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Walker C, Talawalla T, Toth R, Ambekar A, Rea K, Chamian O, Fan F, Berezowska S, Rottenberg S, Madabhushi A, Maillard M, Barisoni L, Horlings HM, Janowczyk A. PatchSorter: a high throughput deep learning digital pathology tool for object labeling. NPJ Digit Med 2024; 7:164. [PMID: 38902336 PMCID: PMC11190251 DOI: 10.1038/s41746-024-01150-4] [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: 07/24/2023] [Accepted: 05/31/2024] [Indexed: 06/22/2024] Open
Abstract
The discovery of patterns associated with diagnosis, prognosis, and therapy response in digital pathology images often requires intractable labeling of large quantities of histological objects. Here we release an open-source labeling tool, PatchSorter, which integrates deep learning with an intuitive web interface. Using >100,000 objects, we demonstrate a >7x improvement in labels per second over unaided labeling, with minimal impact on labeling accuracy, thus enabling high-throughput labeling of large datasets.
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Affiliation(s)
- Cédric Walker
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Tasneem Talawalla
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Robert Toth
- Toth Technology LLC, Toth Technology LLC, New Brunswick, NJ, USA
| | - Akhil Ambekar
- Department of Pathology, Division of AI & Computational Pathology, Duke University, Durham, NC, USA
- AI Health, Duke University, Durham, NC, USA
| | - Kien Rea
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Oswin Chamian
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Fan Fan
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Sabina Berezowska
- Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Sven Rottenberg
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
- Bern Center for Precision Medicine, University of Bern, Bern, Switzerland
| | - Anant Madabhushi
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
- Atlanta Veterans Medical Center, Atlanta, GA, USA
| | - Marie Maillard
- Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Laura Barisoni
- Department of Pathology, Division of AI & Computational Pathology, Duke University, Durham, NC, USA
- Department of Medicine, Division of Nephrology, Duke University, Durham, NC, USA
| | - Hugo Mark Horlings
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Janowczyk
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA.
- Department of Oncology, Division of Precision Oncology, Geneva University Hospitals, Geneva, Switzerland.
- Department of Diagnostics, Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland.
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2
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Poggio F, Molinelli C, Giannubilo I, Lambertini M, Blondeaux E. Controversies on chemotherapy for early HR+/HER2- breast cancer: the role of anthracyclines and dose intensification. Curr Opin Oncol 2024:00001622-990000000-00178. [PMID: 39011733 DOI: 10.1097/cco.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
PURPOSE OF REVIEW Use of adjuvant chemotherapy significantly reduced the risk of recurrence and improved overall survival (OS) in patients with early-stage breast cancer. However few data are available on efficacy of different adjuvant chemotherapy regimens and schedules in patients with hormone receptor positive/HER2-negative (HR+/HER2-) breast cancer. We aim to summarize the available evidence on efficacy of adjuvant anthracycline-based chemotherapy and of the dose-dense schedule in this population. Moreover, current controversies in the management of patients with early-stage HR+/HER2- breast cancer are discussed. RECENT FINDINGS Patient-level meta-analysis evaluating the role of the addition of anthracycline to taxane-based chemotherapy showed that recurrence rate was 14% lower [relative risk (RR) 0.86, P = 0.0004] among patients receiving anthracycline-based treatment.Patient-level meta-analysis evaluating the role of different schedules of chemotherapy administration showed that the use of adjuvant dose-dense chemotherapy is associated with significant reduction in breast cancer recurrences and breast cancer mortality. Less evidence is available in the neoadjuvant setting. SUMMARY For patients with high-risk HR+/HER2- breast cancer, (neo) adjuvant anthracycline and taxane-based chemotherapy, and a dose-dense regimen should still be considered the standard of care. However, in patients with intermediate-low risk breast cancer anthracycline-free regimens could be considered an option of treatment.
