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Larionova I, Tashireva L. Immune gene signatures as prognostic criteria for cancer patients. Ther Adv Med Oncol 2023; 15:17588359231189436. [PMID: 37547445 PMCID: PMC10399276 DOI: 10.1177/17588359231189436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Recently, the possibility of using immune gene signatures (IGSs) has been considered as a novel prognostic tool for numerous cancer types. State-of-the-art methods of genomic, transcriptomic, and protein analysis have allowed the identification of a number of immune signatures correlated to disease outcome. The major adaptive and innate immune components are the T lymphocytes and macrophages, respectively. Herein, we collected essential data on IGSs consisting of subsets of T cells and tumor-associated macrophages and indicating cancer patient outcomes. We discuss factors that can introduce errors in the recognition of immune cell types and explain why the significance of immune signatures can be interpreted with uncertainty. The unidirectional functions of cell types should be entirely addressed in the signatures constructed by the combination of innate and adaptive immune cells. The state of the antitumor immune response is the key basis for IGSs and should be considered in gene signature construction. We also analyzed immune signatures for the prediction of immunotherapy response. Finally, we attempted to explain the present-day limitations in the use of immune signatures as robust criteria for prognosis.
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Affiliation(s)
- Irina Larionova
- Laboratory of Translational Cellular and Molecular Biomedicine, National Research Tomsk State University, 36 Lenina Av., Tomsk 634050, Russia
- Laboratory of Molecular Therapy of Cancer, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Liubov Tashireva
- Laboratory of Molecular Therapy of Cancer, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
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Kumari B, Sakode C, Lakshminarayanan R, Purohit P, Bhattacharjee A, Roy PK. A mechanistic analysis of spontaneous cancer remission phenomenon: identification of genomic basis and effector biomolecules for therapeutic applicability. 3 Biotech 2023; 13:113. [PMID: 36890970 PMCID: PMC9986194 DOI: 10.1007/s13205-023-03515-0] [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: 08/29/2022] [Accepted: 02/09/2023] [Indexed: 03/07/2023] Open
Abstract
Based on the well-documented studies, numerous tumors episodically regress permanently without treatment. Knowing the host tissue-initiated causative factors would offer considerable translational applicability, as a permanent regression process may be therapeutically replicated on patients. For this, we developed a systems biological formulation of the regression process with experimental verification and identified the relevant candidate biomolecules for therapeutic utility. We devised a cellular kinetics-based quantitative model of tumor extinction in terms of the temporal behavior of three main tumor-lysis entities: DNA blockade factor, cytotoxic T-lymphocyte and interleukin-2. As a case study, we analyzed the time-wise biopsy and microarrays of spontaneously regressing melanoma and fibrosarcoma tumors in mammalian/human hosts. We analyzed the differentially expressed genes (DEGs), signaling pathways, and bioinformatics framework of regression. Additionally, prospective biomolecules that could cause complete tumor regression were investigated. The tumor regression process follows a first-order cellular dynamics with a small negative bias, as verified by experimental fibrosarcoma regression; the bias is necessary to eliminate the residual tumor. We identified 176 upregulated and 116 downregulated DEGs, and enrichment analysis showed that the most significant were downregulated cell-division genes: TOP2A-KIF20A-KIF23-CDK1-CCNB1. Moreover, Topoisomerase-IIA inhibition might actuate spontaneous regression, with collateral confirmation provided from survival and genomic analysis of melanoma patients. Candidate molecules such as Dexrazoxane/Mitoxantrone, with interleukin-2 and antitumor lymphocytes, may potentially replicate permanent tumor regression process of melanoma. To conclude, episodic permanent tumor regression is a unique biological reversal process of malignant progression, and signaling pathway understanding, with candidate biomolecules, may plausibly therapeutically replicate the regression process on tumors clinically. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-023-03515-0.
