evaluated mechanisms of acquired resistance in circulating tumor cells (CTCs) from an ER+/HER2− breast cancer patient who initially responded but later progressed under endocrine treatment. We found a switch from ERα-dependent to HER2-dependent and ERα-independent expression of FOXM1, which may enable disseminated ER+/HER2− cells to re-initiate tumor cell growth and metastasis formation in the presence of endocrine treatment. Our results also suggest a role for HER2 in resistance, even in ER+ breast cancer cells that have neither HER2 amplification nor activating HER2 mutations. We found that NFkB signaling sustains HER2 and FOXM1 expression in CTCs in the presence of ERα inhibitors. Inhibition of NFkB signaling blocked expression of HER2 and FOXM1 in the CTCs, and induced apoptosis. Thus, targeting of NFkB and FOXM1 might be an efficient therapeutic approach to prevent late recurrence and to treat endocrine resistance. Collectively our data show that CTCs from patients with endocrine resistance allow mechanisms of acquired endocrine resistance to be delineated, and can be used to test potential drug regimens for combatting resistance.
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Affiliation(s)
- Sven Roßwag
- European Center for Angioscience, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany or (S.R.); (J.P.S.)
| | - Cristina L. Cotarelo
- Institute of Pathology, University Medical Center of Heinrich-Heine University, 40225 Duesseldorf, Germany;
| | - Klaus Pantel
- Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (K.P.); (S.R.)
| | - Sabine Riethdorf
- Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (K.P.); (S.R.)
| | - Jonathan P. Sleeman
- European Center for Angioscience, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany or (S.R.); (J.P.S.)
- Karlsruhe Institute of Technology (KIT) Campus Nord, Institute of Biological and Chemical Systems—Biological Information Processing, 76344 Eggenstein-Leupoldshafen, Germany
| | - Marcus Schmidt
- Department of Gynecology and Obstetrics, University Medical Center of Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Sonja Thaler
- European Center for Angioscience, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany or (S.R.); (J.P.S.)
- Correspondence: ; Tel.: +49-621-3837-1599
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6
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Guerini-Rocco E, Gray KP, Fumagalli C, Reforgiato MR, Leone I, Rafaniello Raviele P, Munzone E, Kammler R, Neven P, Hitre E, Jerusalem G, Simoncini E, Gombos A, Deleu I, Karlsson P, Aebi S, Chirgwin J, Di Lauro V, Thompson A, Graas MP, Barber M, Fontaine C, Loibl S, Gavilá J, Kuroi K, Müller B, O'Reilly S, Di Leo A, Goldhirsch A, Viale G, Barberis M, Regan MM, Colleoni M. Genomic Aberrations and Late Recurrence in Postmenopausal Women with Hormone Receptor-positive Early Breast Cancer: Results from the SOLE Trial. Clin Cancer Res 2020; 27:504-512. [PMID: 33082214 DOI: 10.1158/1078-0432.ccr-20-0126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/10/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Women with hormone receptor-positive early breast cancers have a persistent risk of relapse and biomarkers for late recurrence are needed. We sought to identify tumor genomic aberrations associated with increased late-recurrence risk. EXPERIMENTAL DESIGN In a secondary analysis of Study of Letrozole Extension trial, a case-cohort-like sampling selected 598 primary breast cancers for targeted next-generation sequencing analysis of gene mutations and copy-number gains (CNGs). Correlations of genomic aberrations with clinicopathologic factors and breast and distant recurrence-free intervals (BCFIs and DRFIs) were analyzed using weighted Cox models. RESULTS Analysis of mutations and CNGs was successfully performed for 403 and 350 samples, including 148 and 134 patients with breast cancer recurrences (median follow-up time, 5.2 years), respectively. The most frequent alterations were PIK3CA mutations (42%) and CNGs of CCND1 (15%), ERBB2 (10%), FGFR1 (8%), and MYC (8%). PIK3CA mutations and MYC CNGs were associated with lower (P = 0.03) and higher (P = 0.004) tumor grade, respectively; a higher Ki-67 was seen in tumor with CCND1, ERBB2, and MYC CNGs (P = 0.01, P < 0.001, and P = 0.03, respectively). FGFR1 CNG was associated with an increased risk of late events in univariate analyses [17/29 patients; BCFI: HR, 3.2; 95% confidence interval (CI), 1.48-6.92; P = 0.003 and DRFI: HR, 3.5; 95% CI, 1.61-7.75; P = 0.002) and in multivariable models adjusted for clinicopathologic factors. CONCLUSIONS Postmenopausal women with hormone receptor-positive early breast cancer harboring FGFR1 CNG had an increased risk of late recurrence despite extended therapy. FGFR1 CNG may represent a useful prognostic biomarker for late recurrence and a therapeutic target.