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Affiliation(s)
- Francesca Poggio
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino
| | - Chiara Molinelli
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino
| | - Irene Giannubilo
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova
| | - Matteo Lambertini
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova
| | - Eva Blondeaux
- U.O. Epidemiologia Clinica, IRCCS Ospdale Policlinico San Martino, Genova, Italy
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3
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Bania A, Adamou A, Saloustros E. Racial and Ethnic Disparities in European Breast Cancer Clinical Trials. Cancers (Basel) 2024; 16:1726. [PMID: 38730678 PMCID: PMC11082959 DOI: 10.3390/cancers16091726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Breast cancer is the most prevalent female cancer worldwide with known correlations between the race and tumor characteristics of the patients and prognosis. International and US-based studies, however, have reported a disproportionate representation of Black and Hispanic patients in clinical trials. This is the first study assessing race and ethnicity reporting trends and inclusion in European breast cancer trials. The PubMed and ClinicalTrials.gov databases were systematically searched for trials on breast cancer treatment conducted exclusively in Europe between 2010 and 2022. Of the 97 identified trials, race was reported in 10.31%. Multinational participation, but not the study size or trial phase, was significantly associated with higher race reporting trends. These 10 trials featured a White-predominant population, with 1.08% Asian and 0.88% Black patients included. The acquisition of the race and ethnicity data of patients in European trials is lower compared to the U.S. or worldwide studies and does not permit extensive analysis of minority participation. In a limited analysis, the low rates of minority participation are concerning, based on population-based data on minorities in select European countries. These observations should encourage race reporting practices in European breast cancer trials and adequate minority participation to support the generalizability of the results of the studies and promote healthcare equity.
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Affiliation(s)
- Angelina Bania
- Faculty of Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece;
| | - Antonis Adamou
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, 30625 Hannover, Germany;
| | - Emmanouil Saloustros
- Division of Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
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4
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Su D, Zhang T, Huang H, Su X, Li Y, Wei X, Zhang Y. Selection of breast cancer subtypes to improve benefits of intensive dose‑dense chemotherapy: A systematic meta‑analysis. Oncol Lett 2024; 27:4. [PMID: 38028182 PMCID: PMC10665989 DOI: 10.3892/ol.2023.14136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/15/2023] [Indexed: 12/01/2023] Open
Abstract
Breast cancer (BC) is the most commonly diagnosed cancer and the second leading cause of cancer mortality among women worldwide. A large number of patients experience recurrence and BC-associated mortality following adjuvant chemotherapy. The present study aimed to determine the most suitable pathological subtype of BC to benefit from intensive dose-dense (DD) chemotherapy. A total of four electronic databases were searched from inception up to March 10, 2023. Randomized controlled trials (RCTs) and retrospective studies comparing DD chemotherapy with standard chemotherapy in patients with BC were included. Pairwise random effects and network meta-analyses were performed to summarize efficacy and safety outcomes. A total of 27 original studies including 27,580 patients with BC were included. In terms of efficacy, the present study evaluated overall survival, disease-free survival, event-free survival, recurrence-free survival, pathological complete response and objective remission rate. Significant differences were identified in overall, hormone receptor+ (HR+) and HR- subgroups. Furthermore, from the network analysis, the HR+ and Her2- subgroups had the highest ranking, and these findings suggested that HR+/Her2- patients with BC should adhere to a treatment strategy including intensive DD chemotherapy, which is also characterized by an acceptable safety profile. In conclusion, patients with HR+ and Her2- BC were revealed to be the most suitable pathological type and are most likely to benefit from intense DD chemotherapy. The present study was registered with PROSPERO, CRD2022420351567.
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Affiliation(s)
- Dan Su
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
| | - Tianqi Zhang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
| | - Huimin Huang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
| | - Xiaoyu Su
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
| | - Ying Li
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
| | - Xiuyan Wei
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
| | - Yingshi Zhang
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, P.R. China
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5
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Prekovic S, Chalkiadakis T, Roest M, Roden D, Lutz C, Schuurman K, Opdam M, Hoekman L, Abbott N, Tesselaar T, Wajahat M, Dwyer AR, Mayayo‐Peralta I, Gomez G, Altelaar M, Beijersbergen R, Győrffy B, Young L, Linn S, Jonkers J, Tilley W, Hickey T, Vareslija D, Swarbrick A, Zwart W. Luminal breast cancer identity is determined by loss of glucocorticoid receptor activity. EMBO Mol Med 2023; 15:e17737. [PMID: 37902007 PMCID: PMC10701603 DOI: 10.15252/emmm.202317737] [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: 03/21/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 10/31/2023] Open
Abstract
Glucocorticoid receptor (GR) is a transcription factor that plays a crucial role in cancer biology. In this study, we utilized an in silico-designed GR activity signature to demonstrate that GR relates to the proliferative capacity of numerous primary cancer types. In breast cancer, the GR activity status determines luminal subtype identity and has implications for patient outcomes. We reveal that GR engages with estrogen receptor (ER), leading to redistribution of ER on the chromatin. Notably, GR activation leads to upregulation of the ZBTB16 gene, encoding for a transcriptional repressor, which controls growth in ER-positive breast cancer and associates with prognosis in luminal A patients. In relation to ZBTB16's repressive nature, GR activation leads to epigenetic remodeling and loss of histone acetylation at sites proximal to cancer-driving genes. Based on these findings, epigenetic inhibitors reduce viability of ER-positive breast cancer cells that display absence of GR activity. Our findings provide insights into how GR controls ER-positive breast cancer growth and may have implications for patients' prognostication and provide novel therapeutic candidates for breast cancer treatment.