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Affiliation(s)
- Bindu Kumari
- School of Bio-Medical Engineering, Indian Institute of Technology (B.H.U.), Varanasi, 221005 India
| | - Chandrashekhar Sakode
- Department of Applied Sciences, Indian Institute of Information Technology, Nagpur, 44005 India
| | | | - Pratik Purohit
- School of Bio-Medical Engineering, Indian Institute of Technology (B.H.U.), Varanasi, 221005 India
| | - Anindita Bhattacharjee
- School of Bio-Medical Engineering, Indian Institute of Technology (B.H.U.), Varanasi, 221005 India
| | - Prasun K. Roy
- School of Bio-Medical Engineering, Indian Institute of Technology (B.H.U.), Varanasi, 221005 India
- Department of Life Sciences, Shiv Nadar University (S.N.U.), Delhi NCR, Dadri, UP 201314 India
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3
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Samhouri BF, Dimou A, Boland JM, Edell ES. Spontaneous Regression of Metastatic Lung Adenocarcinoma Following a Core Biopsy. J Bronchology Interv Pulmonol 2023; 30:181-184. [PMID: 35959896 DOI: 10.1097/lbr.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | - Eric S Edell
- Departments of Pulmonary and Critical Care Medicine
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4
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Wu YC, Kao CH, Sun SS, Hsieh TC. Rare "Burned-Out" Testicular Mixed Germ Cell Tumor on 18 F-FDG PET/CT. Clin Nucl Med 2022; 47:e600-e601. [PMID: 35085173 DOI: 10.1097/rlu.0000000000004076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Spontaneous regression of testicular mixed germ cell tumor is rare and is also called burned-out testicular tumor. We herein present the case of a 20-year-old man who was initially diagnosed with metastatic embryonal carcinoma. 18 F-FDG PET/CT demonstrated apparent metastases in the lymph node regions and both lungs. A covert right testicular lesion was noted according to the features on the CT component of PET/CT, which was subsequently confirmed as burned-out testicular mixed germ cell tumor.
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Kim BS, Jung TY, Moon KS, Kim IY, Jung S. Meningioma With Partial and Spontaneous Regression of Peritumoral Edema on Long-Term Follow Up. Brain Tumor Res Treat 2022; 10:275-278. [DOI: 10.14791/btrt.2022.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Bo-seob Kim
- Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Tae-Young Jung
- Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Kyung-Sub Moon
- Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - In-Young Kim
- Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Shin Jung
- Department of Neurosurgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
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Sanseverino R, Baio R, Addesso M, Napodano G, Di Mauro U, Intilla O, Verze P, Libroia A, Molisso G. 'Burned-out' syndrome of testicular teratoma: A case report. Mol Clin Oncol 2021; 15:262. [PMID: 34754448 PMCID: PMC8569295 DOI: 10.3892/mco.2021.2424] [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: 04/13/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022] Open
Abstract
The majority of testicular tumors are germ cell tumors (GCTs) which, although rare, frequently present in young adults. In exceptional circumstances, spontaneous regression of the primary tumor occurs. The appellation ‘burned-out’ is applied to situations in which a metastatic GCT is found to be present, accompanied by histological regression of the primary testicular lesion. It is of crucial importance that a clinical examination of the testis is performed, and scrotal sonography is essential in the preliminary diagnosis of such neoplasms. In the present case report, a burned-out, non-seminomatous testicular GCT case is described. A CT scan revealed that a 29-year-old male patient who was experiencing loss of weight and appetite had retroperitoneal and mediastinal masses. A testicular examination did not reveal the presence of any palpable lesion, and an ultrasound examination of the scrotum disclosed a normal left testis and an atrophic right testicle with heterogeneous architecture, but with no evidence of a tumor. Chemotherapy was administered to the patient following surgical intervention into the retroperitoneal and mediastinal mass. It is evident that it remains problematic to accurately differentiate between a primary retroperitoneal tumor and a metastatic testicular tumor with an occult testicular primary or a ‘burned-out’ testicular cancer. The burned-out phenomenon is a rare occurrence, and further research into its pathogenesis is required. Both the rarity of this phenomenon and the difficulties encountered in diagnosis prompted the writing of the present case report, especially considering that teratomas are categorized as belonging to the histology group that shows the least likelihood of regressing.