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Affiliation(s)
- Elena Guerini-Rocco
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan and University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy.
| | - Kathryn P Gray
- International Breast Cancer Study Group Statistical Center, Frontier Science Foundation, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Caterina Fumagalli
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Rita Reforgiato
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Isabella Leone
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paola Rafaniello Raviele
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisabetta Munzone
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Patrick Neven
- Multidisciplinary Breast Center, University Hospitals, KU Leuven, Leuven, Belgium
| | - Erika Hitre
- National Institute of Oncology, Budapest, Hungary
| | | | | | | | | | - Per Karlsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy/Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Aebi
- Lucerne Cantonal Hospital and University of Bern, Bern, Switzerland
| | - Jacquie Chirgwin
- Box Hill and Maroondah Hospitals, Monash University, Melbourne, Victoria, Australia
| | | | - Alastair Thompson
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | | | | | | | | | - Joaquín Gavilá
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain
| | - Katsumasa Kuroi
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo City, Tokyo, Japan
| | - Bettina Müller
- Chilean Cooperative Group for Oncologic Research (GOCCHI), Santiago, Chile
| | | | | | - Aron Goldhirsch
- International Breast Cancer Study Group, Bern, Switzerland and MultiMedica, Milan, Italy
| | - Giuseppe Viale
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, International Breast Cancer Study Group Central Pathology Office and University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy
| | - Massimo Barberis
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Meredith M Regan
- International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts
| | - Marco Colleoni
- Division of Medical Senology, European Institute of Oncology, and the International Breast Cancer Study Group, Milan, Italy
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Tajiri W, Ijichi H, Takizawa K, Koi Y, Masuda T, Ueo H, Koga C, Nakamura Y, Taguchi K, Okamoto M, Tokunaga E. The clinical usefulness of the CTS5 in the prediction of late distant recurrence in postmenopausal women with estrogen receptor-positive early breast cancer. Breast Cancer 2020; 28:67-74. [PMID: 32601800 PMCID: PMC7796868 DOI: 10.1007/s12282-020-01130-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023]
Abstract
Background Clinical Treatment Score post-5 years (CTS5) is a promising prognostic tool to evaluate late distant recurrence (DR) risk for breast cancer after 5-year adjuvant endocrine therapy. Patients and methods Among 560 postmenopausal women with pathological stage I–III estrogen receptor-positive (ER+) primary breast cancer, 383 women who had received 5-year adjuvant endocrine therapy without any recurrence at 5 years after surgery were included in this study. The CTS5 was calculated for each patient using a previously published formula, and the patients were stratified by their CTS5 values into the low-, intermediate- and high-CTS5 risk groups. Results According to the CTS5, 205 (53.5%), 106 (27.7%) and 72 (18.8%) patients were classified into the low-, intermediate-, and high-CTS5 risk groups, respectively. A higher ER expression level was significantly associated with the low CTS5. The increased administration of adjuvant chemotherapy was significantly associated with a high CTS5. The occurrence of DR was higher in the intermediate and high CTS5 groups than in the low CTS5 group. The DRFS in the low CTS5 risk group was significantly better than that in the intermediate- or high-risk groups. In the ER-high or HER2-negative (HER2−) group, the DRFS in the low-risk group was significantly better than that of the intermediate- or high-risk groups. However, in the low-ER or HER2-positive group, there was no significant difference in DRFS among the three risk groups. Conclusions In postmenopausal women with ER+ breast cancer, low CTS5 was considered to be associated with a very low risk of late DR. Thus, extended endocrine therapy may be unnecessary for patients with low CTS5 scores. Extended endocrine therapy should be offered for patients with intermediate or high CTS5 scores, especially those with high-ER and HER2− breast cancer.