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Affiliation(s)
- Stefan Prekovic
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Center for Molecular MedicineUMC UtrechtUtrechtThe Netherlands
| | | | - Merel Roest
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Daniel Roden
- Cancer Ecosystems ProgramGarvan Institute of Medical ResearchDarlinghurstNSWAustralia
- School of Clinical Medicine, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
| | - Catrin Lutz
- Division of Molecular Pathology, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Karianne Schuurman
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Mark Opdam
- Division of Molecular Pathology, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Liesbeth Hoekman
- Mass Spectrometry/Proteomics FacilityThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Nina Abbott
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Tanja Tesselaar
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Maliha Wajahat
- Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical SchoolUniversity of AdelaideAdelaideSAAustralia
| | - Amy R Dwyer
- Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical SchoolUniversity of AdelaideAdelaideSAAustralia
| | - Isabel Mayayo‐Peralta
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Gabriela Gomez
- School of Pharmacy and Biomolecular SciencesThe Royal College of Surgeons University of Medicine and Health SciencesDublinIreland
| | - Maarten Altelaar
- Mass Spectrometry/Proteomics FacilityThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Biomolecular Mass Spectrometry and Proteomics, Bijvoet Center for Biomolecular Research and Utrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Roderick Beijersbergen
- Division of Molecular Carcinogenesis and Robotics and Screening CentreNetherlands Cancer InstituteAmsterdamThe Netherlands
| | - Balázs Győrffy
- TTK Cancer Biomarker Research GroupInstitute of EnzymologyBudapestHungary
- Department of Bioinformatics and 2nd Department of PediatricsSemmelweis UniversityBudapestHungary
| | - Leonie Young
- Endocrine Oncology Research Group, Department of SurgeryThe Royal College of Surgeons University of Medicine and Health SciencesDublinIreland
- Beaumont RCSI Cancer CentreBeaumont HospitalDublinIreland
| | - Sabine Linn
- Division of Molecular Pathology, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Jos Jonkers
- Division of Molecular Pathology, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Wayne Tilley
- Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical SchoolUniversity of AdelaideAdelaideSAAustralia
- Freemasons Centre for Male Health and WellbeingUniversity of AdelaideAdelaideSAAustralia
| | - Theresa Hickey
- Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical SchoolUniversity of AdelaideAdelaideSAAustralia
| | - Damir Vareslija
- School of Pharmacy and Biomolecular SciencesThe Royal College of Surgeons University of Medicine and Health SciencesDublinIreland
- Beaumont RCSI Cancer CentreBeaumont HospitalDublinIreland
| | - Alexander Swarbrick
- Cancer Ecosystems ProgramGarvan Institute of Medical ResearchDarlinghurstNSWAustralia
- School of Clinical Medicine, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
| | - Wilbert Zwart
- Division of Oncogenomics, Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Laboratory of Chemical Biology and Institute for Complex Molecular Systems, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
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6
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Hobbs J, Lowe J, Ferdinand A, Shook A, Beck B, Blais D, Borchardt C, Xu B. Efficacy of same-day versus next-day administration of pegfilgrastim for the prevention of chemotherapy-induced febrile neutropenia in breast cancer patients receiving dose-dense doxorubicin and cyclophosphamide: A retrospective multi-site analysis. J Oncol Pharm Pract 2023; 29:1853-1861. [PMID: 36579812 DOI: 10.1177/10781552221148116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Administering pegfilgrastim on the same day as chemotherapy can improve patient satisfaction through convenience and may increase the utilization of cost-effective biosimilars compared to