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Affiliation(s)
| | - Raffaele Baio
- Department of Medicine and Surgery 'Scuola Medica Salernitana', University of Salerno, I-84081 Salerno, Italy
| | - Maria Addesso
- Department of Pathological Anatomy, Andrea Tortora Hospital, I-84016 Salerno, Italy
| | - Giorgio Napodano
- Department of Urology, Umberto I Hospital, I-84014 Salerno, Italy
| | - Umberto Di Mauro
- Department of Urology, Umberto I Hospital, I-84014 Salerno, Italy
| | - Oliviero Intilla
- Department of Urology, Umberto I Hospital, I-84014 Salerno, Italy
| | - Paolo Verze
- Department of Medicine and Surgery 'Scuola Medica Salernitana', University of Salerno, I-84081 Salerno, Italy
| | - Annamaria Libroia
- Department of Oncology, Andrea Tortora Hospital, I-84016 Salerno, Italy
| | - Giovanni Molisso
- Department of Urology, Umberto I Hospital, I-84014 Salerno, Italy
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Vempuluru VS, Ghose N, Vithalani NM, Sultana S, Kaliki S. Spontaneous regression of presumed ocular surface squamous neoplasia: A report of 8 cases. Eur J Ophthalmol 2021; 32:3029-3034. [PMID: 34747253 DOI: 10.1177/11206721211057340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report the phenomenon of spontaneous regression in presumed ocular surface squamous neoplasia (OSSN). METHODS Retrospective chart review of clinically diagnosed cases of OSSN during 2016 to 2019. RESULTS Of the 449 OSSN lesions, spontaneous regression was seen in 8 lesions (2%). The mean age at diagnosis of OSSN was 37 years (median, 36 years; range, 21 to 59 years). All were males with unilateral, treatment-naïve tumors. Mean duration of symptoms was 3 months (median, 2 months; range, 1 to 12 months). All tumors arose within the interpalpebral region, located in the nasal quadrant in 88% (n = 7) and in temporal quadrant in 12% (n = 1). The mean tumor diameter was 4 mm (median, 4 mm; range, 3 to 5 mm). Lesions showed nodular (n = 4; 50%) or placoid (n = 4; 50%) morphology. The other features included keratin production and intrinsic vascularity (n = 8; 100%), feeder vessels (n = 4; 50%), and intratumoral pigmentation (n = 4; 50%). The diagnosis of OSSN was confirmed by classic anterior segment optical coherence tomography (AS-OCT) features. Tumors regressed after a mean period of 5 months (median, 4 months; range, <1 to 17 months) from presumed onset and a mean period of 2 months (median, 1 month; range, <1 to 6 months) from presentation to the clinic. No recurrences were noted at a mean follow up of 37 months (median, 35 months; range, 17 to 52 months) after spontaneous regression of tumors. CONCLUSION OSSN can spontaneously regress in 2% of cases. Immune-mediated reversal of dysplastic changes may explain this phenomenon. PRÉCIS In this study, spontaneous regression of presumed ocular surface squamous neoplasia was noted in 2% patients. Tumor regression resulted in restoration of normal epithelial architecture and no recurrences were observed during the follow-up period.