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Affiliation(s)
- Wakako Tajiri
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Hideki Ijichi
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Katsumi Takizawa
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Yumiko Koi
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Takanobu Masuda
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Hiroki Ueo
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Chinami Koga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Yoshiaki Nakamura
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Masahiro Okamoto
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
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8
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Horimoto Y, Sasahara N, Sasaki R, Hlaing MT, Sakaguchi A, Saeki H, Arakawa A, Himuro T, Saito M. High FOXA1 protein expression might predict late recurrence in patients with estrogen-positive and HER2-negative breast cancer. Breast Cancer Res Treat 2020; 183:41-48. [PMID: 32572714 DOI: 10.1007/s10549-020-05751-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multi-gene expression assays have been developed with the aim of predicting late recurrence in patients with estrogen receptor (ER)-positive breast cancer. However, establishment of alternative markers based on immunohistochemistry is also important for achieving practical use. Based on our previous study, forkhead box A1 (FOXA1) protein was tested as a potentially useful predictive marker for late recurrence. METHODS 117 patients with ER-positive HER2-negative invasive breast cancer who developed distant metastasis following curative surgery were retrospectively investigated. We also evaluated responsiveness to endocrine therapy according to FOXA1 expression. Furthermore, publicly available mRNA microarray data were analyzed to examine patterns of metastasis according to FOXA1 mRNA expression, employing the Kaplan-Meier plotter. RESULTS High expression of FOXA1 was an independent factor predicting long disease-free survival (DFS), along with small tumor size (p = 0.010 and 0.016, respectively). Discrimination of DFS was improved by combining these two factors, i.e., patients with FOXA1-high small tumors had the longest DFS while those with FOXA1-low large tumors had the shortest DFS. Moreover, we revealed that risk of distant metastasis started to increase after the completion of adjuvant endocrine therapy in patients with FOXA1-high tumors. CONCLUSION Among patients who developed distant metastasis, those with FOXA1-high tumors had significantly longer DFS. We believe our data to raise the possibility of FOXA1 being a useful predictive marker for late recurrence and to provide new insights into the biology of FOXA1-high breast cancers.
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MESH Headings
- Adult
- Aged
- Breast Neoplasms/chemistry
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Disease-Free Survival
- Estrogens
- Female
- Gene Expression Regulation, Neoplastic
- Hepatocyte Nuclear Factor 3-alpha/biosynthesis
- Hepatocyte Nuclear Factor 3-alpha/genetics
- Hepatocyte Nuclear Factor 3-alpha/physiology
- Humans
- Kaplan-Meier Estimate
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/metabolism
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- RNA, Neoplasm/biosynthesis
- RNA, Neoplasm/genetics
- Receptor, ErbB-2/analysis
- Receptors, Estrogen/analysis
- Recurrence
- Time Factors
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Affiliation(s)
- Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Noriko Sasahara
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ritsuko Sasaki
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - May Thinzar Hlaing
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Asumi Sakaguchi
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Harumi Saeki
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Atsushi Arakawa
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takanori Himuro
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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9
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Altundag K. Late relapse rates in patients with early‐stage hormone receptor‐positive and HER2+ breast cancer treated with adjuvant chemotherapy and neoadjuvant chemotherapy. J Surg Oncol 2020; 121:1042. [DOI: 10.1002/jso.25857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/07/2022]
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10
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Montagner M, Sahai E. In vitro Models of Breast Cancer Metastatic Dormancy. Front Cell Dev Biol 2020; 8:37. [PMID: 32195244 PMCID: PMC7062644 DOI: 10.3389/fcell.2020.00037] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/15/2020] [Indexed: 12/12/2022] Open
Abstract
Delayed relapses at distant sites are a common clinical observation for certain types of cancers after removal of primary tumor, such as breast and prostate cancer. This evidence has been explained by postulating a long period during which disseminated cancer cells (DCCs) survive in a foreign environment without developing into overt metastasis. Because of the asymptomatic nature of this phenomenon, isolation, and analysis of disseminated dormant cancer cells from clinically disease-free patients is ethically and technically highly problematic and currently these data are largely limited to the bone marrow. That said, detecting, profiling and treating indolent metastatic lesions before the onset of relapse is the imperative. To overcome this major limitation many laboratories developed in vitro models of the metastatic niche for different organs and different types of cancers. In this review we focus specifically on in vitro models designed to study metastatic dormancy of breast cancer cells (BCCs). We provide an overview of the BCCs employed in the different organotypic systems and address the components of the metastatic microenvironment that have been shown to impact on the dormant phenotype: tissue architecture, stromal cells, biochemical environment, oxygen levels, cell density. A brief description of the organ-specific in vitro models for bone, liver, and lung is provided. Finally, we discuss the strategies employed so far for the validation of the different systems.
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Affiliation(s)
- Marco Montagner
- Department of Molecular Medicine, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Erik Sahai
- The Francis Crick Institute, London, United Kingdom
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