next-day administration, but the effect on clinical outcomes with commonly used breast cancer regimens is unclear. METHODS This multi-site, retrospective cohort study included breast cancer patients age 18 years or older who received dose-dense doxorubicin and cyclophosphamide (ddAC) and pegfilgrastim between 1 June 2016 and 31 May 2020. Pegfilgrastim was given on the same day as chemotherapy at one site and the day after chemotherapy at the other two sites. The primary endpoint compared the incidence of febrile neutropenia associated with pegfilgrastim administration timing. RESULTS A total of 360 patients were reviewed (146 same-day administration and 214 next-day administration). In the same-day group 36 patients (24.6%) developed FN compared to 25 patients (11.7%) in the next-day group (p = 0.002). Same-day administration also significantly increased the incidences of additional acute care visits (11.6% vs 2.8%, p = 0.0016), grade ≥ 3 neutropenia (38.4% vs 13.6%, p < 0.0001), chemotherapy dose reductions (21.2% vs 6.1%, p < 0.0001), and antibiotic use (26.7% vs 12.6%, p = 0.001). Same-day administration did not significantly increase the rate of hospitalization (15% vs 11.2%, p = 0.36) and delay of next chemotherapy cycle by ≥1 day (8.2% vs 6.1%, p = 0.57) due to neutropenic complications. CONCLUSIONS Administering pegfilgrastim on the same day as ddAC led to a significant increase in neutropenic complications. This study confirms the need to administer pegfilgrastim the day after chemotherapy in breast cancer patients receiving ddAC.
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Affiliation(s)
- Jacob Hobbs
- Department of Pharmacy, Avera Cancer Institute at Sioux Falls, Sioux Falls, South Dakota, USA
| | - Jan Lowe
- John T. Vucurevich Cancer Care Institute Pharmacy, Monument Health, Rapid City, South Dakota, USA
| | - Abigale Ferdinand
- John T. Vucurevich Cancer Care Institute Pharmacy, Monument Health, Rapid City, South Dakota, USA
| | - Anna Shook
- Cancer Center Pharmacy, MercyOne North Iowa, Mason City, Iowa, USA
| | - Bradley Beck
- Department of Pharmacy, Avera Cancer Institute at Sioux Falls, Sioux Falls, South Dakota, USA
| | - Danielle Blais
- Department of Pharmacy, Avera Cancer Institute at Sioux Falls, Sioux Falls, South Dakota, USA
| | - Cole Borchardt
- Department of Pharmacy, Avera Cancer Institute at Sioux Falls, Sioux Falls, South Dakota, USA
| | - Bing Xu
- Molecular and Experimental Medicine, Avera Cancer Institute at Sioux Falls, Sioux Falls, South Dakota, USA
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7
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Tavares S, Liv N, Pasolli M, Opdam M, Rätze MAK, Saornil M, Sluimer LM, Hengeveld RCC, van Es R, van Werkhoven E, Vos H, Rehmann H, Burgering BMT, Oosterkamp HM, Lens SMA, Klumperman J, Linn SC, Derksen PWB. FER regulates endosomal recycling and is a predictor for adjuvant taxane benefit in breast cancer. Cell Rep 2022; 39:110584. [PMID: 35385742 DOI: 10.1016/j.celrep.2022.110584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/28/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Elevated expression of non-receptor tyrosine kinase FER is an independent prognosticator that correlates with poor survival of high-grade and basal/triple-negative breast cancer (TNBC) patients. Here, we show that high FER levels are also associated with improved outcomes after adjuvant taxane-based combination chemotherapy in high-risk, HER2-negative patients. In TNBC cells, we observe a causal relation between high FER levels and sensitivity to taxanes. Proteomics and mechanistic studies demonstrate that FER regulates endosomal recycling, a microtubule-dependent process that underpins breast cancer cell invasion. Using chemical genetics, we identify DCTN2 as a FER substrate. Our work indicates that the DCTN2 tyrosine 6 is essential for the development of tubular recycling domains in early endosomes and subsequent propagation of TNBC cell invasion in 3D. In conclusion, we show that high FER expression promotes endosomal recycling and represents a candidate predictive marker for the benefit of adjuvant taxane-containing chemotherapy in high-risk patients, including TNBC patients.
