2
|
Orlacchio A, Chegai F, Francioso S, Merolla S, Monti S, Angelico M, Tisone G, Mannelli L. Repeated Transarterial Chemoembolization with Degradable Starch
Microspheres (DSMs-TACE) of Unresectable Hepatocellular Carcinoma: A Prospective Pilot Study. Curr Med Imaging 2018; 14:637-645. [PMID: 30197583 PMCID: PMC6110039 DOI: 10.2174/1573405613666170616123657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aims of this study were to: a) evaluate tumor response rates using modified-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepatocellular-carcinoma (HCC) treatment. MATERIALS AND METHODS We prospectively enrolled 24 HCC cirrhotic patients (21/3 M/F, mean age 66.3 years) to be treated with repeated DSMs-TACE procedures, performed at 4-6 week intervals on the basis of tumor response and patients tolerance. Clinical and biochemical evaluations were performed before and after each procedure. Treatment response was also assessed by Computed-tomography (CT) or Magnetic-resonance-imaging (MRI)-scan 4-6 weeks following each procedure. RESULTS In our experience, DSMs-TACE was both safe and effective. A total of 53 DSMs-TACE procedures were performed (2.2 per patient). No procedure-related death was observed. Complete Response (CR) was observed in 5/24 (20.8%), 4/17 (23.5%) and 5/12 (41.6%) patients after the first, second and third procedure, respectively. At the end of each treatment, all patients experienced at least a partial response. At the end of the repeated procedures, no differences between mono- or bi-lobar disease were observed in patients with CR (64.2% vs 50%; p=ns). In most cases, treatment discontinuation was due to worsening liver function. CONCLUSION DSMs-TACE is a valid, well-tolerated alternative treatment to Lipiodol-TACE or DEB-TACE, as it has demonstrated to achieve a relatively high percentage of complete tumor necrosis. CR rates were similar between patients with mono- or bi-lobar disease indicating the possibility of carrying-out repeated procedure in a safe and effective way in both types of patients.
Collapse
Affiliation(s)
- Antonio Orlacchio
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Fabrizio Chegai
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Simona Francioso
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Stefano Merolla
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Serena Monti
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Mario Angelico
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Giuseppe Tisone
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Lorenzo Mannelli
- 1Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology University Hospital Tor Vergata, Viale Oxford 81, 00133Rome, Italy; 2Liver Unit, University Hospital Tor Vergata, Rome, Italy; 3IRCCS SDN, Naples, Italy; 4Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy; 5Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
3
|
Li Q, Gao WQ, Dai WY, Yu C, Zhu RY, Jin J. ATF2 translation is induced under chemotherapeutic drug-mediated cellular stress via an IRES-dependent mechanism in human hepatic cancer Bel7402 cells. Oncol Lett 2016; 12:4795-4802. [PMID: 28105187 DOI: 10.3892/ol.2016.5274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/09/2016] [Indexed: 12/16/2022] Open
Abstract
Activating transcription factor (ATF) 2 is a member of the ATF/cyclic AMP-responsive element binding protein family, which exhibits both oncogenic and tumor-suppressor functions. In our preliminary experiments, it was observed that the expression of the ATF2 protein was induced following treatment with adriamycin (ADR) and paclitaxel (PTX), which may be regulated by internal ribosome entry segment (IRES)-mediated translation. By constructing a bicistronic vector containing the ATF2 5'-untranslated region (UTR), it was demonstrated that the ATF2 5'-UTR contains an IRES and maps a 30-nucleotide (nt) sequence (from nt 299 to nt ~269), which was essential for the IRES activity. The ATF2 IRES activity exhibited significant variation in different cell lines. In addition, it was observed that ADR and PTX also induced ATF2 IRES activity in Bel7402 cells. The present study has demonstrated that ATF2 translation is initiated via IRES, which is upregulated by ADR and PTX, thus suggesting that the regulation of the IRES-dependent translation of ATF2 may be involved in effecting the cancer cell response to chemotherapeutic drugs-mediated cellular stress.
Collapse
Affiliation(s)
- Qi Li
- Laboratory of Molecular Pharmacology, School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Wen-Qing Gao
- Laboratory of Molecular Pharmacology, School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Wen-Yan Dai
- Laboratory of Molecular Pharmacology, School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Chuang Yu
- Laboratory of Molecular Pharmacology, School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Rui-Yu Zhu
- Laboratory of Molecular Pharmacology, School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Jian Jin
- Laboratory of Molecular Pharmacology, School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| |
Collapse
|