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Affiliation(s)
- Vijitha S Vempuluru
- Operation Eyesight Universal Institute for Eye Cancer, 28592LV Prasad Eye Institute, Hyderabad, India
| | - Neha Ghose
- Operation Eyesight Universal Institute for Eye Cancer, 28592LV Prasad Eye Institute, Hyderabad, India
| | - Nidhi Mahendra Vithalani
- Operation Eyesight Universal Institute for Eye Cancer, 28592LV Prasad Eye Institute, Hyderabad, India
| | - Shahenaz Sultana
- Brien Holden Institute of Optometry and Vision Sciences, 28592LV Prasad Eye Institute, Hyderabad, India
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, 28592LV Prasad Eye Institute, Hyderabad, India
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Iannantuono GM, Strigari L, Roselli M, Torino F. A scoping review on the "burned out" or "burnt out" testicular cancer: When a rare phenomenon deserves more attention. Crit Rev Oncol Hematol 2021; 165:103452. [PMID: 34384861 DOI: 10.1016/j.critrevonc.2021.103452] [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] [Received: 06/29/2020] [Revised: 06/15/2021] [Accepted: 08/08/2021] [Indexed: 12/27/2022] Open
Abstract
The "burned out" or "burnt out" testicular cancer (BTC) indicates the spontaneous and complete regression of a testicular germ cell tumor in the presence of distant metastases at the diagnosis. As this condition was never reviewed systematically, a scoping review was conducted to scrutinize the available literature on clinical and histological features of BTC patients. Medline was searched from inception to 19 April 2020. A virtual cohort of 68 BTC patients was generated. Our findings highlighted some inconsistencies: BTC was diagnosed in 5,9% of patients not showing distant metastases and in 2,9% of patients who did not undergo an orchiectomy. Besides, evidence of residual tumor was found in 22,7% of testis specimens, recognized as seminoma in 40% of cases. The emerged inconsistencies may derive from the lack of an unequivocal definition of BTC. Larger collaborative studies are needed to define the best diagnostic workup and treatment for BTC patients.
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Affiliation(s)
- Giovanni Maria Iannantuono
- Medical Oncology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Lidia Strigari
- Department of Medical Physics, S. Orsola Malpighi University Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Mario Roselli
- Medical Oncology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Francesco Torino
- Medical Oncology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
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9
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Singh S, Ahmad F, Kumari N. Spontaneous regression in a primary adenocarcinoma of lung with epidermal growth factor receptor mutation. J Cancer Res Ther 2021; 18:1817-1819. [DOI: 10.4103/jcrt.jcrt_845_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Ziemys A, Kim M, Menzies AM, Wilmott JS, Long GV, Scolyer RA, Kwong L, Holder A, Boland G. Integration of Digital Pathologic and Transcriptomic Analyses Connects Tumor-Infiltrating Lymphocyte Spatial Density With Clinical Response to BRAF Inhibitors. Front Oncol 2020; 10:757. [PMID: 32528881 PMCID: PMC7247820 DOI: 10.3389/fonc.2020.00757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Abstract
Metastatic melanoma is one of the most immunogenic malignancies due to its high rate of mutations and neoantigen formation. Response to BRAF inhibitors (BRAFi) may be determined by intratumoral immune activation within melanoma metastases. To evaluate whether CD8+ T cell infiltration and distribution within melanoma metastases can predict clinical response to BRAFi, we developed a methodology to integrate immunohistochemistry with automated image analysis of CD8+ T cell position. CD8+ distribution patterns were correlated with gene expression data to identify and quantify “hot” areas within a tumor. Furthermore, the relative activation of CD8+cells, based on transcriptomic analysis, and their relationship to other CD8+ T cells and non-CD8+ cells within the tumor suggested a less crowded distribution of cells around activated CD8+ T cells. Furthermore, the relative activation of these CD8+ T cells was associated with improved clinical outcomes and decreased tumor cell proliferation. This study demonstrates the potential of digital pathomics to incorporate immune cell spatial distribution within metastases and RNAseq analysis to predict clinical response to BRAF inhibition in metastatic melanoma.