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Affiliation(s)
- Sandra Tavares
- Department of Pathology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Nalan Liv
- Section Cell Biology, Center for Molecular Medicine, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Milena Pasolli
- Cell Biology, Neurobiology, and Biophysics, Department of Biology, Faculty of Science, Utrecht University, 3584CH Utrecht, the Netherlands
| | - Mark Opdam
- Department of Molecular Pathology, Netherlands Cancer Institute, 1066CX Amsterdam, the Netherlands
| | - Max A K Rätze
- Department of Pathology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Manuel Saornil
- Department of Pathology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Lilian M Sluimer
- Department of Pathology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Rutger C C Hengeveld
- Oncode Institute, Department of Molecular Cancer Research, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Robert van Es
- Oncode Institute, Department of Molecular Cancer Research, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Erik van Werkhoven
- Department of Molecular Pathology, Netherlands Cancer Institute, 1066CX Amsterdam, the Netherlands
| | - Harmjan Vos
- Oncode Institute, Department of Molecular Cancer Research, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Holger Rehmann
- Flensburg University of Applied Sciences, 24943 Flensburg, Germany
| | - Boudewijn M T Burgering
- Oncode Institute, Department of Molecular Cancer Research, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Hendrika M Oosterkamp
- Department of Medical Oncology, Haaglanden Medisch Centrum, 2501 CK The Hague, the Netherlands
| | - Susanne M A Lens
- Oncode Institute, Department of Molecular Cancer Research, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Judith Klumperman
- Section Cell Biology, Center for Molecular Medicine, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Sabine C Linn
- Department of Pathology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands; Department of Molecular Pathology, Netherlands Cancer Institute, 1066CX Amsterdam, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, 1066CX Amsterdam, the Netherlands
| | - Patrick W B Derksen
- Department of Pathology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands.
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8
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Kester L, Seinstra D, van Rossum AG, Vennin C, Hoogstraat M, van der Velden D, Opdam M, van Werkhoven E, Hahn K, Nederlof I, Lips EH, Mandjes IA, van Leeuwen-Stok AE, Canisius S, van Tinteren H, Imholz AL, Portielje JE, Bos ME, Bakker SD, Rutgers EJ, Horlings HM, Wesseling J, Voest EE, Wessels LF, Kok M, Oosterkamp HM, van Oudenaarden A, Linn SC, van Rheenen J. Differential Survival and Therapy Benefit of Patients with Breast Cancer Are Characterized by Distinct Epithelial and Immune Cell Microenvironments. Clin Cancer Res 2022; 28:960-971. [PMID: 34965952 PMCID: PMC9377758 DOI: 10.1158/1078-0432.ccr-21-1442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/30/2021] [Accepted: 12/16/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Extensive work in preclinical models has shown that microenvironmental cells influence many aspects of cancer cell behavior, including metastatic potential and their sensitivity to therapeutics. In the human setting, this behavior is mainly correlated with the presence of immune cells. Here, in addition to T cells, B cells, macrophages, and mast cells, we identified the relevance of nonimmune cell types for breast cancer survival and therapy benefit, including fibroblasts, myoepithelial cells, muscle cells, endothelial cells, and seven distinct epithelial cell types. EXPERIMENTAL DESIGN Using single-cell sequencing data, we generated reference profiles for all these cell types. We used these reference profiles in deconvolution algorithms to optimally detangle the cellular composition of more than 3,500 primary breast tumors of patients that were enrolled in the SCAN-B and MATADOR clinical trials, and for which bulk mRNA sequencing data were available. RESULTS This large data set enables us to identify and subsequently validate the cellular composition of microenvironments that distinguish differential survival and treatment benefit for different treatment regimens in patients with primary breast cancer. In addition to immune cells, we have identified that survival and therapy benefit are characterized by various contributions of distinct epithelial cell types. CONCLUSIONS From our study, we conclude that differential survival and therapy benefit of patients with breast cancer are characterized by distinct microenvironments that include specific populations of immune and epithelial cells.
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Affiliation(s)
- Lennart Kester
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-Hubrecht Institute- KNAW & University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Danielle Seinstra
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Annelot G.J. van Rossum
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Claire Vennin
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marlous Hoogstraat
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Daphne van der Velden
- Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Mark Opdam
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Erik van Werkhoven
- Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Kerstin Hahn
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Iris Nederlof
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ester H. Lips
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | | | - Sander Canisius
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Harm van Tinteren
- Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Alex L.T. Imholz
- Department of Medical Oncology, Deventer Ziekenhuis, Deventer, the Netherlands
| | - Johanneke E.A. Portielje
- Department of Medical Oncology, HagaZiekenhuis, The Hague, the Netherlands.,Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Monique E.M.M. Bos
- Department of Internal Oncology, Reinier de Graaf Gasthuis, Delft, the Netherlands
| | - Sandra D. Bakker
- Department of Medical Oncology, Zaans Medisch Centrum, Zaandam, the Netherlands
| | - Emiel J. Rutgers
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Hugo M. Horlings
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jelle Wesseling
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Diagnostic Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Emile E. Voest
- Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lodewyk F.A. Wessels
- Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marleen Kok
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Alexander van Oudenaarden
- Oncode Institute-Hubrecht Institute- KNAW & University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sabine C. Linn
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Pathology, University Medical Center, Utrecht, the Netherlands.,Corresponding Authors: Jacco van Rheenen, Plesmanlaan 121, 1066CX Amsterdam, Netherlands. Phone: 31-20-512-6906; E-mail: ; and Sabine Linn, Plesmanlaan 121, 1066CX Amsterdam, Netherlands. Phone: 31-20-512-2449; E-mail:
| | - Jacco van Rheenen
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Oncode Institute-The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Molecular Cancer Research, Center Molecular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.,Corresponding Authors: Jacco van Rheenen, Plesmanlaan 121, 1066CX Amsterdam, Netherlands. Phone: 31-20-512-6906; E-mail: ; and Sabine Linn, Plesmanlaan 121, 1066CX Amsterdam, Netherlands. Phone: 31-20-512-2449; E-mail:
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9
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Kucuksayan E, Bozkurt F, Yilmaz MT, Sircan-Kucuksayan A, Hanikoglu A, Ozben T. A new combination strategy to enhance apoptosis in cancer cells by using nanoparticles as biocompatible drug delivery carriers. Sci Rep 2021; 11:13027. [PMID: 34158544 PMCID: PMC8219778 DOI: 10.1038/s41598-021-92447-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/27/2021] [Indexed: 12/21/2022] Open
Abstract
Some experimental and clinical studies have been conducted for the usage of chemotherapeutic drugs encapsulated into nanoparticles (NPs). However, no study has been conducted so far on the co-encapsulation of doxorubicin (Dox) and epoxomicin (Epo) into NPs as biocompatible drug delivery carriers. Therefore, we investigated if co-encapsulation of doxorubicin (Dox) and/or epoxomicin (Epo) into NPs enhance their anticancer efficiency and prevent drug resistance and toxicity to normal cells. We synthesized Dox and/or Epo loaded poly (lactic-co-glycolic acid) (PLGA) NPs using a multiple emulsion solvent evaporation technique and characterized them in terms of their particle size and stability, surface, molecular, thermal, encapsulation efficiency and in vitro release properties. We studied the effects of drug encapsulated NPs on cellular accumulation, intracellular drug levels, oxidative stress status, cellular viability, drug resistance, 20S proteasome activity, cytosolic Nuclear Factor Kappa B (NF-κB-p65), and apoptosis in breast cancer and normal cells. Our results proved that the nanoparticles we synthesized were thermally stable possessing higher encapsulation efficiency and particle stability. Thermal, morphological and molecular analyses demonstrated the presence of Dox and/or Epo within NPs, indicating that they were successfully loaded. Cell line assays proved that Dox and Epo loaded NPs were less cytotoxic to single-layer normal HUVECs than free Dox and Epo, suggesting that the NPs would be biocompatible drug delivery carriers. The apoptotic index of free Dox and Epo increased 50% through their encapsulation into NPs, proving combination strategy to enhance apoptosis in breast cancer cells. Our results demonstrated that the co-encapsulation of Dox and Epo within NPs would be a promising treatment strategy to overcome multidrug resistance and toxicity to normal tissues that can be studied in further in vivo and clinical studies in breast cancer.