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Affiliation(s)
- Arturas Ziemys
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, United States
| | - Michelle Kim
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Alexander M Menzies
- Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia.,Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - James S Wilmott
- Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia
| | - Georgina V Long
- Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia.,Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute of Australia, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and New South Wales Health Pathology, Camperdown, NSW, Australia
| | - Larry Kwong
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ashley Holder
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, United States.,Department of Surgery, Houston Methodist Hospital, Houston, TX, United States
| | - Genevieve Boland
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
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Tomasini C. Cytotoxic-mediated spontaneous regression of inflammatory cutaneous metastases of breast carcinoma. J Cutan Pathol 2020; 47:758-763. [PMID: 32222990 DOI: 10.1111/cup.13694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 12/29/2022]
Abstract
Spontaneous regression (SR) of cancer is a rare but well-documented biological phenomenon, which is even rarer in the context of metastatic breast carcinoma. Different mechanisms of SR are still under debate, including immune-mediated response. We herein report a case of the SR of intralymphatic cutaneous metastases of a breast carcinoma with spontaneously-induced T-cell-mediated cytotoxic response. An 86-year-old female was diagnosed with locally advanced right breast carcinoma and axillary lymph node metastases, without distant metastases The patient refused any therapy. Six months afterwards, she developed multiple, asymptomatic purpura-like plaques with prominent teleangectasias on her right chest wall, continuous to the previous surgical scar and on her ipsilateral abdomen. Skin biopsy showed aggregates of atypical cells admixed with erythrocyte thrombi within dilated dermal lymphatic vessels. SR of the cutaneous lesions occurred within 6 months and persisted at the 15 months follow-up in the absence of therapy, whilst no signs of internal relapse were observed. Immunohistochemically, the estrogen-negative, CK7-positive, C-erb B2-positive intralymphatic metastases were associated with extensive infiltration of CD8-positive cytototoxic T lymphocytes. Factors that may have precluded the implantation of intralymphatic metastases leading to SR are discussed, with local immune surveillance being one major hypothesis.
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Affiliation(s)
- Carlo Tomasini
- IRCCS Fondazione Policlinico San Matteo, Department of Medical-Surgical, Diagnostic and Pediatric Sciences, Dermatologic Clinic, University of Pavia School of Medicine, Pavia, Italy
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Purkart TU, Seifert-Held T, Haybäck J, Holl E, Asslaber M, Payer F, Fazekas F. Vanishing midbrain mass lesion - A germinoma? J Neurol Sci 2019; 404:40-43. [PMID: 31325666 DOI: 10.1016/j.jns.2019.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/24/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Tadeja Urbanic Purkart
- Department of Neurology and Neuroradiology, Vascular and Interventional Radiology, Auenbruggerplatz 22, 8036 Graz, Medical University of Graz, Austria.
| | - Thomas Seifert-Held
- Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036 Graz, Austria.
| | - Johannes Haybäck
- Department of Neuropathology, Medical University of Graz, Austria; Institute of Pathology, Neuropathology and Molecular Pathology, Medical University Innsbruck, Austria; Institute of Pathology, University Clincs Magdeburg, Medical Faculty, Germany.
| | - Etienne Holl
- Department of Neurosurgery, Medical University of Graz, Austria.
| | - Martin Asslaber
- Department of Neuropathology, Medical University of Graz, Austria.
| | - Franz Payer
- Department of Neurology and Neuroradiology, Vascular and Interventional Radiology, Auenbruggerplatz 22, 8036 Graz, Medical University of Graz, Austria.
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036 Graz, Austria.
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Conway AM, Mitchell C, Kilgour E, Brady G, Dive C, Cook N. Molecular characterisation and liquid biomarkers in Carcinoma of Unknown Primary (CUP): taking the 'U' out of 'CUP'. Br J Cancer 2019; 120:141-153. [PMID: 30580378 PMCID: PMC6342985 DOI: 10.1038/s41416-018-0332-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 02/07/2023] Open
Abstract
Cancers of Unknown Primary (CUP) comprise a heterogeneous clinical entity of confirmed metastatic cancer where the primary site of origin is undetectable. It has a poor prognosis with limited treatment options. CUP is historically under-researched; however, understanding its biology has the potential to not only improve treatment and survival by implementation of biomarkers for patient management, but also to greatly contribute to our understanding of carcinogenesis and metastasis across all cancer types. Here we review the current advances in CUP research and explore the debated hypotheses underlying its biology. The evolution of molecular profiling and tissue-of-origin classifiers have the potential to transform the diagnosis, classification and therapeutic management of patients with CUP but robust evidence to support widespread use is lacking. Precision medicine has transformed treatment strategy in known tumour types; in CUP, however, there remains a clinical need for a better understanding of molecular characteristics to establish the potential role of novel or existing therapeutics. The emergence of liquid biopsies as a source of predictive and prognostic biomarkers within known tumour types is gaining rapid ground and this review explores the potential utility of liquid biopsies in CUP.