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Affiliation(s)
- Ertan Kucuksayan
- Faculty of Medicine, Department of Medical Biochemistry, Alanya Alaaddin Keykubat University (ALKU), Antalya, 07490, Turkey.,Chemical and Metallurgical Engineering Faculty, Department of Food Engineering, Yildiz Technical University, Istanbul, Turkey.,Faculty of Medicine, Department of Medical Biochemistry, Akdeniz University, Antalya, Turkey
| | - Fatih Bozkurt
- Chemical and Metallurgical Engineering Faculty, Department of Food Engineering, Yildiz Technical University, Istanbul, Turkey.,Faculty of Engineering and Architecture, Department of Food Engineering, Mus Alparslan University, Mus, Turkey
| | - Mustafa Tahsin Yilmaz
- Chemical and Metallurgical Engineering Faculty, Department of Food Engineering, Yildiz Technical University, Istanbul, Turkey.,Faculty of Engineering, Department of Industrial Engineering, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Aslinur Sircan-Kucuksayan
- Faculty of Medicine, Department of Biophysics, Alanya Alaaddin Keykubat University (ALKU), Antalya, 07490, Turkey
| | - Aysegul Hanikoglu
- Faculty of Medicine, Department of Medical Biochemistry, Akdeniz University, Antalya, Turkey
| | - Tomris Ozben
- Faculty of Medicine, Department of Medical Biochemistry, Akdeniz University, Antalya, Turkey.
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10
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Koyanagi M, Imai S, Matsumoto M, Iguma Y, Kawaguchi-Sakita N, Kotake T, Iwamitsu Y, Ntogwa M, Hiraiwa R, Nagayasu K, Saigo M, Ogihara T, Yonezawa A, Omura T, Nakagawa S, Nakagawa T, Matsubara K. Pronociceptive Roles of Schwann Cell-Derived Galectin-3 in Taxane-Induced Peripheral Neuropathy. Cancer Res 2021; 81:2207-2219. [PMID: 33608316 DOI: 10.1158/0008-5472.can-20-2799] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/18/2020] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a severe dose-limiting side effect of taxanes such as paclitaxel and docetaxel. Despite the high medical needs, insufficient understanding of the complex mechanism underlying CIPN pathogenesis precludes any endorsed causal therapy to prevent or relieve CIPN. In this study, we report that elevation of plasma galectin-3 level is a pathologic change common to both patients with taxane-treated breast cancer with CIPN and a mouse model of taxane-related CIPN. Following multiple intraperitoneal injections of paclitaxel in mice, galectin-3 levels were elevated in Schwann cells within the sciatic nerve but not in other peripheral organs or cells expressing galectin-3. Consistent with this, paclitaxel treatment of primary cultures of rat Schwann cells induced upregulation and secretion of galectin-3. In vitro migration assays revealed that recombinant galectin-3 induced a chemotactic response of the murine macrophage cell line RAW 264.7. In addition, perineural administration of galectin-3 to the sciatic nerve of naive mice mimicked paclitaxel-induced macrophage infiltration and mechanical hypersensitivity. By contrast, chemical depletion of macrophages by clodronate liposomes suppressed paclitaxel-induced mechanical hypersensitivity despite the higher level of plasma galectin-3. Deficiency (Galectin-3 -/- mice) or pharmacologic inhibition of galectin-3 inhibited paclitaxel-induced macrophage infiltration and mechanical hypersensitivity. In conclusion, we propose that Schwann cell-derived galectin-3 plays a pronociceptive role via macrophage infiltration in the pathogenesis of taxane-induced peripheral neuropathy. Therapies targeting this phenomenon, which is common to patients with CIPN and mouse models, represent a novel approach to suppress taxane-related CIPN. SIGNIFICANCE: These findings demonstrate that the elevation of plasma galectin-3 is a CIPN-related pathologic change common to humans and mice, and that targeting galectin-3 is a therapeutic option to delay CIPN progression.
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Affiliation(s)
- Madoka Koyanagi
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Satoshi Imai
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.
| | - Mayuna Matsumoto
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Yoko Iguma
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Nobuko Kawaguchi-Sakita
- Department of Breast Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.,Department of Clinical Oncology, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Takeshi Kotake
- Department of Breast Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.,Department of Clinical Oncology, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Yuki Iwamitsu
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Mpumelelo Ntogwa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Ren Hiraiwa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Kazuki Nagayasu
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Mamiko Saigo
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Takashi Ogihara
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Atsushi Yonezawa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Tomohiro Omura
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Shunsaku Nakagawa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Takayuki Nakagawa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Kazuo Matsubara
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
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11
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Kang YK, Si YR, An GY, Yuan P. Efficacy and safety of cyclophosphamide in anthracycline- and taxane-based neoadjuvant chemotherapy in breast cancer: a meta-analysis. Gland Surg 2021; 10:252-261. [PMID: 33633981 DOI: 10.21037/gs-20-593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Background Our study aimed to compare the efficacy and safety of anthracycline plus taxane (AT)-based neoadjuvant chemotherapy (NAC) with or without cyclophosphamide in the treatment of breast cancer. Methods We searched PubMed, Embase, Web of Science and the Cochrane Library for randomized controlled studies comparing the efficacy and safety of AT-based NAC with or without cyclophosphamide in breast cancer patients. Results Four eligible studies with 2,302 individuals were ultimately included in the quantitative analysis. After applying the AT-based NAC regimen, the overall rates of pathologic complete response (pCR) and breast conserving surgery in all included subjects were 26.5% and 70.6%, respectively. The rates of pCR [risk ratio (RR): 1.35; 95% CI: 0.75, 2.45; P=0.32], breast-conserving surgery (RR: 1.07; 95% CI: 0.97, 1.19; P=0.17) and clinical response (RR: 1.08; 95% CI: 0.97, 1.19; P=0.15) in patients in the cyclophosphamide group were similar to those in the control group. However, participants in the cyclophosphamide group had a lower no clinical response rate than those in the control group (RR: 0.72; 95% CI: 0.60, 0.87; P<0.001). Subjects in the cyclophosphamide group had significantly lower rates of infection (RR: 0.57; 95% CI: 0.41, 0.79; P<0.001) and diarrhea (RR: 0.46; 95% CI: 0.30, 0.68; P<0.001) and higher rates of thrombocytopenia (RR: 3.38; 95% CI: 1.96, 5.84; P<0.001), sensory/motor neuropathy (RR: 1.57; 95% CI: 1.03, 2.39; P=0.03) and nausea/vomiting (RR: 1.51; 95% CI: 1.11, 2.06; P=0.009) than those in the control group. Conclusions The AT-based NAC regimen with or without cyclophosphamide had similar clinical outcomes in breast cancer patients. The addition of cyclophosphamide might increase the risks of thrombocytopenia, sensory/motor neuropathy and nausea/vomiting.
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Affiliation(s)
- Yi-Kun Kang
- Department of VIP Medical Services, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Ran Si
- Department of VIP Medical Services, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guang-Yu An
- Department of Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Peng Yuan
- Department of VIP Medical Services, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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12
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Su Q, Luo S, Tan Q, Deng J, Zhou S, Peng M, Tao T, Yang X. The role of pyruvate kinase M2 in anticancer therapeutic treatments. Oncol Lett 2019; 18:5663-5672. [PMID: 31788038 PMCID: PMC6865080 DOI: 10.3892/ol.2019.10948] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022] Open
Abstract
Cancer cells are characterized by a high glycolytic rate, which leads to energy regeneration and anabolic metabolism; a consequence of this is the abnormal expression of pyruvate kinase isoenzyme M2 (PKM2). Multiple studies have demonstrated that the expression levels of PKM2 are upregulated in numerous cancer types. Consequently, the mechanism of action of certain anticancer drugs is to downregulate PKM2 expression, indicating the significance of PKM2 in a chemotherapeutic setting. Furthermore, it has previously been highlighted that the downregulation of PKM2 expression, using either inhibitors or short interfering RNA, enhances the anticancer effect exerted by THP treatment on bladder cancer cells, both in vitro and in vivo. The present review summarizes the detailed mechanisms and therapeutic relevance of anticancer drugs that inhibit PKM2 expression. In addition, the relationship between PKM2 expression levels and drug resistance were explored. Finally, future directions, such as the targeting of PKM2 as a strategy to explore novel anticancer agents, were suggested. The current review explored and highlighted the important role of PKM2 in anticancer treatments.
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Affiliation(s)
- Qiongli Su
- Department of Pharmacy, Zhuzhou Central Hospital, Zhuzhou, Hunan 412000, P.R. China
| | - Shengping Luo
- Department of Pharmacy, Zhuzhou Central Hospital, Zhuzhou, Hunan 412000, P.R. China
| | - Qiuhong Tan
- Department of Pharmacy, Zhuzhou Central Hospital, Zhuzhou, Hunan 412000, P.R. China
| | - Jun Deng
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan 410013, P.R. China
| | - Sichun Zhou
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan 410013, P.R. China
| | - Mei Peng
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Ting Tao
- Department of Pharmacy, Yueyang Maternal-Child Medicine Health Hospital, Yueyang, Hunan 414000, P.R. China
| | - Xiaoping Yang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan 410013, P.R. China
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