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Affiliation(s)
- Alicia-Marie Conway
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
- The University of Manchester, Oxford Road, Manchester, UK
- Cancer Research UK Manchester Institute, Alderley Park, Alderley Edge, Macclesfield, Cheshire, SK10 4TG, UK
| | - Claire Mitchell
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
- The University of Manchester, Oxford Road, Manchester, UK
| | - Elaine Kilgour
- The University of Manchester, Oxford Road, Manchester, UK
- Cancer Research UK Manchester Institute, Alderley Park, Alderley Edge, Macclesfield, Cheshire, SK10 4TG, UK
| | - Gerard Brady
- The University of Manchester, Oxford Road, Manchester, UK
- Cancer Research UK Manchester Institute, Alderley Park, Alderley Edge, Macclesfield, Cheshire, SK10 4TG, UK
| | - Caroline Dive
- The University of Manchester, Oxford Road, Manchester, UK
- Cancer Research UK Manchester Institute, Alderley Park, Alderley Edge, Macclesfield, Cheshire, SK10 4TG, UK
| | - Natalie Cook
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.
- The University of Manchester, Oxford Road, Manchester, UK.
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Arya M, Duker JS. Vinorelbine-induced regression of a choroidal metastasis from primary breast carcinoma. Int J Retina Vitreous 2018; 4:17. [PMID: 29785284 PMCID: PMC5950186 DOI: 10.1186/s40942-018-0121-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022] Open
Abstract
Background Various therapeutic options exist to treat choroidal metastatic lesions. However, they are all associated with potential long-term adverse effects. This case report discusses a case of choroidal metastasis from primary breast carcinoma that regressed after single-agent chemotherapy. Case presentation We report a case of choroidal metastasis from estrogen receptor (ER) positive breast carcinoma that became resistant to endocrine therapy. The primary malignancy was treated with surgical resection and adjuvant chemoradiation, followed by hormone therapy with various agents in combination with kinase inhibitors for ER resistance. The choroidal metastatic lesion regressed after the initiation of vinorelbine. Vinorelbine is a cytotoxic vinca alkaloid with tolerable systemic adverse effects. Conclusions This case report highlights the possible role of vinorelbine as a single chemotherapeutic agent for the conservative therapy of uveal metastasis from advanced breast carcinoma, irrespective of responsiveness to hormone therapy.
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Horrigan SK. Replication Study: The CD47-signal regulatory protein alpha (SIRPa) interaction is a therapeutic target for human solid tumors. eLife 2017; 6. [PMID: 28100392 PMCID: PMC5245970 DOI: 10.7554/elife.18173] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 11/21/2016] [Indexed: 12/13/2022] Open
Abstract
In 2015, as part of the Reproducibility Project: Cancer Biology, we published a Registered Report (Chroscinski et al., 2015) that described how we intended to replicate selected experiments from the paper "The CD47-signal regulatory protein alpha (SIRPa) interaction is a therapeutic target for human solid tumors "(Willingham et al., 2012). Here we report the results of those experiments. We found that treatment of immune competent mice bearing orthotopic breast tumors with anti-mouse CD47 antibodies resulted in short-term anemia compared to controls, consistent with the previously described function of CD47 in normal phagocytosis of aging red blood cells and results reported in the original study (Table S4; Willingham et al., 2012). The weight of tumors after 30 days administration of anti-CD47 antibodies or IgG isotype control were not found to be statistically different, whereas the original study reported inhibition of tumor growth with anti-CD47 treatment (Figure 6A,B; Willingham et al., 2012). However, our efforts to replicate this experiment were confounded because spontaneous regression of tumors occurred in several of the mice. Additionally, the excised tumors were scored for inflammatory cell infiltrates. We found IgG and anti-CD47 treated tumors resulted in minimal to moderate lymphocytic infiltrate, while the original study observed sparse lymphocytic infiltrate in IgG-treated tumors and increased inflammatory cell infiltrates in anti-CD47 treated tumors (Figure 6C; Willingham et al., 2012). Furthermore, we observed neutrophilic infiltration was slightly increased in anti-CD47 treated tumors compared to IgG control. Finally, we report a meta-analysis of the result.
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